FUSION
Pre and Intraoperative 3D Image Resources for Planning and
Treatment are Mandatory to Perform Complex EVARStphan Haulon, J
Sobocinski, B Maurel, T Martin Gonzalez, R Spear, A Hertault, R
Azzaoui
Aortic Centre, Vascular SurgeryLille, France
DisclosuresResearch support, ConsultingCook Medical, GE
Healthcare
Integrated EVAR workflow3 levels of simplificationPre-op In the
ORPost-op 1-6 weeks before Procedure Following
weekAssessmentFusionPlanning
Sizing and fusion preparation integrated into a planning
softwareAssessmentFusionPlanning
BeforePre-op In the ORAfterSizingCTA overlay creation
Sizing & CTA overlay creation*Time saving in the ORPlanning
overlay
Pre-op
Planning software RedosFragmented planning
Planning exportable to the C-armAssessmentFusionPlanning
3D overlayPlanned Landing zonesOstium outlineOptimized C-arm
angulationsPlanning on CT AngioCT Angio fused in the C-arm
Recall of C-arm angulations from table-side
Overlay of Pre-Op CTA
Easy CT Angio registrationAssessmentFusionPlanning
2 Fluoro shots Table side alignment of bony structures from
pre-op CT to intra-op fluoro
AssessmentFusionPlanning
Accurate fusionAssessmentFusionPlanning
Table side fine-tuning following stiff wire insertion
GE DISCOVERY IGS 730
GE DISCOVERY IGS 730
GE DISCOVERY IGS 730
Dose and contrast savingAssessmentFusionPlanningDose reduction
by 40 to 59 % and contrast load by 24 to 26%
Non injected CT FusionAssessmentFusionPlanningTotal contrast
throughout patients hospital stay was below 25 ml
Completion 3D angio + CE U/SAssessmentFusionPlanningIn the
ORPost-op
CTA
USIn the ORPost-op
Completion DSAAssessmentBeforeAfterCompletion 3D AngioContrast
savingImmediate revision Reduced costRepeated injectionsNo direct
3D asessment
Ease in 3D Angiography and good IQAssessmentFusionPlanning
24
25
Title or Job Number | XX Month 201X26
28
29
Significant reduction in overall dose and
contrastAssessmentFusionPlanning-68%-50%
ConclusionEase of use and accuracy of sizing and fusion are
crucial for routine useIntegrated workflow optimizes the use of
pre-op dataLeveraging 3D capabilities from sizing to fusion to
assessment with Cone beam CT help to reduce dose and contrast
throughout patients hospital stay
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