title: Integration of dual source computed tomography with magnetic navigation system for percutaneous coronary intervention: a feasibility study.
abstract: OBJECTIVE
  To investigate the feasibility of integration of the dual source computed tomography (DSCT) and magnetic navigation system (MNS) to guide percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  MNS has proven to be feasible for yielding high rates of procedural success for PCI. DSCT coronary angiography (DSCT-CA) may provide a roadmap of a target vessel and serve as a reference route for MNS. Combination of these two technologies might decrease the contrast use, fluoroscopy exposure, and be beneficial to the intervention of the totally occluded lesions.
  
  
  METHODS
  Twenty-five patients with positive results of DSCT-CA and indications for PCI were included. CT images were transferred to MNS, and target vessels were extracted and registered to X-ray system as a roadmap.
  
  
  RESULTS
  DSCT-CA and MNS-assisted PCIs were successfully performed in 25 of the 26 target vessels (96.2%), with the mean guidewire crossing time of 100.0 (25-75% inter-quartile ranges (IQR): 70.7-157.8) sec, mean total radiation dosage of 268.1 (IQR: 150.5-527.0) μGym(2) , or 42.0 (IQR: 23.0-70.0) mGy, respectively. The contrast usage for guidewire positioning was 0 (IQR: 0-3.0) ml for the successfully crossed lesions. Both of the two totally occluded lesions in this study were successfully crossed with guidewires under the guidance of the DSCT-CA derived roadmap.
  
  
  CONCLUSIONS
  Integration of DSCT with MNS for PCI is feasible. This integration of advanced modalities might decrease contrast usage, lower fluoroscopy exposure for guidewire positioning, and might also play a role in totally occluded lesions.
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Chunjian
authors.initials: C
authors.lastname: Li
authors.forename: Lijun
authors.initials: L
authors.lastname: Tang
authors.forename: Zhijian
authors.initials: Z
authors.lastname: Yang
authors.forename: Kejiang
authors.initials: K
authors.lastname: Cao
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002681:China; D003287:Contrast Media; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media