title: Fusion of CT Angiography or MR Angiography with Unenhanced CBCT and Fluoroscopy Guidance in Endovascular Treatments of Aorto-Iliac Steno-Occlusion: Technical Note on a Preliminary Experience.
abstract: OBJECTIVE
  To evaluate the feasibility of image fusion (IF) of pre-procedural arterial-phase CT angiography or MR angiography with intra-procedural fluoroscopy for road-mapping in endovascular treatment of aorto-iliac steno-occlusive disease.
  
  
  METHODS
  Between September and November, 2014, we prospectively evaluated 5 patients with chronic aorto-iliac steno-occlusive disease, who underwent endovascular treatment in the angiography suite. Fusion image road-mapping was performed using angiographic phase CT images or MR images acquired before and intra-procedural unenhanced cone-beam CT. Radiation dose of the procedure, volume of intra-procedural iodinated contrast medium, fluoroscopy time, and overall procedural time were recorded. Reasons for potential fusion imaging inaccuracies were also evaluated.
  
  
  RESULTS
  Image co-registration and fusion guidance were feasible in all procedures. Mean radiation dose of the procedure was 60.21 Gycm2 (range 55.02-63.75 Gycm2). The mean total procedure time was 32.2 min (range 27-38 min). The mean fluoroscopy time was 12 min and 3 s. The mean procedural iodinated contrast material dose was 24 mL (range 20-40 mL).
  
  
  CONCLUSIONS
  IF gives Interventional Radiologists the opportunity to use new technologies in order to improve outcomes with a significant reduction of contrast media administration.
authors.affiliation: Interventional Radiology, Department of Radiology, University of Insubria, Viale Borri, 57, 21100, Varese, VA, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.affiliation: Interventional Radiology, Department of Radiology, University of Insubria, Viale Borri, 57, 21100, Varese, VA, Italy.
authors.forename: Ejona
authors.initials: E
authors.lastname: Duka
authors.affiliation: Philips Healthcare, Best, The Netherlands.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Radaelli
authors.affiliation: Vascular Surgery Department, University of Insubria, Viale Borri, 57, 21100, Varese, VA, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Rivolta
authors.affiliation: Vascular Surgery Department, University of Insubria, Viale Borri, 57, 21100, Varese, VA, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Piffaretti
authors.affiliation: Interventional Radiology, Department of Radiology, University of Insubria, Viale Borri, 57, 21100, Varese, VA, Italy. gcarraf@gmail.com.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D011446:Prospective Studies; D011829:Radiation Dosage; D011857:Radiographic Image Interpretation, Computer-Assisted; D015641:Radiography, Interventional / Q000379:methods; D015642:Radiology, Interventional / Q000379:methods; D015607:Stents
keywords: Arterial intervention; Fusion imaging; Imaging; Stent graft; Stenting