Future research needed to ‘optimize’ use of imaging technologies during aortic procedures

IMAGING TECHNOLOGIES IN THE AORTIC SPACE will be a key feature of Saturday’s Plenary Session 8 (11:15 a.m. to 12:30 p.m.) in Potomac A/B.

Valeria Mejia-Martinez, BS, a medical student at the University of Texas Southwestern Medical Center in Dallas, is due to deliver a presentation on the feasibility and benefits of target vessel catheterization with Philips’ Fiber Optic RealShape (FORS) technology using upper extremity (UE) versus transfemoral (TF) access for fenestrated/branched endovascular aneurysm repair (F/BEVAR).

In order to achieve their study objective, the research team conducted a single-center retrospective study with prospectively collected data.

They included data from 74 patients who underwent F/ BEVAR with FORS guidance for target vessel catheterization during an 11-month period. Among 370 navigation tasks reported, the researchers note that 350 (94.6%) were performed with FORS.

The presenter is due to share at VAM the result that technical success was 90.3% and that mean time required to deem the catheterization as a failure was 8.4±5 minutes. She will also communicate that UE access, steerable sheath, and FORS catheters were used in 54.3%, 17.7% and 13.7% of cases, respectively.

Mejia-Martinez will conclude that F/BEVAR with FORS technology is feasible using both UE and TF access and facilitates artery catheterization with ac ceptable technical success and potentially reduced radiation. However, she will stress that further experience is required to “optimize the use of FORS during F/BEVAR”.

Later in the session, Nicholas G. Hoell, MD, integrated vascular resident at the Cleveland Clinic in Cleveland, will speak on the use of Centerline Biomedical’s electromagnetic IntraOperative Positioning System (IOPS) as a 3D imaging adjunct in EVAR based on the results of a safety and feasibility study.

Top: Carlos H. Timaran and

On behalf of senior author Francis J. Caputo, MD, associate professor and program director at the Cleveland Clinic,

Hoell will share the results of a study that aimed to demonstrate the safety and efficacy of the electromagnetic-based IOPS in providing guidance for accurate wire and catheter navigation as an adjunct to fluoroscopy during thoracic endovascular aortic repair (TEVAR), FEVAR and EVAR.

Hoell will detail that 30 patients with aortic aneurysms suitable for TEVAR, FEVAR and EVAR were enrolled across two sites in the U.S. from 2020 to 2022.

The presenter is set to conclude that the electromagnetic-based IOPS is safe and effective in providing adjunctive 3D guidance for wire and catheter manipulation in infrarenal and fenestrated endovascular abdominal aortic aneurysm repair.

He will, however, underline the fact that future research is needed to investigate the potential for IOPS to reduce radiation exposure to patient and operator, reduce contrast usage, and reduce operative time while providing better visualization of complex anatomy.