Dataset Information

Initial Operating Room Experience with Digital Variance Angiography in Carbon Dioxide-Assisted Lower Limb Interventions: A Pilot Study.

ABSTRACT: PURPOSE:In retrospective clinical studies digital variance angiography (DVA) provided higher contrast-to-noise ratio and better image quality than digital subtraction angiography (DSA). Our aim was to verify the clinical usefulness and benefits of DVA in carbon dioxide (CO2)-assisted lower limb interventions. MATERIALS AND METHODS:A workstation running the DVA software was integrated into a Siemens Artis Zee with Pure angiography system, and this new image processing technology was used in four patients (3 male, 1 female, age: 76.2?±?4.2 years) with peripheral artery disease (PAD, Rutherford 2-3) and impaired renal function (average eGFR 25.5?±?11.2 ml/min/1.73 m2). The DSA and DVA images of 46 CO2-assisted runs were visually evaluated by five experts in single-image evaluation using a 5-grade Likert scale and in paired comparisons. RESULTS:DVA images received significantly higher score (3.84?±?0.10) than DSA images (3.31?±?0.10, p?

SUBMITTER: Gyano M

PROVIDER: S-EPMC7369257 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Initial Operating Room Experience with Digital Variance Angiography in Carbon Dioxide-Assisted Lower Limb Interventions: A Pilot Study.

Gyánó Marcell M Csobay-Novák Csaba C Berczeli Márton M Góg István I Kiss János P JP Szigeti Krisztián K Osváth Szabolcs S Nemes Balázs B

Cardiovascular and interventional radiology 20200531 8

<h4>Purpose</h4>In retrospective clinical studies digital variance angiography (DVA) provided higher contrast-to-noise ratio and better image quality than digital subtraction angiography (DSA). Our aim was to verify the clinical usefulness and benefits of DVA in carbon dioxide (CO<sub>2</sub>)-assisted lower limb interventions.<h4>Materials and methods</h4>A workstation running the DVA software was integrated into a Siemens Artis Zee with Pure angiography system, and this new image processing te ...[more]

PMID: 32476034

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Project description:IntroductionDeformities of the lower extremities can be congenital or acquired. Various surgical treatments have been employed for such disorders including osteotomy followed by either external fixation, internal fixation or external fixator assisted internal fixation. The aim of surgery is correction of deformity and restoration of mechanical axis and joint line. External fixator assisted internal fixation with intramedullary (IM) nail insertion is considered the gold standard, however, it is less commonly practiced as expertise required are usually not available at most centers. This study was conducted to assess the radiological and functional outcomes after fixator assisted IM nailing for correction of lower limbs deformity.MethodsIt was a retrospective study at a tertiary care hospital. All cases of lower limb deformity whose correction was done with fixator assisted IM nailing from 2010 till 2017 were analyzed. Pre Op x-rays and post op x rays were analyzed for Mechanical Axis Deviation (MAD), anatomical Lateral Distal Femoral Angle (aLDFA), mechanical Lateral Distal Femoral Angle (mLDFA) and Medial Proximal Tibial Angle (MPTA), post-operative activity and functional status of the patients. Data was analyzed using SPSS.ResultsThirteen patients were included in the study. Fixator assisted IM nailing was performed on 29 long bones of these patients including 16 femur and 13 tibial deformities. Pre Op and Post Op comparison was done for MAD, aLDFA, mLDFA, MPTA. Pre op mean MAD was 38.87 ± 25.58 post op mean MAD 17.54 ± 12.25 mm. Only 2 of our patients developed knee stiffness for which manipulation under anesthesia was done. One of our patients developed weakness in toe extension, which recovered after 6 months. On follow up evaluation patients had normal range of motion and no functional limitation.ConclusionFixator assisted IM nailing for deformity correction is a better option, because it has advantages of both external fixator and internal fixator. Knee stiffness associated with external fixator can be prevented. It is more convenient for patient.

Project description:PURPOSE:In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. METHODS:3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. RESULTS:The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. CONCLUSIONS:Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

Dataset Information

Initial Operating Room Experience with Digital Variance Angiography in Carbon Dioxide-Assisted Lower Limb Interventions: A Pilot Study.

Publications

Initial Operating Room Experience with Digital Variance Angiography in Carbon Dioxide-Assisted Lower Limb Interventions: A Pilot Study.

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