Binzhou Medical University Hospital, Binzhou, People's Republic of China.
Cheeloo College of Medicine, Shandong University, Jinan, People's Republic of China.
J Vasc Surg Venous Lymphat Disord. 2024 Jul;12(4):101660. doi: 10.1016/j.jvsv.2023.08.004. Epub 2023 Aug 10.
The purpose of this study was to report a technique for intraprocedural guidance of endovascular iliac vein stenting procedures using three-dimensional (3D) venography images as an overlay on live biplanar fluoroscopy.
Using 3D venography and a fusion navigation technique, percutaneous transluminal angioplasty and stent placement were performed to evaluate the feasibility of using 3D venography images and the fusion navigation technique to treat MTS compared with traditional digital subtraction angiography. The general epidemiologic data (ie, age, gender), clinical manifestations (ie, major symptoms, affected extremity, CEAP [clinical, etiology, anatomy, pathophysiology] classification, comorbidity, stenosis rate), intraoperative findings (ie, stent type, stent count, stent to inferior vena cava distance, procedure time, radiation dose, contrast agent dosage), and postoperative recovery were obtained and analyzed.
A total of 30 consecutive patients with symptomatic MTS from our institution were enrolled in the present study. Of the 30 patients, 12 (group A) were treated using 3D venography images and fusion navigation and 18 (group B) were treated with two-dimensional venography images during endovascular management. Significant differences were observed between the two groups with respect to the procedure time (64.42 ± 4.35 minutes vs 76.61 ± 3.47 minutes; P = .04), radiation dose (2152 ± 124.7 mGy vs 2561 ± 105.6 mGy; P = .02), and contrast agent dosage (71.42 ± 4.87 mL vs 86.17 ± 4.14 mL; P = .03).
3D venography and its fusion navigation technique can improve prediction of the coverage area of the stent. Its use can also shorten the procedure time and reduce the contrast agent dose and radiation exposure, making it a valuable tool for both the diagnosis and the treatment of symptomatic MTS.
本研究旨在报告一种在术中使用三维（3D）静脉造影图像作为实时双平面透视的叠加来指导血管内髂静脉支架置入术的技术。
使用 3D 静脉造影和融合导航技术，对经皮腔内血管成形术和支架置入术进行评估，以比较使用 3D 静脉造影图像和融合导航技术与传统数字减影血管造影治疗 MTS 的可行性。获得并分析了一般流行病学数据（即年龄、性别）、临床表现（即主要症状、受累肢体、CEAP[临床、病因、解剖、病理生理学]分类、合并症、狭窄率）、术中发现（即支架类型、支架数量、支架至下腔静脉距离、手术时间、辐射剂量、造影剂剂量）和术后恢复情况。
本研究共纳入我院 30 例有症状 MTS 患者。30 例患者中，12 例（A 组）采用 3D 静脉造影图像和融合导航治疗，18 例（B 组）采用二维静脉造影图像进行血管内治疗。两组在手术时间（64.42±4.35 分钟比 76.61±3.47 分钟；P=0.04）、辐射剂量（2152±124.7mGy 比 2561±105.6mGy；P=0.02）和造影剂剂量（71.42±4.87mL 比 86.17±4.14mL；P=0.03）方面差异有统计学意义。
3D 静脉造影及其融合导航技术可提高支架覆盖面积的预测能力。它的使用还可以缩短手术时间，减少造影剂剂量和辐射暴露，使其成为诊断和治疗有症状 MTS 的有价值的工具。
