REGULAR CONTENT
Final ID
558
Type
Original Scientific Research-Oral or Pos
Authors
Y Fujii1, J Koizumi2, T Sekiguchi2, T Hara2, S Ono2, T Kagawa2
Institutions
1Fujisawa city hospital, Fujisawa, Kanagawa, 2Tokai University, Isehara, Kanagawa
Purpose
In BRTO it is critical for technical success to catheterize drainage vein with retrograde approach and fulfill sclerosant into the entire gastric varices. We evaluate feasibility of 3D roadmap obtained from computed tomography (CT) data, fused with real-time fluoroscopy during BRTO procedures.
Materials & Methods
In three patients, 3D volume rendering (VR) image was obtained from preprocedural transvenous contrast CT. The VR image was manually registered to the real-time X-ray fluoroscopy and used as 3D roadmap. Catheterization of the gastrorenal shunt via the left renal vein was attempted using 3D roadmap for interventional guidance. Balloon-occluded retrograde transvenous venography was performed with carbon dioxide (CO2) and after achieving appropriate filling of gastric varices, therapeutic foam polidocanol (3%) which was diluted 5-fold with air was injected. C-arm CT was performed to confirm satisfactory filling of gastric varices by the foam polidocanol and catheter was removed after 50%NBCA plug injection to gastrorenal shunt. The fluoroscopy time and iodinated contrast dose used for BRTO with 3D roadmap were compared to BRTO without it in the past 23 patients.
Results
In all three patients, catheterization of the gastrorenal shunt was accomplished successfully and the catheter could reached into gastric varices without any iodinated contrast under 3D roadmap. The best projection for catheterization could be simulated by C-arm without any radiation because 3D roadmap is simultaneously autoregistered. The fluoroscopy time (16.9±2.4 min) and the iodinated contrast dose (0±0mL) were significantly (p<.05) reduced as compared to 35.7±17.2 min and 144.2±47.5 mL correspondingly. All gastric varices were thrombosed on enhanced CT a few days after BRTO in both groups.
Conclusions
3D roadmap is feasible and enables accurate catheter procedure during BRTO, thus helping to reduce radiation exposure and iodinated contrast material administration.
Final ID
558
Type
Original Scientific Research-Oral or Pos
Authors
Y Fujii1, J Koizumi2, T Sekiguchi2, T Hara2, S Ono2, T Kagawa2
Institutions
1Fujisawa city hospital, Fujisawa, Kanagawa, 2Tokai University, Isehara, Kanagawa
Purpose
In BRTO it is critical for technical success to catheterize drainage vein with retrograde approach and fulfill sclerosant into the entire gastric varices. We evaluate feasibility of 3D roadmap obtained from computed tomography (CT) data, fused with real-time fluoroscopy during BRTO procedures.
Materials & Methods
In three patients, 3D volume rendering (VR) image was obtained from preprocedural transvenous contrast CT. The VR image was manually registered to the real-time X-ray fluoroscopy and used as 3D roadmap. Catheterization of the gastrorenal shunt via the left renal vein was attempted using 3D roadmap for interventional guidance. Balloon-occluded retrograde transvenous venography was performed with carbon dioxide (CO2) and after achieving appropriate filling of gastric varices, therapeutic foam polidocanol (3%) which was diluted 5-fold with air was injected. C-arm CT was performed to confirm satisfactory filling of gastric varices by the foam polidocanol and catheter was removed after 50%NBCA plug injection to gastrorenal shunt. The fluoroscopy time and iodinated contrast dose used for BRTO with 3D roadmap were compared to BRTO without it in the past 23 patients.
Results
In all three patients, catheterization of the gastrorenal shunt was accomplished successfully and the catheter could reached into gastric varices without any iodinated contrast under 3D roadmap. The best projection for catheterization could be simulated by C-arm without any radiation because 3D roadmap is simultaneously autoregistered. The fluoroscopy time (16.9±2.4 min) and the iodinated contrast dose (0±0mL) were significantly (p<.05) reduced as compared to 35.7±17.2 min and 144.2±47.5 mL correspondingly. All gastric varices were thrombosed on enhanced CT a few days after BRTO in both groups.
Conclusions
3D roadmap is feasible and enables accurate catheter procedure during BRTO, thus helping to reduce radiation exposure and iodinated contrast material administration.