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

• DOI: 10.1007/s00270-020-02530-5
• Publication Date: 2020-05-31T18:02:11Z
• Authors: Marcell Gyánó; Csaba Csobay-Novák; Márton Berczeli; István Góg; János P. Kiss; Krisztián Szigeti; Szabolcs Osváth; Balázs Nemes
• Keywords: Digital subtraction angiography

Abstract Purpose In retrospective clinical studies digital variance angiography (DVA) provided higher contrast-to-noise ratio and better image quality than subtraction (DSA). Our aim was to verify the usefulness benefits of DVA in carbon dioxide (CO 2 )-assisted lower limb interventions. Materials Methods A workstation running software integrated into a Siemens Artis Zee with Pure system, this new processing technology used four patients (3 male, 1 female, age: 76.2 ± 4.2 years) peripheral artery disease (PAD, Rutherford 2–3) impaired renal function (average eGFR 25.5 11.2 ml/min/1.73 m ). The DSA images 46 CO -assisted runs were visually evaluated by five experts single-image evaluation using 5-grade Likert scale paired comparisons. Results received significantly score (3.84 0.10) (3.31 0.10, p < 0.001). Raters preferred terms diagnostic value for therapeutic decisions 85.2% 83.9% all comparisons, respectively. These achieved at frame rates (1–3 FPS) usually recommended (4–6 FPS). No adverse events recorded during or after procedures. Conclusions initial experience shows that might facilitate correct decisions, potentially help reduce radiation exposure angiography. Although dose management capabilities have be validated further studies, useful tool operating room contributes safety efficacy -enhanced endovascular Level Evidence IV.