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IVUS (IntraVascular UltraSound) Image Guidance for Treatment of Aorto-Iliac Pathologies
Buch von Jörg Tessarek (u. a.)
Sprache: Englisch

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Beschreibung
Ultrasound-based image guidance for endovascular interventions has long been propagated as safe and (cost)-effective in many respects. IVUS guidance has also been shown to be superior to angiographic guidance in aortic disease, both in terms of imaging and radiation reduction.
This book discusses the value and potential applications of IVUS in aorto-iliac pathologies. Part I explains the potential risks and side effects of using X-rays for patients and staff. The current status of IVUS imaging and the requirements for successful use of this tool are presented. Part II focuses on when and how to use IVUS guidance in the aortic and pelvic segments. In addition to the presentation of the technical equipment, recommendations are given for the implementation of IVUS in the daily routine and for image generation, procedural sequences and interpretation of the findings based on the display on the IVUS monitor.
This book is a useful guide for physicians and other staff members dealing routinely with radiation-based imaging in the operative setting or the angiosuite. It will also raise the reader's awareness for the X-ray-associated risks and available solutions for improving radiation safety in the OR and the procedural and outcome quality.
Ultrasound-based image guidance for endovascular interventions has long been propagated as safe and (cost)-effective in many respects. IVUS guidance has also been shown to be superior to angiographic guidance in aortic disease, both in terms of imaging and radiation reduction.
This book discusses the value and potential applications of IVUS in aorto-iliac pathologies. Part I explains the potential risks and side effects of using X-rays for patients and staff. The current status of IVUS imaging and the requirements for successful use of this tool are presented. Part II focuses on when and how to use IVUS guidance in the aortic and pelvic segments. In addition to the presentation of the technical equipment, recommendations are given for the implementation of IVUS in the daily routine and for image generation, procedural sequences and interpretation of the findings based on the display on the IVUS monitor.
This book is a useful guide for physicians and other staff members dealing routinely with radiation-based imaging in the operative setting or the angiosuite. It will also raise the reader's awareness for the X-ray-associated risks and available solutions for improving radiation safety in the OR and the procedural and outcome quality.
Inhaltsverzeichnis
Part I
1.Introduction12
1.[...] for access to target vessels12
1.[...] guidance for endovascular procedures13
1.3.Therapeutic use of US for endovascular reconstruction13
1.[...] should we perform IVUS guidance for aortic and aorto-iliac procedures13
2.Radiation safety issues and risk awareness16
2.1.Revised radiation safety directives and guidelines 2020-202216
2.2.Radiation safety items in the daily routine: staff training16
2.3.Radiation protection items in the daily routine17
2.4.Personalized radiation protection equipment18
2.5.Reduction of the individual radiation exposure20
2.5.1.Influence of radiation source position and individual behavior20
2.5.2.Influence of room geometry and procedural workflow on staff radiation exposure21
2.5.3.Projection angle and radiation safety: steady AP-projection for optimal radiation protection25
3.Iodinated Contrast Media (ICM) and procedure-related renal side effects30
3.[...]: Contrast-Induced Nephropathy31
3.1.1.Definition of CIN31
3.1.2.Pathophysiology of CIN31
3.1.[...] factors for CIN and prevention31
3.1.4.Differential diagnosis of CIN32
3.1.5.Strategies for CIN prevention33
3.1.[...] for CIN prevention33
3.[...] kidney injury vs. CIN34
4.Software and hardware solutions for radiation dose / contrast media
reduction and workflow improvement37
4.1.ClarityIQ¿ and image noise reduction37
4.[...] fusion solutions37
4.[...] (fiberoptic real shape imaging)38
4.4.Simulation-based endovascular (and open surgery) radiation protection training38
Part II
[...] image guidance for endovascular procedures in respect to current
radiation safety guidelines42
5.[...] revised ESVS radiation guidelines and the role of IVUS42
5.2.Decision making for IVUS use43
5.[...] is the current state of IVUS image guidance in the different vascular territories?
Why use IVUS at all?44
5.3.[...] for Percutaneous Coronary Interventions (PCI)44
5.3.[...] for endovenous procedures44
5.3.[...] for PAD45
5.3.[...]-clinical aspects of IVUS: Cost effectiveness calculations for PVI and PCI45
5.3.[...] and radiation/procedural safety46
6.Current technical state of IVUS image guidance50
6.1.Comparison of IVUS vs. angiographic imaging50
6.2.Catheter portfolio and technical specifications53
6.2.1.Technical basics of IV/US imaging53
6.2.[...] catheter portfolio53
6.2.3.Technical specifications of IVUS catheters56
6.2.4.Imaging techniques and image information content59
6.2.4.1.ChromaFlö59
6.2.4.[...] IVUS59
6.3.Current options for image processing60
6.3.[...] processing with Intrasight 5S61
6.4.Standards of Procedure (SOP) for IVUS use63
6.4.[...] for the hybrid room64
6.4.[...] for the standard operating room (constricted room)65
6.[...] challenge IVUS66
6.5.[...] challenge IVUS catheter use66
6.5.[...] challenge Pioneer Plus catheter use66
[...] for EVAR69
7.1.Published IVUS data for TEVAR69
7.[...] are the key factors for advanced image guidance in TEVAR or aorto-iliac PAD
procedures?70
7.3.Target vessel mapping and sealing zone definition by intraluminal cross-sectional imaging72
7.3.1.Parallaxes and IVUS73
7.[...] for IVUS guidance during TEVAR / PAD74
7.4.[...]-SOP in the local setting74
7.4.1.1.Vessel access74
7.4.1.2.Pullback maneuver with IVUS and image processing74
7.4.1.3.Mapping of the target vessels75
7.4.1.4.Catheter protection during graft deployment75
7.4.1.[...] completion control75
7.4.1.6.Workspace setting for TEVAR / PAD75
7.[...] image interpretation78
7.5.[...] interpretation prior to infrarenal endograft placement79
7.5.2.Interpretation of IVUS images after endograft deployment (completion of IVUS pullback)83
7.5.3.Sealing length84
7.5.4.Endoleak detection with IVUS86
7.[...] benefits in terms of prevention of early complications87
7.[...] and radiation safety87
[...] for TEVAR (for aneurysmal disease, aortic dissections, and other
pathologies)93
8.[...] and when IVUS is useful93
8.2.Procedural pathways and imaging properties for IVUS and angiography in different
pathologies94
8.3.Available evidence concerning IVUS image guidance for thoracic endograft placement95
8.[...] imaging quality for the different TEVAR modalities and their challenges99
8.[...] image guidance workflow and image interpretation99
8.5.1.Femoral artery access99
8.5.2.Advancement of devices99
8.5.[...] vs. CTA centerline99
8.5.[...] image guidance in dissections: the gold standard for reliability?100
8.5.5.Procedural workflow for pathologies in the descending thoracic aorta105
8.5.6.Specific findings using IVUS106
8.5.7.Advantages of IVUS vs. deficits of angiography in completion imaging106
8.5.7.[...] beak sign106
8.5.7.2.Infolding of grafts108
8.5.7.[...] crimping108
8.5.7.4.Imminent stroke risk of arch angiography110
8.5.7.5.Visualization of intra- and extraluminal structures110
8.6.Conclusions113
[...] image guidance for aortoiliac occlusive disease116
9.1.Procedural and clinical outcome of IVUS-guided revascularizations116
9.2.Technical requirements and SOPs for IVUS image guidance for arterial occlusive disease116
9.2.1.Procedural pathway for IVUS mapping and completion control for aorto-iliac stenosis117
9.2.1.1.Procedural steps for IVUS guidance119
9.[...] interpretation121
9.4.Radiation safety issues in aorto-iliac procedures123
9.5.Conclusions126
10.Interpretation and misinterpretation of IVUS images128
10.1.Particular problems of IVUS image guidance and dedicated bail-out proposals128
10.1.[...] shadow vs. vessel lumen128
10.2.Imaging details and decision making129
10.3.Orientation for target vessel definition / mapping and exact device129
10.3.[...] are ambiguous or unambiguous markers?129
10.3.2.Anatomy of the renal vein and misleading interpretation129
10.3.3.Artefacts originating from the catheter tip132
10.3.4.Artefacts originating from implants133
10.3.[...] about orientation and interpretation in severely calcified lesions or after device
placement?133
10.3.6.Interpretation of dissection vs. artefacts in different vessels134
10.3.6.[...] advantages in dissection detection during PAD treatment136
Details
Erscheinungsjahr: 2024
Fachbereich: Andere Fachgebiete
Genre: Mathematik, Medizin, Naturwissenschaften, Technik
Rubrik: Wissenschaften
Medium: Buch
Reihe: UNI-MED Science
Inhalt: 144 S.
156 Illustr.
ISBN-13: 9783837416640
ISBN-10: 383741664X
Sprache: Englisch
Einband: Gebunden
Autor: Tessarek, Jörg
Herrero Flores, Angel
Hersteller: UNI-MED Verlag AG
Verantwortliche Person für die EU: Uni-Med Verlag AG, Alten Eichen 2, D-28359 Bremen, info@uni-med.de
Maße: 243 x 180 x 15 mm
Von/Mit: Jörg Tessarek (u. a.)
Erscheinungsdatum: 05.01.2024
Gewicht: 0,409 kg
Artikel-ID: 128276356
Inhaltsverzeichnis
Part I
1.Introduction12
1.[...] for access to target vessels12
1.[...] guidance for endovascular procedures13
1.3.Therapeutic use of US for endovascular reconstruction13
1.[...] should we perform IVUS guidance for aortic and aorto-iliac procedures13
2.Radiation safety issues and risk awareness16
2.1.Revised radiation safety directives and guidelines 2020-202216
2.2.Radiation safety items in the daily routine: staff training16
2.3.Radiation protection items in the daily routine17
2.4.Personalized radiation protection equipment18
2.5.Reduction of the individual radiation exposure20
2.5.1.Influence of radiation source position and individual behavior20
2.5.2.Influence of room geometry and procedural workflow on staff radiation exposure21
2.5.3.Projection angle and radiation safety: steady AP-projection for optimal radiation protection25
3.Iodinated Contrast Media (ICM) and procedure-related renal side effects30
3.[...]: Contrast-Induced Nephropathy31
3.1.1.Definition of CIN31
3.1.2.Pathophysiology of CIN31
3.1.[...] factors for CIN and prevention31
3.1.4.Differential diagnosis of CIN32
3.1.5.Strategies for CIN prevention33
3.1.[...] for CIN prevention33
3.[...] kidney injury vs. CIN34
4.Software and hardware solutions for radiation dose / contrast media
reduction and workflow improvement37
4.1.ClarityIQ¿ and image noise reduction37
4.[...] fusion solutions37
4.[...] (fiberoptic real shape imaging)38
4.4.Simulation-based endovascular (and open surgery) radiation protection training38
Part II
[...] image guidance for endovascular procedures in respect to current
radiation safety guidelines42
5.[...] revised ESVS radiation guidelines and the role of IVUS42
5.2.Decision making for IVUS use43
5.[...] is the current state of IVUS image guidance in the different vascular territories?
Why use IVUS at all?44
5.3.[...] for Percutaneous Coronary Interventions (PCI)44
5.3.[...] for endovenous procedures44
5.3.[...] for PAD45
5.3.[...]-clinical aspects of IVUS: Cost effectiveness calculations for PVI and PCI45
5.3.[...] and radiation/procedural safety46
6.Current technical state of IVUS image guidance50
6.1.Comparison of IVUS vs. angiographic imaging50
6.2.Catheter portfolio and technical specifications53
6.2.1.Technical basics of IV/US imaging53
6.2.[...] catheter portfolio53
6.2.3.Technical specifications of IVUS catheters56
6.2.4.Imaging techniques and image information content59
6.2.4.1.ChromaFlö59
6.2.4.[...] IVUS59
6.3.Current options for image processing60
6.3.[...] processing with Intrasight 5S61
6.4.Standards of Procedure (SOP) for IVUS use63
6.4.[...] for the hybrid room64
6.4.[...] for the standard operating room (constricted room)65
6.[...] challenge IVUS66
6.5.[...] challenge IVUS catheter use66
6.5.[...] challenge Pioneer Plus catheter use66
[...] for EVAR69
7.1.Published IVUS data for TEVAR69
7.[...] are the key factors for advanced image guidance in TEVAR or aorto-iliac PAD
procedures?70
7.3.Target vessel mapping and sealing zone definition by intraluminal cross-sectional imaging72
7.3.1.Parallaxes and IVUS73
7.[...] for IVUS guidance during TEVAR / PAD74
7.4.[...]-SOP in the local setting74
7.4.1.1.Vessel access74
7.4.1.2.Pullback maneuver with IVUS and image processing74
7.4.1.3.Mapping of the target vessels75
7.4.1.4.Catheter protection during graft deployment75
7.4.1.[...] completion control75
7.4.1.6.Workspace setting for TEVAR / PAD75
7.[...] image interpretation78
7.5.[...] interpretation prior to infrarenal endograft placement79
7.5.2.Interpretation of IVUS images after endograft deployment (completion of IVUS pullback)83
7.5.3.Sealing length84
7.5.4.Endoleak detection with IVUS86
7.[...] benefits in terms of prevention of early complications87
7.[...] and radiation safety87
[...] for TEVAR (for aneurysmal disease, aortic dissections, and other
pathologies)93
8.[...] and when IVUS is useful93
8.2.Procedural pathways and imaging properties for IVUS and angiography in different
pathologies94
8.3.Available evidence concerning IVUS image guidance for thoracic endograft placement95
8.[...] imaging quality for the different TEVAR modalities and their challenges99
8.[...] image guidance workflow and image interpretation99
8.5.1.Femoral artery access99
8.5.2.Advancement of devices99
8.5.[...] vs. CTA centerline99
8.5.[...] image guidance in dissections: the gold standard for reliability?100
8.5.5.Procedural workflow for pathologies in the descending thoracic aorta105
8.5.6.Specific findings using IVUS106
8.5.7.Advantages of IVUS vs. deficits of angiography in completion imaging106
8.5.7.[...] beak sign106
8.5.7.2.Infolding of grafts108
8.5.7.[...] crimping108
8.5.7.4.Imminent stroke risk of arch angiography110
8.5.7.5.Visualization of intra- and extraluminal structures110
8.6.Conclusions113
[...] image guidance for aortoiliac occlusive disease116
9.1.Procedural and clinical outcome of IVUS-guided revascularizations116
9.2.Technical requirements and SOPs for IVUS image guidance for arterial occlusive disease116
9.2.1.Procedural pathway for IVUS mapping and completion control for aorto-iliac stenosis117
9.2.1.1.Procedural steps for IVUS guidance119
9.[...] interpretation121
9.4.Radiation safety issues in aorto-iliac procedures123
9.5.Conclusions126
10.Interpretation and misinterpretation of IVUS images128
10.1.Particular problems of IVUS image guidance and dedicated bail-out proposals128
10.1.[...] shadow vs. vessel lumen128
10.2.Imaging details and decision making129
10.3.Orientation for target vessel definition / mapping and exact device129
10.3.[...] are ambiguous or unambiguous markers?129
10.3.2.Anatomy of the renal vein and misleading interpretation129
10.3.3.Artefacts originating from the catheter tip132
10.3.4.Artefacts originating from implants133
10.3.[...] about orientation and interpretation in severely calcified lesions or after device
placement?133
10.3.6.Interpretation of dissection vs. artefacts in different vessels134
10.3.6.[...] advantages in dissection detection during PAD treatment136
Details
Erscheinungsjahr: 2024
Fachbereich: Andere Fachgebiete
Genre: Mathematik, Medizin, Naturwissenschaften, Technik
Rubrik: Wissenschaften
Medium: Buch
Reihe: UNI-MED Science
Inhalt: 144 S.
156 Illustr.
ISBN-13: 9783837416640
ISBN-10: 383741664X
Sprache: Englisch
Einband: Gebunden
Autor: Tessarek, Jörg
Herrero Flores, Angel
Hersteller: UNI-MED Verlag AG
Verantwortliche Person für die EU: Uni-Med Verlag AG, Alten Eichen 2, D-28359 Bremen, info@uni-med.de
Maße: 243 x 180 x 15 mm
Von/Mit: Jörg Tessarek (u. a.)
Erscheinungsdatum: 05.01.2024
Gewicht: 0,409 kg
Artikel-ID: 128276356
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