Abstract：
BACKGROUND: Fusion imaging systems have proved to reduce radiation exposure mostly in hybrid rooms but reports with mobile C-arms are few. The aim of this study was to analyze the impact of the Endonaut navigation system on radiation exposure in endovascular aneurysm repair (EVAR) performed with mobile C-arms.
METHODS: All patients undergoing EVAR and/or iliac branched devices implantation between January 2016 and August 2022 were included. All procedures were performed with a mobile C-arm (Siemens Avantic or GE Elite until March 2018, Siemens Cios Alpha thereafter). The Endonaut navigation system has been used since January 2021. Two groups were, therefore, compared: before (control group [CGr]) and after the use of Endonaut. Radiation data including Dose Area Product (DAP) values, Air Kerma (AK) and fluoroscopy time (FT) were collected retrospectively.
RESULTS: Overall, 153 patients were included: CGr, n = 121; Endonaut group (EnGr), n = 32. No significant difference was found between the 2 groups regarding demographic data. DAP values were significantly lower in the EnGr (38 Gy cm2 ± 24) vs. the CGr (76 Gy cm2 ± 51) (P < 0.05) despite a significantly higher number of complex procedures such as iliac branched devices (P < 0.05). AK values were not significantly different between the EnGr and the CGr (196 mGy ±114 vs. 209 mGy ±138) as well as FT (33 minutes ±18 vs. 33 minutes ±16). Technical success was 97% (31/32) in the EnGr vs. 96% (116/121) in the CGr (P = 0.79). The volume of contrast media was significantly lower in the EnGr (94 cc ± 41) vs. the CGr (143 cc ± 66) (P < 0.05).
CONCLUSIONS: In this study, the use of the Endonaut angio-navigation system when performing EVAR with mobile C-arms led to a radiation dose reduction without compromising technical success or procedural time.
METHODS: All patients undergoing EVAR and/or iliac branched devices implantation between January 2016 and August 2022 were included. All procedures were performed with a mobile C-arm (Siemens Avantic or GE Elite until March 2018, Siemens Cios Alpha thereafter). The Endonaut navigation system has been used since January 2021. Two groups were, therefore, compared: before (control group [CGr]) and after the use of Endonaut. Radiation data including Dose Area Product (DAP) values, Air Kerma (AK) and fluoroscopy time (FT) were collected retrospectively.
RESULTS: Overall, 153 patients were included: CGr, n = 121; Endonaut group (EnGr), n = 32. No significant difference was found between the 2 groups regarding demographic data. DAP values were significantly lower in the EnGr (38 Gy cm2 ± 24) vs. the CGr (76 Gy cm2 ± 51) (P < 0.05) despite a significantly higher number of complex procedures such as iliac branched devices (P < 0.05). AK values were not significantly different between the EnGr and the CGr (196 mGy ±114 vs. 209 mGy ±138) as well as FT (33 minutes ±18 vs. 33 minutes ±16). Technical success was 97% (31/32) in the EnGr vs. 96% (116/121) in the CGr (P = 0.79). The volume of contrast media was significantly lower in the EnGr (94 cc ± 41) vs. the CGr (143 cc ± 66) (P < 0.05).
CONCLUSIONS: In this study, the use of the Endonaut angio-navigation system when performing EVAR with mobile C-arms led to a radiation dose reduction without compromising technical success or procedural time.
摘要：
目的：融合成像系统已被证明主要在混合房间中减少辐射暴露，但关于移动C臂的报道很少。这项研究的目的是分析Endonaut®导航系统对使用移动C形臂进行的血管内动脉瘤修复（EVAR）中辐射暴露的影响。
方法：纳入2016年1月至2022年8月期间接受EVAR和/或髂分支装置植入的所有患者。所有程序均使用移动C型臂（SiemensAvantic®或GEElite®至2018年3月，此后为SiemensCiosAlpha®）进行。Endonaut®导航系统自2021年1月开始使用。因此比较两组:使用Endonaut®之前(对照组)和之后。辐射数据，包括剂量面积乘积（DAP）值，回顾性收集角膜空气（AK）和透视时间（FT）。
结果：总体而言，153例患者包括：对照组（CGr），n=121；Endonaut®组（EnGr），n=32。在人口统计学数据方面，两组之间没有发现显着差异。EnGr中的DAP值显着降低（38Gy。cm2±24)vs.CGR（76Gy。cm2±51）（p<.05），尽管复杂程序的数量显着增加，例如ilia分支装置（p<.05）。EnGr和CGr之间的AK值没有显着差异（196mGy±114与209mGy±138）以及FT（33分钟±18vs.33分钟±16）。EnGr与EnGr的技术成功率为97％（31/32）CGr中的96%(116/121)(p=0.79)。在EnGr（94cc±41）中，造影剂的体积明显较低。CGr（143cc±66）（p<0.05）。
结论：在这项研究中，在使用移动C形臂进行EVAR时,使用Endonaut®血管导航系统可在不影响技术成功或手术时间的情况下降低辐射剂量.
方法：纳入2016年1月至2022年8月期间接受EVAR和/或髂分支装置植入的所有患者。所有程序均使用移动C型臂（SiemensAvantic®或GEElite®至2018年3月，此后为SiemensCiosAlpha®）进行。Endonaut®导航系统自2021年1月开始使用。因此比较两组:使用Endonaut®之前(对照组)和之后。辐射数据，包括剂量面积乘积（DAP）值，回顾性收集角膜空气（AK）和透视时间（FT）。
结果：总体而言，153例患者包括：对照组（CGr），n=121；Endonaut®组（EnGr），n=32。在人口统计学数据方面，两组之间没有发现显着差异。EnGr中的DAP值显着降低（38Gy。cm2±24)vs.CGR（76Gy。cm2±51）（p<.05），尽管复杂程序的数量显着增加，例如ilia分支装置（p<.05）。EnGr和CGr之间的AK值没有显着差异（196mGy±114与209mGy±138）以及FT（33分钟±18vs.33分钟±16）。EnGr与EnGr的技术成功率为97％（31/32）CGr中的96%(116/121)(p=0.79)。在EnGr（94cc±41）中，造影剂的体积明显较低。CGr（143cc±66）（p<0.05）。
结论：在这项研究中，在使用移动C形臂进行EVAR时,使用Endonaut®血管导航系统可在不影响技术成功或手术时间的情况下降低辐射剂量.
