1
|
Urade T, Verde JM, García Vázquez A, Gunzert K, Pessaux P, Marescaux J, Giménez ME. Fluoroless intravascular ultrasound image-guided liver navigation in porcine models. BMC Gastroenterol 2021; 21:24. [PMID: 33422010 PMCID: PMC7797115 DOI: 10.1186/s12876-021-01600-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background An intravascular ultrasound catheter (IVUSc) was developed for intracardiac ultrasound to assess interventions with compelling results. However, intrahepatic vascular exploration was rarely tested and was always associated with X-ray techniques. The aim of this study was to demonstrate the feasibility to navigate through the whole liver using an IVUSc, providing high-quality images and making it unnecessary to use ionizing radiation.
Methods An ex vivo pig visceral block and an in vivo pig model were used in this study. The IVUS equipment was composed of an US system, and of an 8 French lateral firing IVUSc capable of producing 90-degree sector images in the longitudinal plane. After accessing the intravascular space with the IVUSc into the models, predetermined anatomical landmarks were visualized from the inferior vena cava and hepatic veins and corroborated. Results IVUS navigation was achieved in both models successfully. The entire navigation protocol took 87 and 48 min respectively, and 100% (21/21) and 96.15% (25/26) of the landmarks were correctly identified with the IVUSc alone in the ex vivo and in vivo models respectively. IVUS allowed to clearly visualize the vasculature beyond third-order branches of the hepatic and portal veins. Conclusions A complete IVUS liver navigation is feasible using the IVUSc alone, making it unnecessary to use ionizing radiation. This approach provides high-definition and real-time images of the complex liver structure and offers a great potential for future clinical applications during diagnostic and therapeutic interventions.
Collapse
Affiliation(s)
- Takeshi Urade
- Institute of Image-Guided Surgery, IHU Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France. .,IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France.
| | - Juan Manuel Verde
- Institute of Image-Guided Surgery, IHU Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France.,IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | - Alain García Vázquez
- Institute of Image-Guided Surgery, IHU Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France.,IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | | | - Patrick Pessaux
- Institute of Image-Guided Surgery, IHU Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France.,IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France.,Department of General, Digestive and Endocrine Surgery, Nouvel Hôpital Civil, University of Strasbourg, Strasbourg, France
| | - Jacques Marescaux
- Institute of Image-Guided Surgery, IHU Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France.,IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| | - Mariano Eduardo Giménez
- Institute of Image-Guided Surgery, IHU Strasbourg, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France.,IRCAD, Research Institute Against Digestive Cancer, Strasbourg, France
| |
Collapse
|