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Background: Dynamic Coronary Roadmap (DCR, Philips Healthcare, The Netherlands) is a novel technology that allows the users to see a moving roadmap of the coronary anatomy displayed on top of live fluoroscopy to provide guidance during navigation and positioning of devices. This can provide additional confidence in the procedure, and reduce the need for extra cine runs or contrast puffs. The system extracts a coronary roadmap out of each frame of a cine run. An image registration technique compares moving structures that are present in both the roadmap and the live fluoroscopy images, to provide a precise overlay of the coronary vessel tree on top of the live fluoroscopy, moving exactly with the cardiac and breathing motion.
Methods: This is the first pilot study of DCR during angioplasty. Over a period of 10 months, 102 subjects were enrolled; ethical committee approval and patient's consents were obtained. Primary Angioplasties and Chronic Total Occlusions and first 20 patients as part of the feasibility phase were excluded. Procedure parameters of 79 subjects were analyzed.
Results: The total dose area product (DAP) per procedure showed a reduction from a mean value of 77 575mGycm2 for the first group of subjects based on moving averaged over 20 subjects to 52 323mGycm2 for the last group of the analyzed data. Similarly, total contrast per procedure showed a significant reduction from an average of 244.1ml to 155.8ml over time of subject enrollment (linear regression p<0.05). The limitation of this study was that this was not a case control study.
Conclusions: This pilot study shows the potential of the DCR technology with a trend of both contrast and radiation dose reduction. An initial analysis of the data with linear regression showed a significant reduction of iodinated contract over the 10 months of subject enrollment. Thus it is seen that DCR can be safely used and can have benefits in reducing radiation as well as contrast load.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Interventional Cardiology: Angiography, Intravascular Imaging and Interventional CT/MR
Abstract Category: 16. Interventional Cardiology: Angiography and Interventional CT/MR
Presentation Number: 1153-120
- 2017 American College of Cardiology Foundation