CardioVascular and Interventional Radiology

, Volume 39, Issue 1, pp 111–116 | Cite as

Fusion of CT Angiography or MR Angiography with Unenhanced CBCT and Fluoroscopy Guidance in Endovascular Treatments of Aorto-Iliac Steno-Occlusion: Technical Note on a Preliminary Experience

  • Anna Maria Ierardi
  • Ejona Duka
  • Alessandro Radaelli
  • Nicola Rivolta
  • Gabriele Piffaretti
  • Gianpaolo Carrafiello
Technical Note



To evaluate the feasibility of image fusion (IF) of pre-procedural arterial-phase CT angiography or MR angiography with intra-procedural fluoroscopy for road-mapping in endovascular treatment of aorto-iliac steno-occlusive disease.

Materials and Methods

Between September and November, 2014, we prospectively evaluated 5 patients with chronic aorto-iliac steno-occlusive disease, who underwent endovascular treatment in the angiography suite. Fusion image road-mapping was performed using angiographic phase CT images or MR images acquired before and intra-procedural unenhanced cone-beam CT. Radiation dose of the procedure, volume of intra-procedural iodinated contrast medium, fluoroscopy time, and overall procedural time were recorded. Reasons for potential fusion imaging inaccuracies were also evaluated.


Image co-registration and fusion guidance were feasible in all procedures. Mean radiation dose of the procedure was 60.21 Gycm2 (range 55.02–63.75 Gycm2). The mean total procedure time was 32.2 min (range 27–38 min). The mean fluoroscopy time was 12 min and 3 s. The mean procedural iodinated contrast material dose was 24 mL (range 20–40 mL).


IF gives Interventional Radiologists the opportunity to use new technologies in order to improve outcomes with a significant reduction of contrast media administration.


Arterial intervention Imaging Stenting Stent graft Fusion imaging 



The Acknowledgements are for Engineer Alessandro Radaelli for technical support.

Compliance with Ethical Standard

Conflict of interest

Alessandro Radaelli declares his relationship of employee with Philips. The remaining Authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2015

Authors and Affiliations

  • Anna Maria Ierardi
    • 1
  • Ejona Duka
    • 1
  • Alessandro Radaelli
    • 2
  • Nicola Rivolta
    • 3
  • Gabriele Piffaretti
    • 3
  • Gianpaolo Carrafiello
    • 1
  1. 1.Interventional Radiology, Department of RadiologyUniversity of InsubriaVareseItaly
  2. 2.Philips HealthcareBestThe Netherlands
  3. 3.Vascular Surgery DepartmentUniversity of InsubriaVareseItaly

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