Angio Cone-Beam CT (Angio-CBCT) and 3D Road-Mapping for the Detection of Spinal Cord Vascularization in Patients Requiring Treatment for a Thoracic Aortic Lesion: A Feasibility Study

Background: Spinal cord ischemia is a major complication of treatment for descending thoracic aorta (DTA) disease. Our objectives were (1) to describe the value of angiographic cone-beam CT (angio-CBCT) and 3D road-mapping to visualize the Adamkiewicz artery (AA) and its feeding artery and (2) to ev...

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Bibliographic Details
Published in:Journal of personalized medicine 2022-11, Vol.12 (11), p.1890
Main Authors: Barral, Pierre-Antoine, De Masi, Mariangela, Bartoli, Axel, Beunon, Paul, Gallon, Arnaud, Tradi, Farouk, Hak, Jean-François, Gaudry, Marine, Jacquier, Alexis
Format: Article
Language:English
Subjects:
Aneurysms
Angiography
Aorta
Bioengineering
Cardiology and cardiovascular system
Catheters
Contrast agents
Contrast media
Coronary vessels
Feasibility studies
Feeding
Human health and pathology
Imaging
Intubation
Iodine
Ischemia
Life Sciences
Localization
Mapping
Medical imaging
Multidisciplinary teams
Patients
Precision medicine
Radiation
Spinal cord
Spinal cord injuries
Thorax
Vascularization
Veins & arteries
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Summary:Background: Spinal cord ischemia is a major complication of treatment for descending thoracic aorta (DTA) disease. Our objectives were (1) to describe the value of angiographic cone-beam CT (angio-CBCT) and 3D road-mapping to visualize the Adamkiewicz artery (AA) and its feeding artery and (2) to evaluate the impact of AA localization on the patient surgical strategy. Methods: Between 2018 and 2020, all patients referred to our institution for a surgical DTA disorder underwent a dedicated AA evaluation by angio-CBCT. If the AA feeding artery was not depicted on angio-CBCT, selective artery catheterization was performed, guided by 3D road-mapping. Intervention modifications, based on AA location and one month of neurologic follow-up after surgery, were recorded. Results: Twenty-one patients were enrolled. AA was assessable in 100% of patients and in 15 (71%) with angio-CBCT alone. Among them, 10 patients needed 3D road-mapping-guided DSA angiography to visualize the AA feeding artery. The amount of contrast media, irradiation dose, and intervention length were not significantly different whether the AA was assessable or not by angio-CBCT. AA feeding artery localization led to surgical sketch modification for 11 patients. Conclusions: Angio-CBCT is an efficient method for AA localization in the surgical planning of DTA disorders.
ISSN:2075-4426
2075-4426
DOI:10.3390/jpm12111890