Academic Journal
Comparison of outcomes and radiation exposure using Fiber-Optic RealShape-enabled standard guidewire versus LumiGuide for fenestrated-branched endovascular aortic aneurysm repair.
| Τίτλος: | Comparison of outcomes and radiation exposure using Fiber-Optic RealShape-enabled standard guidewire versus LumiGuide for fenestrated-branched endovascular aortic aneurysm repair. |
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| Συγγραφείς: | Huertas P; Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Porras-Colon J; Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Figueroa A; Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Soto-Gonzalez M; Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Baig MS; Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Timaran CH; Division of Vascular and Endovascular Therapy, Department of Surgery, Emory University School of Medicine, Atlanta, GA. Electronic address: carlos.timaran@emory.edu. |
| Πηγή: | Journal of vascular surgery [J Vasc Surg] 2026 Oct; Vol. 84 (4), pp. 827-836.e1. Date of Electronic Publication: 2026 Jun 22. |
| Τύπος έκδοσης: | Journal Article; Comparative Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: United States NLM ID: 8407742 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6809 (Electronic) Linking ISSN: 07415214 NLM ISO Abbreviation: J Vasc Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2008-> : New York, NY : Elsevier Original Publication: St. Louis, Mo. : Mosby, [c1984- |
| Ιατρικοί όροι (MeSH): | Endovascular Aneurysm Repair*/instrumentation , Endovascular Aneurysm Repair*/adverse effects , Radiation Exposure*/adverse effects , Radiation Exposure*/prevention & control , Radiography, Interventional*/adverse effects , Radiography, Interventional*/instrumentation , Blood Vessel Prosthesis Implantation*/adverse effects , Blood Vessel Prosthesis Implantation*/instrumentation , Fiber Optic Technology*/instrumentation , Aortic Aneurysm, Abdominal*/surgery , Aortic Aneurysm, Abdominal*/diagnostic imaging , Endovascular Procedures*/instrumentation , Endovascular Procedures*/adverse effects , Radiation Dosage* , Vascular Access Devices*, Aortography/adverse effects ; Aortography/instrumentation ; Humans ; Treatment Outcome ; Male ; Time Factors ; Female ; Aged ; Aged, 80 and over ; Retrospective Studies ; Blood Vessel Prosthesis ; Risk Factors ; Prosthesis Design ; Fluoroscopy |
| Περίληψη: | Background: Target-vessel (TV) catheterization during fenestrated-branched endovascular aortic aneurysm repair (FBEVAR) relies primarily on fluoroscopy. Fiber-Optic RealShape (FORS) technology (Philips Medical Systems) uses light-refracted through optical fibers to generate real-time renderings of wires and catheters in three-dimensional (3D) space allowing their navigation without radiation. The LumiGuide is an enhanced longer version of the standard guidewire that is coupled with a 3D Hub connector to enhance visualization of commercially available catheters. This study aims to compare the outcomes and radiation exposure using the standard FORS-enabled guidewire vs the LumiGuide for F/B-EVAR. Methods: Data collected from 218 F/B-EVARs (129 standard FORS, 89 LumiGuide) included 931 TV catheterizations (590 with standard FORS and 341 with LumiGuide). Technical success was defined as the successful catheterization of the TVs using only FORS. FORS and LumiGuide were compared in terms of technical success rates, procedure times, catheterization duration, fluoroscopy times, and cumulative dose-area products (DAP). Welch t-test was used for continuous variables, whereas a z-test was applied for proportions. Results: Patient characteristics did not demonstrate significant differences between groups. FORS technical success was 56.2% with standard FORS vs 79.4% with LumiGuide (P < .001). Compared with standard FORS, the use of LumiGuide resulted in nonsignificant reduced navigation time per TV (6.4 ± 7.4 vs 6.7 ± 9.6 minutes; P = .6), DAP per TV (3.2 ± 5.3 vs 3.36 ± 9.3 Gy·cm2; P = .79), and significant reduction in procedure time (257 ± 91 vs 298 ± 100 minutes; P = .002), fluoroscopy time (58 ± 38 vs 80 ± 40 minutes; P = .01), and contrast dose (130 ± 40 vs 150 ± 50 mL; P = .05). Cumulative DAP remained similar between groups (59 ± 38 Gy·cm2 for LumiGuide vs 64 ± 43 Gy·cm2 with standard FORS; P = .5). Conclusions: The introduction of LumiGuide and the 3D-Hub for F/B-EVAR improved FORS technical success and reduced procedure times compared with earlier FORS procedures. The ability to use different commercially available catheters with LumiGuide results in enhanced convenience and lower radiation exposure, thereby improving efficiency and safety. (Copyright © 2026 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.) |
| Competing Interests: | Disclosures Carlos H. Timaran reports consulting and research support grants from Cook Medical Inc, W. L. Gore & Associates Inc, and Philips Healthcare. Mirza S. Baig reports consulting and research support grants from Cook Medical Inc, W. L. Gore & Associates Inc, and Philips Healthcare. |
| Contributed Indexing: | Keywords: Complex endovascular aortic repair; FORS; Fenestrated endovascular aortic repair; LumiGuide |
| Entry Date(s): | Date Created: 20260622 Date Completed: 20260909 Latest Revision: 20260909 |
| Update Code: | 20260910 |
| DOI: | 10.1016/j.jvs.2026.06.067 |
| PMID: | 42331152 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1097-6809 |
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| DOI: | 10.1016/j.jvs.2026.06.067 |