Rutherford's 033: The Future of Imaging for Endovascular and Open Surgery

#VascularSurgery #EndovascularTherapy #HybridOR #MedicalImaging #ImageGuidance #ConeBeamCT #ImageFusion #RadiationSafety #RutherfordsVascularSurgery #FutureOfSurgery

Step into the future of **vascular surgery**, where advanced imaging is transforming patient care! Drawing insights from Rutherford's Vascular Surgery 10th Edition, this video explores the exciting shift towards sophisticated **3D imaging** and **image guidance** within the operating room. The cornerstone of this evolution is the rise of the **hybrid operating room (OR)**, specialized suites that integrate open surgery and endovascular capabilities, eliminating risky patient transfers and leading to better outcomes, especially in emergencies.

While traditional **X-ray fluoroscopy** and **angiography** remain crucial for real-time, high-resolution imaging, newer mobile C-arms feature significant upgrades like flat panel digital detectors and higher power generators, providing better image quality and longer imaging times for complex cases. **Image fusion**, overlaying pre-operative scans onto live X-ray, is becoming increasingly relevant.

A key advancement is **Cone Beam CT (CBCT)**, enabling the acquisition of 3D CT-like images directly in the OR by rotating the C-arm around the patient. This capability, along with sophisticated **3D/3D image fusion** techniques, allows pre-operative CT or MRI data to be precisely aligned and overlaid onto intra-operative imaging, creating a **"surgical GPS"**. This guidance is vital for meticulous planning and precise navigation during procedures like endovascular aneurysm repair and tricky needle placements, often reducing the need for contrast dye and radiation exposure.

The use of **MRI/MRA/MRV** for image fusion is particularly beneficial for patients with kidney issues, avoiding iodinated contrast.

Crucially, the move to more powerful imaging necessitates a strong focus on **radiation safety** for both patients and staff, adhering to the ALARA principle ("As Low As Reasonably Achievable"). The future points towards even tighter integration of multiple imaging types, potentially including full CT or MRI scanners in the OR, alongside emerging technologies like optical/electromagnetic tracking and catheter robotics, promising more precise, less invasive, and potentially radiation-free procedures.

Видео Rutherford's 033: The Future of Imaging for Endovascular and Open Surgery канала Dr Gregory Weir: Vascular, Hyperbaric, Wound Care