Robotic Digital Subtraction Angiography Systems Within the Hybrid Operating Room

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. 1427-1433 ◽  
Author(s):  
Yuichi Murayama ◽  
Koreaki Irie ◽  
Takayuki Saguchi ◽  
Toshihiro Ishibashi ◽  
Masaki Ebara ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Operating Room ◽  
Intraoperative Imaging ◽  
Neurosurgical Procedures ◽  
Digital Subtraction ◽  
Tomographic Images ◽  
Computed Tomographic ◽  
Aneurysm Clipping ◽  
Imaging Tool ◽  
Artis Zeego

Abstract BACKGROUND: Fully equipped high-end digital subtraction angiography (DSA) within the operating room (OR) environment has emerged as a new trend in the fields of neurosurgery and vascular surgery. OBJECTIVE: To describe initial clinical experience with a robotic DSA system in the hybrid OR. METHODS: A newly designed robotic DSA system (Artis zeego; Siemens AG, Forchheim, Germany) was installed in the hybrid OR. The system consists of a multiaxis robotic C arm and surgical OR table. In addition to conventional neuroendovascular procedures, the system was used as an intraoperative imaging tool for various neurosurgical procedures such as aneurysm clipping and spine instrumentation. RESULTS: Five hundred one neurosurgical procedures were successfully conducted in the hybrid OR with the robotic DSA. During surgical procedures such as aneurysm clipping and arteriovenous fistula treatment, intraoperative 2-/3-dimensional angiography and C-arm-based computed tomographic images (DynaCT) were easily performed without moving the OR table. Newly developed virtual navigation software (syngo iGuide; Siemens AG) can be used in frameless navigation and in access to deep-seated intracranial lesions or needle placement. CONCLUSION: This newly developed robotic DSA system provides safe and precise treatment in the fields of endovascular treatment and neurosurgery.

DEPICTION OF SMALL VEINS DRAINING INTO THE VEIN OF GALEN USING PREOPERATIVE 3‐DIMENSIONAL NAVIGATION IN LIVING PATIENTS

2009 ◽  
Vol 64 (suppl_5) ◽  
pp. ons247-ons252 ◽  
Author(s):  
Mario Giordano ◽  
Karsten H. Wrede ◽  
Lennart H. Stieglitz ◽  
Laura Columbano ◽  
Madjid Samii ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Digital Subtraction Angiography ◽  
Pineal Region ◽  
Digital Subtraction ◽  
Vein Of Galen ◽  
Resonance Imaging ◽  
3 Dimensional ◽  
Small Vessels ◽  
Computed Tomographic

Abstract OBJECTIVE The purpose of this study was to delineate the anatomy of the precentral cerebellar vein, superior vermian vein, and internal occipital vein using reconstructions of computed tomographic and magnetic resonance imaging scans with navigation software. These data were compared with previous anatomic and angiographic findings to show the resolution and accuracy of the system. METHODS We retrospectively reviewed 100 patients with intracranial pathologies (50 computed tomographic scans with contrast and 50 magnetic resonance imaging scans with gadolinium) using a neuronavigation workstation for 3-dimensional reconstruction. Particular attention was paid to depiction of the precentral cerebellar vein, superior vermian vein, and internal occipital vein. The data were reviewed and analyzed. RESULTS The precentral cerebellar vein, superior vermian vein, and its tributary, the supraculminate vein, were depicted in 52 (52%) patients. The internal occipital vein was delineated on 99 (49.5%) sides and joined the basal vein and vein of Galen in 39 (39.4%) and 60 (60.6%) hemispheres, respectively. Comparing these results with previous angiographic studies, the ability of the neuronavigation system for depicting these vessels is similar to that of digital subtraction angiography. CONCLUSION This study illustrates the possibility of depicting the small vessels draining into the pineal region venous complex using 3-dimensional neuronavigation with an accuracy comparable to that of digital subtraction angiography. This tool provides important information for both surgical planning and intraoperative orientation.

Automated Three-dimensional Volume Rendering of Helical Computed Tomographic Angiography for Aneurysms: An Advanced Application of Neuronavigation Technology

2005 ◽  
Vol 57 (suppl_1) ◽  
pp. 69-77 ◽  
Author(s):  
Lucia Benvenuti ◽  
Salvatore Chibbaro ◽  
Stefano Carnesecchi ◽  
Flavio Pulerà ◽  
Rolando Gagliardi
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Volume Rendering ◽  
Intracranial Aneurysms ◽  
Surgical Navigation ◽  
Three Dimensional ◽  
Helical Ct ◽  
Data Sets ◽  
Digital Subtraction ◽  
Computed Tomographic

Abstract OBJECTIVE: To introduce the possibility of volume-rendered helical computed tomographic (CT) angiographic data sets by use of Medtronic StealthStation Treon surgical navigation technology (Medtronic Surgical Navigation Technologies, Louisville, CO) and to evaluate the clinical usefulness of the method in planning and performing surgical treatment of intracranial aneurysms. METHODS: Between November 2002 and July 2003, we studied 15 patients with suspected intracranial aneurysms. All patients but two received conventional digital subtraction angiography, which failed to provide the requested information. Helical CT angiography was performed in all patients, and data sets were transferred to the StealthStation system across an electronic network to be automatically postprocessed by use of three-dimensional (3-D) volume rendering. The 3-D volume-rendered images were accurately analyzed to obtain more complete information about the aneurysm and to provide accurate treatment planning. In all patients, the 3-D volume-rendered model was displayed on the screen of the StealthStation system for the duration of the surgical procedure and compared with the intraoperative image. RESULTS: Data sets from CT angiography were automatically postprocessed by the StealthStation in seconds with excellent results, providing us, before and during surgery, with additional information not always available on traditional digital subtraction angiographic investigation. Because of the very short time necessary to complete this process (<5 min to obtain 3-D volume-rendered images), it was possible to perform emergency clipping of the aneurysms in two patients who had been admitted in very compromised neurological conditions. In 12 patients, integrated digital subtraction angiography and automated 3-D volume-rendered images allowed an accurate presurgical evaluation. Furthermore, in all patients on whom surgery was performed, aneurysms were found in the exact location and with the same anatomic features as depicted by the 3-D volume-rendered models. CONCLUSION: Reports in the literature indicate that information gathered by CT angiography with volume rendering shows a significant impact on aneurysm management. The StealthStation system upgraded with the adequate algorithm seems to provide a time- and cost-effective method of performing automated 3-D volume rendering of CT angiography and provides an interesting alternative to the available investigation modalities in case of emergency.

scholarly journals Computed tomographic features of tracheal shapes and dimensions in awake dogs

2018 ◽  
Vol 63 (No. 3) ◽  
pp. 131-136
Author(s):  
S. Lim ◽  
J. Jeong ◽  
HG Heng ◽  
S. Sung ◽  
Y. Choi ◽  
...  
Keyword(s):  
Cervical Vertebra ◽  
Thoracic Vertebra ◽  
Thoracic Inlet ◽  
Tomographic Images ◽  
Circular Shape ◽  
Computed Tomographic ◽  
Non Invasive ◽  
Imaging Tool ◽  
Seventh Cervical Vertebra ◽  
Different Shapes

There are several reports in the veterinary literature on tracheal assessment; however, there is a lack of studies on the trachea in voluntarily breathing dogs. The aim of this study was to describe the natural shape of the trachea in awake dogs and to assess tracheal dimensions and the width-to-height ratio. Thoracic computed tomographic images of awake small breed dogs without any signs of respiratory malfunction (n = 19) were evaluated. Each trachea was categorised into one of four different shapes: circular, horseshoe, crescent or focal dorsal invagination. The circular shape was prominent, particularly in the thoracic inlet and intrathoracic area, while the horseshoe shape was also normally present. In this group of normal dogs, there were no crescent-shaped tracheas, but focally invaginated tracheas were observed. The mean tracheal heights at five locations, namely the caudal endplate of the fourth cervical vertebra, cranial endplate of the seventh cervical vertebra, mid-body of the first thoracic vertebra, mid-body of the third thoracic vertebra, and 1 cm cranial to the carina were 9.12, 8.96, 9.34, 9.88 and 10.16 mm, respectively. The widths at these same sites were 12.26, 10.42, 10.07, 9.82 and 10.23 mm, respectively. The width-to-height ratios of each tracheal location were 1.38, 1.20, 1.10, 1.01 and 1.03, the last two of which are consistent with the circular shape of the intrathoracic trachea. Multi-detector computed tomography under non-general anaesthesia is a non-invasive and unparalleled imaging tool for describing tracheal appearance in healthy awake dogs.

E-052 Robotic digital subtraction angiography systems within the hybrid operating room

2010 ◽  
Vol 2 (Suppl_1) ◽  
pp. A46-A46
Author(s):  
Y. Murayama ◽  
T. Ishibashi ◽  
M. Ebara ◽  
S. Ikeuchi ◽  
H. Takao ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Operating Room ◽  
Digital Subtraction ◽  
Hybrid Operating Room
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