Preliminary application of 3-dimensional venography and fusion navigation technique in May-Thurner syndrome.

OBJECTIVES: The purpose of this study was to report a technique for intraprocedural guidance of endovascular iliac vein stenting procedures using three-dimensional (3D) venography images as an overlay on live biplanar fluoroscopy.

METHODS: Based on 3D venography and fusion navigation technique, percutaneous transluminal angioplasty (PTA) and stent placement were performed to evaluate the 3D venography images fusion navigation technique feasibility for MTS in comparison with traditional DSA. The general epidemiological data (including age, gender), clinical manifestations (including major symptom, affected extremity, CEAP classification, comorbidity, stenosis rate), intra-operative findings (including stenting classifying, count, stent into IVC distance, procedure time, X-rays dose, contrast agent dosage), and postoperative recovery were obtained and analyzed.

RESULTS: A total of 30 consecutive patients with symptomatic MTS from our institution were enrolled in this study. All of these patients, 12 patients (group A) were treated with 3D venography images fusion navigation, and 18 patients (group B) were treated with 2D path graph during endovascular management. Notably, significant differences were observed between the two groups with respect to procedure time (64.42±4.35min vs 76.61±3.47min; p=0.04), X-rays dose (2152±124.7mGy vs 2561±105.6mGy; p=0.02) and contrast agent dosage (71.42±4.87ml vs 86.17±4.14ml; p=0.03).

CONCLUSION: 3D venography and its fusion navigation technique can improve predict the coverage area of the stent. It can also shorten the procedure time, reduce contrast agent dose and radiation exposure, which makes it a valuable tool both in the diagnosis and treatment of symptomatic MTS.