Imaging-Verfahren-Möglichkeiten zur Strahlenreduktion im Operationssaal

The establishment of endovascular techniques has tremendously changed the world of conventional open vascular surgery and led to a new era in the treatment of vascular surgery patients. Because of these new techniques, patients can nowadays undergo minimally invasive treatment; however, the necessity to use x-rays within the scope of endovascular surgery is still an unsolved problem. In this context the rising complexity of endovascular procedures leads to an extended duration of interventional times and as a consequence to a significant rise in the radiation dose for the patient and the surgeon, with a danger to health due to radiation injuries. Therefore, the adherence to measures for radiation protection is of utmost importance. Relevant device settings can additionally reduce the radiation exposure. Furthermore, an improvement of intraprocedural visualization by image fusion, the use of ultrasound and simulator training for inexperienced endovascular surgeons can significantly reduce radiation exposure; however, all these measures are only additive in the context of conventional interventions under radiation exposure. The establishment of new radiation-free navigation systems is therefore of major clinical interest. Initial approaches are magnetic resonance (MR)-guided endovascular interventions and the use of augmented reality for intraprocedural navigation.