The development of Multi-Detector Computed Tomography (MDCT), together with ECG gating, has brought a reliable 3D reconstruction of the heart and the coronary arteries within reach. The cardiac CT reconstruction allows an evaluation of coronary artery disease, with respect to stenotic area and plaque. The CT reconstruction of the coronary arteries may indicate that percutaneous coronary interventional treatment (i.e. applying stents) is needed, which is being performed using C-arm fluoroscopy. Here we discuss a novel method for the integration of cardiac CT in X-ray fluoroscopy...

Our method offers the possibility of determining the C-arm incidence with the least foreshortening for a selected segment of the coronary vessels, segmented in a pre-operative cardiac CT dataset. In order to assist in stent length selection, the length of a vascular lesion can be measured in 3D along the centerline of the curved vessel. During the intervention the stored C-arm viewing incidence can be recalled, and the C-arm can be automatically steered to the corresponding angles. Furthermore our method allows rendering of a curved...

The proposed methods have been applied in the treatment of over 20 patients. The 3D visualization of the coronary arteries, which were segmented in the CT dataset, augment the sense of orientation and enhance navigation, especially when no contrast medium is visible in the fluoroscopy images. The CT integration especially helps in cases of Chronic Total Occlusions (CTO) where the vessel is no longer visible in angiography and CT may help to discern the original trajectory of the vessel lumen. The methods have been used...

The integration of cardiac CT data helps in improving planning and guidance of cardiovascular interventional therapies. The optimal system angles from true 3D datasets enable better stent lengthselection and in addition can lead to a reduction in the use of contrast medium.