A new imaging device at the University of Texas (UT) Southwestern (Dallas, USA) is making complex aortic repairs safer for patients and OR staff by dramatically reducing their radiation exposure. The device, known as Fiber Optic RealShape (FORS; Philips), uses light to visualize blood vessels, nearly eliminating the need for X-rays typically used during minimally invasive vascular procedures.
“Complex aortic repairs tend to be lengthy operations that require frequent imaging during the procedure. Every time a surgeon presses the X-ray pedal, the patient and staff, including assistants, nurses, scrub technicians, anesthetists and X-ray technicians, receive a dose of radiation, “said Carlos Timaran, professor of surgery at the UT Southwestern. “The safety of each of these individuals is paramount, so reducing radiation exposure during these procedures is an important goal.”
UT Southwestern was one of about a dozen medical centers in the United States and Europe chosen to participate in the first FORS implementation. Timaran has completed more than 300 fenestrated endovascular aortic repairs as part of its physician-sponsored experimental device exemption study, in which a patient-specific graft is used to support the aorta and its major branches.
As an alternative to conventional imaging, the FORS device uses light that travels through very thin optical fibers built into specially designed catheters and wires to show their position and shape within the body. Once this device is placed inside a blood vessel, the tension on the optical fibers changes the path of the light. By analyzing how light reflects along the fibers, a computer algorithm reconstructs and visualizes the entire shape of the device. The result is a real-time, three-dimensional view of the blood vessel that surgeons can overlay on computed tomography images taken before the procedure, providing a roadmap that surgeons can view from any angle to guide the surgery. Timaran said far fewer X-rays are required when using FORS, significantly reducing patient and staff exposure.
The use of FORS is expected to expand to other vascular procedures over time. “This technology could potentially be used for any cardiovascular procedure,” she said. “This will ultimately be the goal.”