オガワ ユキヒサ   OGAWA YUKIHISA
  小川普久
   所属   医学部医学科 放射線診断・IVR学
   職種   登録医員(外部)
言語種別 英語
発表タイトル The isocenter puncture method "ISOP" in various situations.
会議名 CIRSE2015
学会区分 国際学会及び海外の学会
発表形式 ポスター掲示
講演区分 一般
発表者・共同発表者Kazuki Hashimoto
発表年月日 2015/09/26
開催地
(都市, 国名)
ポルトガル、リスボン
概要 Purpose
To evaluate feasibility and safety of the isocenter puncture (ISOP) method in various situations other than for PVP (percutaneous vertebroplasty).
Material and Methods
The ISOP method was developed for PVP and makes use of the isocenter marker (ICM) displayed on the center of the fluoroscopy monitor screen. After positioning the target to the ICM, the C-arm can be rotated to any direction without losing the target as it remains at the center of the monitor. Then, the operator can puncture with a "bull's eye" method from a favorable angle and confirm puncture depth by lateral projection. We applied this method for situations other than for PVP.
Fifty-one puncture cases [median age, 68 (10-86) years] were detected retrospectively between July 2006 and January 2014 in which the ISOP method was employed. Puncture target, indication, technical success rate, median fluoroscopy time, median time needed to puncture, conversion to CT-guided puncture, and complications were evaluated.
Results
Puncture targets were as follows: pelvic bone: 11, pelvic abscess: 10, vertebral disk: 8, iliolumbar muscle: 6, vertebral body: 5, aortic aneurysm sac: 3, and others: 8. Indications were as follows: drainage: 29 cases, biopsy: 10, embolization of endoleak after EVAR/TEVAR: 3, and others: 9. Technical success was 98%. Median fluoroscopy time and median time needed to puncture were 9 (2-47) minutes and 11 (2-32) minutes, respectively. There was no conversion to CT-guided puncture. Unexpected external iliac vein puncture occurred in one case but did not lead to any serious consequence.
Conclusion
The ISOP method is technically feasible and safe for various purposes under only fluoroscopic guidance.