Image fusion guidance was associated with reduced contrast media usage and radiation exposure during endovascular embolization of PAVMs, without compromising procedural outcomes.
Image fusion guidance significantly reduced contrast media consumption during PAVM embolization procedures.
Radiation exposure as measured by dose-area product (DAP) was significantly lower in the image fusion guidance group.
Fluoroscopy time was significantly shorter in procedures using image fusion guidance.
The study was a retrospective analysis of 38 endovascular embolization procedures for PAVMs conducted at a single tertiary care university hospital.
Image fusion guidance was associated with reductions in contrast and radiation without compromising procedural outcomes.
This research suggests that using a technique called image fusion guidance during a minimally invasive procedure to treat pulmonary arteriovenous malformations (PAVMs) — abnormal connections between blood vessels in the lungs — can substantially reduce patients' exposure to both contrast dye and X-ray radiation. The study compared 22 procedures that used image fusion (which overlays pre-existing CT scan images onto live X-ray imaging to help guide the procedure) against 16 procedures performed without this technology. Procedures using image fusion required about 71% less contrast dye, 74% less radiation dose, and took about 44% less fluoroscopy (live X-ray) time. These reductions matter because contrast dye can stress the kidneys and cause allergic reactions, while repeated or high radiation exposure carries long-term health risks. Shorter procedure times with less radiation and contrast could be particularly beneficial for patients who need multiple treatments or who already have compromised kidney function. The improved guidance from fused imaging may help doctors navigate more precisely to the target blood vessels without needing as many contrast dye injections to visualize the anatomy. This research suggests image fusion guidance is a promising tool for improving the safety profile of PAVM embolization procedures, but the authors themselves note these are observational findings from a single hospital over 13 years and should be confirmed in larger, prospectively designed studies before drawing firm conclusions.
Said H, Lehti L, Dias N, Elf J, Zarrouk M. (2026). Reduced radiation and contrast dose using image fusion guidance during endovascular embolization of pulmonary arteriovenous malformations.. Scandinavian cardiovascular journal : SCJ. https://doi.org/10.1080/14017431.2026.2722550