Utility of Marking and Fusion Image-Guided Technique with CBCT in Kidney Ruptured Hemorrhage without Extravascular Leakage in Angiography: a pilot study

Abstract Objective To explore the feasibility of using marking and fusion image-guided technique with cone-beam computed tomography (CBCT) in cases of kidney ruptured hemorrhage without extravascular leakage in DSA images. Methods This is a retrospective case-control study that included 43 patients who underwent TAE for kidney ruptured hemorrhage and difficult hemostasis. The patients were divided into two groups: the CBCT group (cases without extravascular leakage observed in angiography) and the control group (cases with clearly identifiable target vessels in angiography). The baseline characteristics and clinical outcomes were collected and analyzed. Results The results showed no statistically significant differences in the duration of the procedure and intraoperative blood transfusion between the control and CBCT groups (P>0.05). The study clarified that the CBCT group had a significantly higher rate of improvement of gross hematuria compared to the control group (P < 0.05). The CBCT group showed a greater increase in hemoglobin and a lesser increase in creatinine. The clinical success rates were 87.5% in the control group and 90.9% in the CBCT group (P>0.05). Conclusions The marking and fusion image-guided technique is useful in cases of kidney ruptured hemorrhage without extravascular leakage of contrast agent. The technique is safe, feasible, and effective, and we believe it is superior to purely DSA-guidance. Advances in knowledge The use of the marking and fusion image-guided technique is recommended to overcome the challenge of undetectable target vessels during interventional procedures. This technique is considered as non-inferior to purely DSA-guided interventional procedures where the target vessels are clearly identifiable.