SS10 - Effectiveness of Endovascular Navigation with Fiber Optic RealShape Technology: A Single Centre Prospective Study of the First 50 Patients

Objectives: Fiber Optic RealShape (FORS) is a new, light-based imaging modality, that allows real-time three-dimensional visualization of endovascular wires and catheters without radiation. The purpose of this study is to report our early experience on the feasibil-ity and limitations related to FORS.

Methods: Data from all consecutive patients undergoing FORS-guided endovascular procedures at a single center were prospectively collected and reviewed (2/2020-12/2021). Challenges related to vessel catheterization, including stenosis >50% and angula-tion >45º, were assessed. Time required for each catheterization as well as radiation exposure (fluoroscopy time, dose area product, and estimated skin dose) were collected. The primary outcome measure was FORS technical success, defined as suc-cessful wire and catheter navigation into a target artery using only FORS. A per-task analysis was conducted. Secondary end-points included time required and radiation exposure for each catheterization.

Results: The study enrolled a total of 50 patients: 45 treated for aortic aneurysm, 4 for iliac artery aneurysm, and 1 for splenic artery aneurysm. Overall, 201 catheterization tasks were identified and FORS was used for 186 (93%) tasks. There were no complica-tions related to FORS and technical success was 62% (n=116). Reduced technical success was associated with cannulation of renal arteries, vessel angulation, and vessel stenosis (Table I). Catherization tasks through a branch of a complex aortic endo-graft frequently required a non-FORS catheter (technical success with FORS catheter 18%; 0.001). Succesful FORS task cathe-terization was associated with a significant 3-fold radiation exposure reduction (Dose Area Prouct 12.5 vs 4.4 cGycm2, p< 0.001).

Conclusions: Initial experience with FORS technology has been associated with moderate success cannulating aortic branch vessels and a high potential in reducing radiation exposure. The reduced success rate observed in challenging anatomy appears related to the limited availability of FORS catheter shapes and its device properties. Iterative FORS improvements are underway to ad-dress these limitations with the hopes of increasing success.