Future imaging and guidance for endovascular procedures

The considerations which are fundamental when assessing the value of an imaging modality in the endovascular arena are that (1) the equipment must have adequate definition and thereby be able to characterize tissues and define boundaries between anatomic structures; (2) the system must be interactive and intuitive; (3) three-dimensional capabilities are necessary when navigating vascular anatomy; and (4) finally, the fourth dimension, namely, the ability to evaluate motion. The vascular bed is a dynamic one and therefore not including motion could allow for misinterpretation during both preoperative planning and postoperative evaluation. By this we mean that motion affects operative planning for proper stent sizing as well as movement during function (i.e., superficial femoral artery stents during knee movement).