Hybrid CT-angiography (Angio-CT) for combined CT and fluoroscopic procedures in interventional radiology enhances utilization

Abstract

Purpose: To investigate the utilization of an angiography-CT (Angio-CT) system and its advantages for single patient encounters.

Methods: Interventions utilizing both CT and fluoroscopy to perform multiple procedures in a single encounter or single interventions using both were identified. Cases were stratified by complexity (defined by RVUs). Comparative analyses of room (T_Room) and total encounter (T_Encounter) times were performed between non-complex bundled cases and controls.

Results: Between June 2018 and August 2019, 1108 procedures were performed via the Angio-CT system; 10% (114/1108) used both fluoroscopy and CT. 21% (24/114) Involved more than one procedure in a single encounter that required a CT-only and fluoroscopy-only bundled procedure. 59% (67/114) were non-complex, and 70% (80/114) were non-oncologic. 82.5% (14/17) of non-complex bundled procedures demonstrated T_Room below the mean of their respective controls; 52.8% (9/17) were 2 standard deviations below the control means. Pleural catheter placement following post-lung biopsy pneumothorax was the most common non-complex bundled case with a significant reduction in T_Room when performed via Angio-CT compared to control (99 vs. 163 min, p < 0.0001). There was a significant reduction in T_Encounter for abdominopelvic drain placement procedures bundled with either (1) percutaneous nephrostomy tube evaluation with or without replacement, or (2) central venous catheter placement (211 min vs. 344 min, p < 0.001 and 231 min vs. 347 min, p < 0.05, respectively).

Conclusion: The primary use for the hybrid Angio-CT system was to perform non-oncologic and non-complex cases with potential reduction in T_Room and T_Encounter for specific non-complex bundled cases.

Keywords: Angiography; Computed tomography; Fluoroscopy; Healthcare economics; Hybrid angiography-CT; Interventional radiology.