Background/Objectives: Hybrid Angio-CT suites have emerged in response to the growing demands for innovation and procedural complexity in minimally invasive therapies. It is hypothesized that enhanced image guidance capabilities enabled by multimodality imaging can improve procedural safety, accuracy, and efficacy. However, due to the current lack of sufficient data to support a systematic review, the objective of this article is to present a comprehensive synthesis of the existing literature through a narrative review. Methods: This narrative review is based on purposefully identified research reports, their critical evaluation, and synthesis by a group of experienced users. The analysis covers three key areas: (1) current state of available technologies and functionalities, (2) novel perspectives through ‘Direct Intravascular Contrast media Injection CT’ (DICI-CT), and (3) the role of Angio-CT in established and emerging image-guided procedures. Results: The review presents typical configurations and room layouts for Angio-CT systems and discusses further technological improvement potential. Selected literature is complemented by expert experience to report on the current state of the art and demonstrate its use and efficiency. Based on our expert experience, it is demonstrated how DICI-CT can be used to reduce contrast dose and improve lesion visualization, targeting, and endpoint determination. Furthermore, in this review the advantages, including survival benefit (i.e., in trans-arterial chemoembolization and in blunt trauma) and cost-effectiveness (i.e., in emergency care), are reviewed with reference to oncologic and non-oncologic applications in both elective and emergency medicine. Conclusions: Hybrid Angio-CT suites can provide significant additional imaging information with the potential to improve image-guided procedures. This perspective is increasingly supported by retrospective data in interventional oncology and beyond. Provided that further technological advancements are achieved and prospective clinical data substantiates the anticipated clinical and economical benefits, hybrid Angio-CT suites are anticipated to play a key role in the multimodality interventional suite of the future.

OBJECTIVE: In uterine artery embolization (UAE) for the treatment of fibroids, nondegradable particles permanently occlude the uterine artery (UA). These particles remain in the vessels and can cause secondary undesirable effects, such as severe pain after embolization and fertility issues. In this prospective experimental study, we aimed to evaluate the angiographic recanalization, local and systemic reactions, and uterine damage occurring after performing UAE with newly developed degradable starch microspheres (DSMs) in sheep. MATERIALS AND METHODS: Under general anesthesia, eight nonpregnant sheep underwent bilateral UAE using DSMs to achieve stasis. Angiographic evaluation was performed on days 1, 3 and 7 after embolization to assess in vivo recanalization. In addition, the angiographic series were scored via a modified embolization score. A postmortem tissue examination was performed to determine whether DSMs and foreign body inflammatory reactions were present and to assess uterine necrosis. RESULTS: Complete bilateral embolization of the UA and cervicovaginal branches was achieved in all treated animals. Recanalization of the occluded arteries was evident in 25 of 27 arteries during the angiographic evaluation. In all sheep, there were multifocal areas of uterine necrosis, and some uterine vessels contained intraluminal material consistent with DSMs. The average weight of both uterine horns was significantly correlated with both the number of microspheres needed for complete embolization (r = 0.69, ρ<0.01) and the average percentage of necrosis in both uterine horns (r = 0.64, ρ<0.05). CONCLUSIONS: Our findings demonstrated the efficacy of vascular embolization with DSM by inducing ischemic changes in the uterus and subsequent recanalization of previously occluded arteries.