Effectiveness of biplane angiography compared to monoplane angiography for vascular neuro-interventions: a systematic review of the literature

Aim: To compare biplane technology to monoplane technology for vascular neuro-intervention. Materials and methods: A systematic review of the literature in MEDLINE (via PubMed), Scopus, and ScienceDirect was conducted without date or language restrictions. The Downs and Black quality-assessment checklist was used. The findings of this systematic review were combined with local and Canadian data. Results: The nine articles selected for analysis had a very low level of evidence. The studies report that the biplane system appears to reduce ionising radiation and medical complications as well as shorten procedure time. Most major hospitals in Canada use the biplane system. The biplane system could improve the operator's confidence, which could translate into reduced risk, especially for more complex procedures. Conclusion: The superiority of the biplane system cannot be scientifically proven based on the data in the literature. Nevertheless, given the advantages that a biplane system can provide in terms of safety, quality of care, support to university teaching programmes based on best practices, enhanced capability in performing complex procedures, this technology should be implemented with a responsibility to collect outcome data to optimise the clinical protocol regarding the dose of ionising radiation delivered. - Highlights: • This is the first study that reviews the effectiveness of biplane angiography as compared to monoplane angiography. • The scientific level of evidence is low. • The biplane system appears to reduce ionizing radiation and medical complications as well as shorten procedure time.