The new Artis Q.zen angiography system from Siemens has proven itself in everyday clinical practice. The system has been in use since November 2012 at the Basel University Hospital in Switzerland where both patients and staff benefit from the low radiation dose that an entirely novel technology has made possible.
"My team spends about three to four hours a day in the Electrophysiology Laboratory (EP) in connection with about eight to ten operations. This is why reducing the dose is so important," says Prof. Stefan Osswald, head of the cardiology department. With Artis Q.zen, Siemens is demonstrating its innovative strength as part of the global "Agenda 2013" Sector initiative.
Studies show that on average one in four people suffer from atrial fibrillation, the most widespread form of cardiac arrhythmia, at some stage during their lives. A further increase can be expected as a result of demographic change. Electrophysiological studies and interventions can be used to examine and treat a large number of patients. This involves ablating tiny points in the myocardial tissue using an ablation catheter in order to return the heart to its correct rhythm. Depending on the level of complexity, this type of procedure can take two to three hours. Each misrouting of the electrical impulses that trigger cardiac arrhythmia, which is measured in milliseconds, must first be located and mapped using electrophysiology catheters. It is only at that point that the doctor can develop an individual treatment plan tailored to the patients' needs. Prof. Osswald has been working with Artis Q.zen since November 2012. "We can now manage with radiation doses that are up to 85 percent below usual values," he says. This benefits both patients and staff alike.
In addition to cardiac arrhythmia, there is another clinical picture in the field of cardiology that is on the rise, and is the most frequent cause of death in the industrialized nations: coronary heart disease. This involves narrowing and blockage of the arteries supplying blood to the heart muscle. In Europe alone, over 1.8 million people die of this chronic disease each year. Narrowings – known as stenoses – can be widened using balloon catheters to restore the flow of blood. Stents keep the constricted locations permanently open. During this procedure, known as percutaneous coronary intervention (PCI), the cardiologist has to position the stent with millimeter precision despite cardiac movement. Using Artis Q.zen, the cardiologist is supported by the advanced guidance of Clearstent Live. With Clearstent Live, stent enhancement takes place in real time. The software eliminates cardiac movement, allowing cardiologists to verify stent positioning relative to the cardiac anatomy or to previously deployed stents. The enhanced images are displayed side-by-side with the current live-image without any noticeable lag and while the operator can still move the balloon mounted stent. In interventions of this nature, Prof. Osswald has observed a clear reduction in dose compared to the previous model, up to 50 percent. "The main advantage is the massively better visualization of the stent and the respective vessel-section. Hence, additional images to decide whether the stent has been fully expanded are no longer necessary," says Prof. Osswald.
Introduced by Siemens during the Radiological Society of North America (RSNA) congress last year, the Artis Q.zen comes with two new advances making it possible to reduce the radiation dose while maintaining and improving the quality – a new x-ray tube and a new detector. The x-ray tube is the only one on the market exclusively equipped with "flat emitter" technology. The new tube permits the system to generate detailed images of moving objects and even the smallest vessels in a beating heart within a very short time at a maximum current of 1,000 milliamperes (mA). The new technology delivers a more richly detailed image for the subsequent treatment.
The new Artis Q.zen detector enables x-ray checks to be performed in the ultra-low dose range, i.e. 20 nanograys (nGy) or less. What is new and unique worldwide is the fact that the detector is based on crystalline rather than on amorphous silicon technology. This is a material of homogenous chemical structure used mainly in the solar industry. It ensures that the image signal is enhanced with substantially reduced electronic noise in the image. This means that the cardiologist can achieve the same image quality using a lower dose.
The products/features (here mentioned) are not commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens organization for further details.
The statements by Siemens' customers described herein are based on results that were achieved in the customer's unique setting. Since there is no "typical" hospital and many variables exist (e.g., hospital size, case mix, level of IT adoption) there can be no guarantee that other customers will achieve the same results.
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