Vascular suite

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Vascular suite 

Redefining the outcome of vascular treatment

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Vascular interventions are becoming more diverse and complex. An increasing patient population, the development of new devices, and an uptake in the complexity of minimally invasive procedures mean you need to see better to perform better. Our Vascular suite does just that by providing outstanding imaging and an extensive device offering for even the most difficult procedures.  
Vascular suite

Vascular suite

Peripheral artery disease – a growing epidemic


To treat the growing epidemic of peripheral artery diseases (PAD), we see a clear need for standardization when defining interventional treatment strategies. Philips participates actively in further standardization of CLI procedures from both the imaging and device perspectives.

Making endovascular treatment simpler and efficient


Endovascular treatments of aortic diseases are becoming longer and addressing more complex anatomy. Radiation and contrast medium usage are a concern, specifically for elderly and health-impaired patients.

Philips SmartPerfusion

With perfusion angiography, physicians can conduct a simple and highly sensitive diagnostic test to predict whether a patient is likely to benefit from a second revascularisation.
Philips SmartPerfusion

With Philips Azurion a breakthrough in workflow improvement has been realized, resulting in proven efficiency


With the ever growing number of PAD patients, Azurion offers a number of workflow innovations designed to help vascular teams work efficiently and consistently, while maintaining a single-minded focus on the patient and keeping radiation dose low during peripheral vascular interventions.

17% reduction of procedure time with Philips Azurion at St. Antonius Hospital1

Azurion whitepaper

The ability to treat one more patient per day, or in the future


This is just one of the many improvements in lab performance achieved by the Interventional Vascular Department at St. Antonius Hospital after installing the Azurion system. The first Azurion lab performance study achieved impressive results which have been verified by an independent third party.

 

Read the white paper online

ClarityIQ technology – clinically proven

ClarityIQ image
Our novel ClarityIQ X-ray imaging technology provides superb image quality at significantly lower dose across clinical areas, patients, and operators3. One study showed that ClarityIQ reduces patient dose by 83% in iliac DSA procedures4, while maintaining equivalent image quality, compared to a system without ClarityIQ.

TSM and FlexVision Pro

FlexVision Pro
Gives you full control of all system inputs including intravascular ultrasound (IVUS), CX50 vascular ultrasound at tableside to save time and unnecessary walking in and out of the sterile area. It also enables you in viewing CT patient information from external source (e.g. PACS database). All data readily at hand and controllable at table side.

Zero Dose Positioning to manage dose

Zero Dose Positioning
This feature helps you manage dose by allowing you to pan the table, change table height or move the X-ray system on Last Image Hold to determine the new center position. This helps you prepare your next run without using fluoroscopy.

Roadmap Pro with SmartMask

Roadmap Pro with SmartMask
Provides a continuous real-time visualization of the leg as you navigate to the region of interest, making efficient use of iodinated contrast media and radiation dose.

Clinical solutions for peripheral artery interventions

Our Vascular suite provides dedicated vascular interventional tools and advanced vascular devices to support high levels of standardization and redefine outcomes for your PAD patients. They support each step of your procedure – as you decide, guide, treat, and confirm treatment results.

SmartCT** Roadmap for guidewire and catheter

2D Perfusion
SmartCT Roadmap provides a live 3D image overlay that can be segmented to emphasize the targeted vessel and lesions, supporting fast catheter navigation. The SmartCT Roadmap overlays a 3D reconstruction of the vessel tree, vessel segments, or annotations with live fluoro images. You can adapt the transparency and contrast of the 3D image to enhance visibility of details.

SmartPerfusion for instant perfusion feedback

2D Perfusion
SmartPerfusion enables you to obtain stable, reliable, and instant information of the foot perfusion8 while the patient is still on the table, to assess treatment effect. This image analysis tool provides functional information about tissue perfusion based on a digital subtraction angiography (DSA). You can compare perfusion characteristics in micro- and macro-circulation, pre- and post-intervention to quantify the effects of revascularization procedures immediately after the procedure.

Live image guidance with ClarityIQ technology

2D DSA
High definition images of vessels with superior vascular detail to support precise treatment strategies, navigation, and follow-up.

3D image guidance promotes precise navigation

VesselNavigator vascular
3D Image guidance provides an intuitive and continuous 3D roadmap. Dynamic 3D roadmap uses the rotational angiograhpy volume acquired in the angio suite overlayed on a live X-ray image. Vesselnavigator uses an existing CTA or MRA dataset as overlay. Both solutions provide insight into the exact position of the guidewire and catheter within the vessel during navigation. They offer, a high level of precision thanks to real-time compensation for gantry, table, and small patient movements.

IVUS enhances disease assessment

Intravascular ultrasound (IVUS)
Intravascular ultrasound (IVUS) is a catheter-based imaging technology that allows physicians to visualize blood vessels from the inside out to aid assessment of presence and extent of disease. IVUS helps to decide, guide, and confirm the right interventional treatment for each patient.

Philips IGT Devices
 

Philips IGT Devices
During treatment, you have to decide if it is safe to treat the lesion, and what size and type of device should be used, and where to place the stent for best long term patency. Philips IGT Devices provides a portfolio of peripheral device solutions that allow you to personalize treatment decisions for each patient.

SmartPerfusion case: Balloon Angiography of the distal Posterior Tibial Artery.

Patient:

 

  • 55 year old male
  • Diabetic
  • Critical Limb Ischemia
  • Recent amputation of the 3rd toe, bad healing of the wound.
  • Posterior tibial artery occluded and fibular (peroneal) artery is fragile but without significant stenoses.

Treatment:

 

  • Balloon Angioplasty of the distal part of the Posterior Tibial Artery.
  • Peroneal Artery is too fragile to treat.
Dorsalis Pedis Artery (DPA)
Stealing effect in Dorsalis Pedis Artery (DPA), based on pre and post comparison.
Posterior Tibial Artery (PTA)
Posterior Tibial Artery (PTA) shows more and faster flow after treatment.
forefoot image
The forefoot is supplied with more blood after treatment.
Graph 1
  • Peak density drops after treatment in the DPA.
  • Area under curve reduces after treatment, indicating less blood to flow through the region of interest. This suggests a stealing effect due to opening of the PTA.
Graph 2
  • Conversely to the effect in the DPA, the PTA perfusion has increased.
Graph 3
  • Considering the whole forefoot, the perfusion characteristics have improved.

Philips Azurion Hybrid OR solutions featuring FlexArm


Our Azurion Hybrid OR solutions provide an innovative surgical care environment that offers exceptional procedural flexibility and ease of use, while meeting the highest standards for surgical infection control and hygiene. The ceiling-mounted system provides unlimited imaging flexibility for diverse procedures and exceptional positioning freedom for medical teams. You get all this in a compact set-up, providing a highly cost-effective environment ready for the procedures of the future. By working around you, Philips Azurion with FlexArm helps you optimize your suite performance and deliver superior care.

Unlimited imaging flexibility
 
 

ClarityIQ image
Azurion 7 C20 with FlexArm rotates on no less than eight axis to create virtually unlimited flexibility to perform imaging, from head to toe on the left and right side for both 2D and 3D visualizations. The image beam remains aligned with the patient, allowing better visualization of anatomies during rotations or angulations. Consequently, 100% of participants confirmed in a user study that FlexArm would allow them to work with great flexibility.*

Improved workflow for multiple patient access points

FlexVision Pro
The FlexArm C-arm can provide off-center imaging along both sides of the table. This allows physicians to perform radial or brachial access cases on the left or right arm, fully or partially extended, without moving the patient or pivoting the table. The X-ray beam stays aligned with the arm to promote smooth navigation over its full length without making constant adjustments.

ClarityIQ technology – clinically proven

ClarityIQ technology
Our novel ClarityIQ X-ray imaging technology provides superb image quality at significantly lower dose across clinical areas, patients, and operators3. In EVAR procedures ClarityIQ technology reduces patient dose by 57%, while maintainig equivalent image quality, compared to a system without ClarityIQ2,3

FlexVision Pro

FlexVision Pro
Gives you full control of all system inputs including intravascular ultrasound (IVUS), CX50 vascular ultrasound and VesselNavigator at tableside to save time and unnecessary walking in and out of the sterile area.

Zero Dose Positioning to manage dose

Zero Dose Positioning
This feature helps you manage dose by allowing you to pan the table, change table height or move the X-ray system on Last Image Hold to determine the new center position. This helps you prepare your next run without using fluoroscopy.

ProcedureCards standardize system set-up

ProcedureCards image
ProcedureCards help you streamline and standardize system set-up and helps to preparation errors. Select the EVAR ProcedureCard and the system is set up the way you want. Hospital specific protocols and/or checklists can be added to ProcedureCards and displayed on monitors to support consistent workflow in one click.

Flexible workspots

Flexible workspots
Team members can access all information from any workspot to save time, improve consistency, and decrease delays.

Clinical solutions for EVAR, TEVAR, FEVAR, and other aortic procedures

Our Vascular suite provides workflow options, dedicated interventional tools, and a broad selection of advanced vascular devices to improve procedural efficiency and redefine outcomes for your patients with aortic disease. They support each step of your procedure – as you decide, guide, treat, and confirm treatment results.

SmartCT** Soft Tissue - CT-like visualization of vascular

VesselNavigator image
SmartCT Soft Tissue is an X-ray acquisition technique that generates a CT-like visualization of soft tissue in relation to other structures during procedures – all controlled via the touch screen at the table. You can use the CT-like images to assess soft tissue, bone structure and stent deployment before, during and after interventional procedures. This technique is particularly useful for complication check after (complex) EVAR procedures.

VesselNavigator – reduce need for contrast

VesselNavigator image
VesselNavigator provides an intuitive and continuous 3D roadmap based on existing CTA and MRA datasets to guide you through vasculature during aortic procedures. One study showed an average of 170 ml contrast reduction during endovascular repair of complex aortic aneurysms with the use of VesselNavigator CTA image fusion guidance5. Another study showed a reduction in average procedure time from 6.3 to 5.2 (1.1) hours during FEVAR/BEVAR with VesselNavigator CTA image fusion guidance6.

2D DSA with ClarityIQ technology

2D DSA
Visualizes high definition images of vessels with outstanding vascular detail to support precise treatment strategies, navigation, and follow-up.

IVUS enhances disease assessment

CX50 ultrasound system

Intravascular ultrasound (IVUS)
Intravascular ultrasound (IVUS) is a catheter-based imaging technology that allows physicians to visualize blood vessels from the inside out to aid assessment of presence and extent of disease. IVUS helps to decide, guide, and confirm the right interventional treatment for each patient.
CX50 ultrasound system
A realistic visualization of arterial vasculature is required to effectively access the arterial system. Our integrated CX50 ultrasound system provides premium quality images of the radial artery and veins to support radial access interventions.

* Results obtained during user tests performed in 2017/2018 by Philips Healthcare and Use-Lab GmbH, an independent company. The tests involved 17 physicians from Europe and the USA, who performed simulated procedures in a simulated OR environment.

**SmartCT is 510 (k) pending in the USA. Not available for sale in the U.S.A. This material can not be distributed in the United States.

  1. Results are specific to the institution where they were obtained and may not reflect the results achievable at other institutions.
  2. Hybrid atherectomy refers to the Phoenix family of products. 2.4 mm deflecting catheter is the only device with directional cutting ability.
  3. In 18 individual comparative studies, Philips ClarityIQ was associated with reductions in patient radiation exposure.
  4. Van Strijen MJ, Grünhagen T, Mauti M, Zähringer M, Gaines PA, Robinson GJ, Railton NJ, van Overhagen H, Habraken J, van Leersum M. Evaluation of a noise reduction imaging technology in iliac digital subtraction angiography: noninferior clinical image quality with lower patient and scatter dose. J Vasc Interv Radiol. 2015 May;26(5):642-50.e1. The results of the application of dose reduction techniques will vary depending on the clinical task, patient size, anatomical location and clinical practice. The interventional radiologist assisted by a physicist as necessary has to determine the appropriate settings for each specific clinical task. Results based on DSA dose area product per frame from a single center prospective randomized study on 48 patients. DSA runs for Allura Xper with ClarityIQ and Allura Xper without ClarityIQ were randomly acquired on the same patient under same condition of geometry, field of view and injection protocol. Image quality was based on subjective assessment (side-by-side, equal or superior than the other, blinded review by 5 independent radiologists).
  5. Tacher V, et al (2013). Image Guidance for Endovascular Repair of Complex Aortic Aneurysms: Comparison of Twodimensional and Three-dimensional Angiography and Image Fusion, J Vasc Interv Radiol, 24(11), 1698-1706. Doi: 10.1016/j.jvir.2013.07.016.
  6. Sailer AM, et al (2014). CTA with fluoroscopy image fusion guidance in endovascular complex aortic aneurysm repair, Eur J Vasc Endovasc Surg. 2014 Apr;47(4):349-56. Doi: 10.1016/j.ejvs.2013.12.022.
  7. Hybrid atherectomy refers to the Phoenix family of products. 2.4 mm deflecting catheter is the only device with directional cutting ability.
  8. S. Jens, Henk A. Marquering , Mark J. W. Koelemay, Jim A. Reekers. Perfusion Angiography of the Foot in Patients with Critical Limb Ischemia: Description of the Technique.
  9. Gutiérrez Castillo D1, San Norberto García EM, Fidalgo Domingos L, Fuente Garrido R, Estévez Fernández I, Vaquero Puerta C.[Incidence of contrast induced nephropathy in patients who underwent an aortic endovascular repair. Rev Port Cir Cardiotorac Vasc. 2015 Apr-Jun;22(2):101-10

 

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