Decide confidently “to treat” or “not to treat” complex AVMs

 

Your ability to visualize the extremely complex pathologies of arteriovenous malformations (AVMs), fistula and other malformations is crucial in deciding whether to treat or monitor a patient. For decades, neuro specialists have relied on Philips sophisticated neuro imaging solutions to support confident planning and treatment decisions for AVM interventions. Now, as the field shifts towards medical monitoring of unruptured AVMs, the tools we offer can once again support you in making a difference in the lives of your patients.

Highlighted products for this procedure

Azurion 7 B20/15

Azurion 7 B20/15 Image-guided therapy system

Biplane image-guided therapy system with one 20" frontal and one 15" lateral flat detector

Enhance certainty during ischemic stroke, cerebral aneurysm and other neuro interventions

Visualize the full intricacies of complex malformations and less radio-opaque flow diverters

Experience a simple, smooth clinical workflow with the dedicated neuro features

During neuro interventions, the goal is to see clearly, while managing safety for all involved. Philips Neurovascular suite with Azurion biplane 7 with 20'' and 15'' detector X-ray system is designed to enhance treatment and support effective guidance as you work. Seamlessly control all compatible applications from a single touch screen at table side, to help make fast, informed decisions in the sterile field.
SmartCT Soft Tissue on FlexVision

SmartCT

Simplifies 3D acquisition so any clinical user1 can easily perform 3D imaging

3D images are automatically displayed within seconds on the touch screen module2

Visualize the full intricacies of complex malformations and less radio-opaque flow diverters

The ability to visualize sub-millimeter vascular anatomy and endovascular material improves the chances of success and raises your treatment confidence. SmartCT Soft Tissue offers CT-like imaging that can be acquired right in the Neurovascular suite and helps identify subtle soft-tissue lesions. SmartCT Vaso provides the highest spatial resolution imaging available in our portfolio.

    Clinical solutions for monitoring and treating AVMs

    3DRA AVM

    3D visualization of heterogeneous vasculature

     

    SmartCT Angio provides a volumetric view in a few seconds2 to assist assessment of feeding arteries, draining veins, arterialized veins, nidus and ruptured or unruptured pathology to guide decision making. 3D volumes are visualized with high spatial resolution and automatic patient movement compensation to enhance visibility of critical details.

    Enhance visibility of perforators

    SmartCT Vaso
    The ability to visualize sub-millimeter vascular anatomy improves the chances of treatment success and raises treatment confidence. SmartCT Vaso provides high resolution 3D imaging that reveals key information about cerebral vascular structures to support the highest possible spatial assessment of vessels in the soft tissue context.

    Navigate confidently through complex vessel structures

    Navigate complex vessel structures

    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.

    Differentiate between glue and subtraction error

    glue and subtraction error
    When you are monitoring AVMs over time, subtraction artifacts can disguise clinical information. Philips’ unique ClarityIQ automatic pixel shift helps remove information that may be misleading, in real-time and without user interaction.

    Identify direction and arrival of liquid embolic agent

    Lesion boundaries CT Roadmap
    During treatment, subtraction artifacts can obscure the direction liquid embolic agents are traveling. Using the automatic pixel shift in our ClarityIQ enables you to visualize the direction the liquid embolic agent is traveling and its arrival.

    Clearly visualize newly injected liquid embolic agent

    Roadmap Pro Neuro
    The Roadmap Pro glue mode filters out already embolized vessels, allowing you to focus on what you are injecting and how it is diffusing.

    Check final result and potential bleedings

    Cerebral Aneurysm
    SmartCT Soft Tissue is an acquisition technique that generates a CT-like visualization of soft tissue in relation to other structures during procedures. You can use the CT-like images to assess soft tissue after an AVM to check the final result and potential bleedings when the patient is still on the table.

    Workflow innovations to treat AVMs


    Azurion offers a number of workflow innovations designed to help staff work efficiently and easily, while maintaining a single-minded focus on the patient and managing radiation dose during AVM interventions.
    Azurion Biplane B20/12

    Sharp, motion-free vessels at low dose

    ClarityIQ wheel
    ClarityIQ technology reduces patient dose by 75% in neuro DSA,3 while maintaining equivalent image quality, compared to a system without ClarityIQ. Its automatic motion compensation removes skull and motion artifacts which is key when placing small devices at the base of the skull.

    Manage dose and simplify workflow

    Zero Dose Positioning
    Zero Dose Positioning helps you reduce 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.

    Full table side control within sterile field

    FlexVision Pro
    Gives you direct access and full control of pre-operative diagnostic scans, patient information and planning tools at table side to save time and unnecessary walking in and out of the sterile area.

    Reduce in-lab prep time supported by ProcedureCards

    ProcedureCards image
    ProcedureCards streamline and standardize system set-up and help reduce preparation errors. Select the AVM ProcedureCard and the system is set-up the way you want. Hospital specific aneurysm protocols and/or checklists can be added to ProcedureCards and displayed on monitors. One hospital reduced in-lab prep time supported by ProcedureCards.4

    Use neuro headrest to help reduce motion artifacts

    Neuro headrest
    Can be used to restrain restless patients under conscious sedation to help reduce motion artifacts during the procedure.
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    Disclaimer

    Product availability is subject to country regulatory clearance. Please contact your local sales representative to check the availability in your country.

     

    References

    1. The user level of expertise required is described in the Instructions for Use as the Intended Operator Profile.
    2. 3D reconstructions at higher resolution settings may take longer times
    3. Söderman M, Holmin S, Andersson T, Palmgren C, Babic D, Hoornaert B. Image noise reduction algorithm for digital subtraction angiography: clinical results. Radiology. 2013 Nov;269(2):553-60.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 20 patients. DSA runs for Allura Xper with ClarityIQ and Allura Xper without ClarityIQ were acquired on the frontal and lateral channel on the same patient under same condition of geometry, field of view, and injection protocol. Image quality was based on subjective assessment (score 1-5, 1=very poor, 5=excellent, blinded review by 3 radiologists involved in the study).
    4. In a simulation study with over 60 users globally, results obtained during user tests performed in the period of November 2015-February 2016. The tests were designed and supervised by Use-Lab GmbH, an independent and objective usability testing engineering consultancy and user interface design company. The tests involved 31 US-based clinicians (16 physicians and 15 technicians) and 30 European-based clinicians (15 physicians and 15 technologists), who performed procedures using Azurion in a simulated interventional lab environment.

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