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What are the requirements for routine coronary interventions? Users should immediately feel comfortable in the cath lab and be able to orient themselves quickly. Operating the angiography system should be easy and intuitive. Nobody wants straightforward procedures to be delayed by complicated menu selections. On the other hand, image quality will always be crucial. One should never assume that routine interventions do not require excellent image quality. Why is image quality so important in cardiology? Good image quality is a prerequisite for working safely and efficiently. With poor quality images, you run the risk of provoking mistakes and complications. Contrastrich images with good spatial and temporal resolution help us to make the correct clinical decisions. Anyone who has become used to a particular standard would in any case find it difficult to put up with less during routine procedures. When it comes to image quality, every user has a comfort zone which he or she is reluctant to compromise. In addition, something else is important: a good angiography system provides good images; a very good system provides good images at low radiation dose. Which software tools do you appreciate, besides the applications for reducing radiation exposure? Post-processing tools do play a role. Some of the stents we now use are very delicate and therefore difficult to see. Tools that enhance stent visibility are extremely useful. For example, CLEARstent and CLEARstent Live allow you to reconfirm that the stent is fully expanded and was placed properly, or that the spacing of two adjoining stents is correct. An intuitive user interface makes your work safer and more efficient. Do you see additional advantages? An easy to learn and intuitive user interface is also certainly advantageous if several rotating teams use the same system, or if a broad procedure mix is being performed. And this is not just the case for smaller hospitals. Larger hospitals can, for instance, consider starting a peripheral program if cardiac procedures would not occupy an additional angiography system at full capacity. This way, the case mix is improved. Would you see more flexible C-arm positioning as an advantage? When I think about it, I can see numerous relevant advantages. At the moment we have a situation where the space around the patient’s head is occupied by the C-arm. For procedures involving an anesthesiologist, this is where he or she would optimally be positioned. Also, as procedures become more sophisticated, the need for extra equipment – for example, various imaging modalities – in the cath lab increases. However, for this kind of support, you need to have enough room around the table, and the most valuable “real estate” is definitely close to the patient’s head and chest. It woud therefore be really useful to be able to flexibly position the C-arm around the patient. In an emergency, being able to rapidly move it out of the way and far to the side may be crucial. How important are space efficient angiography systems and a quick installation process? Space is always limited in a hospital – in every department, wherever it is in the world. Therefore it is an advantage when a new or additional angiography system requires only little space. Naturally, it also makes a difference whether the installation process takes six weeks or just a couple of days: not just because of the immediate impact regarding procedures that would be missed. When a cath lab is out of action for a long time, cooperation with referring physicians can suffer. They may start referring their patients to other places, and the consequences of this can be long-term. In your opinion, what advantages does the new Artis one offer? Users are very satisfied when they can orient themselves quickly and work efficiently: when they are provided with good image quality; when they find useful tools at their disposal that they really need, and when the radiation exposure for them and their patients is as low as possible. In these respects, the Artis one system has a lot to offer. You are soon to receive the very first Artis one worldwide. What are your expectations? We are very excited. I see our new Artis one installation as a sound investment in routine. In the future, I continue to expect the majority of procedures there, and many of the procedures that we see as complex today will soon become standard, as well. It has always been this way. That is why I am so convinced that it is important to invest in a cath lab which will provide an optimal environment for my department’s everyday challenges. Hildegard Kaulen, PhD, is a molecular biologist. After holding positions at the Rockefeller University in New York and the Harvard Medical School in Boston, she became a freelance science journalist in the mid-1990s. She writes for a number of respected newspapers and science magazines. Contact hanno.herrmann@siemens.com vera.juennemann@siemens.com “I see our new Artis one installation as a sound investment in routine.” Prof. Stephan Achenbach, MD Head of the Cardiology Department, University Clinic in Erlangen, Germany Cover story AXIOM Innovations | December 2013 | www.siemens.com/angiography  13


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