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of reduced image quality: “The low-dose programs are not only sufficient for normal patients, but also offer the best image quality.” In his experience, there has been relatively little need for high-dose programs, since even with corpulent patients the low-dose programs are sufficient in the head and neck area. They are only needed when the spinal column is involved. The low-dose programs are used both for diagnostic vascular imaging and during actual intervention. Prof. Berlis explained: “In diagnostic angiography procedures, the image frequency can be reduced when advancing the catheter and examining the supra-aortic vessels, which also means that the dose can be reduced. An image frequency of 15 per second is used during interventions and when examining minuscule vessels. At this speed the motion is sufficiently continuous for the human eye, which enables the microcatheter to be positioned down to the nearest millimeter.” The CLEAR applications automatically increase certainty during interventions by keeping image quality high. Awareness is Changing The CLEAR applications are finally being combined with the CARE features, which have undergone constant development since 1994, and are now offered as a single package. The Combined Applications to Reduce Exposure (CARE) are simple: They are designed to help you deliver better care at the lowest reasonable dose. CARE does more than focus on patient well-being, however. For the experts it is important to provide protection for their own teams: “Both patients and physicians want to know what dose of radiation to expect with a CT or cardiac catheterization procedure and any potential intervention. Everyone involved is more informed than was previously possible,” said Dr. Göing. Prof. Berlis added: “We are talking about protecting the patients, but also ourselves and our employees. We should be concerned about everyaccept Customer Care CARE+CLEAR a loss of information. CAREposition and CAREprofile help find the right position for the tubes or detectors and the collimation and filter with regard to the part of the patient’s anatomy that has to be displayed, without having to resort to X-rays, and we use them accordingly.” Conversely, in the area of neurointervention, procedures may be very lengthy. However, it is now possible to treat aneurysms, including full cerebrovascular diagnosis and treatment, in under an hour. Dr. Berlis describes the advantages of the CARE+CLEAR features in this regard: “Table and tubes can be moved with no requirement for X-rays. We can plan treatment within seconds after preparing a rotational angiogram.” He adds: “These short intervention times also mean short X-ray times and reduced risks of treatment, which increase with the length of time taken by the intervention process.” In interventional radiology it is standard practice to work with low-dose programs in all parts of the body. The CARE+CLEAR features provide a benefit “for all interventions, actually,” in Prof. Albrecht’s view. From his perspective, too, however, the stars are the CAREprofile (using the Last Image Hold (LIH) as a reference, CAREprofile enables radiation-free collimator and semitransparent image filter adjustment. As a result, dose reductions can be achieved), and CAREposition (based on the LIH, a graphical outline of the upcoming image is displayed on the monitor, allowing you to move the table or C-arm without needing any radiation. As patients can be positioned without additional fluoroscopy, dose reductions are possible – making CAREposition an ideal choice for long procedures). Save on Radiation Dose by All Means – But not at the Expense of Image Quality Whether your patients are tall or short, obese or slender – interventionalists need to see. And in order to see, they need optimal image quality. Dr. Berlis can confirm that the extensive options to save on dose do not come at the cost “With the Artis dose-monitoring features, skin dose control is easy and efficient. State-of-the art reporting solutions enable efficient and transparent reporting and documentation of radiation dose.” Olaf Göing, MD Head Physician Internal Medicine at the Sana Klinikum, Berlin 80  AXIOM Innovations | December 2013 | www.siemens.com/angiography


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