Digital Angio
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Digital Angio Experience of Using the BRANSIST safire VC17 Angiography System Equipped with a 17 × 17-inch FPD Department of Radiological Technology, Kainan Hospital, Aichi Prefectural Welfare Federation Katsutaka Hiratsuna 1. Introduction Our hospital is situated on the western edge of Aichi Prefecture. It functions as a foundation hospital for a region not only containing the medical district of Ama and Tsushima but also stretching as far as the western part of Nagoya City and part of the northwest area of Mie Prefecture. The hospital was founded in August 1943 by the Kainan Federation Responsible for Health Care Purchasing Cooperatives as a group hospital for local residents, with departments of internal medicine and trauma, and 20 beds. In 1948, control of the hospital was transferred to the Aichi Prefectural Welfare Federation of Agricultural Cooperatives, and to this day, we continue to provide medical care based on the needs of the local community. In February 2003, a new inpatient wing currently equipped with 553 beds (including those in the ICU, the convalescence/rehabilitation ward, and the palliative care ward, and those for patients with infectious diseases) went into operation. The Department of Radiological Technology is situated on the first floor of the new wing. Most of our equipment is also kept in the new wing, although we have set up two general radiography rooms, one MDCT scanner, and one urological system in the outpatient ward, where we use them in the day-to-day treatment of patients. 2. Background to Introduction of BRANSIST safire We used to conduct angiography with a setup consisting of two systems: a dual-plane system (for the abdomen and limbs) and a bi-plane system (for the head and heart) equipped with image intensifiers. However, because of the deterioration of the dual-plane system and a yearly increase in the number of cardiac catheter examinations and head examinations, we introduced Shimadzu's BRANSIST safire HB9 (for the heart) bi-plane system equipped with a direct-conversion 9 × 9-inch FPD, and because of the desire of doctors to be able to observe a wide range surrounding the region of interest in a single image, we introduced Shimadzu's BRANSIST safire VC17 equipped with a large-field direct-conversion 17 × 17-inch FPD. The VC17 was the first angiography system in the world to be equipped with a 17 × 17-inch FPD, and the very first model was introduced at our hospital in August last year. I would like to describe our experience of using it. 17×17-inch BRANSIST safire VC17 (Ceiling-Mounted Type) 3. System Overview This system incorporates a ceiling-mounted C-arm equipped with a 17 × 17-inch direct-conversion FPD, and is capable of performing DA, DSA, RSM-DSA (Real-time Smoothed Mask DSA), Rotational RSM-DSA (precessional movement and pendular movement), and 3D-DSA (of the head and abdomen). Five field sizes can be used: 17, 15, 12, 9, and 6 inches (Table 1). The fluoroscopy and radiography rates are shown in Table 2. Fluoroscopy rates of 3.75, 7.5, 15, 15H, 30, and 30H can be selected. Regarding radiography, although different times and rates can be combined freely in accordance with the needs of the facility, it is not possible to change the rate during an X-ray exposure. This is one point that I think requires modification. With Rotational RSM-DSA, precessional movement is performed with a fixed deflection angle of 30º and a cycle of 6 sec (3 cycles max.), and pendular movement is performed in a fixed range of LAO15º to RAO15º, also with a cycle of 6 sec (3 cycles max.). These functions enable the 3-dimensional observation of blood vessels. The maximum rotation speed of the C-arm in 3D-DSA when it is set behind the head is

place objects alongside the patient's head. The C-arm rotation angle ranges are shown in Table 3. Regardless of the setting position, there are no significant restrictions on bed movement distance and C-arm rotation and so examinations can be performed across the entire body with few problems. The ceiling-mounted C-arm has a large range of movement covering 160 cm in the transverse direction and 287 cm in the longitudinal direction. This makes it easy to handle brachial, radial, and femoral approaches, and radiography of the lower limbs can be performed easily without having the patient lie...

Table 3 C-Arm Rotation Angle Ranges 4.3. Operability The Safire-series "Cyber Grip" controller enables one-handed execution of C-arm rotation (25°/s max.) and movement, vertical movement of the FPD, and table movement. The "Direct Memory" auto-positioning function allows angle setting and angle registration to be performed with easy operations. Operators have described these features as being extremely easy to use once they got accustomed to them. These operations can be performed from an operation room, from where it is possible to support the operator. 4.4. Monitors There are independent...

| 6. Summary The large field size of this angiography system equipped with a 17 * 17-inch FPD is effective for observing both the liver and spleen at the same time and for dealing with conditions requiring a large field such as gastrointestinal bleeding. On the other hand, there are some problems that are caused by the wide FPD unit. For example, moving the FPD too close to the patient can obstruct the procedure. I think that such problems can be solved, however, if technologists provide operators with the support appropriate for the circumstances. This system is equipped with many...