Angiographs
Angiographic systems are high-tech digital devices that make diagnostics extremely accurate and simple. The principle of the angiograph is that the apparatus, using low-power X-rays, helps to visualize the structure of the arteries into which a special iodine-based X-ray contrast substance is introduced.
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Main article: Radiology (radiation diagnostics)
Endovascular surgery
Main article: Endovascular surgery.
In addition to the diagnostic method, the angiographic technique under the control of X-rays is used to perform percutaneous endovascular manipulations, such as: balloon dilation, stenting, embolization, etc.
Angiography shots
In angiography, a series of images of blood vessels and the heart is obtained after the contrast drug is injected into the blood channel.
In the video below, angiography of the heart vessels. In this case, the contrast is introduced through the catheter.
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Contrast injectors and contrast agents
Typically, vessels are not visualized on X-ray film. They become visible only after intravascular administration of a water-soluble iodine-containing contrast agent. These are the same contrast agents that used for CT.
The contrast agent, while in the vessel and absorbing X-rays, manifests itself as a light shadow on a black X-ray film. This image reveals the shape and size of the arteries and veins and can help in diagnosing stenoses and occlusions.
Risks of contrast studies
The risk and benefits of performing contrast studies based on iodine drugs should be taken into account when using it for patients with symptoms of renal dysfunction due to the risk of developing acute renal failure. Intravascular administration of iodine drugs is also associated with the risk of allergic reactions, including anaphylaxis, but allergic reactions are significantly less with using new, non-ionic contrast agents.
Chronicle
2024: The first optoacoustic angiograph in Russia was developed. It is needed to assess the state of the vessels
The first optoacoustic angiograph in Russia, designed to assess the condition of blood vessels, was developed by scientists from the Volga Research Medical University (PIMU). This became known at the end of July 2024. The new device allows you to diagnose with high accuracy the progression of vascular diseases in the early stages and distinguish post-thrombotic disease from other pathologies. Read more here
2020: All angiographers of Moscow will be connected to a single digital service
On July 9, 2020, on the official website of the mayor of Moscow, it was announced that all angiographs (for CT and MRI diagnostics of vascular pathologies) in the city's clinics will be connected to the Unified Radiological Information Service (ERIS). Read more here.
2018: Mobile Angiographic Systems
By April 2018, the market for angiographic systems showed a trend towards the use of mobile X-ray devices of the C-arc type, which can be used even on an outpatient basis, which suits patients to a greater extent.
The advent of advanced radiation dosing technologies, flat detectors with an expanded field of view, as well as robotic systems opened the way for a number of angiographic procedures that were previously impossible to perform: from ventricular catheterization hearts to radioembolization. The list continues to grow, and experts consider these changes the beginning of revolutionary updates. According to forecasts of the analytical company Research & Markets, by 2025 the market volume of mobile angiographic devices of the C-arc type will reach $2.3 billion.
Of the more than 400 hybrid operating systems installed by Siemens, about 280 are robotic systems. The use of artificial intelligence ensures the mobility of the device and positioning accuracy. At the same time, the device of the semi-fixed radiological system is such that it occupies a minimum volume, does not interfere with the doctor and does not interfere with cleaning the operating room.
Although the transition from image amplifiers to flat-panel detectors began around 2010, C-arc mobile devices barely got started. The use of such systems improves image quality, which means it reduces the frequency of complications, improves clinical results, and also reduces the length of hospitalization and costs. In addition to the trend towards high image quality, there is an emphasis on patient safety - optimizing radiation dose and limiting exposure.
In addition to the devices themselves, specialized tables for procedures are important - their function can be performed by a regular flat or operating table, depending on the conditions of use of the device. The president of Bluestone Diagnostics, a company specializing in renting and selling renovated C-arc equipment, Matthew Blaustein, says that the right choice of table largely depends on what procedures the system will be used for. Most doctors require a desk with minimal function, however, an angiography specialist needs a carefully equipped place of work. The choice of tools affects the workflow, time and labor costs of doctors, and therefore the final result of diagnosis and treatment, he noted.
Maintenance is a key element of investment in hybrid equipment, so suppliers must provide users with system monitoring and available support. Siemens provides support services and the ability to call service engineers who are ready to deal with any problem. In other cases, the way out may be to rent the necessary services. One of its advantages is that all the necessary services are included in a single package, which can be changed if necessary. In addition, Modular Devices, representing a suite of 25 cardiovascular imaging systems, rent modular and mobile X-ray laboratories to stranded providers.
Although mobile X-ray machines with flat panel detectors are still rare and expensive, Blaustein expects them to account for up to 40-50% of the X-ray machine market by 2023 and finally become fairly affordable. Experts believe that as technologies develop, mobile and fixed devices will combine several imaging methods. Such a system would have a number of advantages: procedures would take less time, and patients could receive several services with a single call.[1]
Notes
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