The State of the Art in Percutaneous Coronary Interventions with Alphenix
Dr. Kengo Tanabe is Director of Division of Cardiology Department at Mitsui Memorial Hospital in Tokyo, Japan. He specialises in diagnosing and treating coronary disease and aortic heart valve disease. The number of patients requiring coronary disease treatment continues to grow in his daily practice, as well as globally. Dr. Tanabe explains how Canon's Alphenix interventional X-ray system supports his daily complex coronary procedures.
X-ray imaging plays a crucial role in the transcatheter treatment approach to coronary interventions, from pre-procedural evaluation through device size selection to treatment and follow-up.
A Partner in Image Guided Procedures
“The Angio system is an essential partner for the interventional cardiologist in delivering precision in complex coronary interventions regardless of patient size,” Dr. Tanabe remarked.
“Canon's Alphenix Angiography systems have been providing us exceptional imaging at low dose for years and years, so my team members really love it. It meets the interventionist’s specific needs and preferences as well.”
“Canon's Alphenix Angiography systems have been providing us exceptional imaging at low dose for years and years, so my team members really love it. It meets the interventionist’s specific needs and preferences as well.”
Compact X-ray Detector Dimensions
Mitsui Memorial Hospital has two cath labs running Alphenix. Cath lab 1 is mainly used for percutaneous coronary intervention (PCI) and electrophysiology (EP), and is equipped with an eight-inch flat panel detector. In cath lab 2, another Alphenix is mainly used for structural heart disease (SHD), endovascular and cerebrovascular interventions, which are performed using a 12-inch flat panel detector.
“The housing of Alphenix’s X-ray detector is very compact, so it helps us avoid bumping the patient with the Flat Panel Detector (FPD) even when steep C-arm angulation is required to succeed in complex coronary procedures,” he explained.
“The housing of Alphenix’s X-ray detector is very compact, so it helps us avoid bumping the patient with the Flat Panel Detector (FPD) even when steep C-arm angulation is required to succeed in complex coronary procedures,” he explained.
Compact X-ray Detector Dimensions
Powerful Imaging
Since the X-ray tube, X-ray detector, and imaging chain technology are quite advanced, the Alphenix system consistently provides outstanding image quality, allowing interventional cardiologists to concentrate on their procedures. The fluoroscopic images are sufficiently noise-reduced, sharp and defined as they manipulate PCI devices and confirm coronary artery blood flow, while minimising dose to patients and medical staff.
“I love the image quality provided by Alphenix’s DA diluted mode even while using really low contrast media volume. You’re able to obtain better images of coronary artery anatomy and confirm blood flow in challenging situations when treating renal failure patients,” said Dr. Tanabe.
“I love the image quality provided by Alphenix’s DA diluted mode even while using really low contrast media volume. You’re able to obtain better images of coronary artery anatomy and confirm blood flow in challenging situations when treating renal failure patients,” said Dr. Tanabe.
DA diluted mode image using three times diluted contrast medium
“From my experience, you can definitely minimise contrast media volume. I often use contrast media that is three times diluted but could be diluted more,” he added. “Alphenix’s DA diluted mode enables us to perform safer and more effective patient treatment.”
From a global perspective, shortages of contrast media over the past few years have affected many hospitals and patients. The shortage has impacted millions of examinations, some of which are essential or improve diagnostic accuracy.
From a global perspective, shortages of contrast media over the past few years have affected many hospitals and patients. The shortage has impacted millions of examinations, some of which are essential or improve diagnostic accuracy.
DA diluted mode image using three times diluted contrast medium
“Although just using regular fluoroscopy to conduct complex PCI with implanting Ultrathin 60 μm drug-eluting strut like Orsiro stent (Manufactured by BIOTRONIK), the imaging of Alphenix is excellent. I don’t even have to use DA/Cine for deploying ultrathin stents in order to evaluate properly through the image.”
Dr. Kengo Tanabe, Interventional Cardiologist and Director of Division of Cardiology Department at Mitsui Memorial Hospital, Tokyo, Japan.
Coronary Stent Enhancing Features
Dynamic Device Stabiliser (DDS)
This Deep Learning technology-based function provides stabilised stentenhanced images even as the heart moves, allowing physicians to evaluate the degree of stent expansion more easily. The basic mechanism of DDS is to detect two balloon markers, fix the balloon markers on the screen and display stabilised stent-enhanced image in real time. This feature can be used in both regular fluoroscopy and Cine/DA.
This Deep Learning technology-based function provides stabilised stentenhanced images even as the heart moves, allowing physicians to evaluate the degree of stent expansion more easily. The basic mechanism of DDS is to detect two balloon markers, fix the balloon markers on the screen and display stabilised stent-enhanced image in real time. This feature can be used in both regular fluoroscopy and Cine/DA.
Stent Mode
This mode doesn’t require balloon marker detection but can enhance and display the coronary stent image in real time. It can be used for Cine/ DA and also allows physicians to more easily evaluate the degree of stent expansion.
“When I decide IVUS/OCT is unnecessary, those two stent enhancing features are effective during the procedure because I can quickly confirm whether the stent has expanded enough or not,” noted Dr. Tanabe. “Besides, DDS doesn’t require Cine/DA, so it’s an absolutely user friendly feature which doesn’t disturb the physician’s workflow and provides lower X-ray dose exposure to patients and medical staff.”
This mode doesn’t require balloon marker detection but can enhance and display the coronary stent image in real time. It can be used for Cine/ DA and also allows physicians to more easily evaluate the degree of stent expansion.
“When I decide IVUS/OCT is unnecessary, those two stent enhancing features are effective during the procedure because I can quickly confirm whether the stent has expanded enough or not,” noted Dr. Tanabe. “Besides, DDS doesn’t require Cine/DA, so it’s an absolutely user friendly feature which doesn’t disturb the physician’s workflow and provides lower X-ray dose exposure to patients and medical staff.”
Physicians can evaluate the stent position and how much the stent has expanded
Unique Workflow Opportunities
Alphenix integrates cardiac-optimised technologies with other modalities to help deliver the best possible outcomes for patients and medical staff. Features include tools to simplify procedure planning, technology to help users see and navigate with confidence, and better patient protection with a comprehensive suite of optimised technologies.
“The fusion of coronary CT image and angiographic image that Canon Medical provides could be a useful tool for training young physicians, Dr. Tanabe suggested. “If the image integration chain technology is upgraded, it could potentially help us plan procedures and deploy PCI devices more precisely.”
“The fusion of coronary CT image and angiographic image that Canon Medical provides could be a useful tool for training young physicians, Dr. Tanabe suggested. “If the image integration chain technology is upgraded, it could potentially help us plan procedures and deploy PCI devices more precisely.”
Impact on Percutaneous Coronary Interventions
“PCI and CTO procedures are becoming more and more complex. Therefore, high image quality and intuitive operation are keys to handling more cases. The Alphenix series has been satisfying us for over a decade and I believe it will continuously become better and better,” concluded Dr. Tanabe.
Interventional treatment is expected to become much less invasive in the near future, particularly through the use of AI technology. However, so far, AI has only been used for post processing of obtained images such as CT and MRI. With new advances in technology, the time has finally come to utilise AI for treatment in real time, enabling lower dose, less contrast media, and better device/vessel visibility. //
Interventional treatment is expected to become much less invasive in the near future, particularly through the use of AI technology. However, so far, AI has only been used for post processing of obtained images such as CT and MRI. With new advances in technology, the time has finally come to utilise AI for treatment in real time, enabling lower dose, less contrast media, and better device/vessel visibility. //
“PCI and CTO procedures are becoming more and more complex. Therefore, high image quality and intuitive operation are keys to handling more cases. The Alphenix series has been satisfying us for over a decade and I believe it will continuously become better and better.”
Dr. Kengo Tanabe, Interventional Cardiologist and Director of Division of Cardiology
Department at Mitsui Memorial Hospital, Tokyo, Japan.
Biography
Dr. Kengo Tanabe
Dr. Kengo Tanabe, MD, PhD is Director of Division of Cardiology at Mitsui Memorial Hospital, Tokyo, Japan. He specialises in percutaneous coronary interventions (PCI). Dr. Tanabe has over 300 affiliated research publications regarding his specialty.
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