From the April 2016 issue of HealthCare Business News magazine


The Valve ASSIST and EVAR ASSIST packages both have sizing and measurement functionalities and the ability to fuse all of that data onto a pre-op CT image. GE is seeing more of their customers fusing live imaging and pre-op CT images in their daily practice.

“One of the major advantages of a hybrid room is to be able to offer the 3-D imaging associated with these hybrid rooms,” says Dr. Robert Y. Rhee, chief of vascular and endovascular surgery at the Maimonides Medical Center in Brooklyn, New York. “In the past, we were using 2-D imaging like angiography to perform these complicated vascular procedures. That requires more radiation, more dye and more [time] in the operating room.”

The hospital uses image fusion technology to perform just about every endovascular case since it decreases radiation in general and allows surgeons to more precisely perform those cases. Rhee believes that all true hybrid ORs should have those types of fusion packages because it makes them more than just a high-definition fluoroscopy unit.

Philips Healthcare launched its VesselNavigator solution a year ago for endovascular aneurysm repair (EVAR) and fenestrated endovascular aneurysm repair (FEVAR) procedures. It allows for live 3-D catheter navigation during those procedures.

It fuses live interventional X-ray images with pre-op MR or CT images of the patient’s vascular structures. It then generates 3-D color-coded images of the vessels, which provides the physicians with enhanced real-time visual guidance. In studies, the technology has been shown to reduce the need for contrast medium by 70 percent and procedure times by 18 percent.



What’s to come?
A trend that’s coming in the not-so-distant future is the use of multi-modality imaging in the hybrid OR, instead of just angiography.

Siemens’ Kulkarni believes that the definition of “hybrid OR” may have to expand to include intraoperative CT (iCT) and intraoperative MR (iMR). Hospitals in Europe are starting to install iCTs and iMRs in their hybrid ORs, and hospitals in the U.S. are interested in doing that as well.

In Sweden, there is a hybrid OR with an angiography system, and in an adjacent room there is a CT on a sliding gantry. For blunt trauma cases, they conduct a CT scan first and then move the patient to the angiography system to perform endovascular surgery.

“We hear a lot of interest from customers in these types of solutions,” says Kulkarni. “There are none yet installed or sold, but we hear that kind of interest.”

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