Clinical suites

Neuro suite 

Neuro decisions are based on what you see, so see more

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Philips Neuro suite offers a flexible portfolio of integrated technologies, services, and neuro accessories that puts you in firm control whether treating an acute stroke patient, visualizing the smallest intracranial vessels, precisely placing a flow diverter, or working slowly through a complex AVM. You can work with the confidence that comes from using sophisticated imaging technologies and neuro options that are the result of intensive research with clinical leaders and industry pioneers in neuro interventions.

Be ready to take on new challenges in ischemic stroke treatment

 

We see a strong increase in thrombectomy interventions as a first line treatment for patients with ischemic stroke. There is also a shift from time-based to image-based patient selection for ischemic stroke treatment. Our Neuro suite has been developed to address these trends. It can support high levels of procedural efficiency and redefine outcomes for your stroke patients.

XperCT and VasoCT
XperCT and VasoCT

The ability to visualize sub-millimeter vascular anatomy and endovascular material improves the chances of success and raises your treatment confidence. XperCT offers CT-like imaging that can be acquired right in the Neuro suite and helps identify subtle soft-tissue lesions. VasoCT provides high resolution 3D imaging that reveals key information about cerebral vascular structures to support the highest possible spatial assessment of vessels in the soft tissue context.

See clearly and navigate efficiently when treating cerebral aneurysms


New devices can be difficult to visualize when treating cerebral aneurysms, and this can lengthen these types of interventions. That makes superb 2D and 3D imaging more important than ever to guide treatment decisions and device placement, while efficiently managing radiation dose.
Aneurysmflow
AneurysmFlow

Post-intervention functional assessment of blood flow can be difficult. AneurysmFlow is designed to give you relevant information before and after flow diverter deployment. It visualizes and quantifies flow changes for greater confidence in procedural effectiveness.

Clinical solutions for treating ischemic stroke

Our Neuro suite provides workflow options, dedicated interventional neuro tools, and neuro accessories to support high levels of procedural efficiency and redefine outcomes for your stroke patients. They support each step of your procedure – as you decide, guide, treat, and confirm treatment results.

Decide


The three main challenges when planning treatment are:

 

  1. Identifying if the patient has an ischemic or hemorrhagic stroke,
  2. Locate the affected area and assess the state of the penumbra and amount of salvageable tissue, and
  3. Know the time window between patient onset and groin puncture.

Comprehensive stroke diagnosis based on three XperCTs

XperCT Dual
Non-contrast XperCT aids detection of early ischemic changes. Early phase XperCT helps to identify the proximal occlusion. Late phase contrast enhanced XperCT supports detection of collaterals.

Dual View to see collateral filling

XperCT Dual View
Viewing early and late phase XperCT Dual volumes side by side enhances identification of penumbra and enables visualization of collateral filling.

VasoCT IV to check location and length of a clot

VasoCT IV
VasoCT IV allows visualization beyond the clot with peri-procedural imaging of the distal vessel aspects in ischemic stroke. By retrograde filling, vessel structures before and after the clot become visible. The VasoCT 3D roadmap can be used to visualize clot retrieval devices.

Guide and Treat


When navigating and treating stroke pathology, clinicians need to be able to visualize the exact location of the clot and assess if and how the clot can be reached.

Maintain sharp images using 2D DSA with ClarityIQ technology

2D DSA ClarityIQ
Automatic Motion Compensation during real-time DSA maintains sharp images of the vessel to support confident decision making throughout stroke procedures.

Enhance visualization of vasculature with Roadmap Pro

Roadmap Pro
This advanced double contrast roadmap helps enhance visualization of overlapping vessels while balancing radiation exposure to make informed decisions about whether the clot can be reached and which route to use.

Gain anatomical references with 3D-RA and 3D Roadmap

3D Roadmap anatomical references
The 3D Roadmap provides anatomical references to support precise navigation of guidewire, catheter, and device to the clot.

Confirm


After stroke treatment, there is a need to confirm if all clot material has been removed and to check for bleedings while the patient is still in the interventional lab.

Confirm treatment success with DSA run-off

DSA run-off visualization
High quality DSA visualizations allow you to assess if you have retrieved the complete clot and if pieces of clot have been dispersed distally in the brain. You can check the restoration of blood flow to the penumbra and check for peri-procedure bleedings.

Peri-procedure check of bleedings with XperCT Dual

XperCT Dual
Use CT-like images in the Neuro suite to check treatment success and bleedings.

Workflow options that helps you optimize lab performance and dose management


Azurion offers a number of workflow innovations designed to help on-call staff work efficiently and easily, while maintaining a single-minded focus on the patient and manage radiation dose during acute ischemic stroke interventions.

ProcedureCards

ProcedureCards
ProcedureCards streamline and standardize system set-up and help reduce preparation errors in acute ischemic stroke procedures. Hospital specific stroke protocols and/or checklists can be added to ProcedureCards and displayed on monitors to support consistent workflow during hectic acute situations.

FlexVision Pro and Touch Screen Module Pro

FlexVision Pro and TSM Pro
Gives you direct access and full control of pre-operative diagnostic scans, patient information, planning tools, at table side to save time and unnecessary walking in and out of the sterile area. Touch screen module Pro allows table side control of images and applications with tablet ease.

Instant Parallel Working

Instant Parallel Working
Allows team members to work on different tasks at the same time without interrupting each other to shorten procedure times for critical stroke patients.

Neuro headrest

Neuro headrest
Can be used to restrain restless patients under conscious sedation to help reduce motion artefacts during the procedure.

Integrated OR table

Getinge Magnus OR table
The Getinge Magnus OR table can be used for emergency and trauma care. It is synchronized with Philips X-ray systems to take advantage of advanced Philips solutions.

Clinical solutions for treating cerebral aneurysms

Neuro suite provides workflow options, dedicated neuro interventional tools, and neuro accessories to improve procedural accuracy and reduce radiation exposure for staff and patients during aneurysm interventions. They support each step of your procedure – as you decide, guide, treat, and confirm treatment results.

Case report low MAFA

Case courtesy of Prof. Laurent Spelle, Hôpital Bicêtre, Paris, France

Patient:

 

  • Female, 35 years old.
  • Saccular aneurysm in internal carotid artery.
  • Exam date: June 16, 2014, Flow Diverter placement.
  • AneurysmFlow MAFA of 0.59
  • Follow-up exam: December 19, 2014, Total aneurysm occlusion.
MAFA 1
June 16th, 2014
MAFA 2
December 19th, 2014
MAFA 3
The clinical user relies on conventional DSA imaging which is the primary source of information throughout the procedure.

Case report high MAFA 1.11

Case courtesy of Dr. Vitor. Mendes Pereira, UHN, University of Toronto, Toronto, Canada

Patient:

 

  • Female, 67 years old.
  • Saccular aneurysm in internal carotid artery.
  • Exam date: July 19, 2012, Hôpital Universitaire de Geneva, à Flow Diverter placement.
  • AneurysmFlow MAFA of 1.11
  • Follow-up MRI exam at 3, 6 and 12 months showed incomplete occlusion.
  • Angiogram 2 years after flow diverter placement clearly shows residual aneurysm.
  • Additional flow diverter placed 3 months later (not shown).
MAFA 1
July 19th, 2012
MAFA 1
October 13th, 2014
MAFA 3
The clinical user relies on conventional DSA imaging which is the primary source of information throughout the procedure.

Decide


The three main challenges when planning cerebral aneurysm treatment are: 1) obtaining insight into tortuous vasculature, 2) accurately assessing the location, size, and neck of the aneurysm, and 3) identifying and confirming if the lesion is severe enough to require an intervention and if there is enough information to make an appropriate treatment plan.

3D visualization of tortuous pathologies with 3D-RA

3D-RA tortuous pathologies
3D-RA provides a volumetric view in a few seconds to assist with assessment of location, size, neck, and severity of aneurysm for treatment planning. 3D-RA also provides high spacial resolution volumes and automatically compensates for patient movement.

Visualize lesion boundaries and corresponding vascularization with MR-CT Roadmap

MR-CT Roadmap
Use a previously acquired CT angio or MR angio scan and overlay it with live fluoroscopy to visualize lesion boundaries and corresponding vascularization for risk assessment. Re-using pre-acquired data helps you manage X-ray dose and contrast medium.

Guide and Treat


New technologies and devices make it more challenging than ever to efficiently navigate to the feeding vessel and accurately position devices - all while avoiding arterial dissection and spasms and minimizing contrast agent and radiation use.

Dynamic 3D image guidance through neurovascular structures

Dynamic 3D image guidance
3D Roadmap enhances visualization of overlapping vessels to support precise navigation of guidewire and catheter through complex vasculature. Offers a high level of precision with real-time compensation for gantry, table, and small patient movements.

Visualize blood flow patterns with AneurysmFlow

Aneurysmflow
Visualize and quantify blood flow patterns in the parent vessel and aneurysm sac to obtain key information that can assist deployment of flow diverters and other embolization devices.

Support accurate guidance of devices with MR-CT Roadmap

MR-CT Roadmap
Visualize lesion boundaries and corresponding vascularization to enhance accurate navigation through challenging pathologies, while reducing unnecessary contrast and manage X-ray dose.

Enhance visualization of cerebral vasculature with Roadmap Pro

Roadmap Pro
This advanced double contrast roadmap helps enhance visualization of overlapping vessels while balancing radiation exposure. It can be customized to see advancement during coil placement.

Confirm

 

After aneursym treatment, check proper device placement and deployment in the context of the feeding vessel, the neck, and the sac of the aneurysm. Efficiently measure the effect of the device placed and check for possible arterial dissections while the patient is still on the table. 

Post-treatment flow calculations with AneurysmFlow

AneurysmFlow
Evaluate changes in blood flow in the aneurysm pre and post, by calculating the change in Mean Aneurysm Flow Amplitude (MAFA ratio) before and after flow diverter placement.

Enhance imaging of vessels and devices in the brain with VasoCT IA

VasoCT IA
VasoCT IA is an acquisition technique that combines a high resolution XperCT with a contrast injection to enhance visualization of endovascular stents, flow diverters, and other devices and of vessel morphology down to the perforator level. It is increasingly used for follow-up of aneurysms treated with flflow-diverter stents to check device positioning.

Peri-procedure check of bleedings with XperCT Dual

XperCT Dual
Use CT-like images in the Neuro suite to check treatment success and identify bleedings.

Innovative neuro interventional workflow


Our Neuro suite with Azurion offers a number of workflow innovations designed to help you simplify your workflow, shorten procedure time, and manage radiation dose during aneurysm interventions.

Sharp, motionless vessels at low dose with Clarity IQ

ClarityIQ wheel
ClarityIQ technology reduces patient dose by 75% in neuro DSA1, while maintaining equivalent image quality, compared to a system without ClarityIQ. Its automatic motion compensation removes skull and motion artifacts which is key when placing small devices at the base of the skull.

Manage dose and simplify workflow with Zero Dose Positioning

Zero Dose Positioning

Helps you reduce dose by positioning the system or table on Last Image Hold so you can prepare your next run without using fluoroscopy.

Full table side control with FlexVision Pro

FlexVision Pro
This features helps you reduce dose by allowing you to pan the table, change table height or move the X-ray system on Last Image Hold to determine the new center position. This helps you prepare your next run without using fluoroscopy.

ProcedureCards

ProcedureCards
ProcedureCards streamline and standardize system set-up and help reduce preparation errors. Select the Aneurysm ProcedureCard and the system is set-up the way you want. Hospital specific aneurysm protocols and/or checklists can be added to ProcedureCards and displayed on monitors to support consistent workflow.

Neuro headrest

Neuro headrest
Can be used to help reduce motion artefacts during the procedure.
  1. Söderman M, Holmin S, Andersson T, Palmgren C, Babic D, Hoornaert B. Image noise reduction algorithm for digital subtraction angiography: clinical results. Radiology. 2013 Nov;269(2):553-60.The results of the application of dose reduction techniques will vary depending on the clinical task, patient size, anatomical location and clinical practice. The interventional radiologist assisted by a physicist as necessary has to determine the appropriate settings for each specific clinical task. Results based on DSA dose area product per frame from a single center prospective randomized study on 20 patients. DSA runs for Allura Xper with ClarityIQ and Allura Xper without ClarityIQ were acquired on the frontal and lateral channel on the same patient under same condition of geometry, field of view, and injection protocol. Image quality was based on subjective assessment (score 1-5, 1=very poor, 5=excellent, blinded review by 3 radiologists involved in the study).

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