The 3-D Bi-Plane
Two Planes Are Better Than One
A big piece of technology is making a big difference for patients receiving angiograms
The buzz in Hollywood these days is about how 3-D is the wave of the future. But while movie directors like James Cameron are busy creating alien planets on the west coast, physicians at St.
Jay U. Howington, MD, in the bi-plane interventional suite
The Artis Zee biplane system, built by Siemens Medical Solutions, enables physicians to obtain three-dimensional views of the patient's anatomy, from any direction, during minimally invasive neuroradiology procedures. The system features two advanced x-ray detectors-called flat-panel detectors-that provide high-resolution images without the distortion common with conventional x-ray techniques. The detectors also help physicians visualize interventional devices such as catheters in precise detail and from almost any angle.
"With the bi-plane technology, I have two different planes of view-an anterior/posterior and then a lateral view," says endovascular neurosurgeon Jay U. Howington, MD. "I use both at the same time so that I can have more anatomic understanding of where a particular catheter is or what a lesion looks like."
During angiography, a physician inserts a catheter into one of the patient's arteries and guides it to the desired position using a video screen. Once the catheter is in position, the physician injects contrast dye, which makes the blood within the arteries or veins visible through x-ray. Angiography is often used to determine whether blood vessels are narrowed or blocked, and makes it possible to combine diagnosis and treatment in a single procedure, as in patients who undergo surgery, angioplasty, or stent placement. The bi-plane technology takes this process further into the realm of 3-D.
"The rotational capabilities of this machine allow the x-rays to be reformatted into a three-dimensional rendering of the vasculature," Dr. Howington says.
The biplane imaging system features an advanced software technology that creates detailed images of soft tissue similar to those generated by a CT scan. These details help detect hemorrhages, visualize brain tissue, and support quick and accurate decision-making for the physician. This saves critical time for some stroke patients by providing physicians anatomical images directly in the interventional suite, reducing the need to move a patient out of the sterile environment for evaluation prior to proceeding with the intervention. But the benefits of this new technology for the patient don't end there.
"The 3-D reconstructional program provides the information to the physician at a great speed and with a minimal amount of contrast dye," Dr. Howington says. 'We couldn't do that before. The previous machine ran slowly and required much more contrast dye, which was very uncomfortable for patients."
Previously, certain patients could become disoriented if a large amount of their blood volume was replaced with contrast dye. Now that risk is virtually eliminated. In addition, the ergonomic design of the system eliminates the time-consuming and uncomfortable repositioning of the patient, making the procedure faster and less stressful.
"A couple of our patients have had rotational angiograms on both the older machine and this new machine," Dr. Howington says. "They have said that the difference is night and day."