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Artis zee biplane

Manufactured by Siemens
Sourced in Germany

The Artis zee biplane is a specialized medical imaging system designed for interventional procedures. It features a biplane configuration, which allows for simultaneous acquisition of two fluoroscopic image planes. The device is capable of capturing high-quality images to support various clinical applications. The core function of the Artis zee biplane is to provide advanced imaging capabilities for healthcare professionals during interventional procedures.

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15 protocols using artis zee biplane

1

3D Rotational Angiography Data Acquisition

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All clinical 3D rotational angiography data were acquired using an Artis zee biplane (Siemens Healthcare GmbH, Forchheim, Germany). During the 5 s run, the rotational angle was 200° with a 1.5° increment. There were 133 projections with a matrix of 1024 × 1024 image elements.
The active imaging size was 382 mm × 293 mm for 2480 × 1920 pixels. The digitization depth was 16 bit, and the pixel pitch was 154 μm. The following imaging conditions were adopted: 3D acquisition: 70 kV, 12.5 ms, small focal spot, 0.36 μGy/frame, Sub/Nat Mask Recon.: 512 × 512 matrix, 0.22-0.34 mm SL. Hounsfield units, Auto. Workstation: syngo X Workplace (Siemens Healthcare). Iopamidol (Iopamiron, 370 mg I/mL, Bayer HealthCare, Leverkusen, Germany; Oiparomin 370 [370 mg I/mL] or Oiparomin 300 [300 mg I/mL]).
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2

Detailed Cerebral DSA Procedure

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Cerebral DSA was performed via the transfemoral arterial approach using a dedicated biplane neuroangiography unit (RF-1000-125, Artis Zee biplane, Siemens Healthineer, Berlin, Germany) with the help of 1 type of guidewire (Terumo®, 0.035 inch, Tokyo, Japan) and 3 types of catheters—Taper (Cook, Bloomington, IN, USA), Imager (Boston Scientific, Marlborough, MA, USA), Simmons I (AngioDynamics, Queensbury, NY, USA). A non-ionic contrast medium (lomeron 300 [iomeprol 612.4 mg/mL], Bracco S.p.A., Milan, Italy) was used for all procedures with automatic machine injection of the contrast medium followed by a saline flush after each injection. The FemoSeal®, vascular closure device, was used for hemostasis at the site of vascular access. All procedures in this series were performed by a single neurovascular surgeon (the author of this study).
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3

Cerebral Vascular Anatomy Exploration

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The anatomical relationship between the CB, AM, and vertebral levels was investigated through a retrospective study on patients who underwent neck computed tomography angiography (CTA) at Srinagarind Hospital, Khon Kaen University, Thailand, between January 2016 and December 2019.
The CTA procedures were carried out using a biplane neuro-angiographic unit (Siemens Artis Zee Biplane), performing a comprehensive cerebral CTA using an 8-second 180° rotational run, injecting contrast material at a rate of 3–4 mL/s into the median cubital vein.
The study utilized a rigorous selection process, conducted by radiologist, based on the following exclusion criteria:
The study anonymously recorded demographic data and clinical characteristics. The AM and CB levels were evaluated bilaterally, relating them to the vertebral body or intervertebral disc level in the horizontal plane. HCB was defined as a CB situated above the C3 vertebra, aligned with previous literature. The positioning of HCB in relation to AM was also explored. Vertical distances from HCB to the ipsilateral AM were measured.
Expert assessors, including a specialist referee, evaluated HCB and relevant distances using computerized measurement techniques to maintain interrater reliability.
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4

Antiplatelet Therapy for PCI Patients

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Antiplatelet therapy was performed with aspirin (100 mg/d) and/or prasugrel (3.75 mg/d) or clopidogrel (75 mg/d) as a maintenance dose for patients who had received percutaneous coronary intervention (PCI). In cases of primary PCI, a loading dose of aspirin (200 mg) and prasugrel (20 mg), or clopidogrel (300 mg) was administered to each naïve patient. Intravenous unfractionated heparin (100 U/kg) was administered at the beginning of catheterization, and an additional dose was repeated to maintain an activated clotting time of ≥250 s during the procedure. GP-IIb/IIIa inhibitors were not used because they were not approved in Japan. Catheterization was performed via radial, brachial, or femoral artery approach using a 6-Fr or 7-Fr sheath and catheters. Coronary angiography was recorded by Artis zee biplane (Siemens Healthineers AG, Erlangen, Germany).
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5

Uterine Artery Embolization for Leiomyomas

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Except 3 patients, all patients underwent bilateral UAE under fluoroscopic control by using a biplane angiographic system (Artis zee Biplane; Siemens, Erlangen, Germany). Unilateral embolization was performed in 3 patients because one of the uterine arteries could not be catheterized. All procedures were performed with local anesthesia (prilocaine hydrochloride 1%, 10 cc). Paracetamol infusion was performed prophylactically for pain palliation. Bead Block (Bead Block; Biocompatibles, Farnham, England) 500–700 μm was used in all patients for embolization. Embolizing agent were suspended in 6–7 mL of normal saline and 6–7 mL of nonionic contrast material. Stagnant flow with a pruned tree appearance and no residual hypervascularization related to the leiomyomas were the angiogenic end points for embolization (Figure). There were no significant anastomoses between the uterine and ovarian arteries, so no procedures were canceled.
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6

3D Rotational Angiography Imaging Protocol

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3DRAs were obtained using the Siemens Artis Zee biplane (Siemens, Forchheim, Germany) and reconstructions were transferred to the Leonardo workstation for post-processing with Syngo DynaCT Cardiac software. All procedures were performed under general anesthesia. Rapid atrial or ventricular pacing was performed in 88 of the 100 3DRAs. Pacing frequency was increased from 180/min upwards until a reduction of 50% of the systolic blood pressure was achieved. Contrast medium was administrated to the cardiac compartment prior to the region of interest meaning the right ventricle for pulmonary imaging and the left ventricle for aortic imaging. Contrast was diluted up to 60% with saline. Contrast was injected from 2 mL/s in 3 kg neonates up to 16 mL/s in 50 kg adolescents in case of a single injection site before start of 3DRA for 5 s. When multiple injection sites were necessary, additional manual injections with diluted contrast were performed.
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7

Biplane DSA for Moyamoya Disease

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DSA was performed by a board-certified neurosurgeon (T.F.) using a biplane DSA system (Artis zee biplane; Siemens Healthineers). Frontal and side views were obtained by hand injection of half-diluted iohexol 300 mg I/ml (Iopaque; FujiPharma, Tokyo, Japan) using a 4-Fr catheter. A power injector was not used in angiography for MMD in our institute since the mechanical pressure may become harmful for the vulnerable collateral vessels. The injection rate was carefully determined according to the disease severity and the diameter of the vessels to avoid the hemorrhagic complications. In most cases, injection rate for adult patients was 1 ml/s for ICA and external carotid artery (ECA), and 2 ml/s for vertebral artery (VA). In pediatric patients, injection rate was 0.5-1 ml/s for ICA and ECA and 2 ml/s for VA.
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8

Pediatric Phantom Fluoroscopic Imaging

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Both fluoroscopic and angiographic acquisitions of the three pediatric phantoms were performed on an Artis Zee biplane (Siemens Healthcare GmbH, Forchheim, Germany) angiography unit, equipped with a state of-the-art flat panel detector (30x40cm).
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9

Intracranial 3D Imaging Using DynaCT

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All images were obtained with a flat panel angiographic C-arm system (Artis zee biplane; Siemens Healthcare, Forchheim, Germany) using the embedded high-quality DynaCT protocol (Siemens Healthcare) with an acquisition range of 200° (matrix 1240×960, 0.4° angular increment) and 496 projections. In contrast to other studies, we used a 20 s rotation protocol after intravenous injection of 80 mL of iodinated contrast agent (Solutrast 300; Bracco, Konstanz, Germany) into the cubital vein (5.0 mL/s). The scan was started when contrast enhancement of the intracranial carotid arteries was observed using a bolus tracking technique (bolus monitoring at 1 image/s).
After image acquisition the raw data were transferred to a workstation (Syngo MM Workplace AXK1447; Siemens Healthcare) and the MAR algorithm was applied as described below. Apart from MAR, all parameters of uncorrected and corrected data were kept identical. The time required for post-processing was measured.
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10

External Carotid Arterial Anatomy Analysis

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The institutional review board approved this study (IRB number: 2019–09–013–001), and the requirement for informed consent was waived because of the retrospective study design. From January 2008 to August 2018, the facial and infraorbital arterial anatomies were analyzed in patients who underwent external carotid angiography for the evaluation of cerebral vascular malformation, congenital anomaly, or intra-arterial procedures such as cerebral arterial thrombolysis, internal carotid arterial stent graft, brain tumoral embolization, and coil embolization of the cerebral arterial aneurysm at the Gyeongsang National University Hospital (center A) and Gyeongsang National University Changwon Hospital (center B). Biplane angiography (Artis Zee Biplane; Siemens, Erlangen, Germany or Allura Xper; Philips Healthcare, Best, The Netherlands) was used for external carotid angiography.
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