Each patient received standard coronary angiography via the radial route with a 5- or 6-French diagnostic catheter after an intracoronary infusion of nitroglycerin (0.1–0.2 mg). Angiographic images were routinely recorded at 15 frames/s using the radiographic imaging system (AXIOM Artis, Siemens, Erlangen, Germany), and several projection views were attempted to avoid severe overlapping or excessive foreshortening. The OCT/IVUS imaging was conducted before revascularization for interrogated vessels or during the diagnostic process in patients who were deferred for stenting.
Axiom artis
Manufactured by Siemens
Sourced in Germany
The Axiom Artis is a medical imaging system designed for diagnostic procedures. It provides high-quality images to support clinical decision-making. The core function of the Axiom Artis is to capture detailed medical images for diagnostic purposes.
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Lab products found in correlation
Innova 4100, by GE Healthcare (3 mentions)
Allura clarity, by Philips (3 mentions)
Excelsior xt27, by Stryker (3 mentions)
Somatom definition as, by Siemens (2 mentions)
Syngo dynact, by Siemens (2 mentions)
Omnipaque, by GE Healthcare (1 mentions)
Somatom definition flash, by Siemens (1 mentions)
Syngo x workplace, by Siemens (1 mentions)
Artis q biplane, by Siemens (1 mentions)
Allura xper, by Philips (1 mentions)
Integris allura, by Philips (1 mentions)
Ultravist 300, by Bayer (1 mentions)
Visipaque, by GE Healthcare (1 mentions)
Iomeprol, by Bracco (1 mentions)
5f catheter, by Terumo (1 mentions)
Iohexol, by GE Healthcare (1 mentions)
Mim platform, by MIM Software (1 mentions)
Azurion, by Philips (1 mentions)
Headway 21, by Terumo (1 mentions)
Trevo pro 18, by Stryker (1 mentions)
57 protocols using axiom artis
1
Coronary Angiography and Imaging Techniques
2
Assessing Coronary Slow Flow via Angiography
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Coronary angiography was performed by an experienced operator (>75 cases per year) using classic Judkins technique via femoral route (Siemens Axiom Artis Zee, Germany). Coronary angiographic recordings were taken at left to right oblique projections with cranial-caudal angulation at a film rate of 30 frames/seconds. Non-ionic low osmolality contrast medium (Ultravist-370 MG/ml) was used for the procedures. Coronary flow rates identified by using the Thrombolysis In Myocardial Infarction (TIMI) frame count (TFC) method9 (link) This method consists calculating frame counts, which are obtained at 30 frame/seconds, until dye reaches the given distal landmarks for each coronary arteries. These landmarks defined as distal bifurcation for left anterior descending artery (LAD), first branch of the posterolateral artery for right coronary artery (RCA) and the distal bifurcation of the segment with the longest total distance for the left circumflex artery (LCx). Due to the longer course of the LAD compared with other epicardial arteries, values multiplied by constant coefficient 1.7 to standardize measurements. Published reference values are 36 ± 2.6 for LAD, 20 ± 3 for RCA and 22 ± 4 for LCx. Any TFC value greater than two standard deviation from the normal published value in the literature was accepted as coronary slow flow.
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Coronary angiography was performed by an experienced operator (>75 cases per year) using classic Judkins technique via femoral route (Siemens Axiom Artis Zee, Germany). Coronary angiographic recordings were taken at left to right oblique projections with cranial-caudal angulation at a film rate of 30 frames/seconds. Non-ionic low osmolality contrast medium (Ultravist-370 MG/ml) was used for the procedures. Coronary flow rates identified by using the Thrombolysis In Myocardial Infarction (TIMI) frame count (TFC) method9 (link) This method consists calculating frame counts, which are obtained at 30 frame/seconds, until dye reaches the given distal landmarks for each coronary arteries. These landmarks defined as distal bifurcation for left anterior descending artery (LAD), first branch of the posterolateral artery for right coronary artery (RCA) and the distal bifurcation of the segment with the longest total distance for the left circumflex artery (LCx). Due to the longer course of the LAD compared with other epicardial arteries, values multiplied by constant coefficient 1.7 to standardize measurements. Published reference values are 36 ± 2.6 for LAD, 20 ± 3 for RCA and 22 ± 4 for LCx. Any TFC value greater than two standard deviation from the normal published value in the literature was accepted as coronary slow flow.
3
Micro-CT and mfpVCT Analysis of Samples
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Micro-CT measurements were performed using a MetRIC setup with the following parameters: Tube voltage = 120 kV; power = 4 W; exposure time = 200 ms; 15 averaged images; 2 mm aluminum and 0.38 mm silicon filters; slice thickness = 18 μm (27 (link)). CT scans were recorded by the multi-slice scanner SOMATOM Definition AS+ (Siemens Healthcare AG) with the following parameters: Tube voltage = 120 kV; tube current = 38 mA; pitch = 0.55; collimation = 0.6 mm; slice thickness = 600 μm. mfpVCT scans were performed on an Axiom Artis (Siemens Healthcare AG) using the following parameters: 20s DynaCT head protocol; tube voltage = 109 kV; tube current = 42 mA; pulse length = 3.5 ms; rotation angle = 200°; frame angle step = 0.4°/frame; slice thickness = 197 μm.
4
Carotid Artery Stenosis Imaging Protocol
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For all 44 patients, DSA acquisitions were performed using a standard, clinically routine protocol on the same biplane AngioSuite (AXIOMArtis®, Siemens Healthcare, Forchheim, Germany). The degree of arterial stenosis was determined by the more severe degree of the anterior-posterior (AP) or lateral views according to NASCET criteria [20 (link)]. A power injector (Liebel-FlarsheimAngiomat®, Illumena, San Diego, USA) was used to administer a contrast bolus by placing a 4-F angiocatheter in the common carotid artery at the C4 vertebral body level. A bolus of 12 mL of 60% diluted contrast medium (340 mg I/mL) was then administered within 1.5 seconds. No additional contrast medium or radiation was used. The acquisition parameters were 7.5 frames per second for the first 5 seconds, followed by 4 frames per second for 3 seconds, 3 frames per second for 2 seconds, and finally 2 frames per second for 2 seconds. The entire DSA acquisition lasted 12 seconds, but was manually prolonged to visualize internal jugular vein opacification in cases of slow intracranial circulation [12 (link)].
5
Angiographic Image Acquisition Protocol
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Angiographic images were recorded at 15 frames/s by monoplane radiographic systems (AXIOM Artis, Siemens Healthcare, Erlangen, Germany). Two projection views at different angles with >25 degrees were required for angiographic image acquisition. The contrast medium was injected manually with a stable and forceful injection, as previously described.8
6
Quantifying XEMs Visibility in Radiology
7
Multimodal Radiographic Imaging of Inner Ear
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Radiographic scans were performed using a fpVCT (Axiom Artis; Siemens Healthcare AG, Erlangen, Germany) and a MSCT system (SOMATOM Definition AS+; Siemens) with commercially available software (Syngo DynaCT; Siemens).
The fpVCT datasets were acquired using the following parameters: 20 s DCT Head protocol; tube current = 21 mA; tube voltage = 109 kV; rotation angle = 200°; pulse length = 3.5 ms; frame angulation step = 0.5°/frame; slice thickness = 466 µm. Secondary reconstructions (fpVCTRECO) from these data sets were performed with the following settings: 512 × 512 section matrix; HU kernel types; sharp image characteristics; slice thickness = 100 µm.
With the same hard- and software, micro-fpVCT was conducted using the following parameters: 20 s DCT Head protocol; tube current = 42 mA; tube voltage = 109 kV; rotation angle = 200°; pulse length = 3.5 ms; frame angulation step = 0.4°/frame; slice thickness: 197 µm.
The MSCT datasets were acquired using a SOMATOM Definition AS+ (Siemens) with commercially available software (Syngo CT; Siemens). The following parameters of the standard application (inner ear high-resolution program) were applied: tube current = 38 mA; tube voltage = 120 kV; collimation = 0.6 mm; pitch = 0.55; slice thickness = 600 µm.
The fpVCT datasets were acquired using the following parameters: 20 s DCT Head protocol; tube current = 21 mA; tube voltage = 109 kV; rotation angle = 200°; pulse length = 3.5 ms; frame angulation step = 0.5°/frame; slice thickness = 466 µm. Secondary reconstructions (fpVCTRECO) from these data sets were performed with the following settings: 512 × 512 section matrix; HU kernel types; sharp image characteristics; slice thickness = 100 µm.
With the same hard- and software, micro-fpVCT was conducted using the following parameters: 20 s DCT Head protocol; tube current = 42 mA; tube voltage = 109 kV; rotation angle = 200°; pulse length = 3.5 ms; frame angulation step = 0.4°/frame; slice thickness: 197 µm.
The MSCT datasets were acquired using a SOMATOM Definition AS+ (Siemens) with commercially available software (Syngo CT; Siemens). The following parameters of the standard application (inner ear high-resolution program) were applied: tube current = 38 mA; tube voltage = 120 kV; collimation = 0.6 mm; pitch = 0.55; slice thickness = 600 µm.
8
Coronary Angiography and Fractional Flow Reserve
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Coronary angiograms were performed on Siemens Axiom Artis coronary angiography system (Siemens, Erlangen, Germany) as described earlier. Measurement of FFR was performed for stenoses with intermediate severity (30–80%) when feasible to assess their hemodynamic significance. Quantitative analysis of coronary angiograms was performed using software with automated edge detection system (Quantcore, Siemens, Munich, Germany) by an experienced reader. Obstructive CAD was defined as either 50% stenosis on ICA or FFR < 0.8. When FFR was available, stenoses with FFR 0.8 were classified as non-significant, regardless of the degree of coronary narrowing.
9
Diagnostic DSA for Cerebral Vasospasm
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Diagnostic DSA was performed using a biplane system (Axiom Artis, Siemens, Erlangen, Germany or AlluraClarity, Philips Healthcare, Best, The Netherlands) or a monoplane system (Innova 4100; GE Healthcare, Waukesha, WI, USA). Iopromid (60–120 mL, containing 300 mg iodine per mL) was used as the contrast agent.
Every patient who underwent intra-arterial spasmolysis primarily received a diagnostic DSA to assess the severity of angiographic cerebral vasospasm. DSA was performed according to vascular regions with suspected cerebral vasospasm. A comparison of the diagnostic DSA and DSA on admission, if applicable, was performed. Therefore, not all segments were necessarily examined in every patient at every time point, especially not the vertebrobasilar region.
We regularly performed intra-arterial administration of spasmolytics over the entire study period, first using nimodipine, later using milrinone, or a combination of both. Nitro-glycerine and/or alprostadil were added as expanded access if the effect of the primarily given substances was insufficient.
Every patient who underwent intra-arterial spasmolysis primarily received a diagnostic DSA to assess the severity of angiographic cerebral vasospasm. DSA was performed according to vascular regions with suspected cerebral vasospasm. A comparison of the diagnostic DSA and DSA on admission, if applicable, was performed. Therefore, not all segments were necessarily examined in every patient at every time point, especially not the vertebrobasilar region.
We regularly performed intra-arterial administration of spasmolytics over the entire study period, first using nimodipine, later using milrinone, or a combination of both. Nitro-glycerine and/or alprostadil were added as expanded access if the effect of the primarily given substances was insufficient.
10
Coronary Artery Ectasia Evaluation and Scoring
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Coronary angiogram was performed with the standard Seldinger technique using a CAG device (Axiom Artis, Siemens Medical Solutions, UK). All of the angiograms were recorded and evaluated visually later by two experienced interventional cardiologists. Coronary artery ectasia was defined as localized or diffuse coronary artery luminal dilatation at least 1.5-fold higher than the adjacent normal coronary artery diameter. The extent of CAE was scored using the Markis score [2 (link), 6 (link)]. Markis et al. classified CAE into 4 groups according to the topographic extent of the ectasia in the major epicardial coronary artery [2 (link), 6 (link)]. Type 1 – diffuse ectasia in 2–3 vessels; type 2 – diffuse ectasia in one vessel and focal ectasia in another vessel; type 3 – diffuse ectasia in a single vessel, type 4 – focal or segmental ectasia in a single vessel [2 (link), 6 (link)].
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