Post on 14-Jul-2015
OPTIS™ Integrated System
Felipe Hernández
Hospital 12 de Octubre, Madrid
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ILUMIEN OPTIS - Nuevos componentes
1Nueva DOC – Me permite el control desde la mesa para iniciar el pullback, posibilidad de rotar a mayor velocidad
2Nuevo motor (C8) – Trabaja a mayor velocidad, lo que me permite pullbacks más largos a mayor velocidad
3 Nuevo PC – Capacidad para 3D
4 Nueva tarjeta DAS– Permite almacenamiento y adquisición de datos de mayor velocidad
5 Dragonfly Duo Imaging Catheter
6 New Software – E.0.2
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ILUMIEN OPTIS
Reconstrucción real 3D
Medidas automáticas de Area, MLA. %DS, %AS
Posibilidad de escoger entre dos pullback: 75mm pullback
54mm alta resolución
FFR con Aeris
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Comparación con ILUMIEN
ILUMIEN ILUMIEN OPTIS
Parameter Nominal Settings
Long Pullback
High-resolution Pullback
Engine speed 100 frames/sec 180 frames/sec 180 frames/sec
Pullback speed 20 mm/sec 36 mm/sec 18 mm/sec
Frame density 5 frames/mm 5 frames/mm 10 frames/mm
Pullback length 54 mm 75 mm 54 mm
Pullback time 2.7 sec 2.1 sec 3.0 sec
Contrast (Max) 14 ml at 4 ml/sec 14 ml at 4 ml/sec 14 ml at 4 ml/sec
File size 271 frames
270 MB
375 frames
375 MB
540 frames
540 MB
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Disponibilidad de varios Pullback
Tenemos disponibles 2 TIPOS DE PULLBACK:
Modo “Survey”: Pullback de 75 mm
Velocidad de 36mm/sg
Mismo nº de imágenes por mm que ILUMIEN (5 fotos/mm)
Misma recomendación de uso de contraste que con ILUMIEN
( 4 ml/sec en bolo de 14 ml)
Modo “High-resolution” Pullback de 54 mm
Velocidad de 18mm/sg
Doble nº de imágenes por mm (10 fotos/mm)
Misma recomendación de uso de contraste
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OPTIS™ Integrated System
Product Goals Strengthen the link between physiological (FFR) and anatomical
(OCT and angio) assessment and subsequent therapeutic action.
Provide the physician with increased control.
Continue to improve technology ease-of-use and procedural workflow.
Make FFR and OCT an integral part of the cath lab.
Clinical Benefits Immediate availability during PCI procedure
Full FFR/OCT system control from tableside
Rapid set-up without making cable connections
Direct tableside control of acquisition and analysis by physician
Enables real-time angio co-registration with OCT
Data displayed on boom monitor
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OPTIS™ Integrated System Architecture
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System Cabinet
Wi-Box™ Unit
DOC and DOC Holster
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Tableside Controller
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Navigation Controller
Rail Clamp
Advanced Display Full Screen (View Mode)
Measurements
Distal Marker Proximal Marker
Lumen Profile
Select Button
Wireless Connectivity IndicatorBlue = Connected Yellow = Not Connected
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Tableside Controller
The Tableside Controller may be used to position the mouse cursor by tilting the Navigation Controller to the left, right, up, down or variations thereof.
The Select button (on the top of the Navigation Controller) functions as the left mouse button.
A twist of the Navigation Controller functions as the mouse scroll wheel; twist counter-clockwise to scroll up or left, and twist clockwise to scroll down or right.
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DOC Holster
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Rail Clamp
Front View Side View
Dust Cover
Cable Connections
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DOC Controller
The DOC functions have not changed from the ILUMIEN™ OPTIS™ system.
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Stop – Press to end catheter motion and laser output.
Enable – Press to Auto Calibrate, Enable recording (if calibration is complete), or Start Pullback when using Manual Trigger.
Live View – Press to switch between Standby View and Live View.
Unload – Press to unload catheter.Note: The Unload button will not work during a broken catheter Safe Unload workflow until all the prior steps have been acknowledged via Accept. See the E.1.1 training module for the workflow steps.
Pullback Motion LEDs – Off when the imaging catheter is stationary.Blinks during pullback.
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FFR Workflow With Tableside ControllerAn FFR recording can be completed using the Tableside Controller. The Proximal Marker Button is used for all key FFR workflow steps; the Distal Marker is used only to Mark points on the recording. Follow the normal FFR workflow and use the Tableside Controller in the following way:
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Proximal Marker Button: All key FFR workflow steps
Distal Marker Button:Mark
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Angio Co-Registration Introduction
Angio co-registration will facilitate the integration of the OCT pullback into the PCI workflow.
How does it work? The software uses the catheter pullback marker bands visible in the angio cine to
create the co-registered images.
Key Benefits Facilitates OCT-guided PCI therapy
Collects all key vessel information for clinical decision making during one angio cine
Reduces OCT learning curve and time required to assess location of OCT
Increases confidence in relative position of angiographic and OCT image features
AC-R software will substantially improve workflow efficiencies when OCT is incorporated into a PCI procedure. Possible reduction in contrast utilization and radiation as compared to using
OCT without AC-R.
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Key Tips for OPTIS™ Angio Co-Registration Success
Good angio acquisition is key for successful OCT angio co-registration. The following are some key tips: X-ray equipment must be stationary throughout the cine. A view
that minimizes occurrences of vessel foreshortening and branch overlapping will minimize co-registration inaccuracies. LAO Caudal view or “spider view” can present challenges for the left
coronary arterial tree, depending on the angle of the image taken, especially if target area is in the proximal vessels.
The cine recording must encompass the entire OCT pullback, including the radiopaque section of the guidewire, all within the field of view.
If you can see the imaging catheter radiopaque marker bands on the angio, so can the software.
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Angio Co-Registration Pullback Workflow
When in Live Mode:
1. Click on the Acquire Angio button.
2. Select Enable (on the DOC or the screen).
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Angio Co-Registration Pullback Workflow
When in Live Mode:
3. Step and stay on the Cine Pedal.
4. Deliver contrast flush and begin pullback.
5. Step off the Cine Pedal upon completion of the pullback.
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Angio Co-Registration Workflow
The Angio Co-registration workflow provides guidance on how to co-register an angio image with the OCT pullback. Once the angio and pullback have been acquired, start the co-registration process
by single clicking Co-Register in the lower right corner.
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Note: This screen demonstrates the Co-Registration step with the catheter connected. When the catheter is disconnected, the two buttons switch locations.
On average, the co-registration takes about 8 seconds.
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Angio Co-Registration Workflow
If angio co-registration was previously completed successfully, the ability to re-register will be available under Menu.
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Angio Co-Registration WorkflowFollow the steps to complete the co-registration process
Notes: It is important to place the points from distal to proximal for the co-registration process to work.
Avoid placing control points within the aorta.
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If an incorrect vessel path is traced after placing the proximal point, click the Undo button and place a new proximal control point.
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Angio Co-Registration Workflow
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Ensure that the enlarged image has a circle tracking the lens marker throughout the pullback and the tracing of the pathway is within the vessel.
Click Accept to finalize or Cancel to start the co-registration over.
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Angio Co-Registration Workflow
The software will always provide something to review. If it does not look accurate or if the image has mostly red frames, Cancel and go through the provided workflow again.
Key Considerations Redoing the workflow:
May provide an improved co-registration if the hint points did not align with the guidewire or are in the wrong vessel
Likely will not provide an improved co-registration if: The vessel is foreshortened or the vessels overlap
The angio is a LAO caudal or spider-view image
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Angio Co-Registration Workflow
Once the co-registration is complete, the marker will move with the cursor on the pullback.
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Quick Zoom is available on the screen or TableSide Controller.
Co-registered marker band. This is white in areas where the software has high confidence.
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Angio Co-Registration Workflow
The marker on the angio will change to red when in areas that the software has less confidence due to poor visibility of the marker band.
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Note: Exercise caution when interpreting angio co-registration results in the red areas as the true location may not correspond to the marker on the image.
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Obtaining an AC-R Pullback From the Patient Summary Menu
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Pullbacks with AC-R will have the angio icon.
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