Devices in the cardiac catheterization field are concerned with the study and treatment of the heart chambers, coronary arteries, and other proximal vasculature. Categories in this field may include: Cath Labs, Radiographic Fluoroscopic units, Digital Vascular Imaging Systems, Angiography Units, Cardiac Catheterization Equipment and Cardiac Cath Lab Imaging Systems

The preferences and recommendations regarding angiography are for systems intended mainly for peripheral and abdominal vasculature cases.
All three types of systems - cardiac catheterization equipment, general angiography units, and multipurpose systems - have different requirements regarding the C-arm assembly, image-acquisition detector, image processor, and patient-table characteristics.
The requirements of general angiography systems include: a larger field of view, expended tabletop movement, a lower frame rate, and C-arm gantry angulation range that is less than that of dedicated cardiac catheterization equipment.
In some hospitals, the demand for any one procedural category may not justify a dedicated Cardiac Cath Lab Imaging System. The multipurpose special procedure systems are designed to meet such needs. However, both cardiologists and radiologists should be concerned with detector size.
Rotational angiography capabilities, which are offered by some Cath Lab systems, allow users to select start and end points for arm rotation. These systems can be used in bolus chasing and certain cardiac imaging procedures. Although rotational angiography is slower than biplane systems, it is useful in studies traditionally performed with biplane systems.
Facilities that are considering the purchase of a Cath Lab capable of rotational angiography, should determine how it applies to the types of procedures performed in the facility and the rotational speed offered by the Digital Vascular Imaging System.
One of the most important factors to consider before purchasing an angiography unit is detector size. For imaging peripheral vessels, larger sizes may be necessary, while smaller sizes are suitable for more detailed images of cardiac anatomy.
When selecting an x-ray generator, facilities must also consider the needs of the department in mind. The following Digital Vascular Imaging System generators are currently available and commonly used for vascular imaging: three-phase, 12-pulse, high frequency, and constant-potential generators.
While constant potential generators have the lowest amount of ripple but can be larger and more expensive, high frequency generators are smaller and easier to install in space-constrained areas, with an amount of waveform ripple that is not clinically significant.
Some additional critical factors when choosing a Cath Lab are the heat dissipation rate and heat capacity of the x-ray tube anode. Only 0.2% of the electrical energy delivered to any given tube is converted to x-rays; the rest is converted to heat, which will harm the anode if not quickly dissipated.
The following may help dissipating the heat: rotating and larger diameter anodes, circulated liquid cooling systems, and ceramic tube envelopes, also crucial when considering a Cath Lab purchase..
When using a Radiographic Fluoroscopic Unit, using higher anode heat capacity provides longer fluoroscopy runs, higher overall output, and an extended x-ray tube life.
For some advanced interventional procedures that require longer imaging times, the high heat capacity and faster heat dissipation tubes are especially important in a Cath Lab.
Cath Lab anode heat capacity should be at least 1,000,000 HU.
Facilities should also consider the Angiography Unit's focal spot size and target angle of the anode. Anodes with a smaller focal spot provide better quality images but do not dissipate heat as well as larger ones, which are ideal for investigating ischemic heart disease. Cath Lab magnification angiography requires a focal spot size of 0.3 mm or less.
Cath Lab Manufacturers often offer multi focus tubes with two or three focal spot sizes, to accommodate this wide range of imaging techniques and procedures.
The focal spot size and the heat dissipation characteristics of the tube are both determined by the target angle, another important feature to consider when purchasing a Cath Lab.
Pulsed fluoroscopy can be carried out by some of the Cath Lab systems. In this technique an x-ray output of 32 pulses per second is possible.
The monitor holds the image acquired during each pulse until it is updated by another pulse; a continuous image is seen as a result, although the pulsed-mode display may become jittery a very fast motion is observed.
Exposure rates can be significantly reduced by pulsed fluoroscopy by as much as 70% without a significant loss of image information; some Cath Lab systems can perform multiple-rate pulsed fluoroscopy with two or more rates ranging from 7.5 to 30 fps.
The last-image holding feature, which retains the fluoroscopic image on the screen even after the x-rays are turned off, is offered by some Cardiac Catheterization Equipment systems. This feature enables the radiologist to examine the area in question with decreased x-ray exposure to the patient.
DSA is the most common application in Cahth Labs; a mask image is digitally stored before injection of the contrast medium and then subtracted from the image acquired after injection.
Another common application is the road mapping, which allows Cath Lab users to retain a contrast-enhanced image on the monitor for use as a guide during certain procedures. Using this feature can facilitate the placement of devices such as stents and balloons and the navigation of guide wires and catheters through severe stenoses, as well as reduce the total contrast medium dose.
Cath Lab Systems offering three-dimensional angiography should be considered by facilities planning to purchase new R/F angiographic systems.
Multiple views can be recorded from a single injection of contrast medium by using rotational angiography, which is an acquisition mode designed to allow this capability in Cath Labs.

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