Page 22 - Journal of Structural Heart Disease Volume 5, Issue 2

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Original Scientific Article
Table 5. Comparison of Camera Characteristics«
PAS
MAS
Product name
FDA cleared, yr Type
Radiation lowering/dose control features
Radiation dose monitor- ing features (for staff and/ or patients)
X ray generator Type
Power rating, kW at 100 kVp
Radiographic mA Radiographic kV Fluoroscopic mA
Fluoroscopic kV Focal spot size (mm)
Pulsed fluoroscopy; Cine range (fps)
Housing heat storage capacity, MHU
Diameter of intensifier or dimensions of detector, cm
Siemens Cios Alpha
2014
Mobile C-arm
Yes Yes
Monoblock
25
10 - 250 40 - 125 3- 250
40 - 125 0.3
Yes; 0.5 - 30
5.3
30x30; Cardiac 20x20
Ziehm Vision RFD
2009
Mobile C-arm
Pulsed fluoroscopy; low-dose mode; object detected dose control; PreMag; removable grid
Calculated DAP; air kerma; mea- sured DAP (option); structured dose report
Monoblock and high frequency
20 / 25
Up to 20 40 - 110
1.5 - 180 (at 20 kW); 1.5 - 250 (at 25 kW)
40 - 120
Dual focus: 0.3 / 0.6
Yes; 1, 2, 4, 8, 15, 30; Cine 1 - 25
Anode: 0.365; System: 10
30x30 (a-Si); 20x20
GE OEC 9900 Elite
2008
Mobile C-Arm
Pulsed fluoroscopy; low-dose mode; preview collimator; laser aimer
Yes
High frequency split block
15
Up to 75 50 - 120
Normal: 0.2 - 10; HLF: 1 - 20
40 - 120 0.3 - 0.6
Yes; 1, 2, 4, 8, 15; up to 30 fps
0.3
31x23x15 image intensifier
Philips Allura Xper FD20
2013
Ceiling mounted single plane
ClarityIQ DoseAware
High frequency
100
1 - 1250 40 - 125 60
40 - 125
0.4 and 0.7 (MRC)
Yes; 3.25, 7.5, 15 and 30 fps; optional 60 fps
Anode: 2.4; System: 5.4
30x38
«Adapted from references 27-29.
kVp = peak kilovoltage; HLF = high level fluoro; a-Si = amorphous silicon; other abbreviations as in Table 3.
can simplify operative workflow, condense OR space allocation, and reduce resource consumption, all of which have the potential to reduce overall cost. PAS may also be used to facilitate conversion of a tradi- tional OR to a hybrid OR, reducing the transition time for implementing a TAVR program. As TAVR proce- dures become more routinely performed in lower risk populations, PAS allows institutions seeking to initi- ate or expand TAVR programs to do so without fur- ther straining institutional resources.
Our study is limited by small sample size and single center, retrospective design. Though the same imag- ing mode was used in both fluoroscopic camera sys-
tems, there may have been differences in their calibra- tions, which could confound the observed differences in outcomes. Furthermore, the relatively small sample size increases the risk of a type II error. The limitation of sample size is further demonstrated in radiation measurements. Because the GE Advantx DLX camera did not monitor radiation exposure, there may have been insufficient power to detect a statistically signif- icant difference in DAP. Similarly, while the subgroup analysis was consistent with the overall observations of the study, there may have been insufficient pow- er to detect a statistically significant interaction be-
Ahmed B. et al.
TAVR Using Portable Fluoroscopy