This Image-guided Technology Is Changing Lives: An Expert Explains How

Eric Vazquez, director of radiology for Cape Coral Hospital, explains how the ARTIS Icono ceiling system is expanding precision medicine, transforming care delivery, and improving patient experience. 

The ceiling-mounted angiography system is designed for a wide range of routine and advanced image-guided procedures in interventional radiology (IR). The system’s high degree of mechanical flexibility also makes it suitable for many complex image-guided procedures. 

Below, Eric explains how the system works in two types of interventional procedures, endovascular leak (endoleak) and interventional oncology procedures.

Q: What is life-changing about this system for patients who have had endovascular aneurysm repair (EVAR) surgery? 

Endovascular aortic repair is a minimally invasive procedure used to treat aortic aneurysms by placing a stent graft within the aorta to reinforce the weakened area. However, endoleaks can occur when blood continues to flow into the aneurysm sac despite the placement of the stent graft. These leaks can potentially lead to complications if left untreated.

It's crucial to closely monitor patients who undergo EVAR surgeries, especially those who experience endoleaks. Lifelong imaging surveillance is recommended to detect and assess the status of the stent graft and identify any potential issues that may arise.

The ARTIS Icono ceiling system offers advanced imaging capabilities, particularly cone-beam CT (CBCT) technology. CBCT is a specialized imaging technique that provides three-dimensional (3D) images of the anatomy by capturing a series of X-ray images from different angles. This technology can offer a clearer and more detailed visualization of the stent graft and the surrounding structures. This enhanced imaging can be valuable for assessing the extent and type of endoleaks and for planning and performing those complex interventional radiology procedures to address them.

Managing endoleaks can involve various strategies, depending on the type and severity of the leak. Some endoleaks may require additional procedures, such as embolization (blocking blood flow to the leak) or re-intervention to modify the stent graft placement.

By combining advanced imaging technologies like CBCT with interventional techniques, medical professionals can make informed decisions about the appropriate course of action to address endoleaks and ensure the long-term success of EVAR procedures.

Overall, the management of endoleaks after EVAR surgeries underscores the importance of ongoing patient care, imaging surveillance, and access to advanced medical technologies that aid in diagnosis and treatment.

Q: Let’s talk about its use in interventional oncology procedures. Can you provide an example that demonstrates how the ARTIS Icono ceiling system is an improvement over older or other imaging technologies? 

Interventional oncology (IO) procedures indeed represents a cutting-edge approach to cancer treatment that allows for precise targeting of tumors while minimizing damage to healthy tissue. The ability to perform these procedures on an outpatient basis and with faster recovery times is a significant benefit for patients.

One of the key IO procedures is transarterial chemoembolization (TACE), which is a minimally invasive technique used primarily for treating liver cancer. In TACE, chemotherapy drugs are directly delivered to the tumor site through the blood vessels that supply the tumor. This targeted delivery helps to maximize the impact of the chemotherapy on the tumor cells while minimizing its effects on the rest of the body.

Additionally, Y-90 SIR-Spheres and TheraSphere procedures are radioembolization techniques that involve injecting microspheres directly into the blood vessels that supply the tumor. These microspheres emit radiation locally, delivering a higher dose of radiation to the tumor cells compared to surrounding healthy tissue. This approach can be particularly useful for treating liver tumors that are difficult to remove surgically or are not responding well to other treatments.

It's important to note that these IO procedures are typically considered when the cancer is advanced or when other treatment options like surgery or systemic chemotherapy might not be suitable. They provide an alternative way to manage the disease and improve the quality of life for patients who may not tolerate traditional treatments well.

As with any medical procedure, patient selection and careful evaluation are essential to determine the most appropriate treatment approach. It's also crucial to have a multidisciplinary team of medical professionals involved, including interventional radiologists, oncologists, and surgeons, to ensure the best possible outcomes for patients undergoing these procedures. Lee Health provides this multidisciplinary approach and Cape Coral Hospital has the market’s most advanced imaging technology to perform these important IO procedures.

Overall, the field of interventional oncology continues to evolve, and these innovative procedures offer promising options for patients with certain types of cancer, such as when unresectable hepatocellular carcinoma (HCC) are present or unresectable metastatic liver tumors from primary colorectal cancer in patients that may be intolerant of chemotherapy. It's impressive to see how these techniques are helping to advance cancer care and improve the lives of those affected by the disease.