EVAR Guidance using previous CT Dataset (VEXX)

EVAR Guidance using previous CT Dataset (VEXX) job aid Angiography – Application software VExx* *An additional job aid is available on PEPconnect to determine the software version of the system. syngo EVAR Guidance is designed for semi-automatic planning and guidance of EVAR procedures using imported CTA data sets. 1. Import the CTA dataset from PACS. a) Browser > DICOM Q/R > Search for patient using appropriate Search Filters > Search > Select Series > Retrieve 2. Load the CTA into 3D Sharing once the patient is registered by double-selecting the series name. If patient demographics vary, confirm that the data belongs to the current patient and select Assign to Existing. Loading 3D Sharing X Different patient demographics! Use 'Load to Review' to close the current review patient and load the selected images for review. If the images belong to the patient "3D3DFusion_ACI_left_right, Head", you can load and add them to this patient by selecting 'Assign to Existing'. Enable the checkbox for confirmation before. I confirm that the data belongs to patient "3D3DFusionACI_left_right, Head" Assign to Existing Load to Review Cancel Loading Note: If you are pre-planning, you can do this workflow before the procedure. Images will load into the Viewer segment. Close image data after completing the workflow below. You may re- open the dataset using the Image Directory or Browser on the day or time of the procedure. 3. Select EVAR Guidance from the Workflow Header. Viewing Review vol Review and Processing browser Viewing Overlay Active Workflows EP Planning Embolization Guidance EVAR Guidance myNeedle Guide SIEMENS Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2024 Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Healthineers Job Aid Effective Date: 10/24/2024 | QR700014549 4. Automatic workflow will begin. 5. Define Vessel Tree will automatically be highlighted. a) The aorta, the iIliacs, and renal arteries are detected automatically. b) Other vessels can be added manually (e.g. SMA, Celiac, etc.) • Add Vessels that were not automatically detected. Select into the most distal end of the branching vessel. The vessel Segment will track back to the aorta “centerline. • Edit the Centerline that was automatically detected. Select and drag a point ...... to edit. 6. Define Landmarks will add or edit a vessel ostiums. a) Add or edit landmarks. b) Check the position and angulation of existing landmarks. Application Control 3D Sharing Application EVAR Guidance Application Object List Add or edit landmarks, if necessary. Check position and lation of any existing landmarks. Define Vessel Tr ... Define Landmarks Tools Bookmarks Layouts Overlay Angulation ADistance Show Landmark Adjust Color L Renal Infrarenal Landing Zone L Renal Ostium R Renal C R Renal Ostium Centerline Surface 7. Before or after draping the patient, drive the C-arm over the region of interest. 8. Overlay will automatically start a 2D/3D fusion workflow. Define Vessel Tr ... Define Landmarks Overlay syngo 3D Regist ... Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 10/24/2024 | QR700014549 Healthineers Page 2 of 5 9. Take two fluoro spots and/or single-shot images at least 30 degrees apart. It is recom- mended that images be obtained 90 degrees apart (e.g., AP and Lateral). 3D3DFUSION_ACI_LEFT_RIGHT, Head Coro (15 #/s) Female, 1/1/1961 (63), ID 778. Coronary p. ClearStent (VFR) 0.0 mGy 8.56 pGym 1 000.1 RAO 91 | 0- @ 49 cm ly 115 cm O FL(-) Card. (7.5 p's) 3D Sharing Q + Live Q Otject Lat 30 Marker Inderaca VOX Pun EVAR Best for training Anonymous y90 CT 2009E Anonymous Sensation 64 syngo CT 2009E CT B/19/2014 FFS 10:15:06 AM 3D3DFusion_ACI_left_right, Head 778 * 1/1/1961 £101212024 0 Application Control 30 Sharing ? @ Application Check registration result. If necessary, align data manually or 2030 3030 Layo symgo 30 Rage Select mage Visualization Show 20 Accept 2030 Cancel () Card. cm 49 R A Angle = 91º kV 82 mA 214 25 HAD 9170 364 294 RAO 91º / 0º FLUORO 7.5 fis 10. Protect 2D images from Heads Up Display or in the control room. Protect 2D mages 11. Perform manual and/or Automatic alignment. Alignment Manual Alignment Automati Registra. 12. Select Accept 2D/3D fusion. Accept 2D3D Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 10/24/2024 | QR700014549 Healthineers Page 3 of 5 13. The overlayed image will be on the 3D sharing segment. 303DFUSION_ACI_LEFT_RIGHT, Head lo Coro (15 $'s) Female. 1/1/1961 (63). ID 778. Coronary II- ClearStent (VFR) 0.0 mGy 8.56 pGym' EO 000.1 RAD 91+1 0' @ 49 cm [x 111 cm o FL[.) Card (7.5 p/s) 3D Sharing Q Live E Live on 30 Define settings for the Overlay visualization - HA 3D3DFusion_ACI_left_right, Head 778 1/1/1961 Application Control 10 Shang . with angulation information, detect joystick to drive to the look Bookmarks Layouts · LRural Inharenal Landing Zon & Renal Ostium Versel Suskes Contour Centering cm 49 A kV 82 mA 214 Overlays adjusted to c RAO 91 / 0 RAO 91º / 0º FLUORO 75 14. Additional overlay functions will be available in the Application Control window. Application Control ? @ Application EVAR Guidance X Close Application Object List Select a landmark from the list, if available. For landmarks with angulation information, deflect joystick to drive to the position. Define Vessel Tr. Define Landmarks Tools Bookmarks Layouts Overlay Show Landmark Ajust L Renal Infrarenal Landing Zone L Renal Ostium R Renal R Renal Ostium Vessel Visualization Contour Centerline Planning Volume a) Vessel Visualization b) Centerline/Planning Volume c) Hide all objects d) Live on 3D e) Object on Live 15. Select the Live on the 3D icon in the workflow. a) Blending bar is available to adjust the overlay of the live image. b) If re-alignment is needed during the procedure, select Align image data manually. Live on 3D Define settings for the Overlay visualization Blending rotect ... Automati ... Reset R Invert 2D Undock X Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 10/24/2024 | QR700014549 Healthineers Page 4 of 5 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the soft- ware and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please con- tact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted 0 Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2024 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: 10/24/2024 | QR700014549 Healthineers Page 5 of 5