Optimizing Cardiovascular Disease Interventions with Alphenix

Dr. Masahiko Asami, Interventional Cardiologist at the Mitsui Memorial Hospital, Tokyo, Japan.

Dr. Masahiko Asami is an Interventional Cardiologist at the Mitsui Memorial Hospital in Tokyo, Japan. He specializes in diagnosing and treating structural heart disease (SHD). The number of patients requiring SHD treatments, including mitral valve repair and left atrial appendage closure, is rapidly growing in his daily practice, as well as globally. Dr. Asami explains how Canon’s Alphenix Intervention System supports his complex SHD procedures.

For transcatheter treatment approach, imaging plays a crucial role in SHD interventions, from preprocedural evaluation and device size selection to treatment and follow-up.

An essential partner

“The Angio system is an essential partner for the Interventional Cardiologist in delivering precision in various kinds of cardiac procedures and treatments for SHD. Therefore, we are very discerning about the quality of the equipment that we use for our daily practices,” remarked Dr. Asami. “We’ve been using Canon’s Alphenix Angiography system for years, and really love it. It provides great image quality, low dose exposure, low contrast media volume, great workflow, and useful panel detector size.”

The Mitsui Memorial Hospital has two Cath Labs running Alphenix. Cath Lab 1 is mainly used for electrophysiology (EP) and percutaneous coronary intervention (PCI) and is equipped with an eight-inch flat panel detector. In Cath Lab 2, Alphenix is mainly used for SHD, endovascular, and cerebrovascular treatments. They are performed using a 12-inch flat panel detector.

“Generally, the eight-inch flat panel detector is preferred for coronary cases because it is easier to avoid FPD interference with the patient, especially with steep C-arm angulation,” he explained. “However, we were uncomfortable with using a smaller field of view for SHD, cerebrovascular, and peripheral interventions. Our Canon 12-inch flat panel detector solved this.”

“Due to the fact that the housing size is very compact on 12-inch detector size of Canon FPD, the risk of collision with the patient is much less, even for coronary cases,” he continued. “The 12-inch flat panel is easy to use, and it can perform all procedures including PCI, so we can also utilize the larger FPD for other various cardiovascular cases, as we’re now able to secure a larger field of view. This ubiquity makes the 12-inch detector a good value investment for us.”

Outstanding image quality

The Alphenix system consistently provides a great image quality, which interventional cardiologists can concentrate on their procedures with fluoroscopic images that is noise-reduced, sharper, and more defined images during manipulating PCI devices and confirmation of coronary blood circulation, while minimizing dose.

“What I love about this system is image quality. With Canon’s technology, you can obtain deeper perception or better anatomy and gain better image comprehension in challenging situations, like steep angulation and examinations for obese patients,” said Dr. Asami.

Left Atrial Appendage(LAA) Closure

“You can minimize the use of contrast media” he added. Even using really low volumes of contrast media like three times diluted, the Alphenix’s DA diluted mode enables us to see great clear clinical images.”

The ability to perform SHD or PCI procedures using a very small amount of contrast medium means that SHD/ PCI can be offered to more patients and enables a broader access to PCI and SHD for patients at risk of, for example, patients with chronic kidney failure or contrast-induced nephropathy (CIN).

From a global perspective, shortages of contrast medium over the past few years have affected many hospitals and patients. The shortage has impacted millions of examinations, some of which are essential or improve diagnostic accuracy.

Transcatheter Mitral Valve Repair procedure

Exceptional agility

The range of C-arm positions of the Alphenix provide coverage from headto-toe and fingertip-to-fingertip.

“The C-arm of Alphenix is incredibly flexible. It can be moved to pretty much anywhere I want without having to move the catheter table.” noted Dr. Asami. “Very wide coverage when puncturing can be achieved both longitudinally and laterally, so we don’t have to move the patient table anymore, which also contributes to avoiding interference with ECG cable, blood pressure monitoring cable, and several lines from the anesthesia side.”

CT fusion during LAA closure

Unique workflow opportunities

The Alphenix offers integrated cardiac-optimized technologies to help deliver the best possible outcomes to patients. These include tools to simplify procedure planning, technology to help users see and navigate in confidence, and better protect patients with a comprehensive suite of optimized technologies.

“I really love the workflow of Alphenix. That is the absolutely unique point of Alphenix,” remarked Dr. Asami. “The CT fusion function would be a good example and that’s useful for us and accurate. It enables us to plan and deploy LAA closure device precisely.”

“I have no doubt that this technology will become one of the global standards in Interventional Cardiology market for the near future.”

Dr. Masahiko Asami, Interventional Cardiologist at the Mitsui Memorial Hospital, Tokyo, Japan.

Impact in Interventional Cardiology

“I have no doubt that this technology will become one of the global standards in Interventional Cardiology market for the near future,” concluded Dr. Asami. Interventional treatment is expected to become much less invasive in the near future, particularly through the use of AI technology. However, so far, it has only been used for post processing of obtained images such as CT and MRI. With the advances in technology, the time has finally come to utilize it for treatment in realtime enabling less radiation dose, less contrast media, and better device/vessel visibility. //

Mitsui Memorial Hospital, Tokyo, Japan

Dr. Masahiko Asami

Dr. Masahiko Asami, MD, FESC, FACC, is an Interventional Cardiologist at the Mitsui Memorial Hospital, Tokyo, Japan. He specializes in structural heart disease (SHD). Dr. Asami has over 52 peer-reviewed publications regarding the subject matter, previously he performed a LIVE TAVI demonstration focused on patient benefits and setting-up for superior long-term outcomes, from Swiss Cardiovascular Center, Bern University Hospital - Bern, Switzerland.