36A79719Q0008-036.pdf

Qty Item Description

1 Artis Q.zen ceil. Combo Card/Rad The Artis Q.zen product line uses a new detector technology based on crystalline silicon, setting new standards for low-dose fluoroscopy in interventional imaging. The GIGALIX X-ray tube concentrates high pulse power on small, square-shaped focal spots (flat emitter technology for all focal spots).

The Artis Q.zen ceiling for interventional cardiology and radiology now features PURE(r).

PURE adds smooth interaction to Siemens' smart technologies. It is designed to boost productivity and enhance outcomes for certain clinical applications, while increasing image quality and reducing dose.

The ceiling-mounted C-arm offers highly flexible positioning. The motorized rotation of the C-arm from a head-end position to a lateral position allows for free head access and full patient coverage without rotating the table.

The mid-size zen30HDR detector enables ultra-low dose imaging.

Frame rates up to 30 f/s and functions for displaying and storing ECG curves are included.

Digital acquisition technology and digital subtraction angiography with up to 7.5 f/s in 1k matrix are available.

The complete CARE+CLEAR package offers optimal image quality at the lowest reasonable dose.

Live and reference images are displayed on two 19" flat screens in the exam room. In the control room live images are displayed on a third screen.

1 Automap Automatic stand positioning depending on the selected reference image and automatic reference image selection depending on the stand positioning.

1 Head-end table tilting Motorized tilt and stepping of the patient table in longitudinal direction for electrophysiological or peripheral examinations, for example, as well as for stabilizing a patient. Includes a power-assisted tabletop control module.

SHIP TO: DISTR CTR

V.A. Medical Center

BLDG 46

1501 SAN PEDRO SE

ALBUQUERQUE, NM 87108

REQUISITION: 501-B80040

Trade-In:

Manufacturer: Philips Healthcare 1 EA Model: FD 20 Serial: 1286 Site# 56855926 Acquisition year: 2012

Notes:

Table tilting reduces the maximum patient weight to 200 kg. As before however, it is possible to install up to 40 kg of additional accessories.

Note: It is mandatory to provide UPS back up with this table option in order to comply with IEC 60601-2-43 CL. 201.15.101. Reason: In the event of power failure a neutral table position suitable for CPR must be reachable within 15 seconds. Please include a suitable UPS from Siemens as required or make sure any existing / planned UPS provision for your installation site will satisfy the requirement

1 Mem. enhncmnt. 3 (50k - 1k Matrix)

Memory capacity extended by 25,000 images, from 25,000 images to 50,000 images in 1k matrix.

1 Mem. enhncmnt. 4 (100k- 1k Matrix)

Memory capacity extended by 50,000 images, from 50,000 images to 100,000 images in 1k

1 EP shielding kit

This compact collimator optimized for EP applications replaces the collimator described in the basic configuration.

1 Fluoro Loop

Storage and review of dynamic fluoroscopic sequences (Fluoro Loop). This saves an additional acquisition and reduces dose. The maximum storable fluoroscopic time depends on the selected pulse rate, e.g. 34 s at 30 p/s, 68 s at 15 p/s.

1 CLEARstent Live

CLEARstent Live is a real-time stent enhancement tool and provides a stabilized view of the moving stent which is displayed on the Assist/Reference Monitor. CLEARstent Live allows real-time verification of stent positioning while moving the device. This enables the physician to precisely position the stent in relation to the anatomy of the heart and stents that already have been implanted. Contains both CLEARstent Live license and CLEARstent license.

The CLEARstent imaging function allows an improved display of fine stent structures, i.e. the grid of inflated stents. CLEARstent is a post-processed stent enhancement and may be used also on previously acquired images.

Using the CLEARstent function special reference images from any scene or fluoroscopy scene acquired natively will be generated. Composite images are created by averaging several frames of a scene and by considering the alignment of balloon markers. If an ECG signal is available, the heart phase will also be taken into account.

1 PERISTEPPING / PERIVISION

Motorized stepping for real-time bolus chasing.

C-arm stepping with ARTIS pheno and ceiling mounted systems, table stepping with floor mounted and biplane systems.

Peripheral digital angiography with stepping and online subtraction display.

1 DYNAVISION DSA/DR

Native or subtracted digital rotational angiography with angle triggering.

1 Vascular analysis

Vessel analysis with determination of degree of stenosis, distance measurement and calibration.

1 LV Analysis

Analysis of the left ventricular function of the heart.

1 Scientific QCA

Scientific coronary vessel analysis with determination of degree of stenosis, distance measurement and calibration.

1 syngo Valve Guide Engine

A workstation for reconstruction, post-processing and handling of 3D information including specific applications to support valve implantation or replacement procedures like TAVI/TAVR.

The package includes the following functionalities:

- 3D high-contrast imaging and syngo DynaCT Cardiac triggered/ untriggered for zen30HDR detector

- syngo DynaCT Cardiac uses proven algorithms to perform 3D reconstruction of ventricles and vessels of the heart from projection images of a rotational angiography of the Artis system

- 3D roadmap for dynamic overlay of planning data and 3D volumes on live fluoroscopy

- workflow support for valve implantation or replacement

- In-room control for table-side operation of advanced applications

- Expert-i functionality for remote operation of the XWP.

- 3D Wizard for expert step-by-step guidance in 3D acquisition

- Parallel patient processing capabilities

- Fusion functionality (3D/3D and 2D/3D) for integration of pre-interventional 3D datasets from other modalities into the Angio-room - Marking of points or lines on the 3D geometry or MPRs and overlay of these markings on live fluoroscopy.

1 syngo TrueFusion syngo TrueFusion efficiently integrates True Volume TEE guidance into structural heart disease procedures. Based on the co-registration of an Artis angiography and an ACUSON SC2000 PRIME ultrasound system syngo TrueFusion enables fusion of TEE landmarks and valve models with live fluoroscopy for target oriented device navigation. The relevant TEE structures for guidance can be marked directly on the US system through the Echo expert and sent for fusion. Additionally the co-registration information can be used to synchronize the image orientation of X-ray and echo images to facilitate communication and potentially save fluoro time and contrast dye.

Disclaimer for Application Software VD2:

The products/features (here mentioned) are not commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens organization for further details.

1 syngo CTO Guidance

Expand your procedure mix by treating more CTO patients Treating Chronic Total Occlusions (CTOs) is one of the most challenging procedures in interventional cardiology. Incomplete crossing of the lesion is a high risk.

syngo CTO Guidance enables better planning with automatic segmentation of coronaries coming from the CTA. This helps to get a better understanding of the lesion and planning the procedure. Further, it provides additional information during the procedure and guidance with color-coded COROwave to avoid foreshortening.

This enables more physicians to treat complex CTO cases and helps to expand the hospital's procedure mix.

syngo CTO Guidance provides industry-leading support and guidance during CTO revascularization procedures.

1 syngo Angio Package

Software package consisting of DSA Angio Viewer as well as High-Speed Review for real-time display (with the same frame rate as the acquisition) of native and subtracted angiography images.

1 Lower body radiation protection

This radiation shield protects the user from scattered radiation when standing at the table side.

It can be attached to the accessory rails either on the right or on the left side of the patient positioning table.

It provides the user an additional accessory rail.

It includes a basic unit (71.5 cm x 75 cm / 28.2'' x 29.5'' (l x w); 7.7 kg / 16.98 Ib), one lower body radiation protection pivot swivel element (77 cm x 48 cm / 30.3'' x 18.9'' (l x w); 3.8 kg / 8.4 Ib) and three clip-on units (57 cm / 22.4'' x 33 cm / 12.99'' (l x h), 2.2 kg / 4.85 Ib;

27 cm / 10.6'' x 33cm / 12.99'', 0.9 kg / 1.98 Ib and 27 cm / 10.6'' x 25cm / 9.8'', 1 kg / 2.2 Ib ) with a lead of 0.5 mm / 0.02'' Pb.

The maximum weight of the accessory rails is 40 kg (88.2 Ib).

Intended only for use with Artis / ARTIS tables.

1 Mobil upper body rad. Prot. XL

This enlarged radiation shield with a curtain provides for the user an increased protection from scattered radiation compared to the smaller one.

It includes two scattered radiation protection blankets, a protective curtain and a ceiling rail (4 m / 157.5''). The blankets cover the patient's body in order to increase the reduction rate of scattered radiation. The curtain increases the scattered radiation protection by closing the gap between patient and shield.

The shield is made of acrylic glass with lead equivalent of 0.5 mm / 0.2'' (w x h: 78 cm x 90 cm / 30.7'' x 35.4'') which can pivot and rotate around a fixed point with a range of 360 degrees.

The shield has a special patient cut-out for interventional examinations.

It is mounted on a counter-weighted, height-adjustable support arm that is fixed on a column with a height of 80 cm or 57 cm / 31.5" or 22,4''.

1 LED Exam Light

Ceiling-mounted, flexible positionable examination light with focusable light system. It is fully integrated into the ceiling-installed radiation protection mounting unit.

- Luminance: 60,000 Lux for 100 cm / 39.4'' distance

- Working distance: 70 to 140 cm / 27.6'' to 55.1''

- Color rendering index Ra at 4500 Kelvin: 95

- Color temperature: 4,300 Kelvin

- Focusable light field: 14 to 25 cm / 5.5'' to 9.8''

- Diameter of light head: 33 cm / 13''

- Number of LEDs: 19

- Total input power: 20 VA

1 VA kit Artis Q/Q.zen systems

Second set of system documentation (operator manual, etc.)

1 Intercom - Comfort

Intercom system for communication between examination room and control room.

It includes

- a microphone with a control box for the control room

- a microphone with an adaptive acoustic filter for background noise suppression for the examination room

- a footswitch for conversation selection for the examination room The microphone of the examination room is installed on the ceiling.

1 Large Display diagn. Protection

The high quality laminated glass protective screen protects the panel of the monitor against mechanical damage and fluid ingress on the front.

It is suited for clinical image evaluation.

Features:

The laminated glass enforces high mechanical strenght and resistivity against mechanical impact, the special coating reduces reflections for a continuous image quality, excellent spectral transmisison of at least 98%, can be added to existing Artis Large Display installations.

Weight: approx. 12kg (55") up to 16kg (60")

Note: Observe the maximum permissible load of the display suspension, a combination with other options mounted to the display suspension might be restricted.

1 Infusion bottle holder

This infusion bottle holder can be mounted at the accessory rail of the patient table. It holds up to 4 infusion bottles.

It includes an infusion bottle holder made of stainless steel with 4 retaining rings.

Length: 84 - 138 cm (21.6'' - 54.3'') Weight: 1.3 kg (2.87 Ib)

Intended only for use with Artis / ARTIS tables

1 Cable clips ECG

Cable clips for securing the ECG cable to the patient tabletop.

It includes 10 cable clips.

Intended only for use with Artis / ARTIS tables

1 Arm holder (pair)

The patient's arms can be comfortably placed along the body using these two arm holders.

They slide underneath the patient mattress and is held in position by the patient's weight.

It includes two pairs of arm holders of different length (540 mm / 690 mm - 21.2'' / 27.2'') and height (85 mm / 115 mm - 3.35'' / 4.53''), suitable both for thick and thin patient mattresses.

Weight small arm holder: each 0.65 kg / 1.43 Ib Weight large arm holder: each 0.95 kg / 2.09 Ib.

Intended only for use with Artis / ARTIS tables.

1 Sec. operation in the control room

Interface for connecting the additional system control from the control room.

Rail profile for hanging control modules (e.g. the table module) in the control room.

Safety button for switching off all system functions from the control room.

1 Secondary Hand Switch Ctrl (C Room)

Additional hand switch for radiation release and additional control functions.

1 VOLCANO s5i cable set

Cable set for operating the Volcano s5i ultrasound system incl. s5iz and s5iu (CORE-System).

It contains all cables for connecting the components at the patient table to the s5i imaging system in the control room.

This cable set will already be integrated into the Artis table in the factory.

With this item, a display is delivered additionally for the examination room if an Artis Large Display was not ordered. If an Artis Large Display is ordered, the configuration includes a connection kit for the Artis Large Display instead of the 19" display.

1 DICOM Print

Provision of DICOM Print service for connection to a laser camera or a network printer (postscript-capable).

1 DICOM RIS-Modality Worklist

Import of patient/examination data from an external RIS/HIS patient management system with DICOM MWL (Modality Worklist).

1 OEM recording system interface

Cable connection to an OEM measurement system.

Holder for the ECG interface when using an OEM measurement system in the examination room.

Recording, storage, and display of an ECG lead. Displayed together with the image information on a single monitor.

1 Injector Wall Connection - Pedestal

Interface for connection of the contrast medium injector in the examination room, remote from the patient table.

Injectors can be offered by Siemens Healthcare Accessory Solutions

1 Large Display large work area

Preparation for the large color flat screen display on an extended arm for increased reach and working range. An additional cantilever beam extends the radial coverage of the display by approximately 60 cm.

This extended suspension is installed on a ceiling-mounted carriage. The display holder is height-adjustable, longitudinally mobile and can swivel and rotate.

In case of a ceiling-mounted or biplane configuration the carriage operates in the same rails as the C-arm carriage, which have been extended by 1.2 m for easy operation.

This item also includes cables for the examination room.

Note: The type of large display can be chosen with a separate position.

1 Large Display video controller 24

Large Display Video Controller 24 is the largest of three different video controller sizes. A maximum of 24 video signals can be connected and 21 displayed simultaneously on the Large Display.

The Large Display video controller 24 receives various internal and external video signals for presentation to scale on the Large Display.

Up to 24 external and internal video sources can be connected, 18 digital (DVI-D), 3 analog (VGA) and 3 combined analog/digital channels.

1 Add 19" display for LD (rear mount)

19" TFT display including 36 m cable with DVI-D connection and transceiver for display installation on the rear of the DCS in combination with the Large Display.

1 LD High Contrast panel size 55"

Large color flat screen display (including cables) for the examination room, with a panel diagonal of 55". This large display version provides an excelling clinical image quality due to it's new IPS panel technology.

1 Artis Cockpit - 2 consoles

The Artis Cockpit enables the operation of up to 9 systems and the presentation of up to 9 video signals on up to two high-resolution High Bright 30" displays. The connected systems are operated via keyboard and mouse. Configuring an additional keyboard and mouse for a second operator is also possible as an option.

Attention: If a Cockpit is selected, the Artis basic configuration includes a connection kit for the Cockpit instead of the display for the control room.

1 Initial onsite training 32 hrs

Up to (32) hours of on-site clinical education training, scheduled consecutively (Monday - Friday) during standard business hours for a maximum of (4) imaging professionals. Training will cover agenda items on the ASRT approved checklist. Uptime Clinical Education phone support is provided during the warranty period for specified posted hours. This educational offering must be completed (12) months from install end date. If training is not completed within the applicable time period, Siemens obligation to provide the training will expire without refund.

1 Follow-up training 32 hrs

Up to (32) hours of follow-up on-site clinical education training, scheduled consecutively (Monday - Friday) during standard business hours for a maximum of (4) imaging professionals. Uptime Clinical Education phone support is provided during the warranty period for specified posted hours. This educational offering must be completed (12) months from install end date. If training is not completed within the applicable time period, Siemens obligation to provide the training will expire without refund.

1 Follow-up training 12 hrs

Up to (12) hours of follow-up on-site clinical education training, scheduled consecutively (Monday - Friday) during standard business hours for a maximum of (4) imaging professionals. Uptime Clinical Education phone support is provided during the warranty period for specified posted hours. This educational offering must be completed (12) months from install end date. If training is not completed within the applicable time period, Siemens

2 Additional onsite training 24 hours

Up to (24) hours of on-site clinical education training, scheduled consecutively (Monday -will cover agenda items on the ASRT approved checklist if applicable. This educational offering must be completed (12) months from install end date. If training is not completed within the applicable time period, Siemens obligation to provide the training will expire without

4 Additional onsite training 32 hours

Up to (32) hours of on-site clinical education training, scheduled consecutively (Monday -will cover agenda items on the ASRT approved checklist if applicable. This educational offering must be completed (12) months from install end date. If training is not completed within the applicable time period, Siemens obligation to provide the training will expire without

2 GOVT Training Class (T & L not included)

Tuition for (1) government attendee to attend a classroom course of choice at one of the Siemens training centers. This educational offering must be completed (12) months from install end date. If training is not completed within the applicable time period, Siemens

1 Mark 7 Arterion, Table Mount Injector

The Arterion Mark 7 Table contrast medium injector allows for the remote installation of the system power supply and installation of the injector head onto a table bracket.

The injector system includes:

Power supply and injector head with corresponding cabling An adjustable height table bracket for the injector head A desk mounted user control console with large touch screen

Functions Pressure limitation:

for 150 ml syringes 689 to 8273 kPa, corresponds to 100 to 1200 psi. .

Flow rates for 150 ml syringes:

0.1 to 45 ml/s in increments of 0.1 ml/s

0.1 to 59.9 ml/min in increments of 0.1 ml/min rise/fall: 0 to 9.9 s in increments of 0.1 seconds

Release delay for injection or radiation:

0 to 99.9 s in increments of 0.1 s.

Adjustable volume for 150 ml syringes:

1 ml to the max. syringe capacity in increments of 1 ml.

Fill rate:

Variable syringe filling speed 1-20ml/s.

Injection protocols:

Up to 40 injection protocols possible.

Parameters currently displayed on the touch screen display and on the head display:

Injection speed Injection volume Remaining volume Injection duration Applied pressure

Contrast medium heating:

Nominal 35°C (95°F)+-5°C (9°F)

Injection data memory Up to 50 injection data items stored

Included in the scope of delivery Injector standard configuration 150 ml SIEMENS interface cable Operator Manual Service manual (English).

Power supply 200 V to 250 V; 50/60 Hz.

1 Arterion Rack Mnt Install

1 Black anti-fatigue mat 36x60

Black NewLife EcoPro anti-fatigue mat (36 inches x 60 inches), 3/4 inch polyurethane foam, fluid and dirt resistant with anti-micorbial properties, matte textured surface.

The ultimate employee benefit for workers who stand, are ergonomically designed to provide the perfect balance of premium comfort and optimal support. Proprietary Cellulon(r)Polyurethane Technology stands up to the tough demands of commercial environments while providing lasting comfort that won't bottom out over time. This eco-friendly line of anti-fatigue mats is certified by the National Floor Safety Institute for its high traction bottom surface.

1 Standard Rigging zee SP GOV

1 Artis Q System Complimentary Biomed Training

This educational offering includes system training tuition for 1 clinical engineering professional on the Artis Q System Training and the syngo multimodality workstation as applicable. The training curriculum depends on and is limited to the system purchased and may include multiple courses including classroom training in USA or an international site, and/or virtual and web-based training. Additional modality basics training may be required as a prerequisite to these courses and must be purchased separately. This system training includes a 15% discount. Travel and lodging are not included. This educational offering must be completed by the later of (12) months from purchase or install end date; if training is not completed within the applicable time period, Siemens obligation to provide the training will expire without refund.

This forfeiture does not apply to Federal government agencies.

Offset Artis Q System Complimentary Biomed Training (

Offset Part 14434137 VA Kit Artis Q/ Q.zen systems

Offset Initial Training 32 hrs

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Detailed Technical Specifications

Description System description:

The single plane X-ray angiography system for digital acquisitions was designed to meet the requirements of modern angiography and interventional procedures, with a focus on interventional radiology with combined applications.

C-arm ceiling-mounted stand:

System cable outlet at the ceiling carriage, on the patient's left side.

- Up to 5 preprogrammed work positions, additional 50 user-definable work positions and 3 direct positions can be stored and recalled from table side.

- One single joystick for patient angle oriented operation of C-arm and change of source image distance (SID).

- Integrated computerized collision protection

- C-arm positioning 0° to the head end and variable up to 135° to the left and right side along the patient longitudinal axis.

- Double oblique projections of ±100° in orbital movements and up to 330° (+180°/-150°) in rotational movements.

- Variable C-arm speeds up to 25°/s.

- Variable focal-spot-to-detector distance between 90 cm and 120 cm.

- Isocenter-floor distance 108 cm.

- Focus-isocenter distance 78.5 cm.

MULTISPACE.T

The stand can be positioned on the left or right of the patient or at the head end, or at any angle in between. It can be moved longitudinally to any position along the length of the patient and also has a park position at a sufficient distance from the patient.

In Focus allows the projection angle to the patient to remain unchanged when rotating the C-arm around the table.

IsoTilt allows the projection angle to the patient to remain unchanged when tilting the patient table (if the tilting function is available).

Both In Focus and IsoTilt improve the efficiency of an examination because there is no need to spend time adjusting the projection angle.

Patient table configuration

Table

- Direct patient access from all sides, both through the swiveling table and large tabletop cantilever.

- Electromechanical release of table swivel at the touch of a button at the table.

- Telescopic foot with motor-driven height adjustment.

- Maximum patient weight: 250 kg. It is possible to install up to 40 kg of additional accessories, plus a further

100 kg for patient resuscitation.

The table can be rotated to ensure quick access to the patient even in emergency situations.

Tabletop Narrow-shaped carbon fiber patient positioning tabletop with head-end recess. Ideal for cardiological applications.

Tabletop tapered in the thorax area for maximum freedom of C-arm angulation.

Mattress Matching, special-foam mattress, 4 cm, incl. a latex-free cover.

This visco-elastic comfort mattress reacts to temperature and has the special property of adapting to the individual body shape under the influence of body weight and heat.

Application-specific accessories

- ECG cable clips

- Unilateral armrest: Carbon fiber armrest for cardiology and arm angiography to slide underneath the positioning mattress.

- Infusion bottle holder

- Instrument tray: Plastic instrument tray to be positioned at the patient table above the patient. It is swivable and height-adjustable, so that it can be positioned directly or sideways above the patient.

- Arm holder (1 pair): Two arm holders for comfortable lateral arm positioning along the patient’s body.

- Hand switch for radiation release and additional control functions.

If narrow tabletop is selected:

- Head-end holder: Accessory rail plus holder, which is installed at the head end of the narrow tabletop. For attaching hand grips, shoulder supports, head supports, articulated arm supports, and anesthesia curtain.

- Handgrips with support The patient can hold on to these hand grips with his arms above his head resting comfortably on the supports.

This is beneficial for examinations requiring the arms to be held in a specific position. The two stainless steel hand grips with two radiolucent arm rests (12.5 x 24.5 cm/ 4.9'' x 9.65'') are mounted to the accessory rails of the head-end holder.

It can only be used in combination with the narrow tabletop and with the head-end holder.

Operating modes

Fluoroscopy

- Digital pulsed fluoroscopy with pulse frequencies of 7.5 p/s, 10 p/s, 15 p/s, and 30 p/s in 1k/12 bit matrix.

Pulse rates of 0.5 - 4 p/s are also possible with CAREvision.

- Overlay fade: On-line overlay of the reference image onto the active fluoroscopy. This improves efficiency and safety during interventional procedures because additional information which is clinically necessary can be displayed directly in the live fluoroscopy image.

Card acquisition Digital card acquisition technology with frame rates of 7.5, 10, 15, and 30 f/s acquisition, display, and storage in 1k

Digital acquisition technology Digital acquisition technology with frame rates of 0.5 to 7.5 f/s in 1k/12 bit matrix and digital real-time filtration.

Single image and serial acquisitions with time-controlled and manually variable frame rate.

The 1k image matrix with a bit depth of 12 bits allows an excellent image contrast by using 4,096 shades of grey.

Thus, the image quality meets highest expectations in angiography and fulfills all prerequisites for precise diagnostics and safe interventions.

Digital Subtraction Angiography:

Digital Subtraction Angiography with frame rates of 0.5 to 7.5 f/s, including pixel shift, remask, roadmap, peak opacification for iodine contrast (MaxOpac), and CO2 contrast (MinOpac); adding of the anatomical background (landmark) from 0 to 100%.

Includes the "Advanced Roadmap" additional function which offers the following clinical benefits:

- DSA image can be selected as a mask for Roadmap

- Zoom can be changed during Roadmap

- Catheter and vascular contrast can be changed separately

Unexpected patient movements in DSA acquisitions can be corrected easily with Auto Pixelshift. This saves time for the user and improves image quality.

CLEARmap Special 2D Roadmap operating mode creating a vessel map from a DSA-scene using Maximum Opacification technique. As an additional operating mode, you can also decide to pick one frame out of a DSA run (i.e. for venous access in Roadmap).

This provides improved image quality compared to conventional Roadmap, and reduces x-ray dose and contrast media.

CLEARmatch Automatic/Online pixel shift processing for most accurate subtracted image display during Roadmap and DSA based on real time movement detection and compensation.

Six degrees of freedom – vertical, horizontal, rotational, zoom and shearing movement (left and right) - allowing highest possible efficacy. In order to show the most recent information in raw format, the pixel shift operation is applied to the mask image. This optimized way of pixel shifting ensures a perfect match of Roadmap image and native fluoro image, being shown at the Assist monitor.

CARE package

ALARA principle Siemens follows the ALARA principle: "As Low as Reasonably Achievable"; the CARE package (Combined Applications to Reduce Exposure) was developed based on this research and development principle to protect the examiner and the patient.

Dose saving

- CAREfilter: Intelligent control software that minimizes X-ray dose. During fluoroscopy and acquisition, special copper prefilters are automatically inserted into the X-ray beam depending on current X-ray transparency, which is calculated continuously. This is necessary to ensure that the optimal prefilter value is always active.

This automation makes work easier for the user because the optimal filter setting need not be adjusted manually for each case.

The adaptive Cu prefiltration has five steps (0.1, 0.2, 0.3, 0.6, 0.9 mm) and is used to lower the reference air kerma and improve radiation quality by reducing the low-energy X-ray radiation.

- CAREvision with zen30HDR detector: Pulsed fluoroscopy with additional, reduced pulse rates of 0.5, 1, 2, 3, 4 p/s. Adaptation of pulse rate to the current application requirements for significant reduction of radiation exposure, especially during interventional procedures.

- CAREprofile: Radiation-free positioning of the primary and semi-transparent diaphragms by means of graphic display in the LIH (Last Image Hold). Collimator shutters and semi-transparent filters can be adjusted as a graphical overlay on the last-image-hold without any need for fluoroscopy or radiation.

- CAREposition: Radiation-free object repositioning by means of graphic display of the X-ray center beam and image edges in the LIH image. With CAREposition it is possible to reposition the object under visual control without radiation.

- In case of table movements the current position of the central beam and the image edges are superimposed on the LIH image as orientation points.

- Low dose acquisition: enables dose savings of up to 67 % during the examination. The Low Dose Acquisition protocol can be released with a separate pedal on the footswitch.

Dose monitoring

- CAREwatch: Display of the measured dose-area product and the calculated patient reference air kerma on the flat-screen display. Electronics unit with DIAMENTOR measurement chamber integrated in the collimator housing for dose acquisition.

Configurable screens on the data display and imaging system monitor:

During fluoroscopy: Reference air kerma rate.

During fluoroscopy interval: Accumulated reference air kerma or dose-area product, or percentage of the reference air kerma limit (total from fluoroscopy and acquisition).

- CAREguard: Monitoring the reference air kerma. If the accumulated reference air kerma exceeds one of the three configurable limits, a warning appears on the live display and tableside on the touchscreen control. This allows ideal monitoring of the accumulated reference air kerma during the examination.

- CAREmonitor: Special model-based monitoring of the measured skin entry dose, taking into account the geometric conditions of the system (actual device angulation, table position, patient weight, patient size). It then continually displays whether the skin entry dose applied to a specific region of the patient's body exceeds a specific configurable upper limit. CAREmonitor continually calculates and displays the actual accumulated skin entry dose as a portion of this upper limit. This helps the user to detect a potential patient hazard at an early stage. The patient is therefore better protected against the damaging effects of radiation.

Dose documentation

- CAREreport: Dose information as part of the DICOM Structured Report. After each examination, the information is available in DICOM format and can be sent to a DICOM archive together with the image data, for example. Saving dose information in DICOM format also enables flexible analysis and further processing via a DICOM-capable analysis software/database.

- CARE Analytics: Standalone PC program for analyzing doses in angiography, CT, and radiological examinations. The data can be exported to statistics programs such as Microsoft Office Excel and SPSS for further analysis. CARE Analytics is available for download from the Siemens Intranet.

CLEAR package The CLEAR package enables optimized image quality through real-time processing of the image data without increasing the radiation dose.

- CLEARpulse optimizes the X-ray pulse in two ways: the high pulse power allows for additional filtration to reduce radiation. In addition CLEARpulse shortens the X-ray pulse through the use of grid-pulsed flat emitter technology in concert with a high anode rotation speed. The required X-ray energy can be provided in a shorter period of time, thereby shortening the X-ray pulse by up to 43% at constant tube voltage. Moving objects like coronary arteries can be visualized sharper and with less blurring artifacts.

- CLEARcontrol: The new histogram analysis provides a more homogeneous image impression by harmonizing over- and underexposed areas of the image. This is done fully automatically, thus eliminating any further manual user corrections through windowing.

- CLEARview: Dose-dependent filtering of the image data efficiently suppresses image noise, enabling clear, sharp images, even for low-dose acquisitions.

- CLEARvessel: Every pixel is analyzed in real time, and vessel edges are shown in high contrast without adding noise to the image.

- CLEARmotion: Fine moving structures, such as small vessels and guidewires, are detected in the image and motion artifacts are suppressed efficiently. The visibility of small moving vessels and guidewires is improved significantly during fluoroscopy.

In addition there is Dynamic Density Optimization (DDO) for on-line harmonization of native series and single images.

Image generation

X-ray generator Microprocessor-controlled high-frequency X-ray generator with automatic dose rate control.

- Power output: 100 kW at 100 kV (IEC 60601-2-7 and IEC 60601-2-54).

- SID tracking: Automatic tube current adaptation to focal-spot-to-detector distance.

- CAREmatic: Automatic X-ray control system for fully automatic calculation and optimization of exposure data based on fluoroscopic data.

- Patient transparency monitoring.

- Tube load monitoring with indication in the live display.

The optimal X-ray parameters depend on the transparency of the patient at the current angulation, measured during fluoroscopy. These parameters are continuously calculated and updated. Test shots are no longer required.

This ensures superior image quality and minimum radiation exposure for user and patient with every exposure release.

GIGALIX 125/40/90 - X-ray tube assembly Dual-focus high-performance X-ray tube assembly with unique flat emitter technology for generating extremely high tube currents of max. 250 mA in fluoroscopy and 1000 mA in acquisition. This provides very good image quality even with heavier patients or steep angulations. The focus is always quadratic and permits outstanding perceptibility of small structures with a nominal focus of 0.4/0.6. The anode has a high heat storage capacity of 5.2 MHU and the metal center tube with liquid bearing technology allows a maximum cooling power of 1520 kHU/min.

This means that pauses are not required during radiation, even for lengthy procedures. The X-ray tube is almost silent, which is an additional benefit for patient and user.

zen30HDR Flat Detector (High Dynamic Range) The flat detector is based on a new crystalline silicon technology. The active sensor matrix enables strengthening of the signal directly at the pixel, reducing the electronic noise especially for fluoroscopy. Catheters and vascular prostheses can be displayed with extremely low dose, reducing radiation exposure for the patient and personnel. It is particularly beneficial for complex procedures with long fluoro times and when treating children.

160 μm pixel arrays provide highest spatial resolution of up to 3.1 LP/mm and excellent contrast. The detector features 16-bit analog-to-digital conversion, resulting in an extremely high gray scale resolution of 65,536 gray scales.

The extremely short readout time of the detector (2 ms) opens the possibility of higher frame rates in the future.

Fluoroscopy as well as image acquisition are always done in 1k matrix and 16 bit gray scale resolution with high detail visibility. Acquisition frame rates of up to 60 f/s are possible.

Usable input formats:

- Overview: 26.1 cm x 28.7 cm; diagonal 39 cm.

- Zoom 1: 22.5 cm x 22.5 cm; diagonal 32 cm.

- Zoom 2: 18.7 cm x 18.7 cm; diagonal 26 cm.

- Zoom 3: 14.3 cm x 14.3 cm; diagonal 20 cm.

- Zoom 4: 11.3 cm x 11.3 cm; diagonal 16 cm.

- Zoom 5: 7.2 cm x 7.2 cm; diagonal 10 cm.

The compact design with integrated collision protection provides maximum C-arm angulation range for excellent patient access.

Motorized adjustment of the detector-patient distance.

The grid can easily be removed, saving the user time in examinations not requiring a grid. For example in pediatrics, where dose reduction is especially important.

Collimator Compact multileaf collimator with rectangular blade, wedge-shaped finger filters for DSA and cardiological applications and graduated filter.

- Independent rotation and shift of filter blades

- Automatic synchronous rotation of detector and collimator unit to compensate image rotation at the different examination positions of the support stand.

- Rotation also possible via table side control enabling upright images of objects or body parts not aligned with the table e.g. arms.

- Manual rotation of the detector and collimator unit using the control right on the detector housing.

- Five-step adaptive Cu pre-filtration (CAREfilter) to reduce the equivalent skin dose and improve radiation quality through dose saving for the soft radiation parts. Filter steps: 0.1; 0.2; 0.3; 0.6; 0.9 mm Cu.

Electronics unit with DIAMENTOR dose measurement chamber integrated in the collimator housing, for acquisition of the dose-area product and the calculated patient entry air Kerma at the patient entrance reference point

(CAREwatch).

StraightView The flat detector and the multileaf collimator are installed on a motorized rotating turntable on the C-arm. They automatically line up with the table swivel, thus ensuring upright images of objects which are in line with the table.

The flat detector and multileaf collimator can also be rotated together at any angle relative to the table, enabling upright presentation and collimation of objects which are not in line with the table.

Image processing

- Image display as positive and negative, windowing, contrast and brightness control, electronic display shutter, image shift (roaming), vertical and horizontal image inversion, magnifying glass, and zoom functions

- Storing of single images as reference images for acquisition and fluoroscopy

- Quantification: angle and length measurements, automatic and manual calibration

- Text functions: user-definable image annotation, free annotation or by means of text components, comments line for the image, R/L display

- Fast and direct access to all series, single images, reference images, and photo file images via MULTIMAP.

Access possible both in the examination and in the control room for displaying or post-processing images

Imaging system

Dual architecture In order to provide highest level system availability, the imaging system consists of two independent computer systems that manage central tasks such as real-time image processing during fluoroscopy or acquisition as well as post-processing and networking functionality separately from one another. This ensures the best possible system performance and availability.

Image storage capacity 25,000 images in 1k/12 bit image matrix. This can be optionally extended to 50,000 / 100,000 images.

Image export and networking

DVD/CD burner DVD drive for automatic digital image storage in the background on DVD-/CD-ROM for off-line data exchange in DICOM format.

Networking

- Network interface (1000 BaseT) with the following integrated DICOM services:

- DICOM Send: Sending of images into the DICOM network: The DICOM Send function enables fully automatic transfer of generated image data to a DICOM archive and/or a DICOM workstation. The user can perform his examinations without interruption, while the system is fully automatically transferring the images to the archive scene by scene. This is a background process, and thus does not interfere with the ongoing fluoroscopy or acquisition.

- DICOM Storage Commitment (StC): Feedback from the image archive. The DICOM StC function automatically gives feedback on whether the generated image data were successfully transferred. This provides the necessary certainty to the user before deleting the acquired images locally in the imaging system.

- DICOM-Query/Retrieve: Retrieval of archived images from a digital archive or from a workstation: Already archived image data from a previous examination can be fully retrieved and is then available for review and processing. The user can request CT or MR system images from the archive and display the image in the examination room. There is no need for a separate workstation.

- DICOM Structured Report: All the quantification results obtained on the system as well as all dose information on the individual radiation releases can be saved in DICOM SR (enhanced SR) format and transferred to a DICOM network.

Note concerning DICOM interface(s) The description in the DICOM Conformance Statement downloadable from the Internet is exclusively binding for the functionality of the DICOM interface(s).

Functionalities across interfaces with/between partner systems require explicit validation, since the interpretation of the interface by the partner/target system is not part of the product’s responsibility.

A modification of the interface that might be required is not included in the offer; e.g. for the rare case that available configurations are not sufficient. With regard to expenses for interface configurations that might be required, the agreements on maintenance/service of the product apply.

Display and display suspension

Displays in the exam room Live and Assist displays are 19” TFT color and gray scale flat-screen displays with high luminance and extended viewing angle.

- Screen size: 19” (48 cm)

- Resolution: 1,280 x 1,024 (pixels)

- Excellent brightness for the entire service life: 400 cd/m² at a contrast ratio of 1000:1

- Flicker-free and distortion-free image display

- Ambient light sensor for optimum adaptation of the image display to the room brightness

Reference images are shown on the Assist display.

Data for device and table position, dose data, and system messages are displayed in the examination and control room on both the live and the Assist display.

Displays in the control room 19“ high-contrast display for live image display in the control room is included as a desktop version.

Display suspension Ceiling-mounted, swiveling, rotating, and height-adjustable display suspension system with longitudinal travel. It features two 19” high-contrast TFT displays for live and reference image display in the examination room (Standard configuration – unless modified).

Operation syngo The intuitive syngo operating elements allow for managing the whole process from preparation of the patient to image post processing in a safe, reliable, and time efficient way.

Footswitch A 4-pedal wired footswitch to release fluoroscopy, exposure, and table brake as well as a configurable additional function is included as standard.

In the examination room For an ideal workflow, full operation capabilities for the system can be accessed directly at the patient table. These include complete system operation through modular control elements for controlling C-arm movements, the patient table, and the multileaf collimator.

syngo-based touchscreen with multi-functional joystick for operation of the imaging system, including post-processing and quantification as well as selection of the organ programs. The touchscreen is specifically configurable to individual clinical requirements.

This means that the user can operate the system on their own without having to leave the examination room if this is deemed necessary by the situation.

In the control room Standard Siemens syngo control via country-specific keyboard and mouse for all imaging system functions such as image post-processing, storing, and configuring of organ programs.

Siemens Remote Service SRS™ Prepared for Siemens Remote Service SRS™ (during warranty, then with service contract):

- Hardware and software remote diagnosis.

- System remote configuration, e.g. adding of a DICOM node.

Early warning system ensuring system operation.

syngo Evolve syngo Evolve is a service feature that is offered as a separate sales option. It is a key component of our upgrade strategy and allows you to take advantage of technological advancements.

Customer Care – the customer care solution from Siemens Healthcare From the moment you purchase your Siemens system you will benefit from many services that are offered by "Customer Care"*. These include:

- Initial application training

- Interactive e-learning for various applications

- Free customer magazines

- Arrangements for clinical training via a global network

- Free trial licenses

You will find information on our e-learning program and further details on general "Customer Care" services on the Internet.

* The availability of "Customer Care" services may be restricted for some systems.

User Training Siemens recognizes the significant investment you are making in purchasing a new imaging system and are determined that you are able to realize the full capability of this new system. Siemens clinical applications training ensures you have every opportunity to fully utilize your new system.

Content of user training: Handover Training and Follow-up Training

- Introduction to the functions, options, and handling of the Angiography system

- Instruction on the use of the Angiography system together with modern, highly-developed applications

Delivery & duration of the user training varies and may be country specific so for additional information please contact your local Siemens representative.

Automap optimizes the procedure workflow, especially during interventions. A selected reference image displaying the needed medical information (e.g. before dilatation) is used as the basis for moving the system to the correlated position automatically. The intervention can be continued immediately without manually repositioning the patient.

On the other hand, the system is able to select a reference image for the current device position. In case of changes in device position, this enables the user to see the corresponding reference images quickly and safely.

- ±15° head up/head down positioning.

- Iso-tilt functionality for maintaining the projection during table tilt along the patient axis.

- Motorized, power-dependent table movement in longitudinal direction when the table is tilted (power-assisted control).

- Electromechanical release of table swivel at the touch of a table button.

- Max. patient weight 200 kg. It is possible to install up to 40 kg of additional accessories.

Excellent image quality from the abdomen to the feet is due to the fact that adjustable parameters such as acquisition frame rate, measuring fields, position of collimator blades and semitransparent filters are stored specifically for each table position. That way the different X-ray transparencies for abdomen, legs and feet can be compensated and a consistent image quality with best possible contrast is achieved.

Just one single injection of contrast media protects the health of the patient and gives the physician an instant, subtracted image display of the peripheral blood vessels.

PERISTEPPING:

Peripheral digital stepping angiography with only a single contrast medium injection under visual control of the bolus flow.

C-arm stepping with ARTIS pheno and ceiling mounted systems, table stepping with floor mounted and biplane systems.

- Position-dependent variable frame rates.

- Fully automatic exposure control.

- Automatic storage of the collimator setting for each step.

PERIVISION:

Peripheral digital stepping angiography with online subtraction display in an examination procedure with only one single contrast medium injection under visual control of the bolus flow.

- Only one single automatically acquired mask image for each individual position.

- Position-dependent variable frame rates.

- Fully automatic exposure control.

Automatic storage of the collimator setting for each step

Angle-triggered digital rotation angiography enables dynamic image display with 3D effect. Dynamic subtraction with optimum alignment of masking and filling, and automatic pixel shift in the entire scene.

- Rotation speed is 60°/s (Artis zeego and Artis ceiling) and…