ARTIS Q Operator Manual VD10 Sept 2012

Global Siemens Healthcare Headquarters Siemens AG Healthcare Sector Henkestr.127 91052 Erlangen Germany Phone: +49 9131 84-0 www.siemens.com/healthcare

Order No.: AXA4-100.620.15.01.02 | © 09.2012, Siemens AG

Global Siemens Headquarters Siemens AG Wittelsbacherplatz 2 80333 Muenchen Germany

Global Business Unit Siemens AG Medical Solutions Angiography & Interventional X-ray Systems Siemensstr. 1 DE-91301 Forchheim Germany Phone: +49 9191 18-0 www.siemens.com/healthcare

Legal Manufacturer Siemens AG Wittelsbacherplatz 2 DE-80333 Muenchen Germany

Operator Manual

Artis Q/zeego/Q.zen/zeego.zen/zee

www.siemens.com/healthcare

Operator Manual

Artis Q/zeego/Q.zen/zeego.zen/zee

Global Siemens Healthcare Headquarters Siemens AG Healthcare Sector Henkestr.127 91052 Erlangen Germany Phone: +49 9131 84-0 www.siemens.com/healthcare

Order No.: AXA4-100.620.15.01.02 | © 09.2012, Siemens AG

Global Siemens Headquarters Siemens AG Wittelsbacherplatz 2 80333 Muenchen Germany

Global Business Unit Siemens AG Medical Solutions Angiography & Interventional X-ray Systems Siemensstr. 1 DE-91301 Forchheim Germany Phone: +49 9191 18-0 www.siemens.com/healthcare

Legal Manufacturer Siemens AG Wittelsbacherplatz 2 DE-80333 Muenchen Germany

Operator Manual

Artis Q/zeego/Q.zen/zeego.zen/zee

www.siemens.com/healthcare

Operator Manual

Artis Q/zeego/Q.zen/zeego.zen/zee

Global Siemens Healthcare Headquarters Siemens AG Healthcare Sector Henkestr.127 91052 Erlangen Germany Phone: +49 9131 84-0 www.siemens.com/healthcare

Order No.: AXA4-100.620.15.01.02 | © 09.2012, Siemens AG

Global Siemens Headquarters Siemens AG Wittelsbacherplatz 2 80333 Muenchen Germany

Global Business Unit Siemens AG Medical Solutions Angiography & Interventional X-ray Systems Siemensstr. 1 DE-91301 Forchheim Germany Phone: +49 9191 18-0 www.siemens.com/healthcare

Legal Manufacturer Siemens AG Wittelsbacherplatz 2 DE-80333 Muenchen Germany

Operator Manual

Artis Q/zeego/Q.zen/

www.siemens.com/healthcare

Operator Manual

Artis Q/zeego/Q.zen/zeego.zen/zee

Legend

 Prerequisites  Instructions  List items  Cross reference

Caution/ Warning

Cause Possible consequences  Precautions or remedies

Caution

21 CFR - Federal law restricts this device to sale by or on the order of a physician.

Usability

BEFORE USING THIS SYSTEM This system should be used only by employees adequately trained in the use of this equipment. Before using this system, the operator should be thoroughly acquainted with the instructions for use and safety recommendations provided in this manual. Failure to follow the instructions for use and safety recommendations provided in this manual can cause serious injury to the patient, to the operator or to other persons.

CE marking

This product is provided with a CE marking in accordance with the regulations stated in Appendix II of the Directive 93/42/EEC of June 14th, 1993 concerning medical devices. In accordance with Appendix IX of the Directive 93/42/EEC, this device is assigned to class II b. The CE marking applies only to medical devices which have been put on the market according to the above-mentioned EC Directive. Unauthorized changes to this product invalidate this declaration.

Original language Version

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This Operator Manual was originally written in English. This Operator Manual applies to system/software version VD10 and higher.

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Table of Contents

Part: Safety

21

Chapter: User Information

21

Information about this Operator Manual General information Structure Text layout Highlighting of safety information Illustrations Value statements Information about the software Data protection System date and time Information about system handling Visual contact to patient Room lighting Prerequisites for diagnosis and treatment planning Pictograms and labels Lasers Monitors/LCDs Large Display Use of hardcopy cameras Use of wireless footswitches Use of video recorders Cleaning and disinfection Sterilization

21 21 23 23 23 24 24 25 27 27 28 28 28 28 29 32 33 34 34 34 35 37 40

Chapter: Safety Notes and Radiation Protection

41

Information about unit movements Red emergency STOP buttons Where are the emergency STOP buttons? Emergency SHUTDOWN button (installed on-site) Maximum patient weight Damage to the tabletop Warning signs Danger zones / danger points ... ... on the Artis zeego stand ... on the floor stand (Artis floor/Artis biplane) ... on the top stand (Artis biplane) ... on the Artis ceiling stand/C-arm ... on the patient table Rescuing the patient in an emergency

41 41 42 44 45 46 46 47 48 49 50 51 52 53

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Radiation protection Dose monitoring and reduction Reducing radiation with CARE Interventional application Cardiopulmonary resuscitation (CPR) Injection Radiation protection (interventions) AP safety for interventional examinations Cleaning and disinfecting (interventions) Additional devices

Chapter: Operating Safety and Safety Precautions

73

Laws and regulations Protective measures Protection against electric shock Combination with other products/components Fire protection Installation, repair, or modifications Maintenance Product service life Disposal Dangerous components

73 73 73 74 76 77 77 78 78 79

Chapter: Security Package Important notes

Part: System Overview Application System configurations

Chapter: Equipment in the Control Room

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61 61 63 67 68 69 69 70 70 71

81 81

85 85 87

89

Imaging system overview System console Artis Cockpit LCD monitors Keyboard Mouse ON box with CD/DVD drives On-site equipment Intercom system

89 89 90 91 92 95 96 96 96

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Chapter: Equipment in the Examination Room

101

Acquisition system overview Overview Artis zeego The Artis zeego stand Overview Artis floor The floor stand (Artis floor and Artis biplane) Overview Artis biplane The top stand (Artis biplane) Overview Artis ceiling The Artis ceiling stand/C-arm Patient table Trolley for control modules

101 101 102 103 104 105 106 107 108 109 110

Chapter: Operating Elements and Displays

111

Control consoles Emergency STOP button Table control module - TCM Stand/C-arm control module - SCM C-arm control module for linear movements (Artis zeego) Orientation key Collimator control module (CCM) Touchscreen control console Laser positioner Keys on the FD Membrane keys for FD lift Membrane keys for C-arm and FD movements Handswitch Footswitch Standard or wireless footswitch Footswitch control for table with lateral tilt Display Ceiling Suspension (DCS) Manual control for table with lateral tilt Voice control units Acoustic signals “Plane ready for radiation” displays

Part: System Operation

111 112 112 114 117 117 118 120 122 123 123 123 124 125 125 129 130 134 134 136 137

139

Chapter: Switching On/Off

139

Switching on and starting

139

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Switching on Start-up Logging in with active security Switching on after a power failure or emergency SHUTDOWN Tests and checks Switching off Shutdown (without active security) Logoff/shutdown with active security Disconnection from the on-site power supply Switching off in an emergency

Chapter: Functional and Safety Check

147

General information Performing checks Daily checks Monthly checks

147 147 148 151

Chapter: Unit Movements

155

Movement possibilities Movements of the Artis zeego stand Movements of the floor stand (Artis floor and Artis biplane) Movements of the top stand (Artis biplane) Movements of the stand/C-arm (Artis ceiling) Movements of the patient table Basic positions of the units General basic positions Stopping in the basic positions Overview of system positions System positions of the Artis zeego stand System positions of the floor stand (Artis floor and Artis biplane) Positions with the top stand (Artis biplane) Initiating unit movements Important information on unit movements Collision protection Stopping movements Operating locations and priorities Positioning the control consoles Table movements C-arm movements Standmovements FD lift / Setting the SID

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139 139 140 141 141 141 142 143 145 145

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Rotating the FD / Setting portrait/landscape Moving to system and programmed positions Moving to system positions using shortcut keys (direct positions I, II, III) Automap Storing programmed positions Storing system positions with shortcut (direct positions I, II, III) Deleting programmed positions Manual stand movements Movement to or from a position with rotated table Positioning the monitors

Chapter: Image Format, Collimation and Filtration

189 190 193 193 194 195 196 196 197 199

201

Selecting the image format/zoom stage Setting the collimators Rectangular collimation Filter diaphragms (wedge and finger filters) Resetting the collimation completely Collimation without radiation - CAREprofile Grid Grids for inserting at the FD

201 202 203 204 208 208 209 209

Chapter: Screen Layout and Configuration

211

Artis screens Artis Cockpit screen layout Large Display screen layout Assist screen Readings on the Assist screen Patient coordinates Selecting the screen layout of the Large Display Selecting the image source for the additional color display Operating the 4x4 Crossbar Videoswitch Operating the 8x8 Crossbar Videoswitch Operation via touchscreen control Touchscreen control (TSC) Selecting a task card Selecting a different layout Button types Selecting the plane (Artis biplane) Displaying tooltip help for buttons Configuring the touchscreen layout Mouse joystick functions Display of the joystick function on the live screen

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Sensis touchscreen operation

234

Chapter: Operation via Voice Control

239

Important information Setup for operation Operation via voice commands Voice commands Troubleshooting

239 239 240 242 245

Chapter: DVD Video Recording

247

Recording with DVO-1000MD Important information Control elements and displays Setup DVD recording DVD playback

247 247 249 252 253 254

Part: Examination

255

Chapter: Preparations - Fluoroscopy - Acquisition

255

Registering a patient Taking over patient data from the RIS Registering an emergency patient Registering the patient and starting examination Registering a patient manually Preregistering the patient Searching for patient data Searching in the HIS/RIS and registering Taking over patient data from Sensis Preparing the patient and equipment Blocking radiation Blocking unit movements Transferring and positioning the patient Attaching the ECG Preparing for pressure measurement Adjusting the units (stand and table) Setting the isocenter The Examination task card Screen layout on the system console in the control room Screen layout in the examination room

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Screen layout on the touchscreen in the examination room Parameters for the examination Patient data Patient position System position Positioning the patient without radiation - CAREposition Exam set, application profile and acquisition program Fluoroscopy/roadmap program Acquisition plane(s) Image mirror/flip preselection Monitoring status displays Fluoroscopy/acquisition Fluoroscopy Storing a fluoroscopic scene Storing images as Store Monitor Using the dilatation timer Resetting the fluoroscopy signal Acquisition Alternative acquisition

Chapter: Reference Images and Display Modes Storing reference images Reference image 2nd Reference image CLEARstent reference image XA reference image Display modes for fluoroscopy/roadmap and acquisition Selecting the display mode Performing Overlay Reference

Chapter: Subtracted Fluoroscopy: Roadmap Performing Roadmap Normal Roadmap Advanced Roadmap using a reference image Replace mask during Roadmap Anatomical background with Roadmap Vessel/catheter contrast with Roadmap Show Progress during Roadmap Pixelshift during Roadmap Roadmap with two system positions (single plane) Roadmap with return to biplane system position (Artis biplane)

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305 305 305 306 307 309 310 311 312

315 318 318 323 325 325 326 327 327 329 330

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Part: Image Postprocessing

333

The PostProc task card On the monitor of the system console in the control room On the touchscreen control in the examination room Text information in images (full screen) Text information in the scene/image directory Starting postprocessing Calling up the Patient Browser Loading a scene/image Searching for and importing data in the network Changing patient data Moving series/scenes/images accidentally acquired under the wrong patient

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333 333 335 335 341 341 342 342 343 344 348

Chapter: Managing and Viewing Scenes/Images

349

The scene directory of a patient Representative Limiting display to scenes/images/reference images Scrolling through the directories Selecting scenes/(reference) images Scrolling through scenes/(reference) images Scene overview Controlling scene review (Loop) Stopping the loop Single step Starting the loop Acquisition mode and frame rate Setting the review frame rate Defining the default review mode Loop through all scenes Replacing the maximum fill image Changing scene/image display Image flip/mirror Setting an electronic shutter Inverting grayscale values Magnifying the scene/image, zooming/panning Panning without zoom Using pointers Switching image text on/off Switching scene time display on/off Switching ECG display on/off

351 352 352 353 354 355 357 358 358 359 360 360 361 362 364 364 365 366 367 368 369 371 372 373 374 374

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Chapter: Processing Scenes/Images Defining window and filter values Information about windowing Setting window values manually Assigning automatic window values Edge enhancement filter Adding text and graphics to images General information about text and graphics Annotating images Drawing circles Drawing lines or arrows Drawing polygons

Chapter: DSA Postprocessing Introduction Setting a new mask Default setting “Move Mask” or “Replace Mask” Moving the mask Replacing the mask Switching over between subtracted and unsubtracted display Anatomical background Vessel/catheter contrast Making the image and mask coincide exactly (Pixelshift) Starting pixelshift Automatic pixelshift Further pixelshift corrections Terminating pixelshift Manual pixelshift Flexible pixelshift Undoing pixelshift Generating the image with maximum contrast medium filling Improving the noise suppression of a scene (averaging)

Chapter: Exam Protocol Displaying the Exam Protocol Calling up the Exam Protocol Entries in the Exam Protocol Entering comments Printing the Exam Protocol Closing the window

Chapter: Saving and documenting scenes/images Automatic storage

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395 396 397 398 398 399 400 401 402 403 405 406 406 407 407 408 409 409 412

415 415 415 416 421 422 422

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Storing the current image (Store Monitor) Documenting scenes/images Filming/printing images Archiving/sending/exporting patients/images Sending an image to the CARTO system Exporting scenes/images as video or bitmaps Exporting scenes/images Closing the patient Configuring patient close Procedure tracking with MPPS Deleting patients/studies/series/scenes

Part: Advanced Examinations Chapter: Cardiac Examinations CLEARstent Dynamic acquisition General information CLEARstent Dynamic acquisition workflow CLEARstent Live acquisition

Chapter: IVUSmap IVUSmap examination workflow Step 1: Start IVUSmap and acquire scene Step 2: Mark the vessel segment of interest Step 3: Pullback Step 4: Review IVUSmap review The IVUSmap task card IVUSmap in biplane configuration IVUS ILD image segment Replay Scrolling Bookmarks Overlay Reference Show/hide settings Corrections Correcting the centerline alignment Correcting the pullback speed Saving a corrected registration Measurements

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Distance measurements Area measurements Drawing and measuring areas

Chapter: Rotational Angiography, 3D Acquisition General information on rotational angiography Acquisition programs for rotational angiography General preparations Preparing the examination Preparing the patient Preparing the stand and table Setting the isocenter Preparing the injection DR-DYNAVISION DR-DYNAVISION examination sequence DR-DYNAVISION workflow Preparing DR-DYNAVISION DR-DYNAVISION test phase DR-DYNAVISION fill phase DYNAVISION DYNAVISION examination sequence DYNAVISION workflow Preparing DYNAVISION DYNAVISION test phase DYNAVISION mask phase DYNAVISION fill phase 3D 3D acquisition programs 3D DR examination sequence 3D DR workflow 3D DSA examination sequence 3D DSA workflow DynaPBV Neuro examination sequence DynaPBV Neuro workflow 3D CARD examination sequence 3D CARD workflow 3D DR - Large examination sequence (Artis zeego) 3D DR - Large workflow (Artis zeego) syngo DynaCT 360 examination sequence (Artis zeego) syngo DynaCT 360 workflow (Artis zeego) 3D eccentric rotation examination sequence (Artis zeego) 3D eccentric rotation workflow (Artis zeego) Preparing 3D (all 3D examinations)

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475 475 479 480 480 481 481 481 482 483 483 484 485 486 488 491 491 493 494 495 497 498 500 506 508 508 510 511 513 514 516 517 519 520 522 522 523 523 523

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3D test phase 3D acquisition phases Test of image quality for 3D

526 527 530

Chapter: Peripheral Angiography

533

General information on peripheral angiography Acquisition programs for peripheral angiography General preparations Preparing the patient Preparing the stand and table Preparing the injection Setting the start position Setting the field of view PERISTEPPING PERISTEPPING examination sequence PERISTEPPING workflow Preparing PERISTEPPING PERISTEPPING test phase PERISTEPPING return phase PERISTEPPING fill phase PERIVISION PERIVISION examination sequence PERIVISION workflow Preparing PERIVISION PERIVISION test phase PERIVISION mask phase PERIVISION fill phase

533 535 536 536 537 538 538 539 539 540 542 543 544 546 547 549 549 551 551 553 555 556

Part: Exam Sets

559

Chapter: The Exam Set and Program Editor

559

Exam Sets Managing and editing exam sets Opening the Exam Set and Program Editor Changing the password for the Exam Set Editor Resetting the password for the Exam Set Editor Viewing exam sets Editing exam sets Viewing and editing acquisition/fluoroscopy/roadmap programs Organizing programs

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Storing and/or applying programs Closing the Exam Set and Program Editor

Chapter: Parameters for Exam Sets CLEAR image quality Acquisition parameters Exposure parameters for acquisition Image parameters for acquisition Frame rates and scene duration Parameters for rotational angiography Parameters for 3D Parameters for peripheral angiography Parameters for fluoroscopy/roadmap Exposure parameters for fluoroscopy/roadmap Image parameters for fluoroscopy/roadmap Pulse rates General parameters K Factor and motion detector Dynamic Density Optimization (DDO)

Part: Calibration and Measurements Accessing calibration and measurements Calibration Calibration methods Performing a calibration Automatic isocenter calibration Calibration using the table-object distance (TOD) Manual distance calibration Catheter calibration Sphere calibration Calibration with a calibration factor Measurements Preconditions Drawing and measuring distances Drawing and measuring angles

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573 573 573 574 577 579 582 584 586 587 587 587 589 590 590 592

593 595 598 598 600 600 601 604 607 610 613 614 614 615 619

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Part: Quantification Quantitative analysis methods Important notes The Quant task card On the monitor of the system console in the control room On the touchscreen control in the examination room General postprocessing functions Selecting patients and scenes/images Defining window and filter values Zooming/panning Calibration and measurements Undoing the last calibration step Confirming calibration / calculating the average Clearing the entire calibration Recalling the last calibration Common functions Report Configuration Checking the installed options Configuring the calibration Closing configuration

621 621 623 623 625 625 625 626 626 627 628 628 628 629 629 631 633 633 634 635

Chapter: Quantitative Vascular Analysis (QCA/QVA, IZ3D)

637

Performing a vascular analysis QCA/QVA workflow IZ3D workflow Selecting a scene/image Scenes/images for IZ3D Calibration Selecting the analysis method Vessel contour detection Selecting the vessel segment Correcting the contour Manual restriction Toggle ostial branch 3D vessel model in IZ3D Creating a 3D vessel model Common image point Viewing the 3D vessel model Stent planning in IZ3D Displaying the quad view Moving the C-arm according to the 3D vessel model

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Documentation of the 3D vessel model Contour information Entering analysis information Selecting diagram display Performing evaluations Information about stenosis calculation Automatically determined reference diameter Modifying an analysis Manually determined reference diameter Manual subsegment Local diameter Recalling an analysis Results (Report) Preliminary results Report Results of the hemodynamic data Configuring QCA/QVA/IZ3D

667 668 669 670 674 674 675 676 677 678 678 679 679 679 682 686 687

Chapter: Quantitative Ventricular Analysis (LVA)

691

Starting analysis Selecting a scene Selecting the analysis method LVA workflow Selecting images Biplane LVA Setting the frontal and lateral plane Defining contours Recalling an LVA analysis Results (Report) Regression formulae Analysis parameters Wall motion analysis Configuring LVA

692 692 692 694 696 697 700 701 707 707 709 710 712 715

Part: Accessories and Auxiliary Devices 717 General information Equipment with accessories Handling accessory parts

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