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Device Motion Indication: A Novel Image-Based Tool to Measure Relative Device Motion During Coronary Intervention
Rami Abu Fanne1, Simcha Ron Meisel, Avraham Shotan
1Department of Cardiology, Hillel Yaffe Medical Center Affiliated with Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. ramia@hadassah.org.il.
Insights
Cardiac cycle movement of coronary stents can affect precise deployment. A novel SyncVision System technology objectively measured device motion, revealing significant displacement, especially in the right coronary artery, highlighting its importance for effective stent implantation.
Area of Science:
- Cardiovascular imaging and intervention
- Medical device technology
- Interventional cardiology
Background:
- Cardiac cycle motion of stent delivery systems is often underestimated, potentially compromising precise stent deployment.
- Objective measurement of intracoronary device motion during the cardiac cycle is crucial for accurate stent placement.
- Novel technologies are needed to quantify and address device displacement in the coronary vasculature.
Purpose of the Study:
- To objectively measure relative intracoronary device motion throughout the cardiac cycle using a novel technology.
- To assess the impact of cardiac cycle dynamics on stent delivery system movement.
- To evaluate the SyncVision System's capability in quantifying device motion.
Main Methods:
- 193 patients undergoing coronary angiography were analyzed using the SyncVision System with its device-motion indication feature.
- Pre-deployment device movement measurement (DMM) was precisely displayed and recorded in three coronary artery segments.
- Analysis focused on quantifying axial displacement and identifying factors influencing motion.
Main Results:
- Median axial displacement varied by coronary segment: 2.97 mm (right coronary artery), 2.22 mm (left circumflex), and 1.84 mm (left anterior descending).
- The mid and distal right coronary artery segments exhibited the most significant motion.
- Both heart rate and cardiac contractility were found to significantly affect device motion measurement (DMM).
Conclusions:
- The SyncVision System effectively measures relative device displacement, offering an innovative tool for interventional cardiologists.
- Relative device movement is a critical quality metric that should be considered for optimizing stent implantation.
- Accurate assessment of intracoronary device motion can lead to improved stent deployment and patient outcomes.
Background:
Movement of the stent delivery system in the coronary bed as a result of the cardiac cycle is a well-known clinical observation that usually is either underestimated or ignored. This effect may potentially jeopardize precise stent deployment. We used a novel technology to objectively measure the relative intracoronary device motion in the different coronary segments throughout the cardiac cycle.
Methods:
A total of 193 patients undergoing coronary angiography were enrolled and their studies were analyzed for device movement using the SyncVision System (Philips Volcano). The SyncVision System is an add-on image-processing system with unique enhancement and stabilization capabilities. A new feature, the device-motion indication, can precisely display the predeployment device movement measurement (DMM). The device movements within the three segments of each coronary artery were recorded.
Results:
We identified 218 branch point sites. Median axial displacement was 2.97 mm at the right coronary artery (RCA), 2.22 mm at the left circumflex, and 1.84 mm at the left anterior descending segments. The most movable segments were mid and distal RCA (P<.05). Both heart rate and cardiac contractility significantly affected DMM.
Conclusions:
The study demonstrates an innovative feature of the SyncVision System as a tool to precisely measure relative device displacement. We claim that the relative device movement is an important quality metric to consider for achieving an effective stent implantation process.
