Improving Door-to-Balloon Times With Toshiba’s Infinix-i

June 28, 2010

The American College of Cardiology (ACC) and the American Heart Association (AHA) recently established new national standards for door-to-balloon time, stating that facilities treating ST-elevation myocardial infarction (STEMI) patients with emergency percutaneous coronary intervention (PCI) should consistently reach a door-to-balloon time of 90 minutes or less. When every minute counts, the right diagnostic technology can make all the difference in meeting or exceeding this standard, as Vinit Lal, MD, a member of the cardiology group HeartPlace (Dallas, Texas), discovered when seeking to improve catheterization-laboratory efficiencies.

Dr. Lal wanted a cardiovascular-radiography system that would enable the group to lower door-to-balloon time by reducing the time required for patient setup and loading, as well as by improving clinician efficiency and confidence. The unique C-arm design of Toshiba’s Infinix-i systems—which offers 270-degree positioning for improved access to the patient, ancillary equipment, and fellow clinicians—met these requirements.

“The ability to move the C-arm quickly in and out of the way facilitates quick loading of the patient,” Dr. Lal notes. “Once the patient is in place, the C-arm is immediately moved back into the desired position to begin the case. This system has saved time by enabling us to start catheterization sooner and reducing overall setup and procedure time.”

Toshiba’s Infinix-i systems boast a five-axis design. Allan Berthe, senior cardiology product manager for the company, explains that this enhances clinician workflow by allowing uninterrupted access to the patient. “If the operators are focused on the patient and don’t have to worry about working around the C-arm or pivoting the table, they can get through the required imaging much faster,” he says. “The system provides excellent access and coverage, and the design of the tableside controls allows clinicians to keep their focus on the patient, capture all the required images and control all key system functions while staying right at the patient’s side.”

Dr. Lal offers an example of the C-arm flexibility in some cases when it is necessary to switch rapidly from femoral to radial access while inserting the catheter. “Within minutes, we have reconfigured the system components to accommodate the transradial approach,” he says. “This flexibility permits more comfortable ergonomic positions for physicians, while also keeping the patient comfortable.”

The time-saving benefits of the Infinix-i systems go beyond design, Berthe explains. Toshiba’s Next Generation Advanced Imaging Processing (AIP) technology, a combination of proprietary hardware and software, supports interventionalists using fluoroscopic and fluorographic imaging by enhancing image quality, sharpness, and contrast during procedures. The technology also substantially reduces image lag time, enabling clinicians to perform fluoroscopic procedures with increased efficiency.

“Next Generation AIP greatly improves coronary-artery visualization and the ability to identify disease,” Dr. Lal says. “The great image detail on all patient types has improved diagnostic confidence and treatment planning, resulting in more accurate device selection and placement.” He adds that Next Generation AIP has improved his department’s efficiency by reducing room time, promoting increased patient throughput: “The reduced exam times have improved the utilization of our staff members and increased patient safety,” he says.

With PCI becoming increasingly prevalent as a treatment for STEMI patients, diagnostic speed and confidence are more important than ever before (as the new ACC/AHA 90-minute door-to-balloon requirement underscores). “If you have a door-to-balloon program, speed is of the essence,” Berthe notes. “Little things matter. The combination of the Infinix-i system’s design and its AIP technology creates an environment where everything is working in concert to produce a more uniform, high-resolution image with increased speed and efficiency.”