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Vascular Surgery

Endovascular aortic procedures and peripheral artery disease Optimizing precision across endovascular procedures

Vascular surgery is increasingly shifting toward minimally invasive techniques, now used in around 80% of abdominal aortic aneurysm treatments in Germany1. In the Hybrid OR, our fixed C-arms with procedural intelligence streamline workflows and bring precision to both routine and complex aortic repairs. Our mobile C-arms deliver flexible, high-quality imaging, ensuring reliable performance in everyday endovascular procedures.

Innovative workflow

Predictive planning included in the intraoperative workflow

Every patient鈥檚 vascular anatomy is unique 鈥攁nd for those facing life-threatening aortic aneurysms or dissections, precision planning can save lives. At Louis Pradel Hospital in Lyon, Dr. Antoine Millon, MD, is using a digital twin workflow in a state-of-the-art hybrid operating room to tailor each endovascular repair down to the millimeter. Watch the video.

Discover our syngo EVAR Guidance workflow

蝉测苍驳辞听EVAR Guidance supports the planning and guidance of your endovascular procedures. It automatically detects the vessel wall of the aorta and its main branches, calculates precise centerlines, and visualizes ostia rings for branched vessels. Additionally, it suggests optimal landing zones for stent positioning. For each landing zone and branching vessel, the system determines the right C-arm angulation, which can be stored and selected directly in the OR鈥攅nsuring precise and efficient stent deployment.

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Overview01
Preparation01
Registration01
Deployment01
Assessment01
EVAR Case Flow01
EVAR Caseflow Steps
EVAR Caseflow Steps
Optimal preparation of CT data
Fast registration for fusion imaging
Precise guidance during stent deployment
Immediate assessment of treatment results
EVAR Case Flow
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Review the clinical evidence

The use of EVAR Guidance unlocks additional benefits for you and your patients.

Fusion imaging may result in up to 30% shorter procedures

Shorter procedures

Complex procedures without image guidance are lengthy. Fusion imaging provides continuous 3D guidance throughout the whole procedure. In a single center study, the procedure time was reduced by 30% using EVAR Guidance.2,3

Fusion imaging requires up to 57% less iodine contrast media

Less iodine contrast media

Renal insufficiency due to high contrast media use creates limitations for treating patients with comorbidities. Fusion imaging provides continuous guidance without additional contrast media and can reduce its use significantly. In a single center study, contrast media was reduced around 57% by using fusion during FEVAR.2,3

syngo EVAR Guidance supports your clinical workflow

The syngo EVAR Guidance software transforms the planning and execution of endovascular procedures. It automatically detects the vessel wall of the aorta and its main branches, calculates precise centerlines, and visualizes ostia rings for branched vessels. Additionally, it suggests optimal landing zones for stent positioning. For each landing zone and branching vessel, the system determines the ideal C-arm angulation, which can be stored and selected directly in the OR鈥攅nsuring precise and efficient stent deployment.

Discover our EVAR workflow

Watch the workflow simulation on how syngo EVAR Guidance assists you and allows you to focus entirely on the procedure.听

Discover the TEVAR workflow

Explore how St. Franziskus-Hospital in Muenster, Germany, is using syngo EVAR Guidance in a TEVAR procedure.听

Discover the BEVAR workflow

Explore how St. Franziskus-Hospital in Muenster, Germany, is using syngo EVAR Guidance in a BEVAR procedure.

Siemens Inventor of the year 2022

Meet Marcus Pfister who develops innovative solutions together with surgeons. He was named "Siemens Inventor of the Year 2022" in the category "Lifetime Achievement".

Customer Voices4

Listen to our customer voices4 talking about syngo EVAR Guidance

鈥瀞yngo EVAR Guidance is fantastic, especially for complex EVAR procedures, fenestrated and branched procedures also for dissections.鈥
Prof. Eric Verhoeven, MD
Prof. Eric Verhoeven, MD
General Hospital Nuremberg, Germany
Vascular Surgery Keyvisual

Publications

Browse a selection of scientific publications in vascular surgery.

Ultra-low dose

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Imaging and ultra-low dose

Achieving ultra-low dose levels requires a holistic approach that combines advanced technological features, standardized clinical workflows, and comprehensive education.

Discover how our customers have successfully reached ultra-low dose levels4,5

How can ultra-low dose levels be achieved?

Prof. Maani Hakimi, MD, from Lucerne Cantonal Hospital in Switzerland, utilizes ultra-low dose protocols to minimize radiation exposure to both patients and the operating room team, without compromising on precision.

syngo听EVAR Guidance assists throughout the entire workflow, from pre-operative planning to intra-operative guidance, allowing to focus entirely on precise stent deployment.

The registration can be performed with very low dose using just two images with different angulations.

During the procedure, dosimeters should be used by the OR team to monitor the radiation exposure and adjust the position accordingly.

OPTIQ algorithm enables constant CNR in support of ALARA dose.

Hakimi Maani
Professor Maani Hakimi, MD

Do you want to learn more about achieving ultra-low dose for endovascular aortic aneurysm repair?

Lowest reported dose area product of 2.4 Gy鈭梒m2 for ultra-low-dose endovascular aortic aneurysm repair of a standard infrarenal aortic aneurysm

Alina Reeg, MD; Yvonne Braun, MD; Dirk Sunderbrink; Maani Hakimi, MD
Society of Vascular Surgery, 2024

鈥淭he combination of OPTIQ low dose protocol and the Lucerne EVAR Milestone Approach (LEMA)6, is leading us to ultra-low dose values. With the right technology, standardization, and education we were able to reach dose values, as low as 2.39 Gy*cm2 for standard EVAR.鈥
Professor Maani Hakimi, MD, 
Head of the Vascular Center
Lucerne Cantonal Hospital, Switzerland

Explore the recording of our latest symposia

Charing Cross Symposium 2024 - Let鈥榮 talk about ultra-low dose levels4,5

LEMA6 as the surrogate measure for reaching ultra-low radiation dose levels in standard EVAR

Presented by Prof. Maani Hakimi, MD,
from Lucerne Cantonal Hospital, Switzerland

The radiation dose of cone beam computed tomography (CBCT) can be decreased by 90%

Presented by Prof. Pekka Aho, MD,
from Helsinki University Hospital, Finland

The questions and answers session of the symposium

What will be the future of Hybrid Operating Rooms?

During his speech at the Paris Vascular Insights Course, Prof. Maani Hakimi, MD, discussed the future perspectives of vascular surgery in hybrid operating rooms. A key topic in this context is achieving the highest possible image quality with the lowest possible radiation dose. Ideally, this should be automated, so that surgeons can fully concentrate on their patients. How can this be achieved? Watch the recording to learn more.

Discover our Hybrid OR Equipment

Hear our customers鈥 voices about our equipment4

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Sharing from three years of experience 

Listen to Jose-Manuel Encisa, MD, Head of Angiology and Vascular Surgery, explaining how he structured his hybrid operating theatre set-up and why he decided to choose the floor-mounted robotic C-arm ARTIS pheno. After three years of experience working with the system, he would choose the same Hybrid OR set-up again, because he is very satisfied with the results. Watch the video to get all the insights.

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鈥濷ur ARTIS icono floor has led to better daily patient care in many ways, because multiple, complex steps are now fully integrated.鈥
Prof. 脡ric Ducasse, MD, PhD
Prof. 脡ric Ducasse, MD, PhD
Endovascular and Vascular Surgeon
CHU Bordeaux Pellegrin

Discover our Robotic and Mobile C-arm Portfolio

Learn more about the capabilities of CIARTIC Move

New robotic C-arm sets new standard for endovascular procedures

New robotic C-arm sets new standard for endovascular procedures

Discover the future of intraoperative imaging with CIARTIC Move, the first robotic C-arm system, that bridges the gap between traditional mobile C-arms and fixed hybrid room systems. Nikolaos Tsilimparis, MD, (Ludwig Maximilian University Hospital, Munich, Germany) shares his recent experiences with the system and highlights the unique features of CIARTIC Move in a conversation with Michele Antonello, MD, (University of Padua, Italy). Discover the enhanced autonomy, efficiency, and image precision of CIARTIC Move.

Learn more about the capabilities of Cios Alpha

Cios Alpha.neo Mobile C-arm Whitepaper Cover

Cios Alpha 鈥 A story about the perfect balance of image quality and dose4

Read the interview with Tara Mastracci, MD, and Jason Constantinou, MD, Royal Free London, UK, 2024.

鈥淐ios Alpha鈥檚 wide variety of applications has meant that we鈥檝e been able to expand our practice in a way that both keeps us and our patients safe because of the lower radiation dose at no costs for image quality.鈥
Tara Mastracci, MD,
Royal Free, London, United Kingdom

Dive into the clinical cases of Cios Alpha

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Partnerships

Explore some of our partnerships

Angiodroid

Angiodroid

The Angiodroid CO鈧 injector employs carbon dioxide鈥攁 naturally occurring contrast agent鈥攖o deliver high-quality imaging during both interventional and diagnostic peripheral angiographic procedures. This technology provides a valuable option for patients with renal impairments who previously had limited imaging alternatives.
Artis Pheno

Boston Scientific AVVIGOTM+

Experience precision and control with the AVVIGO +鈥攁 high-definition IVUS Guidance System. Seamlessly compatible with the ARTIS display ceiling suspension, AVVIGO + integrates effortlessly into your workflow. Its intuitive touchscreen tablet allows tableside operation within the sterile field

Learn about the benefits of CO2 as a contrast agent for EVAR procedures4

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Prof. Michele Antonello, MD01
Thomas Karl, MD01
Jos茅 Encisa de S谩, MD01

Interview with Prof. Michele Antonello, MD,
Azienda Ospedaliera di Padova, Italy

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The products/features mentioned herein are not commercially available in all countries.
Their future availability cannot be guaranteed.
The information shown herein refers to a product of a 3rd party manufacturer, Predisurge, and is in their regulatory responsibility. Please contact the 3rd party manufacturer for further information.
The statements with footnotes in this document are based on a result of the quoted clinical study that evaluates the procedure. The results are not generated with the actual product version. It is expected, that the actual product version has similar or improved functionality to support the evaluated procedure.
Some/All of the features and products described herein may not be available in the United States or other countries.
1
The data for the years 2020 and 2021 from the register of the German Institute of Vascular Healthcare Research(DIGG) of the German Society for Vascular Surgery and Vascular Medicine
2
Michael McNally et al., 鈥淭hree Dimensional Fusion CT Decreases Radiation Exposure, Procedure Time and Contrast Use during Fenestrated Endovascular Aortic Repair,鈥 Journal of Vascular Surgery 61, no. 2 (2014): 309鈥16, http://doi.org/10.1016/j.jvs.2014.07.097. 
3
Compared to procedures performed in a standard hybrid operating room without fusion capabilities.
4
The statements by Siemens Healthineers鈥 customers described herein are based on results that were achieved in the customer's unique setting. Because there is no 鈥渢ypical鈥 hospital or laboratory and many variables exist (e.g., hospital size, samples mix, case mix, level of IT and/or automation adoption) there can be no guarantee that other customers will achieve the same results.
5
The customers are employed by an institution that receives financial support from Siemens Healthineers for collaborations.
6
Lucerne Endovascular Milestone Approach