An interventional platform guided by new generation images, called Azurion, was inaugurated today at Gemelli Molise in Campobasso, the first device present in an Italian hospital, with this innovative configuration.
In recent decades, clinical practices around the world have evolved to successfully perform complex procedures, in the safest, most effective and least invasive way possible, improving interventional performance, through a superior standard of care. The introduction of minimally invasive surgical procedures has thus grown considerably over the years, especially in the fields of cardiology, interventional oncology, neurology and vascular surgery, giving life to a completely new hospital segment, the ‘hybrid’ operating room, which includes imaging devices, which allow the surgeon to use both traditional and minimally invasive surgical techniques.
With this in mind, the new interventional operating platform at Gemelli Molise is a state-of-the-art device, which allows a more accurate vision and better definition of the images, exposing the patient and medical staff to a smaller amount of radiation. For the new angiograph, in fact, technologies have been developed that allow ‘navigation’ without the need to use fluoroscopy. The new operating software of Azurion, then, allows a better integration of patient information in real time, accessible by doctors through a simple touch screen. “Through this new equipment – explains Massimo Massetti, director of the Cardiovascular Diseases department of Gemelli Molise – it is possible to simultaneously see on the same screen images of the patient taken from multiple sources (such as ultrasound scans, CT scans, etc.). In this way – underlines Massetti – it is as if the device creates a ‘navigation map’ able to guide the operator in the procedure in an almost millimeter-accurate way, safer and faster. But the truly revolutionary element in the advancement of imaging is to bring the doctor closer to vision. three-dimensional, even of a moving organ, such as the heart “.
Possible treatments on heart valves even for those who cannot undergo surgery
“Interventional cardiology for the treatment of ischemic heart disease – says Bindo Missiroli, director of the complex operating unit of Cardiology and Hemodynamics of Gemelli Molise – is one of the first therapeutic areas involved in angiography rooms. In addition to percutaneous coronary interventions (angioplasty), it is It is possible to perform treatments on the heart valves, such as aortic stenosis, through a procedure called Tavi (Percutaneous treatment of aortic valve disease), which allows to intervene even on elderly people or people with comorbidities, who could not undergo a traditional surgery “. It is also important to remember the possibility of carrying out treatments on the mitral valve, or some congenital defects such as anomalies of the atrial septum, the membrane that separates the right atrium from the left one.
Still in the cardiology field, thanks to the new interventional platform, highly complex procedures relating to the treatment of cardiac arrhythmias and implants, with subsequent management, of electronic cardiac devices (pacemakers / automatic defibrillators), can be performed with the highest safety standards. under the responsibility of the Electrophysiology Unit directed by Matteo Santamaria.
The procedures for which the new platform will be particularly useful in the electrophysiological field are represented by implants of automatic biventricular defibrillators for cardiac resynchronization therapy in patients suffering from heart failure, catheter ablations of complex arrhythmic subtrates (atrial fibrillation, ventricular tachycardias) by means of mapping electroanatomical, also with an endo-epicardial hybrid approach (internal and external surface of the heart), and transvenous extraction of endocardial leads in case of infection or malfunction of the same. In particular, for these last two categories of procedures (complex ablations, transvenous extractions), the new platform will allow a multidisciplinary approach with the simultaneous involvement of several professionals (electrophysiologist, heart surgeon, anesthetist) aimed at optimizing the efficacy and safety of the surgery.
Vascular Surgery, directed by Pietro Modugno, also benefits greatly from the new concept of hybrid operating room. To treat the pathologies of all the vessels of the human body (aorta, carotids, arteries of the legs, kidneys, etc.). The vascular surgeon can choose, depending on the characteristics of the patient, to perform a traditional (open) intervention, or to approach minimally invasive treatment.
The new angiography room extends the therapeutic opportunities offered by Interventional Radiology, directed by Roberto Iezzi, an ultra-specialized branch of radiology, capable of producing the same clinical results as a traditional surgery, in a much less invasive way. The field of application of this discipline is almost unlimited, and represents a consolidated and documented treatment option for cancer patients, alongside, without contradiction, the other possible solutions. “With the greater accuracy of navigation inside the vessels and definition of the therapeutic target, allowed by the new interventional platform – declares Iezzi – it will be possible to enhance the thermoablation and chemoembolization activities for tumor pathologies, and all the procedures on biliary or urinary pathologies . It will also be possible to perform prostate embolization procedures in patients with prostatic hypertrophy and urinary symptoms, fibroids, haemorrhoids – if symptomatic with episodes of rectorrhagia – or for pain in the major joints (knee, shoulder, elbow), which do not respond to drug therapy “.
Also useful for pain therapy
Another area of application of this new technology is pain therapy, which plays a very important role in modern anesthesiology. In an angiographic environment, specific loco-regional treatments are practiced with pain-relieving drugs which, in addition to being particularly effective, do not affect the patient’s alert state compared to systemic treatment.
With the hope that even the Gemelli Molise, like all the hospitals in our country, will not find itself in the need to reconvert wards and medical health personnel for the pandemic emergency, it is estimated that the number of patients who can benefit from this new technology in the various therapeutic areas mentioned is between 3,500 and 4,000 a year, making this hospital a point of reference at the forefront for the whole Center-South, able to respond in an evolved way to the therapeutic needs of clinicians and of their patients.