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AngioTAC at the Rizzoli Orthopaedic Institute

Latest generation equipment for the treatment of tumors and degnerative-inflammatory pathologies

June 12th, 2023

Treatment of tumors and musculoskeletal metastases for therapeutic, palliative and preoperative purposes, trauma and inflammatory lesions, execution of cutting-edge techniques such as cryotherapy and delicate examinations including bone biopsies.
It is now possible to do all this at the Rizzoli Orthopaedic Institute of Bologna through a new equipment of the latest generation, an AngioTAC acquired thanks to an investment of 2 million euros.

"Thanks to the AngioTAC and a multidisciplinary team of radiologists, orthopedists, technical and nursing staff and with the support of the anesthesiologist in cases where it is deemed necessary, from today we can do much more for our patients - explains the director of diagnostic and interventional radiology Marco Miceli. - In fact, there are cases in which surgical treatment is not recommended, such as certain bone metastases, that with the help of AngioTAC we can treat by acting on the blood vessels that feed them. Embolization, or the occlusion of arterial vessels by navigation with catheters and microcateters, is extremely useful even in cases of trauma or preoperative hypervascular lesions to reduce blood loss, thus subjecting the patient to lower risks during surgery. But the possibilities are innumerable - underlines Miceli - we think of cryotherapy, masses for which the only solution was surgery and which now, instead, we can manage in Radiology with an hospitalization in Day Hospital or at most one night in hospital except particularly complex cases".

The new AngioTAC, which is located on the ground floor of the hospital at the Diagnostic and Interventional Radiology, is  in operation for a few days. It is a hybrid system: an angiography machine combined with a CT scanner that, through the combination of an ultrasound, allows interventional radiologists to simultaneously benefit from multiple diagnostic imaging equipment, allowing to achieve a more complete and useful result. "In this way not only times are reduced - Miceli specifies - but greatly increase the chances of treatment for our patients, starting from oncological cases up to musculoskeletal pathologies in which surgery is not recommended".

It was the case of the first patient operated, which presented a painful bone metastasis to the pelvis for which surgery was strongly discouraged. With the aid of the angioTAC the blood vessels were investigated identifying those that fed the metastasis and were embolized, that is, "plugged", in this case with a kind of glue. The presence in a single environment of angiograph and CT gave the possibility to perform live CT images during angiographic interventions without having to move, with all the difficulties and inconveniences of the case, the patient sedated and allowed radiologists to have diagnostic live images, not static.

Un momento della presentazione dell'AngioTAC. Da sinistra: Anselmo Campagna direttore generale IOR, Raffaele Donini assessore regionale alla politiche per la salute, Giovanni Molari rettore Unibo, Marco Miceli direttore della Radiologia diagnostica e interventistica, Luca Rizzo Nervo assessore al welfare e salute del Comune di Bologna, Milena Fini direttrice scientifica, Viola Damen direttrice sanitaria, Gianluca Facchini medico radiologo IOR.
At the moment of the angio presentation. From left: Anselmo Campagna IOR general director, Raffaele Donini regional councillor for health policies, Giovanni Molari rector of University of Bologna, Marco Miceli director of diagnostic and interventional radiology, Luca Rizzo Nervo Councillor for Welfare and Health of the Municipality of Bologna, Milena Fini scientific director, Viola Damen health director, Gianluca Facchini IOR medical radiologist.

"This new equipment fits into a wider patient-centred path - explains the General Manager of Rizzoli Anselmo Campagna. - It is an investment that further qualifies Rizzoli, developing skills and specialized interventional activities, in particular in the field of oncology, which support and complement surgical and medical treatments and further supports the role of IOR as National Reference Center and regional hub in the treatment of all musculoskeletal diseases. The technological renewal program continues with the acquisition of robotic and advanced navigation technologies, new high-tech operating rooms and a renovated radiological center with enhanced diagnostic equipment."

"The assistance and research activities of all the university staff working within Rizzoli can be further developed through these important technological investments, to the benefit of today’s and tomorrow’s patients. Also in recognition of this fruitful collaboration, the University intends to strengthen its investment in human resources in the orthopedic field to contribute decisively to attract and retain in Bologna the best talents in this field" - says Giovanni Molari, Rector of the University of Bologna.

"Emilia-Romagna healthcare continues to invest in technological innovation, crucial to continue to ensure patients the best possible care - underlines the Councillor for Health Policies of the Emilia-Romagna Region Raffaele Donini. - For Rizzoli, thanks to the acquisition of AngioTAC, a further confirmation of its ability to equip itself with state-of-the-art equipment that confirms its role not only as a reference point in orthopedic, national, but also international, as recently indicated by Newsweek’s World’s Best Specialized Hospitals".

Musculoskeletal interventional radiology deals with the diagnosis and treatment of musculoskeletal diseases using minimally invasive procedures performed under the guidance of images: ultrasound, angiography, computed tomography (CT). The new AngioTAC of Rizzoli is equipped with a digital angiograph for the definition of diagnostic issues of an endovascular nature and for the execution of percutaneous and endovascular interventions, a CT (Computed Tomography, commonly called CT) 128 layers, dual energy, useful to define the diagnostic question and to guide with extreme precision the operator during the therapeutic or palliative intervention, and an ultrasound for the localization of anatomical structures. This hybrid system guarantees greater precision in the treatment of the patient and allows to speed up the path of diagnosis and treatment, with the possibility of less exposure to ionizing radiation, through the combined and optimized use of different techniques.

The performance executable with the new AngioTAC are musculoskeletal biopsies, with a forecast at Rizzoli of about 530 procedures per year, endovascular arterial embolization treatments of primitive bone tumors and bone metastases, with a forecast of about 180 procedures per year, thermoablations of primary tumors, with a forecast of about 60 procedures per year, thermal ablation at low temperatures (cryotherapy) for treatment, for example, of desmoid tumours affecting the young adult population. Rizzoli will also be able to devote many areas of growth to using this new machinery: sclerotization of arteriovenous malformations (vascular tumors) percutaneous treatment of bone lesions predominantly affecting children, cryoablazion of other musculoskeletal tumours, vertebroplastics, minimally invasive and guided treatments for inflammatory or degenerative diseases, innovative endovascular embolization treatments of inflammatory degenerative pathology, placement of caval filters.

Prestazione di radiologia interventistica mediante AngioTAC
Performance of interventional radiology by AngioTAC

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