Dr. Ruairi Meagher 

I heard a rumour of a new state of the art Siemens Angio suite in the works out east (wayyyyyy East, past Toronto!!) and wanted to get the details for everyone we know relies on the CAIR Express for their IR news.  I found my way to Dr. Ruairi Meagher (someone gave me his email), who was kind enough to answer some questions.

NS: Dr. Meagher, tell the readers a bit about yourself and your IR practice.

RM: I am an interventional radiologist practicing in Saint John New Brunswick currently in my 5th year of practice. I did my IR fellowship at CHUM in Montreal and currently practice in a group of 5 IRs. We enjoy a very collaborative practice both amongst the IR’s as well as virtually all services across the hospital with a very broad practice scope.

NS: Tell us about your new Siemens ARTIS ICONO OR suite? When will you be up and running?

RM: Our biplane Artis Icono hybrid suite is one of two fully OR compatible angiosuites in the radiology department. It is a large footprint suite with the ability to host our surgical, anaesthesia and perfusion colleagues simultaneously. Siemens has really worked with us to provide as much functionality as possible packed into one suite and we are really excited to have it up and running. COVID permitting we should be operational 2022.

NS:  What hurdles did you overcome to plan such a room? How will the suite be used?

RM: Beyond the usual funding and space planning issues we all encounter with renovations, including moving our ultrasound department and finding a spot to move them,  we had to decide as a GROUP what functionality/equipment we wanted for the next 10 years eg. single plane, multimodality CT angiosuite, biplane, hybrid OR etc. Our biggest hurdle for the ARTIS ICONO biplane was beyond neuro intervention and advanced aortic branch cases could the unit still handle the high volume bread and butter IR we will throw at it every day. With our current volumes we can’t afford to have a room sit idle, or having physicians waiting for their preferred room to be available. We are planning on leveraging ICONO’s Case Flows to set up the room prior to patient or physician entering to facilitate each case for example  head position stroke and PE,  to radial position TACE, UFE, mesenteric to left side TAVR and TIPS,  to right side for splenic/portal to vascular access from head to toe. The floor mounted plane integrates with a highly mobile table to reach from head to toe and finger tip.

NS:  What types of cases and patient care challenges do you hope to solve?

RM:  The most appealing advantage of this particular biplane is its dual spin time resolved multiphase CTA. In the right patient population we are hoping to skip the conventional diagnostic CT and have patients brought from ambulance to the angiosuite and undergo multiphase CTA, with the ability to do perfusion imaging in certain instances, while the team prepares for EVT. Eventually it may be possible to acquire dynaCT images from both planes simultaneously shortening imaging time and hopefully gaining added information with dual energy capabilities objectively distinguishing blood from contrast post procedure. I am also looking forward to 4 dimensional CTA in vascular malformation cases. We haven’t had a biplane up until now and are hoping to shorten aortic branch graft cases considerably.

NS:  How will patients benefit from this significant investment?

RM: Having a second large footprint hybrid angiosuite will allow for further collaboration in our hospital and maintain services during future maintenance and eventual renovations. Currently there is no finer imaging suite for stroke intervention and as the sole provider for acute stroke intervention in the province the patients win big time with the investment. The suite also offers increased opportunities for interventional oncology and continued collaboration with our surgical colleagues to offer the gamut of minimally invasive treatments.

NS:  What other technologies will be applied in the suite?

RM: Ultrasound will be a must. We are considering Siemens wireless probes to take advantage of the main imaging display and minimize footprint. Transesophageal echo for our TAVR and Dissection cases. Perfusionists are present during our cardiac valve cases with dedicated hook ups and monitors for them. Two PC’s with Third party HIS/RIS/PACS and advanced image processing are integrated into the Siemens control cockpit.  Patient monitoring both at the bedside and anaesthesia integrated into the main display. Third party table mounted injector. Large rail mounted display which can swing to either side of the patient as well as both ceiling mounted 24 inch monitors on a boom for the second operator. Closed circuit video camera for Procter led cases in these COVID times. We are using one of the large display inputs for chromecast /apple airplay as well as cellphone and micro blog paging integration as needed.

NS: What does the future hold for this suite?

RM: CASES! Lots of cases. We would be happy for people to stop in and check out the suite once operational — provided you have your vaccine. There will be a huge variety of work going through the room. The volume in our IR practice just keeps increasing. While we were not hit as hard as other parts of the country our case volume actually increased during COVID. We are fortunate to practice in a hospital that is large enough to do a wide variety or interesting work while being small enough people have to work at maintaining good working relationships. We have an open door policy, we are happy to work with anyone who is willing to work with us.

NS:  Anything else you would like to mention?

RM: Did you see Andre De Grasse win gold in the 200m? That was awesome!


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