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29/08/2016

VesselNavigator has been designed for use in conjunction with Philips interventional X-ray systems to guide catheters during treatment of vascular disease

Philips launches innovative 3D navigation system to enhance minimally invasive treatment of vascular disease

  • VesselNavigator has been designed for use in conjunction with Philips interventional X-ray systems to guide catheters during treatment of vascular disease
  • Major reduction of contrast medium (70%) demonstrated in clinical study, enabling minimally invasive treatment of aortic aneurysms in the fast growing number of patients currently unable to benefit from minimally-invasive techniques

Amsterdam, the Netherlands – Royal Philips (NYSE: PHG, AEX: PHIA) today announced the launch of VesselNavigator*, its latest innovation in live 3D catheter navigation to guide the minimally invasive treatment of patients with vascular diseases such as aortic aneurysms (ballooning of the aorta). This new catheter navigation solution, designed for use in conjunction with Philips’ interventional X-ray systems, enhances the precision and accuracy of stent placement, while at the same time significantly reducing contrast medium usage. As a result, minimally invasive treatment options will be available to patients previously unable to benefit from new image-guided intervention techniques.

Developed in collaboration with clinical partners such as the University Hospital Cologne (Germany) and the University Hospital Ghent (Belgium), VesselNavigator complements Philips’ current image-guided therapy portfolio within the field of endovascular and hybrid suite solutions. It addresses the need for advanced 3D live-image guidance solutions, as the treatment for vascular disease is experiencing a major transition from open surgery to minimally invasive procedures, with such procedure volumes growing at high single-digit rates.

During endovascular procedures a catheter is maneuvered, with the aid of image guidance, through major arteries or veins in order to locally position and deploy implants such as stents to reinforce the wall of the affected blood vessel. Using conventional 2D X-ray image guidance, clinicians often perceive the visualization of the vessel anatomy during these procedures as if a dimension is missing, adding to procedure complexity. Many are more familiar with open surgery, during which they can physically see and touch the blood vessels they are trying to repair. VesselNavigator brings back the 3D anatomy they were used to seeing in open surgery.

VesselNavigator can be used for all types of endovascular procedures, but one of its key applications is guidance during the treatment of aortic aneurysms, which if left untreated could lead to severe complications such as massive internal bleeding. At the location of the aneurysm, the aorta often has smaller side branches, such as those that supply blood to the patient’s kidneys. Custom-made stents are therefore often made with dedicated openings that need to be precisely registered with these feeding vessels in order to repair the aorta and maintain critical blood flow to other abdominal organs. With conventional X-ray imaging it is very challenging to position the stent in the precise orientation. Endovascular aortic aneurysm repair is therefore a very complex procedure, and the more time it takes, the more contrast medium is needed for X-ray visualization and guidance in order to succeed.

VesselNavigator fuses live interventional X-ray images with pre-acquired 3D MRI or CT images of the patient’s vascular structures. The resulting 3D color-coded images of the vessels provide enhanced real-time visual guidance, making it easier to maneuver through the vascular network without the need to enhance the X-ray visualization with the repeated use of an injected contrast medium. In recent studies, VesselNavigator has been shown to reduce contrast medium usage by 70%¹ and procedure times by 18%² , contributing to more patient friendly, more efficient and more cost effective treatment of vascular conditions.

“VesselNavigator gives vascular surgeons during endovascular procedures the 3D view of the patient’s anatomy, which they are familiar with from open surgery. It also significantly reduces the amount of contrast medium required, which means a lesser burden on the kidneys. And with a growing population of elderly and diabetic people who suffer from poor kidney function, reducing contrast medium requirements will open up endovascular treatments to a wider range of patients,” says Professor Dr. Frank Vermassen, Head of Vascular and Thoracic Surgery at University Hospital Ghent.

“The strong growth in image-guided therapy procedures is driven by the significant benefits they offer for healthcare systems and patients, including reduced patient trauma, shorter hospital stays, and lower health care costs,” said Bert van Meurs, General Manager Image Guided Therapy at Philips. “It is an area where technology innovation and clinical innovation go hand in hand. VesselNavigator shows our commitment to – in close collaboration with leading clinical and industrial partners – advance the development of innovative technologies that enable less invasive, more accurate and localized therapies.”

VesselNavigator joins Philips’ extensive portfolio of live, 3D image-guided navigation solutions for image-guided minimally invasive therapies. This portfolio also includes HeartNavigator and EchoNavigator for structural heart disease repairs, EP Navigator for cardiac electrophysiology interventions, and EmboGuide to support tumor embolization in cancer treatment. Philips’ leading position in image-guided therapies was recently further enhanced by the acquisition of Volcano Corporation, a global leader in catheter-based imaging and measurement solutions for cardiovascular applications.

* Not available for sale in the U.S. – pending 510(k) clearance


¹ Ref Pubmed: Tacher et al; J Vasc Interv Radiol. 2013 Nov;24(11):1698-706
² Ref Pubmed: Sailer et al; Eur J Vasc Endovasc Surg. 2014 Apr;47(4):349-56

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29/07/2016

How I got that Trump photo, AP photographer Mark Terrill captured a dramatic image of Donald Trump from above that had people talking.

How I got that Trump photo

, by Lauren Easton
 
On the final night of the Republican National Convention, AP photographer Mark Terrill captured a dramatic image of Donald Trump from above that had people talking.

Plans for capturing a different acceptance photo had been in motion for months, since a media walkthrough of Quicken Loans Arena in the spring. The execution on Thursday night required resourcefulness, teamwork and stealth.

Republican Presidential Candidate Donald Trump wraps up his acceptance speech during the final day of the Republican National Convention in Cleveland, Thursday, July 21, 2016. (AP Photo/Mark J. Terrill)
Republican Presidential Candidate Donald Trump wraps up his acceptance speech during the final day of the Republican National Convention in Cleveland, Thursday, July 21, 2016. (AP Photo/Mark J. Terrill)

“While we had left the exact positioning and lensing up to Mark Terrill, Senior Director of Global Technology Support Howard Gros and his team had to plan for it ahead of time to build a network ring around the catwalk, so we could get the picture on a timely basis for our members and subscribers,” said David Ake, assistant chief of bureau for photos in Washington.

Terrill was on the convention floor when he took the photo remotely via a Nikon D4S camera with a 200–400 lens that was previously positioned up in the catwalk.

He explained how he and a colleague had set up the shot days earlier:

After putting a wide-angle camera that showed the front of the stage in the catwalk with everyone else’s cameras, technician Mark Weisheimer and I walked around the catwalk looking for the reverse angle location that we had planned for and found that one. It was a very small area that wasn’t blocked by apparatus and I doubt anyone else could have mounted there even if they had found it.

Also this week, Terrill hosted a Facebook Live chat, in which he provided a behind-the-scenes look at the convention.

16/07/2016

FranceWebConnected & StefanWebCollection,FranceWebSharing,Connexion,EU CITIZENS who have been in France for more than five years are entitled to apply for a carte de séjour UE – séjour permanent,

Getting a carte de 'séjour permanent'
Connexion edition: 0

EU CITIZENS who have been in France for more than five years are entitled to apply for a carte de séjour UE – séjour permanent, a measure which some experts have told Connexion may be useful in the case of a ‘Brexit’.

Obtaining one is challenging (but not impossible) – as one of the Connexion staff members found out.

We stress that European citizens do not need a residence permit to live and work in France (though non-working early-retirees should have a certain level of income so as not to be a burden on social security and may have to obtain private health insurance). However this measure is one recommended by some experts as a precaution in the case of Britons in the future losing EU citizenship (others have not mentioned it).

That being said, many commentators believe that maintaining basic residence rights of existing expats – both Britons in the EU and EU residents in Britain - would be a priority in the negotiations if the referendum vote was in favour of exiting.

However, many people – and, reportedly some smaller mairies - do not know that there are two kinds of card for which EU citizens are entitled to apply if they wish. In one case, a reader reports their mairie said they did not have the staff to process the request – we would submit that this is unreasonable, as these cards are a right for any long-term resident who is an EU citizen.

The cards that may be issued to European citizens are either the carte de séjour UE, obtainable before five years, or the ‘permanent’ version obtainable after five, which legally certifies that you have a right to stay in France indefinitely (in the case of early-retirees, for example, it is proof of entitlement to French healthcare under the Puma (formerly CMU) system, as opposed to a private policy.

Even a ‘permanent’ card must be renewed after 10 years (but fewer documents are required), however in the event of the residence rights of Britons being called into question after a Brexit it is thought that holding one may be of benefit in proving you have acquired a right to stay.



Our July issue contains a four-page special on the fallout from Britain’s Brexit vote. It will be on sale at selected newsagents from July 1. Find your nearest stockist here. You can subscribe to Connexion here from just €35 a year (less than €3 a month).Or click here to download a PDF of our latest issue.
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So, how is it done?

The basics can be found at: service-public.fr.

The aim of all the pièces (documents) you will be asked for is to prove your uninterrupted legal residence in France for a period of more than five years (stays away are allowable, but France should have been your main home). Apart from consulting the link above and this article, you should also telephone your prefecture to double check what documents they will need. They will want photocopies of all of these, as well as for you to show them the originals. In the case of our staff member these included:

• Letter requesting the carte de séjour on grounds of 5 ans de séjour légal et ininterrompu
• Three passport photographs
• Passport
• Work contract
• A bill (eg. EDF or other utility) showing your address in France, dated in the last three months
• Last three pay slips
• More bills (or similar proof) showing residence in France in each half-year during the last five years (eg. a bill dated in February of a given year and then another dated in September etc).
• French social security number (eg. present your carte vitale)

The point of an employee providing documents like a work contract and recent payslips is to show they have been legally resident, as, before five years, Europeans are required not to be a 'burden on the state' and must have a job, be self-employed of have independent means. A prefecture official told Connexion self-employed people are asked to give documents showing their self-employed income (revenus non-salariés), and early-retirees would be asked for evidence of having 'sufficient means' of their own (ressources propres).This could include tax assessments, she said.

What happened?

Our staff member was told on the telephone to take all the items above to the main prefecture for the department and to go to a certain numbered accueil (desk). The desk in question is only open for limited hours each morning and it was necessary to queue for an hour-and-a-half. It is probably therefore advisable to go before the opening time to be nearer the front of the queue.

On reaching the desk the staff member saw an official who made an initial assessment of whether the request was reasonable and the correct pièces were provided. She looked at the documents rapidly – there was a problem; the work contract had not been rubber stamped at the end by the employer and this was an essential requirement. However on being asked if it would be necessary to queue the next time, the official said it was acceptable to come to the front of the queue and hand the documents in.

On a subsequent day, the staff member did as advised, having to explain themselves to people at the head of the queue who asked why they were ‘pushing in’. They were quickly directed through to a waiting area, where they were then able to see a second official, who listened to the request and looked again at the pièces.

This time the second official said they were in order - however she said the prefecture also requires a birth certificate extract dating from less than three months ago with first applications for a carte de séjour, which had not been provided. On further consultation with colleagues, however, it was accepted that this could be waived in this case.

A temporary récépissé (receipt), valid for six months, was then handed over while the card application was processed. The official said a text message would be sent when the permit was ready to collect.

In conclusion, make sure the officials know it is a ‘UE’ card that you are asking for and that it is for ‘séjour permanent’ (if they are unfamiliar with this, print out the information from service-public.fr or direct them to the site). Aim to obtain the full list of documents required before you visit in person and make photocopies of all of them. Check a work contract has been rubber stamped (with the employer’s name and address and Siret) at the end. Keep your cool and be firm about your rights.

If you have tried to obtain one of these, Connexion would like to hear how it went, at news@connexionfrance.com
 
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