Ziehm Imaging readies push into U.S. C-arm market

Ziehm Imaging has adopted a strategy for its C-arm business that is similar to the one now rejuvenating the ultrasound market. Just as companies such as SonoSite and Zonare have incorporated high-end functionality into their hand-carried sonography units, Ziehm is boosting the image quality and clinical capability of its portable C-arms. The goal is to rival the functionality of bulky x-ray fluoroscopy units currently used in operating rooms.

"C-arms need to be small to allow room for everyone to work," said Ziehm Imaging CEO Mike Palazzola. "So, as we grow in capability, the machine functionally is bigger, but is not physically bigger."

Company engineers are harnessing flat-panel detectors and software to enable the device to do more work within the same footprint.

Ziehm's newly revamped Vision series is based on a new, flexible hardware platform. One element of the portfolio, Vision FD, is the company's first mobile C-arm with a flat-panel detector, a product small enough to be maneuvered easily around a hospital and plugged into an ordinary electrical outlet.

Another product in the series is the Vision R, which features a rotating anode. This unit consolidates a high-voltage power source and a generator to improve performance.

A third product, Vision 3D, provides volumetric information in the operating room. Software control of the mechanical design allows the operator to shift the isocenter to suit the patient.

"With other C-arms, you always have to move the patient to get the region of interest to the isocenter, which is a lot of effort," said Jörg Peter Ströbel, president of Ziehm Imaging.

These systems have been available in Europe, Ziehm's market stronghold, and were largely responsible for a 32% growth last year in global sales, which Ströbel attributes to "having the right product and a strong team."

The company's growth is impressive considering that much of it was achieved outside of the U.S. Ziehm's new portfolio is only now coming to this country as part of an effort to establish Ziehm as a premium provider of x-ray equipment in the U.S.

For much of its existence, Ziehm was part of Instrumentarium. The German company found its independence when the U.S. Department of Justice objected to the purchase of Instrumentarium three years ago by GE Healthcare, and required that the mobile C-arm maker be sold off in order for the deal with GE to go through.

The acquisition of Instrumentarium and consequent divestiture of Ziehm had little effect on Ziehm sales in Europe, where it was well known. It hurt sales in the U.S., however, according to Palazzola, who served as president of U.S. operations for Instrumentarium and joined GE after the acquisition. Ziehm recruited him in June.

"Now we're getting the U.S. up to speed and we're going to the next level," he said.

In packing a bigger punch into its small-sized systems, Ziehm is trying to challenge the concept underlying vascular labs, which is that physicians need large x-ray systems.

"Why tie up dedicated rooms with equipment that can't be utilized for anything else?" Ströbel said. "There is more flexibility in being mobile."

Software-controlled imaging platforms in ultrasound and x-ray are only the beginning of a widespread trend toward miniaturized imaging technology. But there is more to it than that. Palazzola sees miniaturized technology fomenting a fundamental change in medical practice.

"We are beginning to think of the patient as a fixed entity and moving the technology to the patient rather than moving the patient to the technology," he said.