Endovascular procedures allow patients to get life-saving care that’s potentially safer, with less scarring, and a quicker, easier recovery. But these procedures depend heavily on fluoroscopy to guide catheters, stents, and other tools through the vascular system to achieve success.
The downside? Fluoroscopy exposes both patients and surgical teams to ionizing X-ray radiation. Over time, that exposure adds up and carries risks.
That’s where the Intra-Operative Positioning System (IOPS) comes in. IOPS is a GPS-like technology that doesn’t use X-rays to create live images. It provides a more precise view of the body, thereby greatly reducing radiation exposure, improving navigation, and streamlining procedures for patients and providers alike.
Reduced Radiation for Everyone
Surgeons have long known the risks of repeated radiation exposure. “Even though I wear lead and protect myself, I still get irradiated,” says Behzad Farivar, MD, a UVA Health vascular surgeon and director of the UVA Aortic Center.
“I need to put a stent in a blood vessel, but in order for me to do that, I need to go from the groin to the aorta and its branch vessels. And that step is all done under fluoroscopy,” notes Farivar. “The longer the procedure, the more complicated it is, and the higher the radiation dose,” he explains.
Without fluoroscopy, stenting procedures (such as TAMBE) wouldn’t be possible. But like all X-ray technology, it carries long-term risks. “Short exposure is fine, but if you think of it over 20 to 30 years, or if a patient needs multiple interventions, you get radiation exposure. Over time, there's a risk of cancer development with all these radiation exposures,” says Farivar.
But the IOPS technology is different. It doesn’t use constant ionized radiation to work. With IOPS, “It’s an electromagnetic field that is generated, which is non-ionizing radiation,” says Farivar. “So, it's safe both for the patient and the provider.”
Better Visualization During Intravascular Navigation
Fluoroscopy is also limited to providing only 2-dimensional (2D) imaging, like a standard X-ray. IOPS provides a 3D view of the body, which improves on the accuracy and speed of procedures. “You know exactly where you are inside the body without having to guess, which you don't have that luxury in fluoroscopy,” says Farivar.
It works like this: a pre-procedure CT or MRI scan is used to create a 3D map of the patient’s anatomy. Then, during the procedure, IOPS creates a small electromagnetic field and tracks specialized tools using sensors. These sensors tell the system exactly where the tools are inside the body, displaying the information on a screen in real-time.
The result? "You’re able to see a cartoon-like, video game image of where your wire is, where your catheter is, and where you’re going,” says Farivar.
And that image can be manipulated as needed to get the best angles throughout the procedure. The surgeon can “turn this model upside down, turn it, flip it inside out, flip it the way you want it,” explains Farivar. “We don't have any limitations and can look at blood vessels from multiple angles.”
Faster, Less Invasive Procedures With IOPS
IOPS is already FDA-cleared for use in the descending aorta and is in use for procedures like EVAR, renal artery stenting, and complex aortic dissections. Farivar was one of the first in the U.S. to use the IOPS system in clinical practice and has led its implementation at UVA Health. “I performed a procedure using it here at UVA Health for an endovascular repair of AAA (abdominal aortic aneurysm),” he says. “For part of the procedure, we did not use any fluoroscopy, doing it completely without radiation.”
A Step Forward in Vascular Surgery
With its ability to protect patients and providers, improve visualization, and increase procedural efficiency, IOPS represents a major step forward in catheter-based cardiovascular care.
As this technology evolves, it’s paving the way for a new era in safer, smarter endovascular procedures.
