Need a new or used c-arm, recommendations?

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Ligament

Interventional Pain Management
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Looking at the fujifilm persona cs, philips pulsera, Ziehm all in one unit.

I currently have a Philips Pulsera which is working well, but it is at end of service life, cannot get a service agreement any longer. Need something that can be repaired quickly.

Ideas?

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Does anyone have experience with the GE one? I am particularly interested to hear about its ability to shoot a lumbar lateral in >250 lb patients
 
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Bought two Genoray Oscar units recently, work well and best price and warranty on the market. We tend to be minimalists when it comes to our needs with a c arm so we don’t use any bells or whistles.
 
Bought two Genoray Oscar units recently, work well and best price and warranty on the market. We tend to be minimalists when it comes to our needs with a c arm so we don’t use any bells or whistles.

Would you mind letting us know what you like about the function, price you paid and the warranty? Any uptime guarantees?
 
Also which genoray (oscar 15/prime or classic). Do you have contacts for a rep?
 
We got a volume discount price, had to commit to buying 4. We were able to negotiate a 5 year warranty, 4 hour response time on service calls. We also had to agree to let them use our clinics as demo sites if others wanted to see them in use. They didn’t have anyone in our area using their stuff and they wanted to get their foot in the door so to speak. Regarding the machine itself I can’t speak too much about it other than to say it takes fluoro images that are fine for us. We don’t use any special features. Roll the thing in, shoot AP, shoot lateral, contralateral oblique, don’t care about getting the absolute best image but rather an image that is good enough to adequately do the job. We all agree the images are better than our Siemens machines. One nice feature is that the company can remote into the machine via Wi-Fi to help troubleshoot any issues and they do this with just a phone call very quickly. I can also say that entering patient info is quick and easy, also boots up much quicker than the Siemens.

The units we have are the Oscars, not sure if 15 or classic. We didn’t by through a rep, we dealt with upper admin, I’ll see if I can get a contact number.
 
I have a Genoray also. So far so good. Did a kypho Friday with it in hand mode. 😂 Still looked nice enough to get the job done. Autocollimate works well. Pictures are very nice in spine mode. Better than my worn out 9900s at the hospital. Worse than a new flat panel elite at my alternate hospital. So really nice for the office. I like that the handles are color coordinated so you can walk anyone through helping you. It auto saves every image also. I have had multiple (ie hundreds) of cases where the techs forgot to save any images at the hospital or saved and forgot to push them to PACS.

“Unlock the yellow handle. Turn it so the yellow number is at 40.”

It is a little stiff still. Hopefully that will improve with use.
 
My only major complaint is the default gender is “OTHERS”.

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Looking at the fujifilm persona cs, philips pulsera, Ziehm all in one unit.

I currently have a Philips Pulsera which is working well, but it is at end of service life, cannot get a service agreement any longer. Need something that can be repaired quickly.

Ideas?
Am I taking the right path? My pulsera currently works great. I have no complaints. However, I will take a big financial loss if it is down for a few days, or potentially weeks, as it is end of service life and parts may take a long time to source, or potentially no longer exist. C-arm companies are giving me almost nothing on trade in for it. They all want 60k-100k for their new or used models. Maybe there is another option I've not thought of?
 
Am I taking the right path? My pulsera currently works great. I have no complaints. However, I will take a big financial loss if it is down for a few days, or potentially weeks, as it is end of service life and parts may take a long time to source, or potentially no longer exist. C-arm companies are giving me almost nothing on trade in for it. They all want 60k-100k for their new or used models. Maybe there is another option I've not thought of?
Just buy a new one. I have dealt with one of our 2 machines going down and it took months to get a new one; would not recommend. Our CEO is a cheapskate so we first went through several iterations of trying to find replacement parts for the dinosaur of a machine, and those parts not being quite compatible. I wasn’t a partner at the time so I didn’t really have the leverage to insist we just buy a new one immediately. Even so, once we committed to a new machine it took several weeks to negotiate pricing, take delivery, and get it set up.
If you buy one now you risk paying for a new machine maybe a year or two earlier than you needed to, but by waiting you risk tens if not hundreds of thousands of dollars of productivity, as well as the need to negotiate for urgent delivery which takes away a lot of your negotiating power on the price of the machine.
 
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Also, I'm guessing you have the option of keeping the Pulsera (storage space allowing) as a backup in case you have downtime on your new c-arm for whatever reason. Double protection against losing a ton of money because of downtime.
 
Also, I'm guessing you have the option of keeping the Pulsera (storage space allowing) as a backup in case you have downtime on your new c-arm for whatever reason. Double protection against losing a ton of money because of downtime.
I could do that...but space is an issue....I'll consider it. You are right, having backup would be great...
 
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Question for the hive,
opening new practice site, 2 procedure rooms, will need both of them 3-4 days per week.
Lease or buy 2 C arms.
Historically have used OEC 9800s refurbished, but hearing ok things about GenOray. Any help appreciated!
 
You sure you need 2 C-arms out of the gate? Can you be more efficient with 1?

Our Pulsera Pulsera went down and we found out just how worthless our service contract with Philips was. The battery was dead and there were none in the country. It took a week + to get a leased unit in and wasn't easy to find. We are now back up, but took almost a month to get the Pulsera back online.

We are expecting delivery of a Philips Zenition 70 on the 16th. We are keeping out Pulsera for backup or possible second room.
 
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My GE 9800 went out in the middle of a stim trial once. Battery dead. Friggin ridiculous. I hate that thing.
 
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Batteries are easy and should be preventative maintenance on your calendar
 
Batteries are easy and should be preventative maintenance on your calendar
Thats the thing, they were. For some reason this one went out after 18 months. Premature. No idea why.
 
Batteries can go out anytime after 1 year. There is preventing it
 
I would like 2 for the purpose of in office kyphos. I hear they pay well
 
I purchased the Fujifilm Persona CS. Have used it for about two weeks now so very early experience. Overall, image is better than my Pulsera in every way. Physical build quality worse than the Pulsera (cabinet, hinges, movements, etc). Fit and finish is a bit sloppy (poor paint job, vinyl stickers instead of painted labels, etc). It also has a much smaller footprint with no imaging tower needed. Will update folks as I get more experience with it.

It does connect to wifi and Fujifilm engineers have already signed in remotely to the system to do work on it, which is a nice feature.

Given the price I am happy so far, but needs more testing.
 
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Good info an above.
My pulsera is also at 10 years and the battery pack is failing yearly . I am also waiting this week for a replacement part. Program obsolescence?

I am looking at the GE one, Brivo, or another philips. I feel the repair techs are more sparse for philips than GE based on market share , and parts are also less available. GE is getting more competitive with pricing at the lower end models , so philips really has no advantage IMO…
 
I think refurb 9800 is the way to. Workhorse. Lots of parts and techs. As long as you don't have a super old born on date since they've been around for a while
 
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Good info an above.
My pulsera is also at 10 years and the battery pack is failing yearly . I am also waiting this week for a replacement part. Program obsolescence?

I am looking at the GE one, Brivo, or another philips. I feel the repair techs are more sparse for philips than GE based on market share , and parts are also less available. GE is getting more competitive with pricing at the lower end models , so philips really has no advantage IMO…
FWIW, the Fujifilm tech told me today my Persona CS has NO battery pack, which is great. That means no more $8500 battery pack expenses every 1-2 years...
 
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You don’t need two c arms for kyphos. One works great. In fellowship we used two, but either in office or at the hospital I have only used one.

The Genoray I have doesn’t have much oomph especially noticeable on laterals on obese men. Maybe I can grow enough to take it to a satellite office or use it as backup someday.
 
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I bought GE Brivo in Aug 2016, took a 5 year lease, paid it off. It is a workhorse. With proper annual maintenance there were no issues except changing a battery once. Little underpowered on the lateral views on 300lbs pts, otherwise no issues.
 
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Anybody have preference on Flat Panel vs Image Intensifier units. The Siemens guy was trying to sell my CEO on the flat panel tech - supposedly lower radiation exposure and sharper images compared to Image Intensifier tech. Overkill? Also, any opinions on GE vs Siemens?
 
I hired a couple radiation physicists to assist me in making my recent c-arm purchase. Flat panel is superior in every single way. Does it ultimately matter to you in real world performance for pain procedures; probably not. There is also a phenomenon called phosphor burn out or something similar, which WILL degrade image quality over time with II systems; again, probably not of significance to most pain docs. I've never seen a Siemens unit I liked. My understanding is their market share in c-arms is mostly due to bundling when buying CT and MR machines ie. large accounts. GE are totally fine but nothing exceptional about them other than ubiquity. The best portable c-arm units are the Ziehm Vision R machines, but too expensive for my budget and likely overkill.
 
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I hired a couple radiation physicists to assist me in making my recent c-arm purchase. Flat panel is superior in every single way. Does it ultimately matter to you in real world performance for pain procedures; probably not. There is also a phenomenon called phosphor burn out or something similar, which WILL degrade image quality over time with II systems; again, probably not of significance to most pain docs. I've never seen a Siemens unit I liked. My understanding is their market share in c-arms is mostly due to bundling when buying CT and MR machines ie. large accounts. GE are totally fine but nothing exceptional about them other than ubiquity. The best portable c-arm units are the Ziehm Vision R machines, but too expensive for my budget and likely overkill.
Thanks @Ligament! Super helpful. Thoughts on purchase vs leasing?
 
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