Surgical C-arm

APX HF 3
USER MANUAL

APELEM S.A Parc Scientifique Georges Besse

175 Alle Von Neumann, 30035 Nmes cedex 1 FRANCE
Tl (33) 04 66 29 09 07 - Fax (33) 04 66 29 71 23

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Surgical C-arm APX HF 3

Contents
Safety ........................................................................................ 5
Protection against Radiation ................................................... 5
Transport .................................................................................. 5
Installation ................................................................................. 6
Operating .................................................................................. 6
Cleaning and Disinfection ........................................................ 6
Storage ...................................................................................... 6
Life time ..................................................................................... 7

General description .................................................................. 8

Characteristics ....................................................................... 11
1 General characteristics ...................................................................... 11
2 Radioscopy ....................................................................................... 11
3 Radiography ...................................................................................... 12
4 Protection devices ............................................................................. 12
5 Functioning indicators ........................................................................ 12
6 Other characteristics .......................................................................... 12

Description of the console .................................................... 13

Use in fluoroscopy ................................................................. 22

1 Manual fluoroscopy ............................................................................ 22
2 Automatic fluoroscopy ........................................................................ 22
3 Flash radioscopy ............................................................................... 22
4 Inversions of the fluoroscopy camera scan ......................................... 23
5 Digital video memory use ................................................................... 23
6 Remote control of video printer ........................................................... 24
7 Fluoroscopy timer .............................................................................. 24

Use in radiography ................................................................. 25

1 Use of the anatomical memories ......................................................... 25
2 Memory search .................................................................................. 25
3 Exposure setting ................................................................................ 26
3 Memorization ..................................................................................... 26
4 Standby time after a radiography........................................................ 26

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User Manual

Description of the identification label................................... 27

Apparatus grounding point.................................................... 28

Preventive maintenance ........................................................ 29

This manual was originally written in French

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Surgical C-arm APX HF 3

Thank-you

Thank-you for having chosen the Radiographic Mobile Generator APX HF 3.

We hope that it will meet all of your requirements.
Our company has invested this unit with its latest technical expertise and savoir
faire.

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User Manual

Safety
The user is requested to observe national laws concerning the use and installation
of x-ray equipment.
This equipment is not intended to function in an atmosphere containing explosive gas.
A check of the reliability and efficiency of the apparatus every 12 months is recommended
for the safety of both patient and operator.
Worn parts may become dangerous; they must be checked and replaced by new ones.
Before using the unit, the operator is to ensure that all safety devices are in working order.

Only properly qualified Technical Department personnel is authorised to remove the

protective housing of the apparatus.

No modification is to be made to the apparatus without the authorisation of the manufac-

turer.

The condition of the cables and connections is to be regularly checked; they are to be
replaced if they show signs of wear.
In case of any doubt, call the Technical Department.

Protection against Radiation

For protection against radiation during exposures, the operator must always remain
at a sufficient distance away from the generator by using the full length of the handswitch
cable.
The personnel must use the protection accessories for protection against radiation and
respect the security rules. Wear an anti-X apron. Make sure that the patient is fully protected
in case of exposures near the reproductive organs.
Protective clothes should also be worn by the persons that stay near the patient during the
exposure.
For the patient security, we recommend to use a distance from focus as large as possi-
ble, and advise the patient on the secondary effects that the X-Rays emission added can
develop.

Before each utilisation, the operator must check the leaded collimator. To do it, make a
fluoroscopy, press on keys 24 and 23 (see page 10), and watch on the screen, the openning
and closing of collimator

Transport
The equipment does not be moved without taking precautionary measures.
For more information, please contact the representative of APELEM Company.

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Surgical C-arm APX HF 3

Installation
The installation of the equipment must be realised in a room without any humidity and
dust.
Please, refer to the chapter "Safety" page 5 of this manual.

Operating
The conditions of use are the following :
- Ambient temperature : 10 to 40C
- Relative humidity : 30 to 75%
- Atmospheric pressure range : 500 to 1060 hPA

Cleaning and Disinfection

Before cleaning the unit make sure that the power supply is disconnected, and the
trolley be is switched off.
Clean the unit using a humid rag and tepid water.
Do not use detergents or sprays abrasive or corrosive like Acetone or pure alcohol, only
alkaloid solutions with a soft rag.
Be careful not to allow water or liquid of any kind to enter the unit or in the trolley as this
could cause a short-circuit or corosion to occur. However the keyboard is water proof and
can be clean without particulary protection.

Storage
The conditions of storage are the following :
- Temperature : 0 to 40C
- Relative humidity : 10 to 80%
- Pressure : 700 to 1060 hPA

After a period of storage at a temperature inferior to 10C, it is recommended to place the

turned-off device in place with a temperature of between 10 to 40C for a minimum
period of 4 hours.
After a long period of non-use (3 weeks), please follow this procedure for the setting
up of the machine again :
-Switch on the machine and let it warm up for half an hour
-Close the blades of the leaded diaphragm using key N20 and the iris with key
N17 (see page 10) so as to reduce the radiation of the X-Ray.

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User Manual

-Then carry out the following phases in fluoroscopy (manual scopie mode) :
50 kV and 0.5 mA for 5 minutes followed by a pause of 5 minutes.
70 kV and 2 mA for 5 minutes followed by a pause of 5 minutes.
90 kV and 2 mA for 5 minutes followed by a pause of 15 minutes.
- Slowly, (over the next 5 minutes) increase from 90 to 110 kV then respect a 2 hour
pause before using the machine.

Nota : To replace the X-rays monobloc, follow the same procedure.

Life time
The life time of the APX HF3 is 10 years. Beyond this time the manufacturer does not
guarantee technical characteristics of the product.

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Surgical C-arm APX HF 3

General description

Arm translation Rotation Orbital Camera TV

+/- 10 cm +/- 200 rotation 130

Wheel steering
ang blocking

Fluoroscopy
foot switch

Console

Swivelled wheels Swivelled front Rotating anode

2 position notches 0-90 wheels tube

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User Manual

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Surgical C-arm APX HF 3

Monitors Trolley

X-Ray Lamp Indicator

Monitors

Video printer

CCD Processor

APX HF 3
Connexion Wire

Locker Wheels

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User Manual

Characteristics
1 General characteristics
Aparatus class Class 1, Type B

Type of power supply high frequency switching

Electricity 230 V 10%

Nominal power 5 kW on 100 kV and 50 mA

Maximum power 9 kW on 100 kV and 50 mA

Current produced reference time 15 mAs for 70 and 100 kV

20 mAs for 120 kV

Leak radiation 0.36 Gy/h for 120 kV and 2 mA

Console dose 80 Gy / h maximum

Digital memory 944x544x12 bits for LC 10...

Processor dimage 512x512x10 bits for LC 8000 and DSA 500

Traitements / LC10...LIH-1, 2, 5, 10, 200 images

images storages LC 8000 : 10 000 Images on hard disk
DSA 500 : 10 000 Images on hard disk
Analog output to video printer (digital 3m952
optional)

Nose reduction LC 10..., LC 8000 et DSA 500

CCD Camra 625 lignes (50Hz), 525 lignes (60Hz)

Console / trolley
LC10... 2 monitors 17 / 44 cm
LC 8000 et DSA 500 2 monitors 17 / 44 cm (or 21/51 cm optionial)

2 Radioscopy
kV from 40 to 120 kV by 1 kV-steps

Automatic selection of the mA from 0.1 to 6.0 mA by continuous fluoroscopy

Manual setting of the mA from 0.1 to 6.0 mA by 0.1 mA-steps

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Surgical C-arm APX HF 3

3 Radiography
mA maximum mAs Focal spot

From 40 to 45 kV 80 250 BFS

From 46 to 50 kV 80 250 BFS
From 51 to 55 kV 80 250 BFS
From 56 to 62 kV 80 250 BFS
From 63 to 71 kV 70 250 BFS
From 72 to 83 kV 60 250 SFS
From 84 to 90 kV 55 250 SFS
From 91 to 100 kV 50 250 SFS
From 101 to 111 kV 45 225 SFS
From 112 to 120 kV 40 200 SFS

BFS = big focal spot

SFS = small focal spot

The minimum value is 3 mAs.

The radiographic mA value is automatically adjusted according to the kV displayed.
The mAs value is altered by steps of 1 mAs.

4 Protection devices
Temperature of the X-rays tube assembly temperatures indicators
Operating error
Protection of the frequency inverter

5 Functioning indicators
X-ray emission
Stop
Temperature of the X-rays tube assembly temperatures indicators

6 Other characteristics
Flash radioscopy
Pulsed radioscopy
Anatomical memories in radiography

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User Manual

Description of the console

1 47
41 39 37 43 36
13 44
2 42 40 38 35 34 33
45
3
30
32
4 31

29 28
10 46
5

11 14 17 19 21 23 25 27
6
12 15
7 8 9
16 18 20 22 24 26
1 Thin patient 25 Lower c-arm
2 Normal patient 26 Radioscopy
3 Big patient 27 Raise c-arm
4 Profile 28 Timer reset
5 Child 29 mA or mAs setting
6 Anatomical memory search 30 Automatic scopy
7 Anatomical memory search 31 Contour enhancement
8 Anatomical memorisation 32 kV setting
9 Anatomical memorisation 33 Radiography mode
10 Storage B monitor 34 Flash radioscopy
11 Image intensifier field 35 Pulsed radioscopy
12 Rotation to the left 36 On-off switch
13 Operating mode 2 (future version) 37 Safety-stop
14 Scan inversions 38 High-energy radioscopy
15 Rotation to the right 39 Housing temperature
16 Less light 40 Low-energy radioscopy
17 Close iris 41 X-ray emission
18 More light 42 Radioscopy mode
19 Open iris 43 On-off indicator light
20 Close shutters 44 Operating mode 1 (future version)
21 Shutter rotation to the right 45 Reprography (optional)
22 Open shutters 46 Memorised image search
23 Shutter rotation to the left 47 Anatomical panel
24 Laser centering (optional)

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Surgical C-arm APX HF 3

1 Thin patient

This key is used to select, for a thin patient, the values recorded in the anatomical
memory of high-tension radiography and of the quantity of exposure mAs, for
15 different examination sections, head-on or profile.

2 Normal patient

This key is used to select, for a patient of normal corpulence, the values
recorded in the anatomical memory of high-tension radiography and of the
quantity of exposure mAs, for 15 different examination sections, head-on or
profile.

3 Big patient

This key is used to select, for a big patient, the values recorded in the
anatomical memory of high-tension radiography and of the quantity of exposure
mAs, for 15 different examination sections, head-on or profile.

4 Head-on/Profile

This key is used to select from the anatomical memory the type of examination
required, head-on or profile.

5 Child

This key is used to select, for a child, the values recorded in the anatomical
memory of high-tension radiography and of the quantity of exposure mAs, for
15 different examination sections, head-on or profile.

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User Manual

6&7 Anatomical memory search

Both these keys are used to search for an anatomical memory amongst the
15 observation sections possible

8&9 Anatomical memorisation

By pressing both keys simultaneously the radiography cons

tants are transferred into the anatomical memory in course
of selection. The previous values are deleted.

10 Storage B monitor

This key is used to recopy the direct montitor image onto the recopy (B)
monitor.

11 Image intensifier field selection

This key with indicator lights controls the field selection of the
image intensifier when the c-arm is equipped with a bi-field or tri-
field image intensifier.

12, & 15 Image rotation keys

These keys are used to rotate the image in order to obtain the
best radioscopic observation.

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Surgical C-arm APX HF 3

13 Integration x 4

This key allows the camera integration rate selection (x4). (only available on
the compact version)

14 Selection of camera scan inversions

This key is used to select the camera scan inversion mode required,
horizontal or vertical. Indicators light up to show the mode which has
been selected.

16 & 18 Monitor light remote control

These keys are used to vary monitor brightness (except on monitors

21 (51 cm)).

17, 19, 20, 21, 22 & 23 Collimator controls

These keys are used to open, close and rotate the
iris and the shutters. This accessory is fixed on the
end of the x-ray tube and limits the emission zone
to the required area alone.

24 Laser centering (optional)

This key is used to activate the laser, the intersection of the cross indicating
the center of the observation zone.
To use this system, first put the centering accessory above the image
intensifier and adjust it until the light beam covers the center mark.
Caution: Laser rays have high energy power which can lead to
serious ocular lesions. Do not look directly into the center of the beam!

25 & 27 Lowering and raising C

These keys are used to set the height of the C.

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User Manual

26 Fluoroscopy

This key activates the emission of x-rays in fluoroscopy.

28 Timer reset
This key is used to reset the timer at 5 minutes. The number of
minutes remaining is shown on the display left of this key.
When the timer reaches zero, fluoroscopy is stopped. The
operator is warned of this in advance by a beeper sounding off
during the last thirty seconds.

29 mA or mAs setting
Both these keys are used to select anodic current.
If the machine is in automatic radioscopy mode, press either
of these keys to invalidate.
The values of high-tension current that can be obtained manually
range from 0.1 mA to 3 mA in low energy mode and from 0.1
mA to 6 mA in high energy mode, by steps of 0.1 mA (keys 40
and 38).
These two keys are equipped with an automatic repetition, i.e. press briefly to obtain the
increase or decrease of the value by one unit, but if either key is pressed down and held
for a longer time, the value will increase or decrease rapidly.

30 Validation/invalidation of the automatic fluoroscopy mode

This key is used to validate or invalidate the automatic fluoroscopy mode
which fixes, without manual setting, the values of the high tension and the
current needed in order to obtain a good image at all times, whatever the
subject.
There is an indicator lamp above the key.
The automatic radioscopy mode is invalidated by pressing either this key or
one of the four keys used to set the high tension or current manually.

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Surgical C-arm APX HF 3

31 Edge enhancement
This key is used to validate the system emphasising the contours of the
image.

32 Manual kV setting
Both these keys are used to set the kV in fluoroscopy or
radiography.
The values of kV that can be obtained manually range from 40
kV to 120 kV, by steps of 1 kV.
These two keys are equipped with an automatic repetition, i.e.
press briefly to obtain the increase or decrease of the value by
one unit, but if either key is pressed down and held for a longer time, the value will increase
or decrease rapidly.

33 Radiography mode

Press this key to switch the machine into radiography mode. There is an
indicator lamp above the key to show if the mode is active or not.

34 Flash fluoroscopy
This key is used to validate or invalidate flash fluoroscopy. There is an
indicator lamp above the key to show if the mode is active or not.
Flash fluoroscopy is used to obtain one x-ray pulse , of short duration but
high intensity.
The image memorised automatically at the end of the pulse is strongly
contrasted.

35 Pulsed fluoroscopy
This key is used to validate or invalidate pulsed fluoroscopy, a technique
used to reduce the amount of X-rays received by the patient. There is an
indicator lamp above the key to show if the mode is active or not.
Pulsed fluoroscopy consists in sending a number of x-ray pulsations at
fixed intervals.

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User Manual

36 On-off

This key is used to switch the machine on and off, on condition that the lamp
on the left of this key indicating it is plugged in is alight.
Caution : Switch on the machine only after plug on the trolley.

37 Safety-stop
If this indicator is alight, no new operation can be effected. The following is a
list of error codes. In case of a safety-stop, the corresponding error card will
be shown on the kV and mA/mAs displays:

Code -1- : Keyboard error; a key is activated when the machine is switched on.

Code -2- : Radiation error; the x-ray key is activated when the machine is switched on.

Code -3- : EEPROM error. Call the technical service.

Code -4- : Housing temperature error; the temperature of the X-rays tube has reached
the limit of 65C. Stop the machine until the X-rays tube has cooled down.

Code -5- : Heating error; either the x-ray tube filament is cut or there is a faulty
connection.

Code -6- : Frequency error; there is something wrong with the frequency inverter or with
the X-rays tube (high voltage discharge).

Other possible safety-stops:

- The radioscopy timer has reached zero. This can be rectified by resetting the timer
with key 28.
- The machine has been started up while the inverter capacitors are charging. Once
this charge phase is finished, a beeper sounds and the safety-stop is unblocked.

Call the Technical Department for the errors code 1, 2, 3, 5 and 6.

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Surgical C-arm APX HF 3

38 High-energy fluoroscopy
Press this key to enter the high-energy fluoroscopy mode. There is an
indicator light above showing if this function is activated.
This operating mode is used if in low-energy fluoroscopy the image is
flecked or if the x-rays have difficulty in penetrating the subject.
This technique varies the anodic current from 0.1 mA to 6 mA.
Do not use high-energy fluoroscopy all the time, to avoid the high value of
the current overheating the X-rays tube and the patient receiving a too
high radiation dose.

39 X-rays tube assembly temperature indicator

This indicator light is constituted of three progressive zones

indicating the rise in X-rays tube temperature.
The first zone is green and indicates low temperature.
The second is orange and indicates that the housing is hot.
The third is red and indicates that the housing is very hot, and a
safety-stop is activated.

40 Low-energy fluoroscopy

Press this key to enter the low-energy fluoroscopy mode. There is an

indicator light above showing if this function is activated.
This mode is automatically activated when the machine is switched on
and varies the anodic current from 0.1 mA to 3 mA.

41 X-ray emission indicator

This indicator lamp lights up when x-rays are emitted.

42 fluoroscopy mode

This key is used to change from the radiography to the fluoroscopy mode.
There is an indicator light above showing if this function is activated.

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User Manual

44 Integration x 8

This key allows the camera integration rate selection (x 8). (only available on
the compact version).

45 Video reprography

A video printer can deliver a paper copy of the image seen on the television
screen in a few seconds.
If your machine is equipped with this option, press this key to obtain a print.

46 Memorised image search

If your machine is equipped with a memory able to store several images,

this key is used to search for and select the memorised image you require.

47 Anatomical panel

This zone contains a reproduction of the human skeleton with indicator

lights on certain parts to locate the anatomical memories. An anatomical
memory contains the values of the radiography high-tension and of
the quantity of exposure-mAs for 15 examination sections, head-on or
profile, for 4 patient sizes

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Surgical C-arm APX HF 3

Use in fluoroscopy
The image intensifier and the X-rays tube are to be covered with protection bags to
avoid any liquid getting inside.

When switched on, the machine will always start up in fluoroscopy mode.

If in the course of use you find yourself in a different mode, press the fluoroscopy mode
key.

1 Manual fluoroscopy
The manual fluoroscopy mode is obtained when the automatic fluoroscopy indicator
light is off.

If this indicator is alight, just press either the corresponding key or one of the four kV- or
mA-setting keys.

The operator adjusts the high tension and anodic current values using the appropriate keys
so as to obtain a good operating image on the video screen, and thus disactivates the
automatic mode if that was the mode the machine was in. If the mode is changed, the
operator is informed by a short beep sounding off.

If the automatic fluoroscopy mode is exited with the automatic radioscopy key there is no
beep.

2 Automatic fluoroscopy
In the automatic mode, the operator does not need to adjust the high-tension and
anodic current values; this is done by an electronic system which examines the video in a
circular zone in the screen centre and adjusts the fluoroscopy settings to obtain the best
image. There is two Automatic fluoroscopy mode :
low-energy : from 40 to 120 kV and from 0.1 to 3 mA
high-energy : from 40 to 120 kV and from 0.1 to 6 mA

3 Flash radioscopy
The flash fluoroscopy mode is used to obtain a highly contrasted image of the subject
thanks to x-ray emission of short duration but high intensity.

This operating mode can only be used if the subject under observation moves slowly.

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User Manual

The operator presses the fluoroscopy pedal and an x-ray emission takes place.
Once an image is obtained, it is stocked in the memory and the x-ray emission ceases,
even if the operator continues to press the fluoroscopy command.

After flash fluoroscopy, the machine returns automatically to continuous fluoroscopy mode.

4 Inversions of the fluoroscopy camera scan

In order to make the fluoroscopic observation easier, the direction of the camera
scans can be inverted both horizontally and vertically. Right and left sides are inverted, or
top and bottom.

A configuration parameter is used to define the inversion modes active on start-up.

The scan inversion mode required is selected by pressing the corresponding key.

Each time it is pressed one of four different inversion combinations is obtained. Two indicator
lights indicate the activated inversions.

5 Digital video memory use

This machine usually has two digital video memories.

The first memory is connected to the live TV monitor and enables the last image obtained
to be frozen. If this memory is of the continuous integration type, the quality of the image
can be improved by reducing the noise swarming. Memorisation is automatic and takes
place each time the radioscopy control is released (L.I.H.).

The second memory is connected to the second monitor and enables to compare
examinations with the first monitor by stocking, in the course of the observation, the different
images obtained.

Two keys on the console control the functioning of this memory: one key is used to transfer
the image from the direct monitor to the copy memory, the other key is used to search for
images.

Both these keys may be activated at any time, during radioscopy or not.

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Surgical C-arm APX HF 3

6 Remote control of video printer

The possibility of obtaining in a few seconds a paper copy of an image on the screen
is given with the video printer.

If your machine is equipped with a video printer, a print can be obtained at any moment by
pressing the corresponding key on the keyboard.

7 Fluoroscopy timer
This machine is equipped with a five-minute fluoroscopy timer.

After five minutes of x-ray emission in fluoroscopy mode, the timer must be reseted by
pressing the corresponding key on the keyboard.

If the fluoroscopic timer is not reseted, the fluoroscopy will be stopped and blocked, a
beeper will bring this to your attention if you attempt to start another fluoroscopy by pushing
the pedal.

During fluoroscopy, you are informed that one minute has been spent by a short beep.

When you have only 30 seconds left, a beep will sound every second, and then when the
time is up, a long beep will sound off and the stop light will come on.

The fluoroscopy timer can be reseted at any time.

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User Manual

Use in radiography
Enter the radiography mode by pressing the radiography mode key.

The mA/mAs displays show in this mode the quantity of mAs selected for the following
exposure.

In this operating mode the high-tension value and the mAs quantity are selected for the
following exposure.

1 Use of the anatomical memories

The anatomical memories constitute an aid in obtaining radiographic prints by enabling
you to create a library of graphies for 15 examination zones, including head-on and profile,
for four different sizes of patient.

To recall a memory, simply press the anatomical memory search keys which validate a
zone on the anatomical panel, the head-on or profile indicator and one of the patient sizes.

The high-tension and mAs quantity values previously memorised are then displayed.

The constants of an anatomical memory can be modified by setting the high tension value
or the mAs quantity. If the contents of the anatomical memory differs from the radiographic
constants displayed, the patient size indicator lamp will blink.

The values really in the memory can then be obtained by pressing the key corresponding
to the blinking lamp.

2 Memory search
There is a total of 120 anatomical memories. These memories are divided into 4
groups of patients: normal, thin, child and fat.

Each group of 30 memories is sub-divided into 2 groups: head-on or profile.

The anatomical panel is used to pinpoint the zone to be examined. There is a choice of 15
different zones.

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Surgical C-arm APX HF 3

3 Exposure setting
Take the hand switch and move back of the machine. Press on the first button, keep on
pressing and wait the start of the exposure.

The time between pressing the hand switch and the effective begining of the exposure is
3 secondes (parameter 15)

The second button of the hand switch is not use (no 2sd time fonction)

3 Memorization
To transfer the graphic constants to the anatomical memory, first select an
examination zone, head-on or profile, size of patient. Then display your own constants,
and press the memorisation keys.

4 Standby time after a radiography

In order to prevent an abnormal fluoroscopy immediately following a radiography,
the machine stops all x-ray emission for a few seconds.

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Description of the identification label

CE marking Name of the device

(European Directive
93/42/CEE) Serial Number

N of the body
notifier for APELEM
products
Protection Type
B Address
Manufacturer

Power supply

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Surgical C-arm APX HF 3

Apparatus grounding point

Grounding
point

This terminal, link at electric ground of the apparatus allows, with the yellow /green
wire gift, to realise a grounding connection with an other equipment (examples: tables,
monitoring, etc).

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User Manual

Preventive maintenance
The user is requested to observe national laws concerning the use and installation
of x-ray equipment.

A check of the reliability and efficiency of the apparatus every 12 months is

recommended for the safety of both patient and operator.

Worn parts may become dangerous; they must be checked and replaced by new
ones.

Before using the unit, the operator is to ensure that all safety devices are in working
order. Particular attention is to be paid to indicator and display lamps by using the lamp
test.

The indicator lamp (x-ray emission) on the console is to remain alight only when the
x-ray emission controls are pressed. If it does not go out, disconnect the plug and call the
Technical Department.

No modification is to be made to the apparatus without the authorisation of the ma-

nufacturer.

Good earthing of the sockets is to be ensured.

The condition of the cables and connections is to be regularly checked; they are to
be replaced if they show signs of wear.

In case of any doubt, call the Technical Department.

The vertical displacement mechanics of the structure, the wheel movements, the
mechanical brakes and the safety switches are to be checked once a year.

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Surgical C-arm APX HF 3

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