Angiogram uses X-rays to examine blood vessels within the human body.  These X-ray angiography imaging systems have been developed to address the need to lower the X-ray dose for the patient.  In order to address these issues, a new generation of X-ray tube combination are incorporated into the next generation of angiogram machines. These changes are included in the Azurion 7 FlexArm systems which are designed to enhance positioning flexibility for image-guided procedures.  During the angiogram procedure, the clinicians need to quickly visualise any problems and changes to the patient’s anatomy during the procedure. The Azurion 7 system includes technology to perform both 2-D and 3-D imaging and this is carried out using an image beam which automatically maintains alignment with the patient: this approach allows consistent visualisation enabling the clinician to maintain focus on the treatment.  Angiogram systems can be used for complex procedures in structural heart space which require visualisation of the surrounding soft-tissue anatomy in a 3-D setting.  During the angiogram, ultrasound imaging can be used such as a transesophageal echo.  This ultrasound technology assists the operator to see real 3-D images of anatomy whilst also looking at the main screen in the cath lab.  Furthermore, interventional cardiology has been developed to replace pressure wires: this allows fractional flow reserve (FFR) to be determined and also to evaluate if stenting is required. The next generation of angiogram machines will use artificial intelligence algorithms to allow automation and analysis, for example, Liver Assist Virtual Injection technology. This technology incorporates intelligence-enhanced software which can identify the feeder blood vessels in liver tumours. Artificial intelligence can enhance and map the blood vessels and demonstrate the direction of flow in each vessel segment by generating a 3-D rotational angiography image to aid navigation. These new angiogram machines aim to reduce the X-ray dosages during imaging and scatter radiation by using the modern patient table. Studies have shown that these patient tables gave scatter dose of between 640 and 2,040 μSv/h compared to standard shielding which gives a reading of between 7,910 and 34,870 μSv/h.