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Game-Changing Technology Uses Live X-Ray Images for Guiding Endovascular Surgery

By MedImaging International staff writers
Posted on 07 Jul 2022

Image: Cydar EV aids in planning and guiding endovascular surgery (Photo courtesy of Cydar Medical)

Endovascular aneurysm repair (EVAR) is an alternative to open aortic surgery due to perceived advantages in patient survival, reduced post-operative complications and shorter hospital lengths of stay. Despite these potential advantages, there is still significant variability in pre-operative planning and sizing, problems associated with imprecise visualization and device positioning intra-operatively, and inconsistent patient outcomes. Now, a game-changing technology for vascular navigation aids in planning and guiding endovascular surgery and is simple to integrate with the existing imaging hardware that is already present in the hospital.

Cydar Medical’s (Cambridge, UK) Cydar EV is the first product from Cydar’s Intelligent Maps system. The patented computer vision automatically overlays the Map on the live X-ray imaging with exceptional accuracy and robustness. When guidewires and instruments deform the blood vessels, real-time imaging is used to update the Map to match the new, deformed anatomy. The result is an accurate, responsive 3D Map on the screen throughout a procedure.

During endovascular surgery, stiff guidewires often straighten, shorten and displace blood vessels. The surgeon uses grab handles positioned along virtual guide wires to adjust the shape of the 3D Map to match the real-time anatomy (non-rigid transformation). And, once adjusted, the system remembers that adjustment in 3D even when the X-ray set moves position. Toggling between the pre-operative map and the adjusted map helps the clinical team visualize how the anatomy has changed and position devices precisely. This reduces procedure length by 30-60 minutes in endovascular interventions and radiation exposure for clinical staff and patients is radically reduced, by 50% even in standard EVAR.

Cydar, in partnership with King’s College London (London, UK), has now initiated the ARIA Study: a randomized controlled trial to assess the clinical, technical and cost-effectiveness of a cloud-based, ARtificially Intelligent image fusion system in comparison to standard treatment to guide endovascular aortic aneurysm repair (ARIA). The randomized trial will enroll 340 patients in 10 sites across the UK with a clinical diagnosis of abdominal aortic or thoracoabdominal aortic aneurysm (AAA and TAAA respectively) suitable for endovascular treatment. The trial will follow patients for one year and assess the effect of Cydar EV Maps on clinical-, technical- and cost-effectiveness in comparison to standard treatment in endovascular aortic aneurysm repair, used for both standard and complex devices.

“Our central hypothesis is that digital technology - specifically cloud-computing and artificial intelligence (AI), can be used to assess and learn from large volumes of data to inform clinical decision making and has the potential to improve the predictability of individual patient outcomes and the consistency of outcomes in the NHS,” said Dr Rachel Clough, Principal Investigator of the ARIA Study and Clinical Senior Lecturer from King’s College London.

“Cydar EV Maps is a game-changing technology for vascular navigation. The ARIA study provides a unique opportunity to demonstrate the benefits like reduced procedure time and reduction to radiation exposure, although some of the more subtle benefits related to procedural quality and reduced operator fatigue may never be directly measured but are obvious as an operator,” said Dr. Simon Neequaye, Principal Investigator at the Liverpool University Hospital NHS Foundation Trust.

Related Links:
Cydar Medical
King’s College London

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59 (!!!!! 2961.1587524414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

60 (952.00538635254): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

61 (!!!!! 3182.8880310059): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

62 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

63 (133.99124145508): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

64 (410.07995605469): SELECT fid FROM jos_deeppockets WHERE id=294793783 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793783 AND published='1' LIMIT 1

65 (!!!!! 3031.0153961182): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

66 (82.969665527344): select jos_twitters.link from jos_twitters where cat=10

67 (37.908554077148): select jos_facebook.link from jos_facebook where cat=10

68 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

69 (35.04753112793): select jos_linkedin.link from jos_linkedin where cat=10

70 (55.074691772461): SELECT fid FROM jos_deeppockets WHERE id=294793783 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294793783 AND published='1' LIMIT 1

71 (42.915344238281): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

72 (267.02880859375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (538.11073303223): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (674.00932312012): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

75 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (37.908554077148): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (41.961669921875): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

92 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (118.97087097168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

107 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

108 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793783 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (!!!!! 2151.9660949707): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793783 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (799.89433288574): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

111 (262.02201843262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

112 (607.96737670898): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793783 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (!!!!! 2600.9082794189): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793783 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (996.11282348633): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793779 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (365.01884460449): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294793779 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (640.1538848877): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (!!!!! 1474.142074585): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (!!!!! 4465.8184051514): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

119 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

120 (47.206878662109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

121 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

122 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

123 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

124 (333.07075500488): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 217623.9490509): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (!!!!! 13809.9193573): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

127 (125.88500976562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

128 (!!!!! 8745.9087371826): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793783 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793783 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 2396178.9608002): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (!!!!! 1409727.0965576): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (!!!!! 1657.9627990723): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

132 (!!!!! 1546.8597412109): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

133 (!!!!! 1625.0610351562): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

134 (306.12945556641): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

135 (!!!!! 1216.8884277344): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

136 (!!!!! 6646.8715667725): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

137 (!!!!! 1303.9112091064): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (302.07633972168): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (!!!!! 1599.7886657715): SELECT name FROM jos_deeppockets WHERE id=211

140 (38.862228393555): SELECT name FROM jos_deeppockets WHERE id=211

141 (560.99891662598): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (514.03045654297): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (895.02334594727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

144 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

145 (!!!!! 19492.864608765): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 6619.930267334): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793783 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (!!!!! 1725.9120941162): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294793783 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (!!!!! 8934.0209960938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (!!!!! 4415.9889221191): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (599.86114501953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

151 (254.15420532227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

152 (!!!!! 1688.0035400391): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (640.1538848877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

154 (782.96661376953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

155 (!!!!! 6181.9553375244): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294793783 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294793783 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (496.86431884766): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

157 (190.97328186035): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

158 (!!!!! 1086.950302124): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (752.92587280273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

160 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294793783 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294793783 AND published='1' LIMIT 1

161 (!!!!! 1624.8226165771): select jos_twitters.link from jos_twitters where cat=10

162 (!!!!! 2990.9610748291): select jos_facebook.link from jos_facebook where cat=10

163 (295.87745666504): select jos_google_plus.link from jos_google_plus where cat=10

164 (492.09594726562): select jos_linkedin.link from jos_linkedin where cat=10

165 (!!!!! 1147.985458374): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1377.1057128906): insert into jos_banners_delta values (14615,'2025-04-30 18:52:03','18.190.154.145','view'),(14202,'2025-04-30 18:52:03','18.190.154.145','view'),(14203,'2025-04-30 18:52:03','18.190.154.145','view')

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