| Expert Insights &
Feature Articles |
| Scalpel… Suture… Suction… Pencil? |
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The concept of Maintenance of Certification (MOC) was to ensure that physicians who had been certified in their specialty kept current with medical practice and the current guidelines. It's not that concept that Dr. Paul Teirstein objects to, but its heavy-handed implementation by, as he puts it, "people not directly involved in patient care who have lost contact with the realities of day-to-day clinical practice." Ouch! |
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| Philips Buys Volcano: It's About Money, Technology, and History |
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The acquisition of Volcano by Philips is a landmark event in the world of imaging. For years, Volcano's mantra was "angiography alone is not enough." Well now, angiography agrees and one of the largest manufacturers of cath labs will be offering IVUS, FFR and iFR modalities as part of its total imaging package. The potential spread of these technologies can only benefit patients, with better outcomes and more targeted procedures, and also save hospitals and healthcare systems money. |
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| FDA Approves HeartFlow FFR-CT: Non-Invasive Method for Determining Coronary Ischemia |
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The FDA has approved HeartFlow's FFR-CT software for measuring coronary blockages non-invasively. While the accuracy of FFR-CT to correctly differentiate significant blockages from those not needing revascularization is only in the mid-80% range, the fact that a CT scan can be performed quickly, non-invasively, and with relatively low radiation doses, makes this procedure a significant contender to the extremely common nuclear stress test, and a potential game-changer in the diagnosis of coronary artery disease. |
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| DAPT Study: Extended Treatment After Stenting Lowers Stent Thrombosis and Heart Attacks |
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"Longer is better." That's what Dr. Dean Kereiakis told Angioplasty.Org when characterizing the results of the long-awaited Dual Antiplatelet Therapy (DAPT) study, which were presented today at the annual American Heart Association Scientific Sessions in Chicago. Dr. Kereiakes is the co-principal investigator for this five year study of 10,000 patients, which adds to the knowledge base of whether long-term treatment with aspirin and a thienopyridine, such as Plavix, after stent implantation is beneficial to patients. |
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| Fractional Flow Reserve: Measuring Pressures in the Marketplace |
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The FFR market has been a duopoly, split almost evenly between St. Jude Medical and Volcano Corporation. While these companies compete with each other, both have expressed upon occasion that the real challenge to increasing their sales and profits is not in gaining share from each other, but from expanding the field of FFR as a whole. However, some new smaller device companies are beginning to enter the marketplace. And the technology is slightly different: instead of pressure wires, these newer systems are utilizing fiber-optics. |
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| FFR and iFR: Roadmapping Your Heart, With Traffic |
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What has become clearer in the past few years is that seeing is not believing. The angiogram may show a narrowing, but that narrowing may not be causing a reduced flow of blood to the heart, a.k.a. "ischemia." Stenting or bypassing such a "non-ischemic" narrowing may not be of much benefit to the patient, but it will add a small risk factor of stent restenosis or perhaps a surgical complication. |
| FDA Approves Volcano's iFR® Pressure Measurement Modality for Use in Coronary Stent Guidance |
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The FDA has granted approval to Volcano's proprietary coronary pressure measurement modality, iFR (Instant wave-Free Ratio). iFR represents a significant advance in the field of functional measurement (FM), in which the actual flow pressures inside the coronary artery can be measured and the deficit caused by a coronary blockage or lesion can be accurately assessed. |
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| Can Near-Infrared Imaging Predict Heart Attack Risk? |
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What causes a heart attack? Is it a physical narrowing in the coronary artery, a blockage that can be seen on angiography? Or is it more likely the eruption of a lipid-rich plaque, a so-called vulnerable plaque, that may not look significant in percent stenosis during a standard catheterization? To find an answer, MedStar Heart Institute and Infraredx announced enrollment of the first patient in the Lipid-Rich Plaque (LRP) Study, which will involve 100 centers worldwide and have a target enrollment of 9,000 patients. |
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| The Incredible Shrinking Cardiac Devices |
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The "world's smallest, minimally invasive cardiac pacemaker," Medtronic's Micra™ Transcatheter Pacing System, was implanted last week for the first time in the United States. This implantation comes just two-plus months after its first in-human implantation and just two weeks after its competitor St. Jude Medical announced the "first in U.S." implantation of its own miniaturized device, the Nanostim™ leadless pacemaker. |
| DUTCH PEERS: Resolute Integrity vs. Promus Element 3rd Generation Stents |
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Are 3rd generation drug-eluting stents interchangeable? And what exactly is a "third generation" drug-eluting stent anyway? These were questions addressed by the DUTCH PEERS randomized clinical trial. The results showed that the Resolute Integrity was non-inferior to the Promus Element. There was, however, one parameter in which the two stents were not the same: longitudinal stent deformation. |
| 50 Years Ago, Dr. Charles Dotter Invented Angioplasty |
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It was 50 years ago that Dr. Charles T. Dotter, a radiologist in Portland, Oregon, performed the first angioplasty. But it wasn't in the heart; it was in the leg. An 82-year-old woman was scheduled for amputation of a gangrenous foot, but Dotter had a theory that he could open her blocked leg artery without surgery, with a catheter, and save her foot. He was right.... |
| Wrist Angioplasty Sees Unprecedented Growth in U.S. |
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In the current issue of Circulation, a landmark analysis of almost 3 million coronary interventions performed in the U.S. from 2007 to 2012 concludes that utilization of the transradial approach, in which balloons and stents are delivered to the heart via the radial artery in the wrist instead of the femoral artery in the groin, has increased 13-fold in the past five years. |
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| Patients Are Talking About... |
- I had radial angiography 2 days ago...it was a fascinating experience and was able to watch part of the procedure. I feel fantastic, have no "heart ache" or any problems with my arm.
- I can't afford my post-stenting meds, where can I find help paying for Plavix or Effient?
- I'm 64. After 4 stents and 2 heart attacks since Dec. 2008, I'm as physically active or more so than ever. I plan to hit 4,000 miles on my bike this year. I've hiked/climbed at 13,000 feet.
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| Patients
Are Reading About... |
Radial Hospital Locator
A list of physicians and hospitals offering the transradial (wrist) approach to angiograms, angioplasty and stent procedures. |
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| Read patient stories and Learn about medications after stenting, symptoms and complications, care giving, taking charge of your health, communicating with your cardiologist and much more in our Patient Center. |
 see
video clip:
" The 1st Angioplasty" |
ANGIOPLASTY
AT 35: 2012
marked the 35th anniversary of coronary angioplasty. In
1977 in Zurich, Switzerland, a young physician named Andreas
Gruentzig inserted a catheter into a patient's
coronary artery and inflated a tiny balloon, successfully
opening a blockage and restoring blood flow to a human
heart. |
| Today over
two million coronary angioplasties are
performed worldwide each year and angioplasty has become the gold standard for emergency heart attack treament. |
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