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Cath Lab of the Future: Angioplasty, Stents, Robots and More

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Imaging &
Diagnosis Center

Mason Sones in his cath lab, circa 1960
Mason Sones in his cath
lab at the Cleveland
Clinic, circa 1960

January 28, 2011 -- A half century ago, Dr. Mason Sones, working in his cath lab, discovered that he could inject contrast dye selectively into the coronary arteries. His discovery revealed in great detail the anatomic nature of coronary artery disease and, within a very short time, led to the treatments of both bypass graft surgery and angioplasty.

Along with Dr. Melvin Judkins, Sones founded an organization dedicated to excellence in imaging and diagnosis of heart disease: the Society for Cardiovascular Angiography and Interventions (SCAI). This month, SCAI has published a paper forecasting what the cath lab of the future might look like.

The paper, titled "The Catheterization Laboratory and Interventional Vascular Suite of the Future: Anticipating Innovations in Design and Function," appears in the current issue of Catheterization and Cardiovascular Interventions. It features predictions on the future of these medical spaces, including advances in technology and design as well as changes in function, staffing and economics.

Advancements in medical technology accompanied by improved patient outcomes have led to an increase in the number of catheter-based therapies performed by clinicians, a trend that is expected to continue with the discovery of novel techniques and superior medical technology. As science continues to guide medical advancement, the design and functionality of the cath lab and interventional vascular suite will likely continue to evolve. To achieve this, the paper recommends working with teams of physicians, scientists, regulators and manufacturers to create a functional suite for patients and staff.

"The future of the catheterization lab and interventional vascular suite is exciting to think about as we seek to continue improving patient care through minimally invasive techniques," said Lloyd Klein, M.D., FSCAI, professor of Medicine at Rush Medical College and lead author of the paper. "As new therapies are pioneered we have the opportunity to collaborate and provide patients with state-of-the art facilities that ensure the highest quality of service and care, while offering a functional and safe medical environment for both patients and staff."

Medical advancements have also shifted trends in cardiac care, including a new case mix with fewer diagnostic catheterizations, earlier diagnosis of blocked arteries and increased use of combined (or hybrid) procedures. The number of structural heart disease patients treated with catheter-based treatments is likely to increase, as will patients treated for valvular disease.

According the paper, the future cath lab will likely include design and technology features such as:

  • Robotic catheter manipulation directed by advanced imaging systems;
  • Miniaturization of therapeutic devices;
  • Integration of visual and other data from multiple sources, including the availability of archival solutions that are easily available and transferable to other medical professionals for consultation;
  • Advanced digital imaging, detailed 3-dimensional reconstruction and molecular imaging;
  • Utilization of virtual interfaces, trial procedures using virtual reality, and intelligent navigation during a procedure;
  • A dedicated information technology staff to manage ever-changing hardware, applications and monitoring programs that improve efficiency, eliminate disparate information and improve patient satisfaction.

The paper also forecasts the future functionality of the cath lab, predicting two different interventional laboratory types. The first will be reminiscent of today's cath lab but will include greater diagnostic capability and improved patient comfort through decoration, lighting and diversions. The second will be a much larger alternative surgical suite equipped with large and complex imaging modalities and used for more complex procedures. This suite would be staffed and equipped to accommodate open surgery procedures, something not common in today's labs. Additionally, the lab design will minimize patient and staff radiation dose, allow for database consolidation and pooled learning, incorporate a sophisticated storage and inventory management system and improve catheter navigation and device placement.

Source: Society for Cardiovascular Angiography and Interventions (SCAI) with additional reporting by Burt Cohen of Angioplasty.Org