From Bench to Bedside to Bench Revisited: Supreme Court Justice Ginsburg Back in Action

  Almost two decades ago, interventional cardiology pioneer Dr. Spencer B. King III penned an article for Circulation titled, “Angioplasty From Bench to Bedside to Bench.” Dr. King’s article was a recounting of the history of the development of the angioplasty balloon catheter by his colleague at Emory University, Andreas Gruentzig.

This morning, the title of his article took on new meaning, as Supreme Court Justice Ruth Bader Ginsburg entered the courtroom and took her seat, engaging in several complex legal arguments concerning mortgage loan officers, Facebook threats, and more. Continue reading

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Filed under Celebrity Patients, History, Media Coverage, Stent

The Beginnings of Endovascular Abdominal Aortic Aneurysm Repair (EVAR)

Dr. Frank J. Veith

Today was day one of the 41st Annual Veith Symposium in New York City. Started by Dr. Frank J. Veith, a pioneer in the field of endovascular approaches to vascular surgery, this five-day event covers the entire field of minimally invasive approaches to clinical situations that just a couple decades ago were the exclusive purview of open surgery.

The whole field of endovascular repair and intervention has grown exponentially since the  first endovascular repair of an abdominal aortic aneurysm (EVAR) was performed by Dr. Juan Parodi in 1990, but it took quite some time to be accepted as a standard of care. Today the endovascular approach is the preferred procedure to repair an AAA and this is because of the advances in medical device design and manufacturing and the dedication of physicians to this less invasive non-surgical approach, physicians who will be attending this year’s Veith Symposium.
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Filed under Endovascular, History, Innovators, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

Plavix and Aspirin After Stent: 8 Years Later – Is Longer Better?

plavix_and_stentNo one thought it would take quite so long to get this information, but in just a couple hours results from the Dual Antiplatelet Therapy (DAPT) Study will be presented at the American Heart Association Scientific Sessions 2014. The question to be answered: Is there a benefit to extending dual antiplatelet therapy (aspirin plus a thienopyridine, such as clopidogrel/Plavix, prasugrel/Effient, etc.) beyond one year after stenting?

This is a question asked back in 2006, during a special two-day FDA hearing, convened to discuss all known issues with drug-eluting stents and prompted by the “ESC firestorm” over the problems of increased incidence of late stent thrombosis in drug-eluting stents. (See “Problems Resurface with Drug-Eluting Stents” – September 9, 2006.) Continue reading

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Filed under Antiplatelet Medications, Bare Metal Stents, Clinical Trials / Studies, Drug-Eluting Stents, Global Trends, Meetings & Conferences, Optimal Medical Therapy, Stent Thrombosis

Vascular Surgery and the Battlefield: Honoring Our Veterans

  Today is Veterans Day in the U.S., honoring the soldiers who fought in the country’s wars. Last week was the VIVA 14 meeting, presenting the latest advances and techniques in endovascular repair and therapy of blood vessels.

These two events are actually closely aligned: the development and advances made in vascular surgery, and now endovascular therapies, were pioneered on the battlefield. Continue reading

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Filed under History, Innovators, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

Fractional Flow Reserve: Measuring Pressures in the Marketplace

Dr. Andreas Gruentzig

I don’t know how anyone can do these procedures without measuring pressures!

That’s what Andreas Gruentzig, the father of coronary angioplasty, said to me back in 1985. He knew that looking at the angiogram alone was not sufficient for judging the blockage in an artery. Integral to the design of his technological breakthrough, the double-lumen angioplasty balloon, was a feature which allowed him to measure the blood pressure at either end of the arterial blockage. At the start of the procedure, he could quantify how significant the blockage was; when he was done inflating the balloon, he could see the benefit of the dilatation. The post-angiogram might look good, but the pressures sometimes signaled that blood flow through the area was not. So, inflate again. And maybe again. OK, pressure now looks good, we’re done! Pretty simple. Not brain surgery. Continue reading

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Filed under Business & Industry, Cost Effectiveness, FAME I / FAME II, FFR, History, Stent

Crazy Charlie’s Amazing Idea: Angioplasty at 50

Dr. Charles Dotter in LIFE Magazine (1964)

Crazy Charlie. An August 1964 LIFE magazine photo spread on Dr. Charles Dotter reinforced that nickname, given to Dotter by the vascular surgeons who knew him and his work at Oregon Health Sciences University in Portland — and who did not like what he was doing. Unblocking arteries in the leg without surgery? From the inside, using catheters? Crazy!

So that was 50 years ago, and to call Dotter a visionary is a vast understatement because this week, radiologists, cardiologists and surgeons have gathered in Las Vegas, not to gamble (although who’s to say…) but to present and hear the latest information, late-breaking trials and reports on vascular interventional therapies at the VIVA 14 meeting and see demonstrations of an array of devices and techniques. Continue reading

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Filed under Back to the Future, History, Innovators, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

The First Endovascular Abdominal Aortic Aneurysm Repair (EVAR)

November 4 begins the 14th Annual VIVA meeting in Las Vegas. Yes, that’s “Viva, Las Vegas!

The whole field of endovascular repair and intervention has grown exponentially since the first VIVA meetings. For example, the first endovascular repair of an abdominal aortic aneurysm was performed by Dr. Juan Parodi in 1990, but it took quite some time to be accepted as a standard of care. Today the endovascular approach is the preferred procedure to repair an AAA and this is because of the advances in medical devices and dedication of physicians to this less invasive non-surgical approach, physicians who will be attending this year’s VIVA meeting. Continue reading

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Filed under History, Meetings & Conferences, Peripheral Artery Disease (PAD), Video