InterZENtion: Transradial PCI as an Art

Transradial Coronary Interzentions by Dr. Ferdinand Kiemeneij

Transradial is one of the big buzzwords in interventional cardiology these days. In the United States practitioners recently have been discovering its advantages and have been learning how to perform it successfully. Utilization of transradial in the U.S. has jumped from 2% to almost 25% in less than a decade. In Europe, Japan, India, and China, transradial has been used for years and in most of those regions adoption runs from 50-90% of all catheter-based procedures. In Japan, and now in Europe, a specialized group of physicians has been pushing the limit of what can be done via the wrist artery, using “slender” procedures and equipment, with systems using 3, 4 and 5F sized catheters.

But the heart (pun intended) of this revolution in catheter-based access goes back over two decades to the pioneering work done by Dr. Ferdinand Kiemeneij, rightly dubbed “the father of transradial intervention.” You can read my interview with Dr. Kiemeneij here, but more importantly, you can and should and must read his brand-new hot-off-the-press book, “Transradial Coronary Interzentions,” available on Amazon. Continue reading

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Filed under Europe, France, Global Trends, Innovators, Japan, Medical Education, Patient Experience, Patients, Transradial Approach

An American Cardiologist in Paris

FranticNext week more than 12,000 cardiologists will stream into the Palais des Congrès in Paris to make presentations and learn about stents, angioplasty, fractional flow reserve, intravascular ultrasound, dual antiplatelet therapy, etc. It’s the annual EuroPCR meeting, “the world-leading course in interventional cardiovascular medicine.”

Just be careful in the shower and don’t answer the phone. Especially if you’re traveling with your wife! Continue reading

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Filed under France, Meetings & Conferences, Video

40 Years Ago, There Was a Poster at the American Heart Association Meeting….

Today being TBT (Throw Back Thursday) on Twitter, Dr. Jordan Safirstein (@CardiacConsult) posted a photo this morning of a poster that appeared 40 years ago at the 1976 American Heart Association meeting. (At the left is our photo of that poster from our history archive.)

It’s a meaningful poster, since it was the first public presentation of the concept and initial studies of something called “Percutaneous Dilation of Coronary Artery Stenosis” or simply, coronary angioplasty. This procedure had not yet been done in humans, but this poster directly led to that ground-breaking development within a year. Continue reading

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Filed under History, Innovators, Meetings & Conferences, Video

Happy 100th Anniversary to the RSNA

Mason Sones in a Philips cath lab of the 50's

Mason Sones in a Philips cath lab of the 50’s

This week the Radiological Society of North America, a.k.a. RSNA, is holding its annual meeting in Chicago. RSNA is an international society of radiologists, medical physicists and other medical professionals with more than 54,000 members from 136 countries across the globe. And this year the 55,000 attendees in Chicago are celebrating something special: the 100th anniversary of the RSNA.

To help honor the work of the Society, Angioplasty.Org would like to offer the video below which details the impact that imaging had on our field: the treatment of coronary artery disease. Continue reading

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Filed under ACC, Angiograms, History, Imaging, Innovators, Meetings & Conferences, Video

COURAGE: Does 15-Year Data Have Any Clinical Relevance?

pills_vs_stent_140sqThis past week saw publication of an update to the 2007 COURAGE trial which compared optimal medical therapy (OMT) to stenting (PCI) as the initial management strategy for stable coronary artery disease. (Please note the phrase “initial management strategy.” This will not be the last time you see it in this post.)

Appearing in the New England Journal of Medicine and titled “Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease,” this study, performed by Dr. Steven P. Sedlis and other COURAGE trial investigators, is described as “an extended survival analysis to examine the potential long-term survival benefit from initial PCI among the patients with stable ischemic heart disease who were followed for up to 15 years after initial enrollment in the COURAGE trial.”

This new analysis concluded: “…we did not find a difference in survival between an initial strategy of PCI plus medical therapy and medical therapy alone in patients with stable ischemic heart disease.” This also was the finding of the original COURAGE trial at five years. Continue reading

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Filed under Appropriate Use Criteria (AUC), Bare Metal Stents, Clinical Trials / Studies, COURAGE, Drug-Eluting Stents, FAME I / FAME II, FFR, Intravascular Guidance, IVUS, OCT, Optimal Medical Therapy, Stent

AimRADIAL Masterclass IV in Liverpool

Next week, on September 17-18, 2015, the 4th Advanced International Masterclass on the Transradial Approach will be held in Liverpool, England and, if you already perform or want to start using the wrist approach to diagnostic or interventional procedures, you need to attend. Where else will you be able to spend two-days with the most expert and experienced radial practitioners in the world?

I went to the last two AimRADIAL courses in New York City and Chicago and witnessed something I hadn’t really seen since the early days of angioplasty: a relatively small meeting (i.e. less than 300) attended by the pioneers of the procedure, cardiologists who have the largest experience in the radial approach, talking among themselves and trading their latest findings and techniques with each other, and sharing this information with the newer generation of physicians in attendance.It felt like an actual community! Continue reading

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Filed under Global Trends, Medical Education, Meetings & Conferences, Transradial Approach

Frontiers in Cardiology – One Day Course in New Jersey

MMC_Course_2015_140sq If you’re a cardiologist, Fellow, or in the allied health fields, and you weren’t able to make it to London for the five-day-long European Congress of Cardiology meeting, you can get a quick dose of the latest and greatest in a single day on Saturday, September 19, in Short Hills, New Jersey.

Titled “Frontiers in Cardiology,” this symposium is presented by the Morristown Medical Center, part of the Atlantic Health System, and features a stellar international faculty, including Maurice Buchbinder, Roxana Mehran, James Udelson, Nanette Wenger, and more. A range of contemporary topics are on the agenda, from atrial fibrilation to coronary artery disease, imaging and heart disease in women. Continue reading

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Filed under ACC, Medical Education, Meetings & Conferences