Fractional Flow Reserve and Ebola: Thresholds and Decision-Making

   This week started off with me watching a demonstration of fractional flow reserve (FFR) during multivessel PCI. This very instructive case was transmitted live from Hammersmith Hospital in London and featured Dr. Justin E. Davies showing how to perform FFR and, more importantly, how the use of FFR changed the treatment plan for this patient.

The angiogram had shown three intermediate blockages (LAD, OM, RCA) and, as such, this patient might have been a candidate for CABG instead of PCI. However, when FFR was used to measure whether or not these blockages were ischemic, two were found to be hemodynamically insignificant: it would be safe to defer stenting and treat them medically. The third lesion in the LAD clearly was the cause of the symptoms and stenting would have benefit for the patient. Continue reading

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Filed under Appropriate Use Criteria (AUC), FAME I / FAME II, FFR, Media Coverage, Stent, Video

AimRADIAL Masterclass Comes to Chicago

   On October 23-25, 2014 the 3rd Advanced International Masterclass on the Transradial Approach will be held in Chicago 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-and-a-half days with the most expert and experienced radial practitioners in the world?

I went to the very successful AimRADIAL course in New York City last fall 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, Innovators, Meetings & Conferences, Patient Experience, Transradial Approach

Will a Denial of Service DOS Attack Hit New York State Medicaid Patients? Or Perhaps Your State?

  What does a Denial of Service Attack have to do with stents, angioplasty and PCI?

In the world of computing, a DOS attack is defined as “an attempt to make a machine or network resource unavailable to its intended users.” Typically netbots programmed by hackers overwhelm the web servers of banks, credit card providers, etc. whose sites then become unavailable to their customers. Now it seems similarly that in New York State, cardiovascular treatments may become unavailable to some Medicaid patients: a denial of service. Continue reading

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Filed under ACC, Appropriate Use Criteria (AUC), Cost Effectiveness, Health Insurance, Interviews, Media Coverage, SCAI

FFR and iFR: Roadmapping Your Heart, “With Traffic”

The coronary angiogram is often referred to as a road map of the heart. As such, it serves the cardiologist and cardiac surgeon well. It shows where the coronary arteries are, how they intersect, the angles of the branches, etc. There are diagrams of these anatomical features in many textbooks, but the reality is that these characteristics can vary from individual to individual, so it’s necessary to get a road map for each individual in whom an intervention is being contemplated.  Then, of course, there’s the issue of narrowings in the coronary arteries. Should these receive stents? Should they be bypassed? Should they be left alone and treated with medical therapy? Continue reading

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Filed under Angiograms, FAME I / FAME II, FFR, Heart Attack, Imaging, Stent

Frontiers in Interventional Cardiology Symposium

If you’re an interventional cardiologist, Fellow, or in the allied health fields, and you aren’t able to make it to Washington for the five-day-long TCT meeting, you can get a quick dose of the latest and greatest in a single day on Saturday, September 20, in Short Hills, New Jersey.

Titled “Frontiers in Interventional 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, George Dangas, Eberhard Grube, Raoul Bonan, and Stephen Ellis. A range of contemporary topics are on the agenda, including a transradial talk by pioneer Olivier Bertrand, discussions about catheter-based treatments for mitral and aortic valve disease, and even a brief talk about Google Glass in the cath lab by Morristown Medical Center’s Jordan Safirstein, who also runs the annual MARS radial course at Morristown Medical Center

Course co-directors are Drs. Maurice Buchbinder, Barry Cohen and Robert Kipperman.  Time is short so register soon. Admission fees range from free (for Fellows) to $125 for physicians, with several levels in-between. You can register for the course online, or call 1-800-247-9580.

Did I mention that Fellows are free? #TakeAdvantageOfFreeCoursesWhileYouCanFellows

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Filed under Meetings & Conferences, Stent, Transradial Approach

SCAI and CRF Training Programs in Transradial PCI

Radial DiagramThe next few months offer some unique training opportunities for the U.S. interventional cardiologist regarding the transradial approach to catheterization, angioplasty and stent implantation via the wrist artery.

In just two weeks the annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI) begins, and on the first afternoon there will be a two-part symposium devoted to the Transradial Approach. From 1:00pm to 5:30pm on Wednesday, May 28, SCAI will hold a series of presentations and discussions led by pioneers in the transradial approach. Continue reading

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Filed under Meetings & Conferences, Transradial Approach

MARS Across the Hudson: Mid-Atlantic Radial Symposium is May 3

Dr. Jordan Safirstein and his Google Glass

Dr. Jordan Safirstein and his Google Glass

If you are an interventional cardiologist or work in a cath lab where the transradial approach is being utilized, and you live anywhere near New York-New Jersey-Pennsylvania, you might want to consider a day trip to Morristown, New Jersey on May 3. This trip won’t cost you anything, because the Mid-Atlantic Radial Symposium (MARS) is free; and yes, there still is such a thing as a free lunch. (For those who want to come in the day before, the Westin Governor Morris is offering a special room rate.)

Oh yes: you’ll also be able to receive 5.5 AMA PRA Category 1 CME credits. Continue reading

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Filed under Meetings & Conferences, Transradial Approach