September 28, 2012 · 7:37 pm
Medtronic’s Resolute Integrity zotarolimus-eluting stent
According to reports yesterday by the Mumbai Bureau of Pharmabiz, and confirmed today by MassDevice, Medtronic has launched its Resolute Integrity Drug-Eluting Stent (DES) in India for the treatment of coronary artery disease (CAD). The Resolute Integrity is the only stent approved by the FDA for use in diabetics, based on a large cohort of diabetic patients in the Resolute clinical program.
Diabetics historically have had higher adverse events when treated with PCI (angioplasty and stents) — but the data from the Resolute trials showed virtually no difference between diabetics and non-diabetics, leading the FDA to approve the indication. Continue reading →
September 26, 2012 · 7:45 pm
Published “online first” today in the New England Journal of Medicine are two articles, authored by the Democratic and Republican presidential nominees, President Barack Obama and former Massachusetts Governor Mitt Romney, describing their health care platforms and their visions for the future of American health care. The editors of NEJM had asked the nominees for these statements which are brief and concise, summing up the two positions in less than 1,300 words each.
President Obama’s statement, titled “Securing the Future of American Health Care,” recaps the highlights of the Affordable Care Act, passed in his first term, and lays out plans for future improvements. Continue reading →
September 18, 2012 · 8:42 pm
Findings in a report issued last week by the Blue Shield of California Foundation demonstrate that an informed patient is an empowered patient: one who feels more comfortable asking questions of one’s healthcare provider, and making decisions about one’s own healthcare.
While this equation may seem obvious, the report puts numbers to the equation, marking the significant differences between the informed and uninformed patient. Most importantly, the patient population studied consisted of low income families with annual household incomes less than 200% of the federal poverty level, or about $46,000 for a family of four. Continue reading →
September 16, 2012 · 7:11 pm
Angioplasty balloon being manufactured on the kitchen table in Gruentzig’s apartment
Today is the 35th anniversary of the first percutaneous transluminal coronary angioplasty (PTCA) which was performed in 1977 by Dr. Andreas R. Gruentzig in Zurich, Switzerland. This angioplasty procedure utilized an expandable balloon, fashioned on a kitchen table in Gruentzig’s apartment by Gruentzig’s assistant, Maria Schlumpf (note the bottle of wine…and yes, she used Krazy Glue).
The patient was Adolph Bachman, age 37 (the same age as Gruentzig), who was scheduled for bypass surgery. Gruentzig has been working on this idea for several years; it was an idea first germinated by a U.S. radiologist, Dr. Charles Dotter, in the early 60’s. Dotter in fact coined the term “angioplasty” to describe opening up a blocked artery not through open surgery, but by threading a catheter into the artery and opening it up from the inside out: less traumatic, quicker, and possibly (he thought) more durable.
Dotter’s idea was mocked as crazy (he became known as “Crazy Charlie”) by the surgical community of the day and it took years for Dotter’s concept to travel across the world to Europe, where Gruentzig learned about it. He added a balloon to the tip of the catheter and, after experimenting in the lab in Zurich, he teamed up with Dr. Richard K. Myler of San Francisco to try the idea intraoperatively in patients who were having open heart surgery.
When the concept had been proven in a few of these surgical cases, Gruentzig returned to Zurich to attempt doing an angioplasty in the cath lab without surgery: percutaneously — just through a needle stick, the same procedure as a diagnostic angiogram. Except with a balloon. That’s where our video below begins: the story of the first angioplasty.
(By the way, the clip below is excerpted from my feature-length award-winning documentary, “PTCA: A History,” which tells the whole tale of how this “crazy” idea turned into a major branch of modern medicine. The complete 72 minute DVD is available for sale on our web site — of course!)
Continue reading →
September 15, 2012 · 9:45 pm
Jerry Lawler, announcing during a match in 2007 (courtesy Mshake3)
Jerry “The King’ Lawler, semi-retired professional wrestler, holder of 168 championships (reportedly) and commentator for WWE’s “Monday Night Raw” collapsed on September 10, during a live broadcast in Montreal, Canada.
62-year-old Lawler was having a heart attack.
EMTs performed CPR and defibrillated him (seven times, it is reported). He was revived and rushed to a Montreal hospital where he received an angioplasty with two stents. Continue reading →
· 7:46 pm
A study from Denmark of almost 100,000 patients over a 12-year period has concluded that:
The use of NSAIDs is associated with persistently increased coronary risk regardless of time elapsed after first-time MI. We advise long-term caution in using NSAIDs for patients after MI.
The study, published online before print in Circulation is titled, “Long-Term Cardiovascular Risk of NSAID Use According to Time Passed After First-Time Myocardial Infarction: A Nationwide Cohort Study.” The researchers looked at the nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark for the years 1997-2009 and calculated the incidence of death and heart attack associated with NSAID (Non-Steroidal Anti-Inflammatory Drug) use up to five years after a heart attack (in one-year increments). Continue reading →
· 1:00 pm
Artist illustration of the iFR “Wave Free Period”
As previously reported on Angioplasty.Org, a new method for the functional measurement of intracoronary pressures and the severity of blockages has been developed by researchers at Imperial College in London. One of the main advantages of this new method, called Instant Wave-Free Ratio™ (iFR), is that, unlike standard fractional flow reserve (FFR), it does not require injection of a vasodilator drug, such as adenosine, to induce stress on the heart. The result is that the procedure is more comfortable for the patient and potentially useable in clinical scenarios where vasodilation is not feasible, such as acute coronary syndromes, infarctions, unstable patients, patients with breathing problems; it may also be somewhat quicker, easier to use, and more cost-effective. Continue reading →