On Tuesday morning the Transcatheter Cardiovascular Therapeutics (TCT) 2013 Conference celebrated the “father of angioplasty,” Dr. Andreas Roland Gruentzig, with the Career Achievement Award. Gruentzig, who died in 1985, was honored with a very moving tribute, which included a video, remembrances from his colleagues, and by the presence of his wife and two daughters, who were flown in from Zurich and Berlin by the TCT to receive the award on his behalf. Continue reading
Monthly Archives: October 2013
Let’s Disagree to Agree: the Not-So-Great Coronary Angioplasty Debate and a Patient’s Right to Speak
I read yesterday morning that I was now a party to “The Great Coronary Angioplasty Debate.” (Note to self: don’t look at Twitter before Sunday brunch.)
This all started a week ago, when Dr. Nortin Hadler posted an op-ed piece on The Health Care Blog, titled “The End of the Era of Coronary Angioplasty.” He opined that angioplasty was unnecessary in the setting of a major heart attack (a.k.a. STEMI) and might even worsen outcomes. His title and thesis was so over-the-top (intentionally so, I’m sure) that I felt obliged to pen a response to his very anti-stent article. Continue reading
A criticism from some cardiologists of the transradial approach, in which diagnostic angiography and percutaneous interventions (angioplasty and stents) are performed through the radial artery in the wrist, has been that the radial artery is too small to permit successful navigation of the various sheaths, wires and catheters. Of course, it’s been more than two decades since Dr. Ferdinand Kiemeneij successfully opened a blocked coronary artery via the wrist and today, in many parts of the world, half of all procedures are done this way. Continue reading
How does a physician treat a heart attack where the blood flow to the heart muscle is suddenly cut off by a blocked artery? In the most severe cases, the ST segments on the ECG are elevated, signalling that a major part of the heart muscle is at risk. It’s called a STEMI (ST-Elevated Myocardial Infarction). And, if you subscribe to the concept that the heart and circulation are like the plumbing in your house, like Dr. Charles Dotter did (he invented the concept of angioplasty and, in his offbeat humorous way, he used the graphic to the left as his logo), then you would assume there are two major ways to treat the problem: use Drano to dissolve the blockage or use a mechanical roto-rooter to clear it out. Continue reading
I’m in shock. Dr. Nortin Hadler of the University of North Carolina has proclaimed that the era of coronary angioplasty is over.
Poor, poor angioplasty…you were barely 36 years old, but you’re no longer needed. Guess we’re going to have to find a new name for our web site!
Of course, my first thought upon seeing this Op-Ed piece posted today on The Health Care Blog was that it was yet another article railing against the overuse of stents in patients with stable angina. Continue reading
Obviously, with the Federal government in shut down mode, a situation precipitated by the House of Representatives’ demand to delay the implementation of the already-implemented Affordable Care Act (a.k.a. Obamacare), no new device approvals will be forthcoming today, or any other day, until the U.S. Government gets an infusion of start-up capital (puns intended).
Maybe a Kickstarter campaign would be in order here. Continue reading