Category Archives: Global Trends

Unclogging Blocked Information About Angioplasty From the Wrist

Cleveland Clinic

Cleveland Clinic

A new article about transradial angioplasty (the placement of a stent using the radial artery in the wrist) appeared today in the Cleveland Clinic’s Heart & Vascular Health Blog, authored by their “Beating Edge Team.” Titled, “Unclogging Blocked Arteries Via the Wrist: Angioplasty approach may offer clinical benefits for certain patients,” the article’s purpose seems to be to familiarize patients with this new alternative approach to diagnostic angiography and angioplasty, “now being offered” at the Cleveland Clinic.

Unfortunately this short article, while supposedly an “advertisement” for wrist angioplasty, continues to promulgate several widely-held myths about the radial approach. Continue reading

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Filed under Global Trends, Heart Attack, Media Coverage, Patient Empowerment, Patient Experience, Patients, Shared Decision-Making, Transradial Approach

TCT 2012 – Transcatheter Cardiovascular Therapeutics in Miami Beach

Miami Beach

The TCT will be held in Miami Beach, October 22-26, 2012

The Transcatheter Cardiovascular Therapeutics conference (TCT) is the largest U.S. meeting devoted to interventional cardiology (angioplasty, stents, and related procedures) and it starts next week. Organizers are predicting a new attendance record of over 12,000 cardiologists and associated healthcare professionals, as well as members of the device, imaging and pharmaceutical industries, venture capitalists, and press. Speaking of which, yes…I will be there and Angioplasty.Org will be reporting on late-breaking trials, new directions and innovative devices.

The annual  meeting is truly international: attendees will be traveling from 70 countries; in fact, this year more than two-thirds of the registrants hail from outside the United States. Continue reading

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Filed under Clinical Trials / Studies, Cost Effectiveness, FDA, Global Trends, Heart Attack, High Blood Pressure, Intravascular Guidance, Meetings & Conferences, Stent, Transradial Approach

Medtronic Launches Stent for Diabetics in India; Abbott Launches Absorb “Scaffold”

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

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Filed under Clinical Trials / Studies, Diabetes, Drug-Eluting Stents, FDA, Global Trends, Stent

Cost Effectiveness of Wrist Angioplasty from Japan

Patient exchange in cath lab at Kihara Cardiovascular Hospital in Japan

Patient exchange in cath lab at Kihara Cardiovascular Hospital in Japan

Earlier today I reported on an important study, published online first in Circulation: Cardiovascular Quality and Outcomes. The study fed the results from 14 radial vs. femoral trials (RIVAL et al) into the cost-benefit analysis machine at Penn Medicine’s Center for Evidence-based Practice (CEP).

And the results? The transradial wrist approach to catheter-based procedures (angiograms, stents, etc.) was less expensive ($275 per procedure) and resulted in two-thirds less complications than the femoral/groin approach. Continue reading

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Filed under Clinical Trials / Studies, Cost Effectiveness, Japan, Patient Experience, Video

Can Using IVUS (Intravascular Ultrasound) Prevent Stent Thrombosis?

IVUS image shows stent under-expansion (click for larger image)

IVUS image shows stent under-expansion (click for larger image)

A recent paper, published online before print in SCAI’s journal, Catheterization and Cardiovascular Interventions, yet again adds to the evidence that intravascular ultrasound (IVUS) imaging during PCI can improve stent placement and expansion in a way that may prevent stent thrombosis (ST).

Titled, “Angiographically confirmed stent thrombosis in contemporary practice: insights from intravascular ultrasound“, the study looked at five years (2005-2010) of a multicenter registry of stent thromboses and studied the IVUS images where performed. Continue reading

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Filed under Innovators, IVUS, Japan, Stent Thrombosis

An American Cardiologist in Paris: Be Careful in the Shower

FranticToday EuroPCR 2012 begins. More than 12,000 cardiologists descend on the Palais des Congrès in Paris to present and learn about stents, angioplasty, fractional flow reserve, etc.

Just be careful in the shower. Especially if you’re traveling with your wife! Continue reading

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Filed under France, Meetings & Conferences

Cross-Country Training for Transradial Wrist Angioplasty

Duke Transradial LogoHaving an coronary angiogram or heart stent placed via the wrist approach is common in Europe. India and Japan — much less so in the U.S. — even though the wrist (transradial) approach offers lower complications and higher patient comfort. Some studies have even shown that the radial approach, with its significantly lower bleeding complications, is superior in treating heart attacks (STEMI) since those patients need to be on high levels of anticoagulation meds.

So why are only 5% of U.S. procedures done via the wrist while figures in other countries run 50-80%? One reason has been training. In the U.S. cardiology fellows are trained in the femoral (leg/groin) approach, because that’s what’s practiced at their hospitals. So it’s been a self-perpetuating practice. Continue reading

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Filed under Global Trends, Meetings & Conferences, Transradial Approach