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
Category Archives: Interviews
For several years now, I’ve been advocating for expanded use of functional measurement, otherwise known as Fractional Flow Reserve (FFR), as a way of determining whether or not a blocked artery is actually causing ischemia. A new measurement, made possible by recent advances in computer technology, called iFR (instant wave-Free Ratio™) may provide the momentum that pushes this concept into mainstream cardiology. Continue reading
This weekend Richard R. Heuser, MD, FSCAI and John E. Lassetter, MD, FSCAI of St. Luke’s Hospital and Medical Center in Phoenix, Arizona will be conducting a one-day course in transradial (wrist) angioplasty at the Wynn/Encore Hotel in Las Vegas, Nevada. But the games of chance will be relegated to the casinos because, as Dr. Heuser recounts in his exclusive interview with Angioplasty.Org, the wrist approach to diagnostic and interventional coronary procedures is safer for patients, more comfortable for patients and (trumpet fanfare) has the potential to reduce costs of healthcare as well.
And Dr. Richard Heuser has been performing PCIs since the beginning days of balloons and stents — so his perspective on why the transradial approach offers significant benefits is definitely of import to cardiologists across the U.S. Continue reading
Dr. Paul Chan sat down with me recently to talk about the study published this week in JAMA that he served as lead author on. The article, “Appropriateness of Percutaneous Coronary Intervention.” has generated hundreds of news reports about “unnecessary stenting”, “overuse of angioplasty”, etc.
In my exclusive interview with Dr. Chan, we talked about the real meaning of this study, what it was meant to do (benchmark the use of PCI in the U.S.) and how it’s being (mis) interpreted by the press (I’ll be discussing this aspect in a subsequent post). Continue reading
Dr. Ralph Brindis is the Immediate Past President of the American College of Cardiology and helmed the National Cardiovascular Data Registry (NCDR) since its inception in 1997 — this is the registry that was the source for the data analyzed and reported in yesterday’s JAMA study, “Appropriateness of Percutaneous Coronary Intervention.”
In my exclusive interview with Dr. Brindis, I talked with him about the study, his feeling about what it showed, both the positive findings and what he calls “opportunities for improvement.” While there was almost 100% adherence to guidelines for acute angioplasties (which made up 71% of the total angioplasties performed) the study also pinpointed the fact that PCIs for non-acute patients had a higher rate of “inappropriates”, as defined by the ACC/SCAI Appropriateness Criteria — and that this rate varied widely from hospital to hospital. This means that those hospitals with higher than average “inappropriate” PCIs needed to look at their cases, their decision-making process and work to bring it closer to the norm. Continue reading
Dr. Jack Hall, Program Director at St. Vincent’s Heart Center in Indianapolis, Indiana will be heading a faculty of transradial experts on Saturday. The “Indianapolis Transradial Summit” has been organized to train and inform cardiologists, cath lab techs and hospital administrators on the benefits for both patient outcomes and comfort, as well as potential cost-savings that are afforded by the use of the wrist as the catheter-access site of choice, when peforming angioplasty, angiography and stent placement. Continue reading
I had a chance to talk with Alan C. Yeung, MD, FACC of Stanford about the RESOLUTE US study just presented at the 60th Annual Scientific Session of the American College of Cardiology (ACC). He was one of the principal investigators of this study, which was just sent to the FDA as the final component of Medtronic’s approval submission package. The company is hoping for U.S. approval in the first half of 2012. You can read the full interview on Angioplasty.Org.