December 7, 2012 · 6:25 pm

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

December 6, 2012 · 10:53 am

The Activated Patient Blog Launches

Partnering with informed patients is a central tenant of the newly released joint 2012 Guidelines For Diagnosis and Management of Patients with Stable Ischemic Disease, as well as SCAI’s consensus update on Ad-Hoc PCI. And new studies about angioplasty and stents are being presented regularly that call for shared decision-making: for example, the OVER study, showing that endovascular repair of abdominal aortic aneurysms with stent grafts is equivalent to open surgery, the FREEDOM study discussing the options for multivessel disease in diabetic patients, and FAME 2 for the treatment of stable heart disease with significant ischemia as measured by fractional flow reserve. Patient preference comes into play in all of these. Continue reading →

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Filed under ACC, Clinical Trials / Studies, FFR, Patient Empowerment, Patient Experience, Patients, Shared Decision-Making

December 2, 2012 · 7:27 pm

Fractional Flow (Chart) Reserve

Flow Chart from Ad Hoc PCI Consensus Statement

Click to enlarge flow chart

Best medical practices for angioplasty and stent placement are a moving target because no sooner than a guideline is published it can be changed by the results of a more recent study. And the SCAI Ad Hoc PCI Consensus Statement posted online just three days ago is no exception. Continue reading →

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Filed under FAME I / FAME II, FFR, Non-Invasive Testing, Optimal Medical Therapy

December 1, 2012 · 11:17 pm

Ad Hoc Angioplasty: The Patient Is On The Table

Cardiologist and patient in cath lab

Cardiologist talks to a patient “on the table” in cath lab

Something that is “on the table” is defined as an item that is “up for discussion.” And this week The Society for Cardiac Angiography and Interventions (SCAI) issued a consensus statement about the proper use of “ad hoc PCI” — and the patient was definitely on the table, up for discussion, part of the conversation.

Since we’re into definitions, ad hoc PCI is the scenario in which a diagnostic catheterization is followed in the same session by PCI (angioplasty and stents). And this is a common scenario: in New York State, for example, 80% of all angioplasties are done in the same session as the diagnostic angiogram, although the vast majority of these are emergency or primary angioplasties, where a patient in the midst of a heart attack (or close to it) is brought into the cath lab and the blockage is opened up, saving the heart muscle and possibly the patient’s life. Continue reading →

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Filed under COURAGE, FAME I / FAME II, FFR, Heart Attack, History, Optimal Medical Therapy, Patient Empowerment, Patients, Shared Decision-Making, Stent

November 27, 2012 · 6:03 pm

Stents, Trials and Studies: What’s in a Word?

What's In a Word?Today the editors of the HEART Group Journals, comprising the Journal of the American College of Cardiology and other participating cardiovascular publications, issued a “Statement on Matching Language to the Type of Evidence Used in Describing Outcomes Data.”

Although the title of the article may be a bit yawn-inducing, the editors deserve a kudo or two for attempting to clarify reporting on medical issues. Continue reading →

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Filed under ACC, Appropriate Use Criteria (AUC), Clinical Trials / Studies, Drug-Eluting Stents, FDA, Media Coverage, Patients

November 15, 2012 · 7:16 pm

Angioplasty: From the Legs to the Heart and Back to the Legs

Charles Dotter, MD in LIFE Magazine

Charles Dotter, MD in LIFE Magazine, August 1964

Angioplasty! A word at the center of the recent TCT meeting in Miami, attended by 12,000 healthcare professionals. A word coined half-a-century ago by Dr. Charles Dotter, a radiologist who practiced at Oregon Health & Science University in Portland, Oregon.

Dotter’s idea was simple: to open up arterial blockages in the legs from the inside out: by snaking a catheter down the circulatory system to the blockage, instead of cutting through the various layers of body tissue to repair the artery through open surgery. Continue reading →

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Filed under History, Innovators, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

November 14, 2012 · 12:05 am

Today is World Diabetes Day!

World Diabetes DayWorld Diabetes Day (WDD) is celebrated every year on November 14. The World Diabetes Day campaign is led by the International Diabetes Federation (IDF) and its member associations. It engages millions of people worldwide in diabetes advocacy and awareness.

World Diabetes Day was created in 1991 by the International Diabetes Federation and the World Health Organization in response to growing concerns about the escalating health threat that diabetes now poses. World Diabetes Day became an official United Nations Day in 2007 with the passage of United Nations Resolution 61/225. Continue reading →

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Filed under Diabetes, Risk Factors