July 8, 2012 · 10:30 pm

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

June 20, 2012 · 10:39 am

Thomas Fogarty on the Process of Innovation and Angioplasty Pioneer Charles Dotter

Thomas Fogarty, MD

Thomas Fogarty, MD

Few people in the field of medical devices are as qualified to talk about innovation as is Dr. Thomas Fogarty, founder, chairman or board member of over 30 business and research companies and holder of over 130 patents.

So, as we are on the verge of a new age in medicine, incorporating SmartPhones, mobile technology and individualized medicine, courtesy of genomics, it is worthwhile remembering what “change” in this field entails — in the words of Dr. Fogarty: “The process of innovation always involves overthrowing the establishment” and that the people who drive this innovation have “always been perceived as crazy…and inappropriate.” Continue reading →

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Filed under History, Innovators, Video

June 10, 2012 · 3:03 pm

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

June 7, 2012 · 3:53 pm

Lasorda Released from Hospital

Tommy Lasorda, photo by Phil Konstantin

Tommy Lasorda, photo by Phil Konstantin

So here we are in 2012!

It’s been almost 35 years since the first coronary angioplasty was performed in Zurich, Switzerland, and now we have an 84-year-old baseball icon, who had a heart attack, was treated with angioplasty and a stent, and is released from the hospital after less than 72 hours. And what does he “Tweet“? Continue reading →

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Filed under Celebrity Patients

June 6, 2012 · 4:10 pm

What We Can Learn from Tommy Lasorda’s “Mild” Heart Attack

Tommy Lasorda, photo by Phil Konstantin

Tommy Lasorda, photo by Phil Konstantin

Before he was Hall of Fame manager of the Los Angeles Dodgers, Tommy Lasorda was a scout and coach for the team. And part of his duties was to teach the rookies. So, in that tradition, there is a lesson in Tommy’s latest health scare: if you think you may be having a heart attack, get to the hospital ASAP, preferably a hospital that performs emergency angioplasty. Continue reading →

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Filed under Celebrity Patients, Heart Attack, Video

May 15, 2012 · 9:18 pm

FAME II: Should Fractional Flow Reserve (FFR) Be Mandatory?

Should Fractional Flow Reserve (FFR) Be Mandatory?Earlier today, the opening day of EuroPCR, Dr. Bernard De Bruyne presented preliminary results from the FAME II trial which tested the diagnostic power of Fractional Flow Reserve to guide PCI (stenting) of the coronary arteries. I wrote about FAME II back in January, when enrollment in the trial was halted for ethical reasons because the results of the ongoing FAME II trial were showing that the outcomes for stents in patients with stable angina were clearly superior to those in patients who were being treated with medications (a.k.a. Optimal Medical Therapy or OMT) alone. An independent Data Safety Monitoring Board advised that continuing the randomization would not change the findings and so, it was unethical to withhold the option of stents from this patient population. Continue reading →

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Filed under Appropriate Use Criteria (AUC), COURAGE, FAME I / FAME II, FFR

· 3:30 pm

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