Cath Lab of the Future: Angioplasty, Stents, Robots and More
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Mason Sones
in his cath
lab at the Cleveland
Clinic, circa 1960 |
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January 28,
2011 -- A half century ago, Dr. Mason
Sones, working in his cath lab, discovered that he could inject
contrast dye selectively into the coronary arteries. His discovery
revealed in great detail
the anatomic
nature of coronary artery disease and, within a very
short
time, led to the
treatments of both bypass graft surgery and angioplasty.
Along with Dr. Melvin Judkins, Sones founded an organization
dedicated to excellence in imaging and diagnosis of heart
disease: the Society for Cardiovascular
Angiography and Interventions
(SCAI). This month, SCAI has published a paper forecasting what
the cath lab of the future might look like. |
The paper, titled "The
Catheterization Laboratory and Interventional Vascular Suite of
the Future: Anticipating
Innovations in Design and Function," appears in the current issue
of Catheterization and Cardiovascular Interventions. It features
predictions on the future of these medical spaces, including advances
in technology and design as well as changes in function, staffing
and economics.
Advancements in medical technology accompanied by improved patient outcomes have led to an increase in the number of catheter-based therapies performed by clinicians, a trend that is expected to continue with the discovery of novel techniques and superior medical technology. As science continues to guide medical advancement, the design and functionality of the cath lab and interventional vascular suite will likely continue to evolve. To achieve this, the paper recommends working with teams of physicians, scientists, regulators and manufacturers to create a functional suite for patients and staff.
"The future of the catheterization lab and interventional vascular suite is exciting
to think about as we seek to continue improving patient care through minimally
invasive techniques," said Lloyd Klein, M.D., FSCAI, professor of Medicine at
Rush Medical College and lead author of the paper. "As
new therapies are pioneered we have the opportunity to collaborate
and provide patients with state-of-the art facilities that ensure the
highest quality of service and care, while offering a functional and
safe medical environment for both patients and staff."
Medical advancements have also shifted trends in cardiac care, including
a new case mix with fewer diagnostic catheterizations, earlier diagnosis
of blocked arteries and increased use of combined (or hybrid) procedures.
The number of structural heart disease patients treated with catheter-based
treatments is likely to increase, as will patients treated for valvular
disease.
According the paper, the future cath lab will likely include design and technology features such as:
- Robotic catheter manipulation directed
by advanced imaging systems;
- Miniaturization of therapeutic
devices;
- Integration of visual and other data
from multiple sources, including
the availability of archival solutions that are easily
available and transferable to other medical professionals for
consultation;
- Advanced digital imaging, detailed 3-dimensional
reconstruction and molecular imaging;
- Utilization of virtual
interfaces, trial procedures using virtual reality, and intelligent
navigation during a procedure;
- A dedicated information
technology staff to manage ever-changing hardware,
applications and monitoring programs that improve efficiency,
eliminate
disparate information and improve patient satisfaction.
The paper also forecasts the future
functionality of the cath lab, predicting two different interventional
laboratory types. The first
will be reminiscent of today's cath lab but will include greater
diagnostic capability and improved patient comfort through decoration,
lighting
and diversions. The second will be a much larger alternative surgical
suite equipped with large and complex imaging modalities and used
for more complex procedures. This suite would be staffed and equipped
to
accommodate open surgery procedures, something not common in today's
labs. Additionally, the lab design will minimize patient and staff
radiation dose, allow for database consolidation and pooled learning,
incorporate a sophisticated storage and inventory management system
and improve catheter navigation and device placement.
Source: Society for Cardiovascular
Angiography and Interventions
(SCAI) with additional reporting by Burt Cohen of Angioplasty.Org
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