A post-game roundup by Imaging Technology News (ITN) Contributing Editor Greg Freiherr and Diagnostic and Interventional Cardiology (DAIC) and ITN Editor Dave Fornell on the trends and new tech seen on the show floor at the Radiological Society of North America (RSNA) 2016 meeting.
VIDEO: Augmented Reality for Surgical Planning Example
This is an example of the FDA-cleared OpenSight augmented reality (AR) system for surgical planning from NovaRad at the Radiological Society Of North America (RSNA) 2018 meeting. It uses a HoloLens headset to register an overlay of the patient’s MR or CT scan in the patient. The operator can use hand movements to slice through and manipulate the images.
The vendor gained an FDA indication for AR to be used in surgical planning in 2018. NovaRad is working with the FDA for a second indication for use of the AR in the operating room during procedures.
This video is jerky, slightly misaligned and the hand movements did not always respond because itwas shot with an iPhone inside the visor. The image quality and hand movements are much better when actually wearing it on your head and aligned for the specific user.
Shimadzu's latest generation interventional lab angiography imaging system, the Trinias, enables advanced imaging capabilities, including reduced patient dose, 3-D rotation angiography acquisitions table side, and stent enhancement software. This video tour of the system was created at the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting. For more information: www.shimadzu.com/med/products/angio/index.html.
Corindus Vascular Robotics received U.S. Food and Drug Administration (FDA) 510(k) clearance for its CorPath GRX, the second generation of its vascular robotic system. The system builds upon the original CorPath platform, adding a significant number of key upgrades that increase precision, improve workflow and extend the capabilities and range of interventional procedures that can be performed robotically. These features include Active Guide Management, which enables control of the guide catheter along with robotic control of the guidewire and balloon or stent catheter, with 1 millimeter advancement, from the Control Console. This precise positioning will enable physicians to adjust guide catheter position during PCI procedures, and may expand use of CorPath to more complex cases. The new system also features a completely redesigned Bedside Unit, featuring an Extended Reach Arm and a touchscreen display to streamline workflow. The CorPath GRX was displayed for the first time at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 conference. Read more about the FDA approval.
DAIC Editor Dave Fornell takes a video tour of some of the most innovative new interventional cardiology technologies he found at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 meeting. Watch the related VIDEO “Editor's Choice of the Most Innovative New Technologies at TCT 2015.”
A discussion with Juan Granada, M.D., about transcatheter mitral valve advancements and device challenges at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Granada is executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation. Read the articles “Advances and Future Directions for Transcatheter Valves,” and “Transcatheter Mitral Valve Replacement Devices in Development.”
A discussion with Torsten Vahl, M.D., about advancements in transcatheter valve repair technology, including new devices for the aortic, mitral and tricuspid valves. Vahl is director of experimental and translational research and assistant professor of medicine, Columbia University Medical Center, Center for Interventional Vascular Therapy. The interview took place at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting.
Related Transcatheter Valve Content:
VIDEO: Update of Mitral Valve Repair and Replacement Technologies at TCT 2017 — Interview with Ted Feldman, M.D.,
VIDEO: Tricuspid Device Clinical Trial Overview — Interview with Ori Ben-Yehuda, M.D.
VIDEO: Tricuspid Valve Imaging and Interventions Developing Hand-in-hand at ASE 2018— Interview with Rebecca Hahn, M.D.
VIDEO: TAVR for Degenerated Surgical Valves - 2017 Update— Valve-in-Valve TAVR Procedures — Interview with Sammy Elmariah, M.D.
VIDEO: The Essentials of CT Transcatheter Valve Imaging — Interview with Jonathon Leipsic, M.D.
VIDEO: TAVR For Asymptomatic Severe Aortic Stenosis — Interview with Philippe Genereux, M.D.
VIDEO: Conscious Sedation for TAVR Procedures — Interview with Mario Goessl, M.D.
A discussion with guidewire expert Dimitri Karmpaliotis, M.D., Ph.D., FACC, about the basics of interventional guidewire design and function. He is, assistant professor of medicine, Columbia University Medical Center, and director of CTO, complex and high-risk angioplasty program at the Center for Interventional Vascular Therapy, NewYork Presbyterian Hospital. He spoke with DAIC at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Understanding the Design and Function of Guidewire Technology.”
A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to evaluate chest pain patients in the emergency department. He is chairman of the Department of Cardiovascular Medicine at Beaumont Health System and a professor of Medicine at the Oakland University William Beaumont School of Medicine. He discussed the first year of experience with FFR-CT at Beaumont Hospital in Royal Oak, Mich., during the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Clinical Applications of FFR-CT.”
A discussion with Todd Brinton, M.D., about the newly FDA-cleared Shockwave Medical Lithoplasty System, at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Brinton is clinical associate professor and adjunct associate professor of bioengineering at Stanford University Medical Center. Read the article “FDA Clears Lithoplasty Balloon That Shatters Calcified Lesions With Ultrasound.”
William Abraham, M.D., FACC, discusses advances in heart failure device treatment technologies at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He is director of the division of cardiovascular medicine and a professor of internal medicine, physiology and cell biology at The Ohio State University Wexner Medical Center. He also served as principal investigator of the CHAMPION Trial for the CardioMEMS device. Read the article "Reducing Heart Failure Readmissions."
A discussion with Michael Reardon, M.D. about the state of transcatheter aortic valve replacement (TAVR) as of late 2016. He is a professor of cardiothoracic surgery at Houston Methodist DeBakey Heart and Vascular Center, was the chairman of the patient screening committee for the CoreValve U.S. pivotal trial, nation PI on the Lotus Pivotal Trial, and the national PI of the ongoing the CoreValve intermediate and low-risk trials. Read more in the article "Trends in Transcatheter Aortic Valve Replacement (TAVR)."
Brijeshwar Maini, M.D., and Brian Bethea, M.D., from Tenet Florida’s structural heart program, explain the importance of building a good heart team and how that team should interact. They gave a presentation on image guidance for structural heart procedures at TCT 2016, but focused repeatedly on the need for close collaboration to be successful. Read more in the article "Requirements for Interventional Echocardiographers."
Juan Granada, M.D., executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation, explains the shortcomings of the first bioresorbable stent on the U.S. market, proper patient selection and what new BRS technologies are in development. Granada presented numerous sessions on bioresorbable scaffolds at TCT 2016. Read more about bioresorbable stents in "Tempering the Bioresorbable Stent Euphoria Following FDA Clearance of the Absorb."
Krishna Rocha-Singh, M.D., Prairie Vascular Institute, Springfield, Ill., explains advancements in device therapy for hypertension at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He was involved in the SYMPLICITY HTN-3 denervation trial and is the principal investigator for the ongoing Rox Coupler arteriovenous device trial. Watch the VIDEO “New Approaches to Denervation Therapy.”
David Kandzari, M.D., director of interventional cardiology and chief scientific officer, Piedmont Heart Institute, Atlanta, Ga., explains the impact of the EXCEL Trial at TCT 2016. Piedmont recruited the highest number of patients for the large, randomized trial found the Xience V drug-eluting stent had comparable outcomes to coronary artery bypass graft surgery. This is the first time this parity has been shown in a large trial. Read the article "Stents, Bypass Surgery Equally Safe and Effective for Many With Left Main Heart Disease."
Studies have shown transcatheter aortic valve replacement (TAVR) has an increased risk of stroke and cerebral damage due to emboli released during the procedure. Recent clinical data show the extent of this damage on MRI. Several TAVR embolic protection systems are being developed to reduce this damage. This video explains one of those systems. Read about trial data presented at TCT 2016 "Delirium Significantly Associated With Brain Lesions in Patients Post-TAVR." Read the article, “TAVR Embolic Protection Did Not Reduce Emboli Brain Lesions,” which was a second trial presented at TCT 2016.
This video, provided by Xeltis, demonstrates the world’s first bioresorbable heart valve enabling cardiovascular restoration for pediatric patients. The Xplore-I clinical study of Xeltis bioabsorbable pulmonary heart valve, is a a multi-centered feasibility trial currently enrolling pediatric patients from 2 to 21 years of age in leading heart centers in Europe. Read the article “First Bioresorbable Heart Valves Implanted to Enable Cardiovascular Restoration.”
Interview with Patricia Dickson, LRT (CT), assistant director, diagnostic and outpatient services, Capital Cardiology Associates, Albany, N.Y., at the Society of Cardiovascular Computed Tomography (SCCT) 2016 annual meeting. She explains what technologists need to know when prepping patients and imaging during cardiac CT exams. For trends in cardiac CT, watch the VIDEO "The Future of Cardiac CT in the Next Decade."
Interview with Claudio Smuclovisky, M.D., FACC, FSCCT, director of South Florida Imaging Cardiovascular Institute, Holy Cross Hospital, at the Society of Cardiovascular Computed Tomography (SCCT) 2016 annual meeting. Smuclovisky explains what imaging departments need to know about advances in CT systems when purchasing the newest generation of CT scanners. He explains there is more to scanners than slices, offering information beyond the hype over 64-, 128-, 256-, 320-, and 640-slice CT scanners. For more information, read "Costs vs. Benefits: Comparing 64-Slice to 256, 320-Slice CT."
An interview with Jonathan Leipsic, M.D., FSCCT, chairman of the department of radiology, St. Paul’s Hospital, Vancouver, Canada, at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Leipsic is heavily involved with the procedural planning and anatomical assessments for TAVR and clinical trials for new transcatheter mitral valves and annulus repairs.
DAIC/ITN editor Dave Fornell shows some of the most innovative new cardiac CT and angiography technologies from sessions and the expo floor at the Society of Cardiovascular Computed Tomography (SCCT) 2016 annual meeting. Read the article "Advances in Cardiac CT Technology."
An interview with Matthew Budoff, M.D., FACC, director of cardiac CT, Harbor-UCLA Medical Center, Torrance, Calif., at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Budoff explains how CT calcium scoring can be used to assess patients risk for coronary disease and if they should be on statin therapy. Read the 2017 article "Screening for Heart Disease May Lead to Prevention, Better Treatments."
An interview with Leslee Shaw, Ph.D, FACC, FASNC, FAHA, co-director of the Emory Clinical Cardiovascular Research Institute at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Read the related article “Advances in Cardiac CT Technology."
An interview with Ricardo Cury, M.D., director of cardiac imaging, Miami Cardiac and Vascular Institute, at the Society of Cardiovascular Computed Tomography (SCCT) 2016 meeting. Cury who was instrumental in the development of the new CAD-RADS scoring system, which similar to BI-RADS used for breast imaging or LUNG-RADS use for assessment of lung diseases, is used to standardize the radiological assessment of coronary artery disease. For more information, read "Multi-Society Group Releases CAD-RADS for Standardized Coronary CT Angiography Reporting."
DAIC/ITN editor Dave Fornell shares some of the innovative new technologies on the show floor of the American Society of Echocardiography (ASE) 2016 annual meeting. Read the article "Top Trends in Cardiac Ultrasound."
Interview with Stephen Little, M.D., medical director of the Valve Clinic at the Houston Methodist DeBakey Heart and Vascular Center, at the American Society of Echocardiography (ASE) 2016 annual meeting. He explains the technologies his center is using to aid transcatheter structural heart procedure navigation, including TAVR, transcatheter mitral valve replacement (TMVR), LAA occlusion, and septal defect occlusions. Read the article “Requirements for Interventional Echocardiographers.” Also, watch the VIDEO "What is Required for Interventional Echo - Discussion With Rebecca Hahn."
Interview with Federico Asch, M.D., FACC, FASE, associate director of the echocardiography core lab at Medstar Health Research Institute and assistant professor of medicine (cardiology) at Georgetown University, at the American Society of Echocardiography (ASE) 2016 annual meeting. Asch discusses the technology used for cardio-oncology cardiotoxcity assessments and how to set up these types of collaborative programs between oncology and cardiology. For more information, read the article Assessing Cardiotoxicity Due to Cancer Therapy.
Interview with MD Buyline clinical analysts Jon Brubaker and Sabrina Newell at the American Society of Echocardiography (ASE) 2016 annual meeting. They highlighted trends they have seen in cardiac strain imaging, 3-D echo, bubble contrast, interventional echo, structural heart, and point-of-care ultrasound. Read the article on trends from Brubaker and Newell - "Top Trends in Cardiac Ultrasound at ASE 2016."
Interview with Rebecca Hahn, M.D., FASE, Columbia University Medical Center, New York, at the American Society of Echocardiography (ASE) 2016 meeting. She is an expert in the new subspecialty of interventional echo and discussed considerations for hospitals thinking of creating interventional echo programs to help guide complex transcatheter structural heart procedures in the cath lab or hybrid OR. Read the article “Requirements for Interventional Echocardiographers.” Also, watch the related VIDEO "Transcatheter Structural Heart Procedure Navigation Technology Advances."
ITN/DAIC Editor Dave Fornell takes a tour of some of the most innovative new trends and health information technologies (IT) on the expo floor of the Healthcare Information and Management Systems Society (HIMSS) 2016 meeting. Technologies include radiation dose management, wearables, patient engagement, admission kiosks, analytics software and imaging workflow aids.
MD Buyline market analyst Jon Brubaker explained the new technology and trends he saw on the show floor at ACC.16.
Michael Jaff, M.D., medical director of Massachusetts General Hospital’s Fireman Vascular Center, explains the current trends and technologies in critical limb (CLI) ischemia at ACC.16. Jaff also discusses strategies used by hospitals to recruit patients into CLI programs. Read the article, "New Technologies to Treat Peripheral Artery Disease (PAD)."
DAIC Editor Dave Fornell takes a tour of some of the trends and interesting new technologies from the vendor booths on the expo floor at the 2016 meeting of the American College of Cardiology (ACC).
David Holmes, M.D., professor of medicine, Mayo Clinic College of Medicine and consultant, Department of Internal Medicine, Division of Cardiovascular Diseases, shares details from his presentations at ACC.16 regarding the Watchman left atrial appendage occluder.
MDbuyline clinical analyst Tom Watson, BS, RCVT, explains the new hemodynamic system technology trends at ACC.16. All technologies are being increasingly integrated into the electronic medical record. Read the article “Improving Cath Lab Efficiency With Today’s Hemodynamic Systems.”
Chandan Devireddy, M.D., assistant professor of medicine at Emory Healthcare in Atlanta and an investigator in the PARTNER trials, discusses the positive late-breaking PARTNER II and IIA data presented at ACC.16. Among the key measures in these trials was the stroke rate, which is now the same as surgery.
John Carroll, M.D., professor of medicine at the University of Colorado School of Medicine, and director of interventional cardiology at the University of Colorado Hospital, explains his late-breaker presentation data at ACC.16. He researched outcomes and procedural volume based on the transcatheter aortic valve replacement (TAVR) STS/ACC TVT Registry.
Gregg Stone, M.D., director of cardiovascular research and education at Columbia University Medical Center / New York-Presbyterian Hospital, explains ABSORB Trial data showing bioresorbable stents had poor outcomes in small coronary vessels. This might be included as a restriction in the instructions for use of the Abbott Absorb stent, which is currently pending FDA final review. Read the related article "Questions Remain on Future of Bioresorbable Stents." Also, read the article "FDA Approves First Totally Bioresorbable Stent."
A discussion on the adoption rate of FFR-CT with Dr. Campbell Rogers, chief medical officer of HeartFlow. It is the first vendor to gain FDA approval for noninvasive, virtual fractional flow reserve measurements derived from cardiac computed tomography scans. Read the article "Clinical Applications of FFR-CT."
Dr. Vinod Thourani, professor of surgery, Division of Cardiothoracic Surgery, Department of Surgery, Emory University School of Medicine and a co-investigator for the PARTNER II Trial, discusses the biggest news item from ACC.16 — the Sapien 3 TAVR device performed better that surgical aortic valve replacement.