Canada is spearheading an international study to determine if an implantable cardioverter defibrillator (ICD) can prevent death from serious heart rhythm problems in those patients who’ve survived a heart attack. Heart disease is a leading cause of death in Canada and the fastest growing disease worldwide.

July 15, 2011 — Attendees at the 2011 annual scientific meeting of the Society of Cardiovascular Computed Tomography (SCCT), July 14-17 at the Colorado Convention Center in Denver, will learn how Siemens Healthcare facilitates “Sustainable Cardiovascular Care” through its portfolio of products and services, including the Somatom Definition Flash CT scanner and <i>syngo</i>.via imaging software.

Photo A: This 86-year-old female presented with inferior ST-elevation myocardial infarction. Emergent coronary angiogram (pictured here) showed 100 percent occlusion of right coronary artery with significant thrombus burden, for which aspiration atherectomy was done.

Coronary revascularization does not always lead to coronary reperfusion. When readily available, percutaneous coronary intervention (PCI) using primary balloon angioplasty, with or without use of stenting, is the standard of care for ST-segment elevation myocardial infarction (STEMI). However, there is a group of patients who seem not to benefit fully from prompt restoration of antegrade flow, as they fail to show resolution of the indirect signs of ischemia such as electrocardiographic (ECG) changes and improvements in perfusion abnormalities.[1,2] These patients also present an angiographic phenomenon characterized by evidence of slow-flow in the affected vessel (Thrombolysis in Myocardial Infarction [TIMI] flow equal to or less than 2) and lack of contrast uptake “blush” by the subtended myocardium, leading to a potential dissociation between coronary revascularization and myocardial perfusion in STEMI.

Digging through boxes, waiting for couriers, finding smashed VHS tapes in the mail, jockeying back and forth between multiple modalities. Like at other hospitals across the country, the manual, tape- and film-based workflow in the pediatric cardiology department at Mercy Children’s Hospital in Toledo, Ohio, had stagnated, quadrupling the time it should have taken the cardiologists to read echocardiograms for the hospital and four outreach centers, resulting in a report turnaround time that could be as long as five to seven days.

Swedish SCAAR Registry data were presented in May during the EuroPCR meeting in Paris. The 30-day ST-elevated myocardial infarction (STEMI) mortality was 4.4% in the femoral access group vs. 3.2% in the radial access group (adjusted odds ratio 0.57, p<0.01). The benefit of radial approach was present at one year as well (7.3% femoral vs. 6.2% radial mortality, adjusted OR 0.78, p=0.018).

A review of recent transradial study data.
radial access, transradial hemostasis compression band
radial access, transradial
Radial access, allens test, patent radial artery, Allen’s test
Occluded radial artery, radial access, Allens test, Allen’s test

Transradial catheterization is increasingly becoming the access site of choice for many hospitals throughout the United States. Completing the procedure through the arm offers greater satisfaction for the patient as a result of increased comfort and patient mobility compared to femoral artery access. Radial artery access for cardiac catheterization is associated with a different set of complications and although infrequent, they present a challenge to cath lab staff to manage and prevent these issues as they appear. Education about the benefits and challenges of transradial catheterization is an important tool to nurses and technologists as they transition to cardiac catheterization through the wrist. This article will discuss patient satisfaction of radial versus femoral artery access and two of the most prevalent complications of transradial catheterization.

In recent years, advanced visualization has also become more accessible and prevalent. What used to be a niche technology, available only on dedicated and expensive workstations, has become very common. The software is now included in most workstations and multi-site picture archiving and communications systems (PACS).

A drug-eluting, self-expanding stent that does not use a drug-carrier polymer is before the U.S. Food and Drug Administration (FDA) final pre-market approval (PMA) review and a decision is expected later this year. Its chances of approval appear very bright, considering its positive clinical trial data to date.

Navigating through the world of coronary stents is about to become more complex.  A plethora of new products are on the horizon, which will utilize new platforms and alloys and present novel options in polymer technology.  Whilst most of the new stents will upgrade the platform and polymer, the choice of drug is not changing in most cases.  This new generation of drug-eluting stents (DES) promises increased deliverability and radial strength in the platform. New polymers will minimize the concerns around late stent thrombosis (LST) and the need for long-term dual antiplatelet therapy (DAPT). A bioresorbable drug-eluting scaffold also may be game changer in the treatment of coronary artery disease.  
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