Ajay Kirtane, M.D., SD, chief academic officer at Columbia University Medical Center/New York Presbyterian Hospital, explains the key highlights regarding interventional cardiology at the American College of Cardiology (ACC) 2013. These included data on the use of cangrelor vs. clopidogrel during cath lab procedures, first U.S. reports on using the smaller Sapient XT transcatheter aortic valve, and the safety of using shorter duration dual-antiplatelet therapy with drug-eluting stents.
VIDEO: Example of How Artificial Intelligence Can Improve Patient Care
This is an example of how artificial intelligence (AI) can help improve patient care by pulling together patient data from numerous sources n the elect if medical records that are specific to a patient’s diagnosis and treatment for a specific disease state. This is Siemens’ AI-Pathway Companion introduced at the Radiological Society Of North America (RSNA) 2018 meeting this week. In this examples. A prostate cancer patient has all their data on a single time line that can be accessed by single clicks on the points to open reports, images, procedures or labs.
At the end of the time line it integrates AI driven clinical decision support that recommends the next course of action based on clinical guidelines. The guidelines cited can also be opened for review by the clinician.
The American College of Cardiology (ACC) 2013 Scientific Session Committee Chairman Miguel Quinones, M.D., explains some of the key highlights from this year's meeting. Highlights included the impact of niacin on lowering cholesterol, new data on transcatheter aortic valve repair, and how mummies show atherosclerosis is not a modern disease.
DAIC Editor Dave Fornell explains his choices for the most innovative new technology on the expo floor at the American College of Cardiology (ACC) 2013. These include new angiography systems, dose monitoring software and technology integrations, an iPhone ECG monitoring device, ultrasound-aided CRT lead optimization, and new radiation protection aprons that are up to 50 percent lighter.
The Iowa Heart Center created a telecardiology program that connects cardiologists in Des Moines with satellite facilities in rural towns around the state. With help from Esaote, patients can have their echo exams performed on a compact ultrasound system and delivered to Des Moines for review by experts. Iowa Heart will detail its program during sessions at ACC.2013, March 9-11, in San Francisco.
At RSNA 2012, Hitachi featured its Echelon Oval 1.5T MRI system, which features the widest bore on the market at 74 cm, a wide table and the ability to perform non-contrast MR angiography exams. Hitachi also highlighted new features for its Scenaria CT system, which is upgradeable to a 128-slice system, offers new, faster iterative reconstruction software and cardiac imaging packages.
DAIC Editor Dave Fornell highlights the latest advancements that will impact cardiovascular imaging from the 2012 Radiological Society of North America (RSNA) meeting. RSNA is the largest medical imaging show in the world and most advancements are shown here first.
Imaging Technology News experts discuss the trends and latest technology they saw on the show floor and in sessions at RSNA 2012. Their discussions include some of the most innovative new devices and software to solve issues facing radiology today.
One-year results from the ADAPT-DES Trial were presented during TCT 2012. It examined patient hyporesponsiveness to clopidogrel and aspirin in a large-scale, prospective, multicenter study.
Results from the POSEIDON Trial were presented at TCT 2012. Data showed a positive strategy to prevent contrast-induced nephropathy in patients with renal impairment undergoing interventional catheterization procedures.
The PC Trial data presented at TCT 2012 looked at transcather PFO closure vs. medical therapy in preventing cryptogenic strokes.
The results of the FAME II Trial were presented at the 2012 Transcatheter Cardiovascular Therapeutics (TCT) meeting. The study showed the cost effectveness of fractional-flow reserve (FFR) therapy vs. standard medical therapy.
Positive results from the RESPECT Trial of transcatheter patent foramen ovale (PFO) closure vs. standard medical therapy were presented by John Carroll, M.D., University of Colorado Hospital, at the Transcatheter Cardiovascular Therapeutics (TCT) 2012 meeting.
Read the article on the trial results — "PFO Closure May Improve Outcomes Over Medical Therapy in Cryptogenic Stroke."
Diagnostic and Interventional Cardiology Editor Dave Fornell shares his choices of the latest advances in cardiac ultrasound from the show floor of the American Society of Echocardiography (ASE) 2012. With the increasing use of more complex interventional procedures, transesophageal echo (TEE) and intracardiac echo (ICE) are being used for guidance to reduce fluoroscopic radiation dose.
Three big trends were seen in cardiovascular ultrasound during the American Society of Echocardiography (ASE) 2012 meeting. Malissa Wood, M.D., co-director of the Women's Center at Mass General Hospital, Boston, and chair of the ASE Public Relations Committee, explains these trends. The biggest is the expanding use of ultrasound and transesophageal echo (TEE) in the cath lab and hybrid OR for structural heart procedural navigation. Other trends include use of pocket ultrasound and new software advances to simlify and reduce the time it takes to use 3-D echo and make quantifications. For more information: www.dicardiology.com/article/ultrasound-sees-increasing-use-interventional-procedures
To help hospitals upgrade their electrophysiology (EP) reporting systems and integrate EP into cardiovascular and hospital reporting systems, Michael Mirro, M.D., FACC, medical director, cardiology/electrophysiology, Parkview Physicians Group, Ft. Wayne, Ind., offers suggestions of what to look for in systems. He spoke about cardiovascular/EP IT integration and the impact of healthcare reforms during the Heart Rhythm Society (HRS) 2012 scientific sessions. For more information: www.DIcardiology.com
Data was presented during the Heart Rhythm Society (HRS) 2012 scientific sessions that showed the Riata ICD lead had a higher malfunction rate than comparable leads. The results from "Independent Multicenter Study of Riata and Riata ST Implantable Cardioverter Defibrillator (ICD) Leads" were presented by Raed H. Abdelhadi, M.D., FACC, a cardiologist and electrophysiologist researcher at the Minneapolis Heart Institute Foundation.
Diagnostic and Interventional Cardiology Editor Dave Fornell shows some of the most innovative new technology displayed on the show floor at the Heart Rhythm Society (HRS) annual scientific sessions. The tour includes new devices and trends in electrophysiology. For more information: www.DIcardiology.com
Heart Rhythm Society (HRS) President-Elect Hugh Calkins, M.D., FACC, director, cardiac arrhythmia services and EP lab, Johns Hopkins University, Baltimore, Md., offers an overview of trends and top news in electrophysiology at the HRS 2012 scientific sessions. For more information: www.DIcardiology.com
Pivitol trial data regarding the safety and efficacy of the Cameron Health Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) system was very positive. The system is currently pending FDA approval and would be the only subcutaneous lead electrophysiology device cleared for use in the United States. The system eliminates the need for venous leads and intra-cardiac securement, greatly simplifying the implant procedure. Data from Cameron Health's IDE trial was presented by Martin Burke, DO, FACC, FACOI, FRCP, director, Heart Rhythm Center, University of Chicago, at the Heart Rhythm Society (HRS) 2012 scientific sessions. For more information: www.DIcardiology.com
Implantable cardioverter defibrillators (ICDs) are safe in patients who participate in sports, according to a study presented during Heart Rhythm Society (HRS) 2012. Rachel Lampert, M.D., associate professor of medicine, section of cardiovascular medicine, Yale School of Medicine, explains the study findings during a press briefing at HRS. For more information: www.DIcardiology.com
The ACRIN-PA trial showed computed tomography (CT) coronary angiography can be more cost-effective than the standard-of-care in evaluating patients with chest pain in the emergency department. The data was presented during the American College of Cardiology (ACC) 2012 scientific sessions. For more information: www.DIcardiology.com
New data from the PARTNER trial for the Edwards Sapien Valve were presented during the American College of Cardiology (ACC) 2012 scientific sessions. The new information included two-year clinical and echocardiographic outcomes after transcatheter vs. surgical aortic valve replacement in high-risk surgical patients. For more information: www.DIcardiology.com
One of the most interesting educational exhibits at the recent American College of Cardiology (ACC) 2012 Scientific Session was "The Heart of Innovation" display on the show floor. The ACC in collaboration with marquee sponsor Philips Healthcare and several other industry leaders created this non-accredited, hands-on education experience. The exhibit explored the evolution of the standard-of-care for heart disease and heart failure caused by valvular disease. It looked at these issues through the lenses of personalized medicine, techno-biology, minimally invasive procedures and physician-patient engagement. The exhibit included technology from the past, present and future of healthcare. To incorporate a historical view, the entrance to the display included the ACC's special collection of historic artifacts encompassing medical books, stethoscopes and device technology dating back hundreds of years, including a stethoscope from 1535. This historical perspective was juxtaposed with a modern attendee experience that included the option to explore the entire exhibit with a specially provided iPad tour. The centerpiece was a mockup of a hybrid OR. It included a Corindus CorPath robotic cath lab intervention guidance system. Other partners included Maquet, showing a portable heart-lung machine the size of a small suitcase and the CFI Medical Solutions ZeroGravity radiation protection system. What made the hybrid OR particularly unique was that it was situated across from the Minimally Invasive Gallery, which featured many of the innovations that are driving procedures performed in the hybrid OR. The gallery encompassed solutions from Medtronic and Edwards Lifesciences, including Edward's breakthrough Sapien transcatheter heart valve. The display discussed current treatments and what the future technologies will likely be from the standard-of-care in the future.
Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging the pulmonary vein. The technology may play a role in better guiding transcatheter electrophysiology (EP) ablation procedures. The technology was shown as a work-in-progress during ACC 2012.
Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging the left atrial appendage (LAA). The technology may play a role in guiding and properly seating transcatheter LAA occluders. The technology was shown as a work-in-progress during ACC 2012.
Siemens' AcuNav V 3-D intracardiac echo (ICE) catheter offers detailed, live 3-D images of the interior of the heart. This video shows an example of the catheter imaging a transseptal puncture. This new ICE technology may help better guide these punctures, which are routinely used in catheter ablations and transcatheter left atrial appendage (LAA) occluder delivery. The technology was shown as a work-in-progress during ACC 2012.
Diagnostic and Interventional Cardiology Editor Dave Fornell discusses trends and shares his choices of the most innovative technologies shown on the floor of the American College of Cardiology (ACC) 2012 Scientific Session, held March 24-27 in Chicago. A couple of key trends were evident on the show floor — new technology to support trans-aortic valve replacement (TAVR) and the launch of new cardiovascular image and information systems (CVIS) to support healthcare's adoption of proposed Stage 2 meaningful use (MU) requirements. Other highlights include a balloon-inflatable TAVR/EVAR introducer sheath, 3-D intra-cardiac echo, a mobile angiography system for hybrid ORs and chocolate for heart health. For more information: www.DIcardiology.com
During the American College of Cardiology (ACC) 2012 Scientific Session, McKesson displayed new features for its cardiovascular information system (CVIS). These included an electrophysiology (EP) reporting workflow, the addition of stress and Holter support and integrated inventory management. The features were shown as works-in-progress as part of the upcoming release of McKesson Cardiology v13.0, slated for release by early summer 2012. The EP reporting module integrates diagnostics including tilt tables, implantable devices and ablation treatment EP recording systems. For more information: www.allaboutCVIS.com
New evidence shows that with appropriate preparation, angioplasty can be safely and effectively performed at community hospitals without on-site cardiac surgery units. This was according to data presented from the CPORT-E trial during the American College of Cardiology (ACC) 2012 Annual Scientific Session. The study is the first randomized controlled trial to investigate elective cath lab angioplasty (or percutaneous coronary intervention, which includes stenting and balloon angioplasty) in community hospitals in the United States.
Results showed no difference in death rates among patients undergoing elective angioplasty at facilities with and without on-site cardiac surgery units. There were also no significant differences in rates of complications such as bleeding, renal failure and stroke. "The study shows that under certain circumstances, non-primary angioplasty can be performed safely and effectively at hospitals without on-site cardiac surgery," said Thomas Aversano, M.D., associate professor of cardiology at Johns Hopkins University and the study's lead investigator. Until a recent guideline change by the American College of Cardiology and the American Heart Association, community hospitals without cardiac surgery units performed only emergency angioplasties. Patients needing elective angioplasty were transferred to facilities with on-site cardiac surgery units. "The study supports and reinforces the [new] guidelines," said Aversano, adding that the findings can help hospitals and healthcare planners more efficiently allocate financial and human resources. The ability for community hospitals to offer elective angioplasty benefits patients, Aversano said. Other studies have shown that patients are often reluctant to transfer to a hospital that may be farther away or more expensive than their community hospital. "It's not just a question of patient convenience — it's also a question of access," he said.
For more information: www.DIcardiology.com
DAIC editor Dave Fornell explains some of the most innovative cardiovascular imaging technologies showcased by vendors at the Radiological Society of North America (RSNA) meeting in December 2011.
At RSNA 2011, McKesson shared case studies about its CVIS end-users, who are enjoying new features that increase efficiencies and save time.
At RSNA 2011, Toshiba unveiled its Aplio 500 ultrasound system, which offers a unique 3-D fly-through imaging capability. The system takes the image dataset and processes it to create a cine loop fly-through of any hollow, fluid-filled blood vessel, duct or organ. The example in this video is of a blood vessel in the liver. The capability and image quality is similar to what is seen in a virtual colonoscopy created from CT datasets. The technology was highlighted in our editor's choice for most innovative new technologies at RSNA 2011. The future applications of this technology may include 3-D ultrasound navigation aids for vessels in the cath lab.
Three companies showed different versions of a combined positron emission tomography (PET)/magnetic resonance (MR) system during the Society of Nuclear Medicine (SNM) 2011 annual meeting in San Antonio, Texas. Representatives from Siemens, Philips and GE Healthcare explain how their systems work and how PET/MR may be used as a new modality to show both physiologic and anatomical information.
Society of Nuclear Medicine (SNM) President George Segall, M.D., offers insights into the trends he saw at the society's 2011 annual meeting, including PET/MRI and amyloid plaque imaging.
MIM Software offers remote viewing software to call up diagnostic-quality medical images on an iPad, iPhone and other smart phones. The software, images and computing power are hosted on a cloud-based server, which can be accessed with these devices from any location. MIM Chief Technology Officer Mark Cain demonstrates the system during the Society of Nuclear Medicine (SNM) 2011 annual meeting.
Horizon Cardiology provides solutions to some of the challenges encountered by clinicians today, particularly to improve workflow. It provides improved interfacing, eliminates redundancies and gives clinicians the information they need to perform at maximum efficiency. Other improvements to workflow efficiencies include the charge manager, as well as improving the flow of information from the cath lab. McKesson also has been experimenting with development of an interface for the iPad. For more information: www.AllAboutCVIS.com
In the largest randomized trial to compare radial access and femoral access for coronary angiography and intervention, researchers found radial access reduced rates of vascular complications, according to research presented at the American College of Cardiology (ACC) 2011 Scientific Session in New Orleans. The trial also found that radial access did not reduce the primary outcome measure of death, heart attack, stroke and non-CABG-related major bleeding compared to femoral access in the overall study population. The data showed these outcomes were equal for both femoral and radial access procedures.
"Interventional cardiologists can feel reassured both radial and femoral approaches are safe and effective," said Sanjit Jolly, M.D., M.Sc., assistant professor of medicine at McMaster University in Hamilton, Ontario, Canada. Radial access did lead to reductions in the primary outcome measure in patients who underwent the procedure at hospitals that conducted a high volume of radial procedures. For centers that were less experienced with radial access, Jolly said it was clear there is a learning curve, and operators got better and faster with radial procedures with more experience. "The take-home message is practice makes perfect," he said. Jolly explained the high-volume centers using radial access performed very well, but it was clear from the study operators need a lot of radial cases to increase performance. To read more, visit www.dicardiology.net/article/rival-trial-radial-access-reduces-vascular-complications