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.
VIDEO: SCAI Prospective on Key Takeaways at TCT 2019
Chandan Devireddy, M.D., offers insights about what he saw as the top take aways from the 2019 Transcatheter Cardiovascular Therapeutics (TCT) annual meeting. He is cath lab director at Emory University Hospital Midtown, associate professor of medicine of interventional cardiology at Emory University, and chairperson for the Society of Cardiovascular Angiography and Interventions (SCAI) Communications Committee.
Devireddy said his key take aways from TCT 2019 were:
• The poor results of the Boston Scientific Acurate Neo self-explaining TAVR system compared to the current devices on the U.S. market;
• Results of the Abbott Portico TAVR system;
• Levant Trial shows no increased mortality due to use of a paclitaxel-coated balloon; and
• CT study of TAVR valve leaflet thrombosis.
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.
Toshiba (Canon) unveiled its Aplio 500 ultrasound system at RSNA 2011, , 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) (PET-MRI) system during the Society of Nuclear Medicine (SNM) 2011 annual meeting. 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.
Each company took a different approach to how they create PET-MRI images. Siemens integrated both modalities into one gantry. Philips uses two gantries with a table that moves between the two that maintains patient alignment for fusion imaging. GE Healthcare uses a cot that can move between the MR and PET rooms and fits both systems to maintain alignment and does not require buying a new decicated scanner.
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.
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