Clinical Editor's Corner »

When Do You Need to Do Pericardiocentesis?

By: Morton Kern, MD, Clinical Editor; Chief of Medicine, Long Beach Veterans Administration Health Care System, Long Beach, California; Associate Chief Cardiology, Professor of Medicine, University of California Irvine, Orange, California

We were called to the intensive care unit to see a 52-year-old man with end-stage renal disease on weekly hemodialysis who had a large pericardial effusion and increasing dyspnea with activity.

Cath Lab Spotlight »

Cath Lab Spotlight: Houston Methodist San Jacinto Hospital

By: Marsha Stevens, MBA/MHA, Director of Cardiology Services, Baytown, Texas

Houston Methodist San Jacinto Hospital’s Cardiovascular Catheterization Lab has three procedure labs. Two of the labs are diagnostic/interventional labs and one is dedicated to electrophysiology (EP).

Antiplatelet Therapy »

Tirofiban in Acute Coronary Syndrome: Finding Value in the Cath Lab


Cath Lab Digest talks with Michael McDaniel, MD, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Decatur, Georgia, about the creation and implementation of the Emory University ACS algorithm, and its use of high-dose bolus tirofiban in ACS.

Can you tell us about the creation of the acute coronary syndromes algorithm at Emory University?

The Emory ACS algorithm(1) is the result of an ongoing effort that began a few years ago, and is, at its heart, an attempt to maximize quality and value in the services we provide to our patients. Emory’s real goal with standardization and ACS algorithms was to try to maximize quality and maximize value.

Case Report »

Spontaneous Coronary Artery Dissection in the Postpartum Period: A Pregnancy-Related Phenomenon

By: S.K. Chutani, MD, DM, FHRS, CEPS, CCDS, FACC, Sr. Consultant Cardiology, Pushpanjali Crosslay Hospital, Ghaziabad, Delhi, India

Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndromes in young, otherwise healthy patients, with a striking predilection for the female gender.

Cath Lab Basics »

Octogenarians and Issues in Cath Lab Care

By: Richard J. Merschen, EdS, RT(R)(CV), RCIS, Ibrahim Khormi, MS, RT(R)(T)(CT)(MR), Lamis Jada, MS, RT(MR), Tamara Kobakhidze, MS, RT(R), Jennifer Robinson, MS, RT(R), Jefferson School of Health Professions and Pennsylvania Hospital, Philadelphia, Pennsylvania

The elderly represent the fastest-growing group of patients referred for cardiac surgery and are also becoming an increasingly large segment of the patients in the cath lab. There are many issues that complicate their care, including high co-morbidity rates, frailty, and disability.


Improving PVI Quality in Your Cath Lab

By: A look at the new Peripheral Vascular Interventions Registry, launched by the American College of Cardiology’s National Cardiovascular Data Registry

The expanded PVI Registry continues to include both endovascular and open surgical carotid revascularization, adding lower extremity endovascular revascularization procedures. The registry captures patient demographics, provider and facility characteristics, comparisons for high-risk surgical patients treated with carotid artery stenting versus carotid endarterectomy, the use of balloons, stents and embolic protection devices, and adverse event rates

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Exclusive Content

The Anchor-Balloon Technique for Difficult Chronic Total Occlusions

Rajiv Goswami, DO, Assistant Professor of Medicine, Baylor College of Medicine, Ben Taub Hospital, Houston, Texas

This report describes intervention on a 73-year-old female with significant left main and triple-vessel coronary artery disease. We describe the sequence of multi-vessel intervention on the left main, obtuse marginal, and left anterior descending coronary artery CTO. Success in this case depended on application of the anchor balloon technique to deliver the balloon catheter for initial dilatation after successful crossing of the CTO with the guide wire.