Volume 10 - Issue 8 - August, 2002
Cath Laughs: The Latest Email to Make the Rounds...
- Thu, 6/19/08 - 2:00pm
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Subject:
We've always done it that way (Engineering Standards)
Does the statement, We've always done it that way ring any bells…?
The US standard railroad gauge (distance between the rails) is 4 feet, 8.5 inches. That's an exceedingly odd number. Why was that gauge used? Because that's the way they built them in England, and English expatriates built the US Railroads.
Why did the English build them like that? Because the first rail lines were built by the same people who built the pre-railroad tramways, and that's the gauge they used.
Why did they use that gau
Saint Vincent Heart Center
- Thu, 6/19/08 - 2:00pm
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Saint Vincent is a 450-bed referral center. We have 3 cath labs on site (one Philips [Bothell, WA] and two GE Medical labs [Waukesha, WI]). One of the GE labs is also used for special procedures. Saint Vincent has an 8-bay holding area, and the patients are admitted and returned to a short-stay cardiology unit. We also manage a fourth Toshiba (Tustin, CA) lab off-site, about four miles away.
Our cardiology practice consists of 21 physicians:
6 perform non-invasive as well as diagnostic studies;
5 perform interventions;
4 are dedicated solely to non-invasive procedures (echos, str
Anticipating the Era of Drug-Eluting Stents
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Components of a Drug-Eluting Stent Program
Four key elements that must be considered when developing a drug-eluting stent include:
The drug,
The polymer,
Release kinetics, and
The stent delivery system.
The Drug
Restenosis is a complex biological process that involves inflammation, smooth muscle cell proliferation and migration, matrix secretion, and other contributing factors.1-4
The first drug extensively investigated as part of a drug-eluting stent system was a derivative of taxol called taxane, which was incorporated into a polymeric
A New Strategy for Treating Inflammation in Atherosclerotic Plaque: Photodynamic Therapy
- Thu, 6/19/08 - 2:00pm
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Photodynamic therapy involves the following basic process:
1. A medication is administered intravenously;
2. It is taken up by inflammatory cells in the
vessel wall;
3. The medicine is activated using a specific wavelength of light;
4. The inflammatory cells die.
It’s a very attractive concept, even in the era of drug-eluting stents, because of the importance of vulnerable plaque. We are quickly moving into an era where cardiologists will not only find vulnerable plaque, but treat it. Unlike our current patient population, future patients may not have severe st
Welcome to our Annual Special Clinical Issue on PCI!
- Thu, 6/19/08 - 2:00pm
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This year alone, Cath Lab Digest has covered cardiac gene therapy, homocysteine and coronary restenosis, new imaging procedures, and alcohol septal ablation. That list covers only a few of the paths that are opening up to cardiac cath labs everywhere, or are looming on the horizon.
In this issue, we bring you Dr. Gregg Stone’s article on clinical trials recently concluded and/or currently underway for various drug-eluting stents. All eyes are turned hopefully towards the wonders seemingly promised by these stents.
I was lucky enough to spend some time with Dr. Dean Kereiakes at
Fun in the Las Vegas Sun: The 1st Cath Lab Digest Annual Symposium on Cardiovascular Care (ASOCC)
- Thu, 6/19/08 - 2:00pm
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Thursday Evening, June 6th: ASOCC Education Begins
Dr. Richard Myler of San Francisco, California, officially opened the symposium with his keynote lecture, You want to put a catheter where and do what!?!. Dr. Myler took us on a walk through time as he presented a brief look into the history of interventional cardiology. His presentation was one that was very personal, discussing his relationships with the founding fathers of interventional cardiology. Dr. Myler was part of a group of physicians who were both mavericks and great scientists, highly motivated by their passion
Letter to the Editor
- Thu, 6/19/08 - 2:00pm
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Cross-training in Missouri Misrepresented in CLD Discussion Group
I work in the Kansas City, Missouri area. I have been involved in four programs. In two of the programs, RNs and technologists had identical roles. There were no differences in their duties. In Missouri, technologists are allowed to administer medications under the direct supervision of a physician. In a third program, the lab was staffed by technologists only. There were no RNs on staff. In the fourth program, there are both RNs and technologists. The RNs circulate and administer medications, the technologists scrub a
Reimbursement Issues in the Era of Drug-Eluting Stents
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Drug-eluting stents, like many breakthrough technologies, may present a tremendous opportunity for hospitals, both in terms of potentially advancing the quality of patient care and the efficiency with which they provide health care services. This new technology also presents a challenge because realizing these potential opportunities requires re-examining business and financial analysis practices to reflect the changing economics of cardiovascular disease, stenting procedures, and the cardiac catheterization lab or cardiovascular unit. Drug-eluting stents may present hospitals with both
The Frontrunner CTO Catheter Experience
- Thu, 6/19/08 - 2:00pm
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Although the treatment of CTOs via conventional percutaneous intervention is a well-established modality with reasonably predictable results, the failure to cross using conventional guidewire technology frequently precludes subsequent repair of the lesion in the cardiac cath lab and many of these patients are ultimately managed surgically or medically. Given the high fluoroscopic times, increased use of contrast, and repetitive guidewire selection that traditionally accompanies conventional attempts to open CTOs, our staff has always thought: there must be a better way and now, there is.
L
Advances in Coronary Intervention: Focus on Subacute Stent ThrombosisPhosphorylCholine (PC) Coated Stents and Suture-Media
- Thu, 6/19/08 - 2:00pm
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Therefore, it is logical to consider coating a metal stent with an agent that allows uniform coverage of both internal and external surfaces, does not increase the profile or affect deliverability of the device, remains stable during manipulation, allows rapid endothelialization and is biocompatible. This would prevent exposure of the stent metal to bloodstream and intimal surface. The recent advent of the BiodivYsio coated stent (Abbott Vascular Devices, Redwood City, CA) allows for the benefits of a balloon expandable stent implantation without the exposure of the thrombogenic bare metal. Th
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