Volume 18 - Issue 12 - December, 2010
STEMI Interventions: The Finest Indication for PCI
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Can you tell us about the February 2011 LUMEN meeting, focusing on the process and the procedure of ST- elevation myocardial infarction (STEMI) interventions?
This is the 10th year for LUMEN, now converted for the third year in a row into a pure STEMI meeting. I believe it is the largest subject-centric acute myocardial infarction meeting in the world. LUMEN will be held February 24-26, at the Marriott Marquis hotel in Miami. The faculty will contain many world experts, experts both in the STEMI procedure and in the STEMI process. I am also very pleased to announce that Dr. Alice Jacobs, chairperson for the American Heart Association’s Mission: Lifeline, will be the recipient of the LUMEN achievement award in 2011.
An Update on the Transradial Lounge at Saint Joseph’s Hospital of Atlanta
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Saint Joseph’s Hospital of Atlanta built a unique post procedure lounge for transradial patients that opened in March 2010. CLD catches up with the originator of this project, radialist Dr. Jack Chen, to discuss its impact on the hospital and patients.
A Refresher on the Percutaneous Treatment of Lower Extremity PAD
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Atherosclerosis is a systemic disease affecting all major vascular beds. In the cerebrovascular system, atherosclerosis can result in stroke; in the coronary system, it can result in myocardial infarction, and in the peripheral arteries, atherosclerosis can result in claudication or acute limb ischemia.
Peripheral arterial disease (PAD) affects 12-20% of Americans age 65 and older with only 50% of that age group being symptomatic.1 Approximately 12 million people in the U.S. alone have PAD.2 Risk factors for atherosclerosis, and therefore, for PAD, include active smoking, dyslipidemia, diabetis mellitus, and hypertension. Risk is higher in patients with diabetes mellitus. It is estimated there is a 3-fold greater risk for PAD in those with diabetes also over the age of 50.2 The International Diabetes Federation estimates that somewhere in the world, a leg is lost to diabetes every 30 seconds.3 Each year there are 150,000 lower-extremity amputations, with a $270-million price tag.4
FAQ for FFR
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Since the release of the FAME1 study [Fractional flow reserve vs. Angiography in Multivessel Evaluation] and new interest in the long-term fractional flow reserve (FFR) outcome studies,2-6 appreciation and use of FFR has risen. Many former skeptical interventionalists have now begun to use FFR. Of course, and as one could expect when beginning a new procedure, some common and frequently asked questions (FAQ) arise. Since I often get emails or calls asking about both basic and advanced use of FFR, I thought it would be a good time to address some of these questions.
NPO Status for Cath Labs: Letters to the Clinical Editor
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Dear Dr. Kern,
I read your article “Should NPO be the Rule Before Cath?” (CLD Oct 2010) with great interest. As the service line educator for the heart and vascular center at our institution, I recently spent a great deal of time developing a diabetic protocol. The protocol allowed our RNs to practice within scope in the advising of diabetic patients on their need to adjust diabetic medications in relation to their NPO status pre procedure. Certainly, avoiding the NPO status would have solved many of these issues and this is something I will bring forward at our next CV council meeting. I am writing, though, to ask about your comment regarding the avoidance of hyperglycemia episodes by avoiding NPO orders. Our issue was with hypoglycemia, not hyperglycemia, as patients were getting instructions to be NPO, but not appropriate instructions on holding or decreasing their medications. How does hyperglycemia figure into the diabetic patients who are being made NPO?
What Should We Do About Lipid Core Plaque? The InfraReDx LipiScan IVUS and the CANARY Trial
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CLD did not speak to Dr. Rizik in time to include his comments with those of the other CANARY trial investigators in the November 2010 article. Below, Dr. Rizik shares his experience with the LipiScan and thoughts on the CANARY trial.
We have been using the LipiScan for a little over a year now and have found it ridiculously easy to use. The images are very easy to interpret and what I call the “knobology” of the device is easy to learn. The LipiScan IVUS is no more complex than placing a standard intravascular ultrasound (IVUS) device. It has not posed any issues with the learning curve and takes about the same exact timeframe as using an IVUS catheter.
A Q&A for Cath Labs with Physicians Performing Radial Access
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Email your question to Orlando.Marrero@WinterHavenHospital.org
Does your lab do any rotational atherectomy via the right radial approach?
Managing the Impact of Healthcare Reform
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How prepared is your organization to recognize and embrace the new and changing healthcare regulations that will no doubt impact both ‘big picture’ strategy and day-to-day operations in the coming years? Understanding what these changes mean on every level will be critically important, especially as hospitals strive to provide the highest level quality care to patients at the lowest cost.
Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab
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Todd is the Cardiology Manager for Memorial Hermann Southeast in Houston, Texas. He also teaches an online RCIS Review course for Spokane Community College, in Spokane, Washington, and regularly presents with RCIS Review Courses.
I don’t understand why there is a difference in dosages of Cordarone for different situations. Isn’t it a case of “more is better”? — Online submission
Cordarone, generically called amiodarone, does have specific doses for specific situations. We often describe the differences in dosages as a “dead” dose and a “live” dose. To answer this question, there needs to be a short review of amiodarone.
