Volume 19 - Issue 10 - October 2011

Rochester General Hospital

  • Mon, 10/3/11 - 1:09pm
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Tell us about your lab.

Rochester General Hospital has 4 angiography suites, 2 electrophysiology (EP) suites, and a 26-bed pre/post procedure area. Staff is a mix of registered nurses (RNs), radiologic technologists (RTs), licensed practical nurses (LPNs), intra-aortic balloon pump (IABP) techs, and patient care technicians. We have 48 staff members, with many staff members having over 10 years of experience. 



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“Inappropriate” PCIs in the U.S.: Appropriate Use Criteria, Referrals to the Cath Lab, and the Nuances of Intervention

  • Mon, 10/3/11 - 2:42pm
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In July 2011, the Journal of the American Medical Association published “Appropriateness of Percutaneous Coronary Intervention,” a look at 500,000 PCIs at 1,000 hospitals from 2009-10.1 Data was gathered from the American College of Cardiology’s National Cardiovascular Data Registry (CathPCI). Senior author Dr. Paul Chan reflects on the study and where we go from here.



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AngioJet Rheolytic Thrombectomy in a Thrombotic Free Right Internal Mammary Artery Graft

  • Mon, 10/3/11 - 3:31pm
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Introduction

Distal embolization of thrombus material is a known complication of percutaneous coronary intervention (PCI), and is associated with both a larger infarct size and increased mortality.1 Several devices attempt to address the issue of how to remove a large thrombus burden from vessels while avoiding distal embolization.



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Refer Your Interventional Patient to Cardiac Rehab The Role of Cardiac Rehabilitation for Overall Cardiovascular Health

  • Mon, 10/3/11 - 3:54pm
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Abstract

Cardiac rehabilitation programs have historically been under-utilized as a treatment modality in cardiovascular health.  Issues such as lack of physician referral, financial burden to the patient, and limited awareness of the benefits of cardiac rehabilitation are major contributing factors regarding the under-utilization of cardiac rehabilitation.



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Transradial Post-Procedure Protocols

  • Mon, 10/3/11 - 4:22pm
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Across the United States, the use of the radial artery to perform cardiac catheterization and percutaneous coronary intervention (PCI) has steadily risen within the past year. The interest among physicians, allied health professionals, and hospital administrators has also risen precipitously. This has been driven by evidence of profound reductions in bleeding complications, high rates of patient satisfaction, and in a subgroup analysis from the RIVAL study, a reduction in mortality among ST-elevation myocardial infarction (STEMI) patients.



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Cut to the Pace: Transcoronary Pacing

  • Mon, 10/3/11 - 4:49pm
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We have all been there: p-waves casually marching across the monitor. Giving the patient orders to “Cough! Cough!” It is a stressful scenario and as the technologists frantically unwrap transcutaneous pacing electrodes and another circulator grabs the venous sheath while a nurse is preparing atropine, this mayhem can be unnerving for even the most confident of cardiac teams. There is no luxury of time during hemodynamic decompensation.



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Alternative Pacing Techniques in the Catheterization Laboratory

  • Tue, 10/4/11 - 9:32am
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We have to be obliged to Cary Lunsford, Laura Minarsch, and their crew for keeping the interest alive in a simple and potentially life-saving technique that does not cost anything.

Coronary pacing was introduced in the early 80’s to rid coronary angioplasty (PCI) of the necessity to preventively insert a pacemaker lead before starting PCI. In conjunction with the contrast media used in the early years of PCI, bradycardia was notorious when dilating the right coronary artery. Pacing was usually only required for a very brief period of time and had to be installable within the minute to avoid cardiac massage likely to cause rib fractures, for one thing.



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A Percutaneous Intervention Strategy for Chronic Total Occlusions of Saphenous Vein Grafts with Absence of Native Artery Revascularization Options

  • Tue, 10/4/11 - 10:25am
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Abstract

Percutaneous revascularization of chronic total occlusions of saphenous bypass grafts have a relatively low success rate and considerably higher adverse event rates, leading to a non-recommendation based on current guidelines. However, due to absence of native artery revascularization options, occasional intervention of occluded vein grafts is necessitated.



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Applications of the Distal Anchoring Technique in Coronary and Peripheral Interventions

  • Tue, 10/4/11 - 11:16am
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The balloon anchoring technique was initially described by Fujita in 2003 as inflation of a balloon in the side branch of a target coronary vessel to facilitate equipment delivery to a target lesion.1 Two variations of this technique (coaxial and distal anchoring) have subsequently been described. In coaxial anchoring, a balloon is inflated proximally in the target coronary vessel to enhance the penetration capacity of a guidewire.2 In distal anchoring, a balloon is inflated distal to or at the target lesion to enhance support for equipment delivery.2



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Insertion of the Modified Pinnacle sheath for Reduction Of Vascular Events (IMPROVE) Study

  • Tue, 10/4/11 - 11:53am
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Abstract

Objectives. The aim of this study was to prove the efficacy and safety of the Pinnacle TIF Tip sheath during the performance of diagnostic and interventional cardiovascular procedures. Background. Vascular sheaths have been used for almost 30 years to avoid trauma to the subcutaneous tissues.



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