What are some of the most frequent criticisms about COURAGE that you've had to address? It does seem that the controversy surrounding this trial has died down.

It's fair to say that there was perhaps an initial overreaction when the study first came out, and at least a superficial unrest within the interventional community. Now that people have had an opportunity to read the study and digest the results, more people are embracing the trial results. Interventional cardiologists have indicated that perhaps the trial represents a much-needed mid-course correction and that

Our prep/recovery area staffs four full-time registered nurses, three full-time patient care techs, three part-time registered nurses and one part-time patient care tech. Residences of all our staff members in the cath lab and prep/recovery area range from two months to 12 years.

Fifteen cardiologists perform procedures in our labs, seven of which are interventional cardiologists.

What type of procedures are performed at your facility?

A vast array of procedures are performed at our facility, including:

Bilateral cardiac catheterizations

Primary angioplasty and ste

This outcome should have been no surprise. The only surprise is that many in the medical and lay public were surprised to learn that the life-saving benefits of PCI for acute coronary syndromes did not transfer to the stable angina patient. An erroneous but previously widely-held belief was that mechanical lumen enlargement (i.e., stenting) for stable, focal CAD would save lives over medical therapy alone. The COURAGE Trial¹ was widely touted in the media as a study demonstrating there was too much angioplasty and unnecessary stenting. I believe that this is not true to a large exte

Part I (March 2007) discussed the need for cath lab staff to have an understanding of hemodynamics. We reviewed the importance of building a foundation of knowledge, starting with a basic understanding of how blood flows through the heart, and what the chambers and valves do to get the job done. We hope readers felt encouraged in their study of the Wiggers diagram and found answers to questions they may have had.

Part II focuses on the need to assist physicians and other staff in providing better patient care. The intent is to help professionals new to the cath lab gain a basic understand

Do you think drug-eluting stents (DES) would have made a major difference?

No, not a major difference. Everything always tends to balance out. Obviously, everyone is well aware of the recent concerns about late and very late stent thrombosis with DES. Our current best guess as to the rate of late stent thrombosis is somewhere in the range of 1 in 200 to 1 in 500 patients. If used in the COURAGE trial, DES may have added the adverse consequences of late stent thrombosis to the PCI group. In contrast, the benefit from DES would have been to lower the rate of restenosis and thus to lowe

The field of interventional cardiology has drastically evolved over the past 30 years. Where have you seen the most evolution?

From my standpoint, the evolution from angioplasty to stenting has had the most impact on the field of interventional cardiology, resulting in safer interventions that can be performed on more complex lesions. More recently, there has been a dramatic improvement in rates of restenosis and target vessel revascularization (TVR). Studies of bare-metal stents (BMS) have demonstrated that IVUS has played a role in improving these interventional results. IVUS has a

On March 31-April 1, 2007, Wake Medical Center (WakeMed) in Raleigh, North Carolina continued its long tradition of supporting cath lab professional education by hosting its second Registered Cardiovascular Invasive Specialist (RCIS) Board Review Course (the first WakeMed review course was held in August 2005).

Wake AHEC is one of nine AHEC centers located throughout North Carolina and is affiliated with the North Carolina Health Education Centers Program of the School of Medicine of the University of North Carolina. The mission of the AHEC Program is to meet the state's health and health

This article is reprinted with permission from J INVASIVE CARDIOL 2007;19:113-122. It is available online at: http://invasivecardiology.com/article/6849

The board of directors of the NSRPA, planning committee and members of the society express sincere gratitude to our corporate sponsors: AngioDynamics Inc., B|Braun, Burlington Medical Supplies, Inc., Cardinal Health, Cook Inc, Elsevier and Kyphon.

Attendance

Over 200 certified RPAs, several RPA students from Weber State University, in Ogden, Utah; one ARRT-certified radiology assistant (RA); and the Board of Directors of the CBRPA were in attendance. ASRT officer Kevin Powers, an associate member of the NSRPA who is also the ASRT Director of Education, attended the meeting and

New Questions

Entering Meds

We were wondering about the practice of entering medications during procedures. Previously the monitor person used to enter all meds, and they were verbalized out loud to the whole team. But the circulating RNs felt that they were giving the med and needed to enter them. Who enters the meds in other labs? Thanks in advance!

Terry Leonard, RN, BSN, CCRN
Unit Educator Heart Center
Email:
tleonard (at) notes.cc.sunysb. edu
Cc: cathlabdigest@aol.com

An Advanced-Level Cardiology Physician Extender Program: Could it be a reality?