Clinical and Industry News

Clinical and Industry News

Hemostatic HemCon Patch™ Selected by the Premier Healthcare Alliance as Commitment to Healthcare Quality Improvement, Innovation

The hemostatic HemCon Patch from HemCon Medical Technologies, Inc. and Cardinal Health was recently featured in the Premier healthcare alliance’s inaugural Innovation Celebration, an event to celebrate advances in healthcare while highlighting healthcare industry suppliers committed to innovation and improving patient outcomes. The HemCon Patch improves patient care following diagnostic and interventional vascular access procedures by offering safe and fast hemostasis with an effective antibacterial barrier that may help to reduce the risk of hospital-acquired infections. Premier’s Innovation Celebration highlights innovative solutions that bring a positive impact to health care delivery. The 26 products showcased were selected by a cross-functional team of Premier alliance members and staff of varying expertise, including clinical product planners, clinical field specialists, pharmacists, supply chain professionals, materials management and nurses. Premier contracts with more than 800 suppliers, and Cardinal Health was one of 24 selected to participate in the Innovation Celebration. Cardinal Health, the exclusive distributor and co-branded partner of the HemCon Patch™, and HemCon joined together at the event to represent the co-branded hemostatic dressings. Innovation Celebration participants were featured on June 16 at the 2009 Premier Annual Breakthroughs Conference and Exhibition in Anaheim, Calif. Basic criteria for selection included solutions that displayed uniqueness, as well as solutions that have an impact on an unmet medical need. For more information, please visit ______________________

Abbott Receives CE Mark for Company’s Next-Generation Xience Prime™ Drug-Eluting Stent

Abbott has received CE Mark (Conformité Européenne) for its next-generation Xience Prime™ Everolimus Eluting Coronary Stent System for the treatment of coronary artery disease. The company plans to launch Xience Prime in a broad size matrix with lengths up to 38 mm in Europe in the third quarter. Xience Prime utilizes the same drug and proven biocompatible polymer as Abbott’s Xience V® Everolimus Eluting Coronary Stent System. In addition, it offers a novel stent design and a modified delivery system designed for greater flexibility and improved deliverability. Xience Prime uses cobalt chromium technology, which allows for very thin struts while maintaining strength to support the vessel as well as excellent visibility under x-ray during the stent implantation procedure. Xience Prime is based upon the Multi-Link® family of stents. Upon launch in Europe, Xience Prime will be available in an expanded size matrix, including Xience Prime SV for small vessels and Xience Prime LL for long lesions. Abbott’s vascular research program includes clinical trials in coronary artery disease and peripheral artery disease. Products in the vascular pipeline include: the Multi-Link 8™ Coronary Stent System, a next-generation frontline balloon dilatation catheter, a fully bioabsorbable drug-eluting coronary device, and the Omnilink Elite™ Peripheral Stent System. Additional information about Xience V is available online at The Multi-Link 8 Coronary Stent System, the next-generation frontline balloon dilatation catheter, the fully bioabsorbable drug eluting device and the Omnilink Elite Peripheral Stent System are in development and are not available for sale. Xience Prime currently is an investigational device in the United States and not available for sale. ______________________

AccessClosure Launches 5 French Vascular Closure Device Mynx M5™ Offers Patients “Artery-Friendly” Closure Solution

AccessClosure announced the newest addition to the Mynx® Vascular Closure family, the Mynx M5. The M5 is a closure device that can be delivered directly through a small 5 French (5F) cardiovascular sheath without enlarging the arterial hole or traumatizing the surrounding tissue in the process. The M5 eliminates the need for a sheath exchange, saving procedure time and expense. “Before the Mynx M5, existing closure devices required the physician to create a larger hole in the artery just to seal it in diagnostic cases,” explains Dr. Dharmesh Patel, MD, FACC, a diagnostic cardiologist from Memphis Heart Clinic in Memphis, Tennessee. “The M5 is the first device that specifically addresses the primary clinical need for the 5F market, which is to reliably close the puncture site without enlarging it first. This is particularly useful in my practice, allowing patients to ambulate quicker with greater safety and tolerability.” The Mynx Vascular Closure Device was first approved by the FDA for 6F and 7F cardiovascular procedures in May 2007. Since its full market release, the Mynx has been used in over 225,000 patients in over 700 hospitals nationwide. Of the Top 50 hospitals listed in US News & World Report’s “Best Hospitals: Heart & Heart Surgery,” over 75% have used the Mynx. Like the original 6/7F Mynx device, the Mynx M5 offers patients the same important benefit – a comfortable closure experience. Many patients report that closing their artery was the most painful part of their cardiovascular procedure. The Mynx uses a soft, bio-absorbable polymer material. This sealant material, polyethylene glycol (PEG), has been used safely for over a decade in a wide range of medical products, such as gel caps and eye drops. During the closure procedure, the sealant is placed gently over the arterial puncture area. The sponge-like sealant immediately expands three to four times its original size by rapidly absorbing blood around the puncture site, which immediately stops the bleeding and seals the artery. The sealant then dissolves naturally within 30 days, leaving nothing behind, inside, or on top of the artery. For more information, visit ______________________

Philips Expands Emergency Healthcare Offering with Acquisition of InnerCool Therapies

Royal Philips has reached an agreement to acquire the assets of InnerCool Therapies Inc., focusing on the field of therapeutic hypothermia. InnerCool, a wholly-owned subsidiary of Cardium Therapeutics, Inc., will be acquired in an asset purchase transaction for US $11.25M, as well as the transfer of approximately US $1.5M in trade payables. Therapeutic hypothermia solutions aim to safely induce, maintain and reverse hypothermia or maintain normal body temperature, to preserve organs such as the heart and brain in the event of sudden cardiac arrest (SCA). This rapidly-advancing technology has been recognized by the American Heart Association and the International Liaison Committee on Resuscitation as crucial in improving the survival and neurological recovery for SCA patients. Headquartered in San Diego, California, InnerCool Therapies was founded in 1998 and will be integrated into Philips’ Clinical Care Systems business. ______________________

Terumo Interventional Systems Announces Line Expansion of Its Pinnacle® R/O II Radiopaque Marker Introducer Sheath Products

Creates Broad Selection of Marker Band Sheath Sizes Terumo Interventional Systems announced the expansion of its Pinnacle® R/O II Radiopaque Marker Introducer Sheaths. The Pinnacle R/O II Radiopaque Marker Introducer Sheaths are now available in 4 French through 9 French, each in 6cm, 10cm and 25cm lengths. The 10cm and 25cm are appropriate for interventional procedures (e.g. balloon and stent) or with ipsilateral approaches. The 6cm sheath can be used for superficial access sites. The 6cm and 10cm in 4 through 9 French sizes are also available with 0.038” mini guidewires (0.035” wire with 4 French sizes). The Pinnacle R/O II lets physicians know the exact sheath tip location during a procedure. Its long gradual taper on the dilator and sheath leads to easier insertion with less force, which may result in reduced trauma and reduced complications. Additionally, the Pinnacle R/O II maintains kink resistance, which reduces the need for a second sheath. For more information, contact Terumo Interventional Systems by calling its Inside Sales Customer Care Team at (800) 862-4143 or by visiting ______________________

Vascular Solutions Launches the Trespass™ Angiographic Catheter

Vascular Solutions, Inc. announces the availability of the new Trespass™ angiographic catheter. The Trespass catheter is specifically designed for use by interventional radiologists and other physicians performing endovascular abdominal aortic aneurysm (AAA) repair procedures, and its hybrid design offers simplicity and multiple functionality. The Trespass angiographic catheter combines an angled tip design to facilitate guidewire delivery and direction with radiopaque markers for vessel sizing and sideports for high pressure injections. Because the Trespass is a flush catheter, angled tip catheter and vessel sizing catheter all in one, it replaces multiple catheters that are commonly used in AAA procedures with just one. The catheter comes in a 5F, 65cm configuration. The Trespass catheter is intended for use for delivering radiopaque media to selected sites of the vascular system, and for pressure and anatomical measurements, and is currently available for sale in the United States. For more information, visit ______________________

FDA Approves Boston Scientific’s Taxus® Liberte® Long Stent

Boston Scientific Corporation has received approval from the U.S. Food and Drug Administration (FDA) to market its Taxus® Liberte® Long Paclitaxel-Eluting Coronary Stent System, a next-generation drug-eluting stent (DES) designed for long lesions. At 38 mm, it provides doctors an option that can potentially reduce the number of stents used in more complex cases. It affords a more efficient treatment option for the estimated 8 to 10%(1) of patients with long lesions. The Company plans to launch the product in the U.S. It received CE Mark approval in 2007. “The Taxus Liberte Long Stent offers physicians and patients distinct advantages compared to using two overlapping drug-eluting stents,” said Mark Turco, MD, FACC, FSCAI, Director of the Center for Cardiac & Vascular Research at Washington Adventist Hospital, Takoma Park, Maryland. “In the ATLAS Long Lesion Trial, the 38 mm Taxus Liberte Stent significantly reduced myocardial infarction when compared to the Taxus Express® Stent, making the Taxus Liberte Long Stent an attractive option for interventional cardiologists faced with long, challenging lesions.” The TAXUS ATLAS Long Lesion Trial reported a significant 79% reduction in the rate of nine-month myocardial infarction for the Taxus Liberte Long Stent as compared to the Taxus Express Stent control (1.3% vs. 6.3%, p=0.026). At two years, the composite measure of cardiac death or myocardial infarction showed a significant 63% reduction for the Taxus Liberte Long Stent compared to the Taxus Express Stent (3.5% vs. 9.4%, p=0.0426). The rate of stent thrombosis at two years was zero percent for the Taxus Liberte Long Stent and 0.8 percent for the Taxus Express Stent(2). The TAXUS Liberte Stent Series is now available in 92 sizes, ranging from 2.25 mm to 4.0 mm in diameter and from 8 mm to 38 mm in length. For more information, please visit: (1) Percentage estimates from April 2009 Millennium Research Group report and ARRIVE 1 and 2 registries. (2) In the TAXUS ALTAS Long Lesion Trial, the Taxus Liberte Long (38mm) Stent met its primary endpoint of non-inferiority to the Taxus Express control stent in nine-month percent diameter stenosis (31.7% vs. 32.6%, p=0.71) and reported a 36 percent reduction in MACE (9.4% vs. 14.8%, p=0.16). ______________________

Kidney Damage from Medical Imaging Procedures Can Cause Long-Term Health Problems

Kidney injury that can arise after undergoing certain medical imaging procedures increases a patient’s risk of having a stroke or heart attack over the next year or two, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN). The findings indicate that seemingly minor and reversible kidney damage from these common clinical procedures is a serious health threat. Exposure to contrast agents can injure the kidneys, but patients are often told that this is only a temporary side effect. Recent research has suggested that such contrast-induced kidney damage may actually be more serious, although no thorough studies have looked into the hypothesis. To investigate the issue, Richard Solomon, MD (University of Vermont), and his colleagues studied 294 patients with kidney disease who were exposed to contrast agents during cardiac angiography. Patients in the CARE (Cardiac Angiography in REnally Impaired Patients) trial were randomly divided to receive one of two contrast agents: iopamidol or iodixanol. After following patients for at least one year, the researchers found that 92 (31%) of the patients experienced negative health effects. Thirty-eight (13%) of the patients experienced a major event, such as death, stroke, heart attack, or end-stage renal disease. Individuals who developed contrast-induced kidney injuries had twice as many long-term negative health effects compared with patients whose kidneys were not damaged. In the absence of contrast-induced kidney injury, there was no difference in the incidence of long-term negative health effects between patients taking iopamidol or iodixanol. However, the investigators found that patients taking iopamidol had reduced incidences of both kidney damage and long-term negative effects. These parallel decreased incidences support the theory that contrast-induced kidney injury causes long-term negative effects. The CARE trial findings should prompt investigators to design additional studies on the long-term negative health effects of contrast-induced kidney damage. This work was supported by Bracco Diagnostics, Inc., which manufactures iopamidol. ______________________

Live Complex Coronary Interventions to be Broadcast Monthly at

Samin Sharma, MD, Director of Mount Sinai Heart Cardiac Catheterization Laboratories, will host a new monthly series of live coronary interventions at The interventions showcased in the series will highlight in-depth procedural techniques for managing complex cardiac care. New cases will be broadcast on the website from 8:00 – 9:00 am on the third Tuesday of every month, beginning July 21st. Viewers will be able to email questions and participate in a live online discussion. The first featured patient is an 85-year-old male with multivessel disease and a left ventricular ejection fraction (LVEF) of 20 percent. The patient’s treatment plan calls for rotational atherectomy. That will be followed by the implantation of a drug-eluting stent. The Impella Recovers 2.5 Device will be inserted to help maintain left ventricular support and increase patient safety for this high-risk, complex intervention. “The live broadcast of complex cases fulfills the educational mission of Mount Sinai Heart by helping to advance the field of interventional cardiology around the world,” said Dr. Sharma. “It will also give the general public a glimpse into the workings of a cardiac lab, and how doctors use the latest techniques and devices to treat cardiac patients.” ______________________

Owens & Minor Wins Top Honors from Premier in Three Award Categories:

Supplier & Customer Service Excellence, Supplier Diversity Efforts, and Excellence in Contract Management Owens & Minor, a distributor of national name-brand medical and surgical supplies and a healthcare supply-chain management company, won top honors in three award categories from Premier Inc., a national healthcare alliance. Owens & Minor was cited for its high supplier quality and customer service, for its efforts to increase the diversity of its suppliers, and for its contract management excellence. The awards were announced on June 17, 2009, at Premier’s Annual Breakthroughs Conference and Exhibition in Anaheim, California. According to Premier, Owens & Minor was the only supplier to receive three individual awards. Premier awarded Owens & Minor with the following distinctions: • Owens & Minor was one of only two organizations awarded the first annual Premier 2009 Polaris Award. The Polaris Award, which “aligns supplier contract performance with the customer service expectations” of Premier alliance members, recognizes excellence on a range of quantitative measures, as well as qualitative aspects of excellent customer service such as high relationship value and customer service, as determined by the votes of Premier members. • Owens & Minor was awarded the 2009 Premier Diversity Award for “efforts to purchase goods and services from Premier contracted diverse suppliers, as well as develop procurement strategies aligned with the communities they serve.” The award recognizes Premier-contracted suppliers that support efforts to increase purchasing from diverse suppliers and provide economic development opportunities for communities throughout the U.S. Of the more than 800 Premier suppliers eligible for this award, Owens & Minor was the only supplier chosen for this recognition. • Owens & Minor was also awarded the Premier 2009 Supplier Pinnacle Award, which is based on excellence in managing the Premier contract. Owens & Minor was one of 19 suppliers chosen to receive this award out of 800 Premier-contracted suppliers. For more information about Owens & Minor, visit ______________________

Center Receives Grant Renewal for Hypertension and Vascular Disease Studies

The Hypertension and Vascular Research Center at Wake Forest University School of Medicine has received renewal of a multi-million dollar grant from the National Heart, Lung and Blood Institute of the National Institutes of Health to continue the development of new approaches to treat hypertension and vascular disease. The program is in its 16th year of existence at the School of Medicine. The $6.643 million grant, a five-year renewal of an existing award, will provide major funding for the center’s basic science component. It will support ongoing projects that investigate the causes and cures of high blood pressure and vascular disease, including the mechanisms of blood pressure regulation and the balance between hormones that raise blood pressure and those that lower it. Specifically, researchers at the School of Medicine plan to use the money to continue studying the mechanisms by which the renin angiotensin system, which regulates blood pressure, contributes to hypertension, cardiac hypertrophy, and other conditions. In addition, new studies to investigate the regulation of cardiac function and hypertension are underway. Over the course of its history, the Program Project Grant has made major contributions to hypertension research. It first began in 1974 under the leadership of Irvine H. Page MD, at the Cleveland Clinic Foundation, Cleveland, Ohio. Carlos M. Ferrario, MD, a professor of surgical sciences and physiology/pharmacology, assumed leadership of the program in 1982 and, as principal investigator, has continued to successfully lead the research efforts. An internationally recognized center for the investigation of vascular disease and hypertension, the Hypertension and Vascular Research Center provides comprehensive care for hypertension and vascular disease, a mobile blood pressure clinic, early screening and management of peripheral artery disease. The renewed funds will also include support of resource facilities that provide analytical tools for molecular biology, radioimmunoassay procedures, and housing and maintenance of genetic models of hypertension. “The country, and our region specifically, continues to suffer from high rates of mortality due to strokes and heart disease,” Ferrario said. “An explosion of diabetes and obesity has aggravated the situation and demanded that we explore new approaches and medicines to reduce the risk of hypertension, treat obesity and diabetes, and develop new medicines that are specific and without side effects. Our new studies will pave the way for the development of new antihypertensive medicines that are directed to block the action of hormones that contribute to hypertension and diabetes.” ______________________

Cardiovascular Systems Announces First Patient Enrolled in COMPLIANCE 360° Clinical Trial

Prospective, Randomized Trial Evaluating the Clinical Benefits of Treating Above-the-Knee Peripheral Arterial Disease with the Diamondback 360°® System Cardiovascular Systems, Inc., a medical device company developing and commercializing interventional treatment systems for vascular disease, announced that the first patient has been enrolled in the COMPLIANCE 360° clinical trial. This prospective, randomized study will generate additional data on patient outcomes achieved in treating lesions above the knee with CSI’s Diamondback 360°® System, a minimally invasive catheter for treating peripheral arterial disease (PAD). COMPLIANCE 360° will compare the benefits of first modifying calcified plaque with the Diamondback 360° system followed by low-pressure balloon inflation if needed, versus the use of high-pressure balloon angioplasty alone in calcified lesions above the knee. Treatment with only high-pressure balloon angioplasty often damages large diseased vessels above the knee. Initial treatment with the Diamondback 360° could reduce the level of balloon pressure required to finish opening the vessel. The COMPLIANCE 360° study calls for enrolling 50 patients at five U.S. medical centers. Patients will be followed for 12 months, and an independent angiography core lab will verify results. David L. Martin, CSI president and chief executive officer, said, “COMPLIANCE 360° is the first of several post-market studies CSI is sponsoring to provide physicians with the clinical data they need. We plan to launch CALCIUM 360°, a study evaluating treatment with the Diamondback 360° in calcified lesions below the knee, in the coming months.” CSI received FDA 510(k) marketing clearance for the Diamondback 360° as a PAD therapy in August 2007 on the basis of data from the OASIS study, a prospective study which enrolled 124 patients at 20 medical centers. Since then, nearly 500 hospitals have adopted the Diamondback 360° system. For more information, visit ______________________

Daiichi Sankyo and Lilly Receive U.S. FDA Approval for Effient

Effient™ Reduces Thrombotic Cardiovascular Events Daiichi Sankyo, Inc. and Eli Lilly and Company announced that the U.S. Food and Drug Administration (FDA) approved Effient™ (prasugrel) tablets for the reduction of thrombotic cardiovascular events (including stent thrombosis) in patients with acute coronary syndromes who are managed with percutaneous coronary intervention (PCI). Effient (pronounced Ef-fee-ent) helps keep blood platelets from sticking together to form clots, which can block an artery. Taking Effient with aspirin after PCI has been shown to reduce the chances of having a cardiac event and stent thrombosis among patients with acute coronary syndromes (ACS). Effient should be initiated with a loading dose of 60 mg followed by a maintenance dose of 10 mg once daily. In addition, for those patients who weigh less than 132 pounds (60 kg), physicians should consider lowering the maintenance dose to 5 mg once daily. Patients taking Effient should also take 75 mg to 325 mg aspirin orally once daily, according to their doctors’ instructions. “The data from the TRITON-TIMI 38 Phase 3 pivotal trial provide compelling evidence that treatment with prasugrel significantly reduced the combined risk of cardiovascular death, heart attack or stroke over the current standard of care, clopidogrel, across a wide variety of patient types,” said lead TRITON-TIMI 38 investigator Elliott Antman, MD, professor of Medicine at Brigham and Women’s Hospital (BWH) in Boston and senior investigator with the BWH TIMI Study Group. “Prasugrel is an important new option for patients with ACS who are managed with PCI. Prasugrel was associated with a significantly higher risk of serious bleeding events compared with clopidogrel. However, appropriate patient selection may help reduce this risk.” The risk of bleeding was highest in Effient-treated patients who were either 75 years of age or older, weighed less than 132 pounds (60 kg), or who had a prior history of transient ischemic attacks (TIA) or stroke. Effient is contraindicated in patients with a history of prior TIA/stroke. It is generally not recommended in patients 75 years of age or older, except for patients in high-risk situations, such as those with diabetes or a history of prior heart attack. The approval was based on results from the pivotal Phase 3 TRITON-TIMI 38 clinical trial, which compared Effient with Plavix® (clopidogrel bisulfate) in reducing cardiovascular events in 13,608 acute coronary patients managed with PCI. The study showed that Effient taken with aspirin had a 19 percent relative risk reduction of the combined endpoint of cardiovascular death, non-fatal heart attack or non-fatal stroke versus Plavix taken with aspirin. This benefit was driven predominantly by reduction in heart attacks. The benefit of Effient compared with Plavix was seen as early as three days and continued over the 15 months of the trial. In addition, there was less stent thrombosis in patients treated with Effient compared with Plavix (a relative risk reduction of approximately 50 percent). The risk of non-coronary artery bypass graft (non-CABG) related bleeding, which included life-threatening and fatal bleeding, was significantly higher with Effient (2.2 percent) compared with Plavix (1.7 percent). When compared with the overall treatment population, the risk of major bleeding was highest among those patients treated with Effient who were either 75 years or older, had a body weight less than 132 pounds, or had a prior history of transient ischemic attack/stroke. An analysis from TRITON-TIMI 38, weighing the risk of major bleeding and the reduction in cardiovascular events, found an overall benefit significantly favoring Effient compared with Plavix. For every 1,000 patients treated with Effient as compared with Plavix, there were 23 fewer patients with heart attacks and six more with major bleeding events. For more information, please visit ______________________

GE Healthcare To Help Centers Monitor X-Ray System Dose Use Via InSite Remote Service Connection

Innova Dose Reports Show Monthly Detail on Customer Use of Innova X-ray Systems, Including Dose Utilization and Dose Usage Trends GE Healthcare introduced its Innova Dose Reports, a service for centers that operate the company’s Innova interventional x-ray systems. Innova Dose Reports harnesses the system’s InSite™ broadband connection to GE to remotely collect critical information on procedure utilization, views, dose usage per procedure and dose utilization trends during a given month. This is especially important as interventional procedures grow in complexity and length, making attention to dose a more urgent need. Information collected via InSite is subsequently combined in a comprehensive report and delivered directly to the customer. Innova Dose Reports also provide the customer with a notification when total dose exceeds their prescribed threshold to support post-procedure activities. According to Stephen Balter, PhD, Medical Physicist at Columbia University Medical Center, and Chairman of NCRP Committee 3-2: Safety in Interventional Fluoroscopy, the introduction of the Innova Dose Reports service comes at a good time. “Two major factors are making attention to the patient’s radiation dose more important than ever: the increasing complexity of interventional procedures, which increases total x-ray dose, and a general lack of ready access to radiation data by clinicians, which has led to increased radiation injuries,” says Dr. Balter. “Innova Dose Reports satisfy the need for specific procedure dose details and visibility of dose usage through the month, giving clinicians awareness of the total radiation exposure.” Customers can purchase Innova Dose Reports during their system warranty period or as part of an annual service agreement. For more information, contact GE Healthcare’s Dedicated Cardiovascular Center at 1-800-437-1171, Option 4. ______________________

CHS Forms New Business Unit, Sanger Heart and Vascular Institute (SHVI), to Guide the Future Growth of Cardiac Services

Carolinas HealthCare System, the largest healthcare system in the Carolinas, with 25 affiliated hospitals in North and South Carolina, has organized a new business unit to guide the growth and development of cardiovascular services on a regional basis. The newly formed Sanger Heart and Vascular Institute (SHVI) represents a combination of Sanger Clinic, Charlotte Cardiology Associates and Carolinas Heart and Vascular Institute. Effective July 1, all three entities will begin the transition to Sanger nomenclature. Dr. Paul Colavita, current president of Sanger Clinic and Carolinas Heart and Vascular Institute, will become President of SHVI, reporting to Paul Franz, Executive Vice President, Physician Services Group. Colavita said the recent granting of chest pain accreditation to numerous hospitals within the CHS network is a prime example of the type of coordinating work that SHVI is geared up to handle. “We are extremely proud of this achievement,” he said. “A network of accredited chest pain centers ensures that patients can present for treatment at numerous locations, and be assured that quality standards and training levels meet the highest national standards. “ After July 1, all Sanger Clinic and CCA medical offices and practice locations will start being referred to as Sanger Heart and Vascular Institute facilities. Colavita said the Sanger name was retained in SHVI nomenclature because it enjoys such widespread recognition on a regional and national basis. Sanger Clinic was named in honor of Dr. Paul Sanger, an early Charlotte pioneer in thoracic surgery and vascular research, who died in 1968. Colavita noted that more than 420 physicians and support staff will be directly affected by the new blending of cardiac services. They currently work in more than 30 full-time and part-time medical offices spread across 16 counties in North and South Carolina. In addition, a large number of hospital-based personnel working in cardiac cath labs, operating rooms, etc. will come under the SHVI umbrella.