The growth in fluoroscopy-guided procedures has put operators between a rock and a hard place, or should I say, between exposure to radiation and the opportunity to obtain clinically useful information. According to the American Heart Association, the rate of patients who underwent PCI increased 58 percent between 1992 and 2004, making the potential for cumulative exposure to operators as they treat more of these patients greater.

LAS VEGASWhen treating a real-world sample of patients for intermittent claudication or critical limb ischemia, two off-label iliac artery stents showed a statistically significant performance goal for low major adverse event rates, according to the late breaking MOBILITY trial results presented May 10 at the 35th annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI). During the press conference, experts suggested that this study may further reinforce the role of percutaneous treatments over the more invasive surgical option for these sick patients.

LAS VEGASA robotic remote-control coronary intervention system demonstrated technical and clinical effectiveness comparable to manual operation, but the operator exposure to radiation was significantly lower, based on PRECISE, a late breaking clinical trial presented May 10 at the 35th annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI).

LAS VEGASCoronary angiography has a variety of limitations in the cardiac cath lab due to both operator and technological causes, according to a May 9 presentation by J. Dawn Abbott, MD, of Rhode Island Hospital in Providence, at the 35th annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI).

LAS VEGASWhile higher failure rates with transradial PCI are clearly aligned with lower operator volumes, Christopher T. Pyne, MD, of the Lahey Clinic in Burlington, Mass., suggested that switching sides of the transradial is a better bailout strategy than going femoral, during a May 9 presentation at the 35th annual meeting of the Society for Cardiovascular Angiography and Interventions (SCAI).

While STEMI patients benefit from reperfusion therapy with PCI, a two-center study published May 7 in the Archives of Internal Medicine found than one-third of patients referred for primary PCI from the emergency department did not have a STEMI and 36 percent were deemed to be false-positive activations. An accompanying editorial questioned the impact of these false-positive activations and concluded that they lead to high costs and increased risk.

Cardiothoracic surgeons and endocrinologists from Boston Medical Center have found that among patients undergoing CABG surgery, achieving Surgical Care Improvement Project benchmarks for glycemic control may be irrelevant when perioperative continuous insulin infusion protocols are implemented. These findings were presented May 1 at the annual meeting of the American Association for Thoracic Surgery (AATS) in San Francisco.

Implementing hospital strategies, such as encouraging physicians to solve problems creatively and designating physician-nurse champions instead of only nurse champions, can significantly lower hospitals 30-day risk-standardized mortality rates (RSMR) with acute MI (AMI), according to a study published May 1 in the Annals of Internal Medicine. The mean 30-day RSMR at hospitals that used all five strategies identified in the study was more than a full percentage point lower than those that implemented only two strategies.