Happy New Year! It’s hard to believe that another year has gone by but we are excited for what 2016 will bring. In honor of 2015, we’d like to take a look back at some of the top stories and trends we followed in interventional cardiology.
Adoption of transradial access (TRA) for Percutaneous Coronary Intervention (PCI) continues to grow in the United States. In 2013, the rate of PCIs done transradially was estimated to account for 16% of all US PCI procedures, but more recent reports put the estimates at closer to 30%. Transradial access is associated with lower vascular and bleeding complication rates, is preferred by patients and is cost-effective compared with transfemoral access.1 The benefits of transradial access, however, don’t come without a cost. The REVERE trial found that the primary operator receives up to 50% more radiation exposure when performing coronary angiographic and interventional procedures from the left radial approach as compared to the femoral approach.1
For the second year in a row, Corindus participated and exhibited in the SCAI Fellows Course, which took place December 6-9th in Las Vegas, generating a great deal of buzz for robotic-assisted PCI. The show is attended by interventional and structural fellows from across the globe.
The last year has seen a significant increase in data on the serious occupational hazards of working in the cath lab. The interventional community is beginning to take note of the rising concern: data and best practices are being presented at conferences, a new organization has been developed that is dedicated to raising awareness for these risks, and entire courses are being dedicated to radiation safety. Unfortunately, new data suggests that there is yet another in the long list of risks to interventional teams: cognitive impairment as a result of long term exposure to low dose ionizing radiation.
Background: Prevalence of LGM & current status of robotic-assisted PCI
Over the past 15 years, we have seen tremendous progress in the techniques and treatments available to patients in the cardiac cath lab. Thanks to innovations and technological development, patients that used to require open-heart surgery, or worse, not survived their condition, can now be treated utilizing the minimally invasive techniques available in the cath lab. However, the advancement of these procedures has come at expense of the health and safety of physicians and staff in the cath lab who endure exposure to radiation during each procedure and, as a result, spend long hours wearing heavy lead protective gear.
Radiation safety in the cath lab is an ongoing topic of discussion in interventional cardiology. Recently, Cath Lab Digest editor Dr. Morton Kern published an article examining gaps in current radiation safety practices and initiatives that some of country’s leading hospitals have undertaken to improve radiation safety protocols for the entire cath lab team. Although there are common themes that span all cath labs including use of personal protective equipment such as lead aprons and regular monitoring of dosimeters, practices vary widely and not everyone receives the same radiation safety training across the board.