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.
PCI Makes a Comeback
In recent years, the focus in interventional cardiology shifted towards new procedures with TAVR, mitral valve repair, and peripheral interventions dominating the conferences. This year, bioresorbable stents have made waves with new data showing equivalent outcomes compared to standard drug-eluting stents and the FDA approval of the first partially bioresorbable stent. In addition to these new technologies, interventionalists have been focused on building programs to perform more complex PCI procedures.
Several factors have contributed to the increase in complexity of PCI. Recent modifications to appropriate use criteria mean that patients oftentimes don’t reach the cath lab unless their condition has developed to a point that warrants intervention. In addition, the cath lab now has access to technologies that enable them to treat more complex cases without the need for open heart surgery. Hospitals are developing programs to treat chronic total occlusions (CTOs) and adopting ventricular assist devices such as the Impella 2.5 to treat high-risk patients.
Radial Access Adoption on the Rise
Across the globe, transradial access has become the standard of care for PCI. While adoption in the United States has lagged behind, data on the benefits to patients of radial access continues to mount, including reduced access site bleeding and less time in the hospital. Data presented in 2015 continued to back up the benefit of radial PCI for patients but several studies showed an increase in radiation exposure for operators during left radial procedures. With the appropriate training and equipment including proper shielding, disposable drapes, and robotic systems, these risks can be reduced for physicians and their staff.
Radiation Safety a Top Priority
In 2015, there were over 40 scientific manuscripts on occupational hazards in the cath lab and methods to reduce exposure. This number is double the number of scientific manuscripts published on the topic in the 5 previous years. New data published in 2015 increases the number of brain tumors document in interventionalist and demonstrates increased risk for vascular aging and even cognitive impairment.
In response to these dangers, the Organization for Occupational Radiation Safety in Interventional Fluoroscopy (ORSIF) was developed to bring together physicians, allied health professionals, occupational health specialists, and industry to raise awareness for these risks and to find new and better ways to protect interventional fluoroscopy professionals. The organization distributed a comprehensive white paper on the topic and released a video featuring noted endovascular surgeon, Dr. Ted Diethrich, who has experienced several health issues attributed to his work with radiation including a brain tumor.
Robotics in the Cath Lab
Robotic-assisted PCI continues to be top of mind in interventional cardiology. 2015 saw the first conference dedicated to teaching robotics for complex PCI, The San Diego Cardiovascular Interventions: Robotics & High Risk Course which featured two live cases performed via robotic-assisted PCI. Robotics is a critical tool for performing complex PCI giving physician’s robotic precision, protection from radiation exposure, and the ability to sit comfortably without the need for lead. These factors are especially important in complex PCI procedures that not only require a high level of precision but also tend to be longer and require more radiation.
Another big story this year was the FDA approval of the CorPath Vascular Robotic System for radial access PCI. Robotics can play an important role in radial procedures, offering the same benefits of radial access for patients while protecting physicians from additional radiation exposure. For all PCI procedures, robotics can enable the entire cath lab team to reduce their radiation exposure but taking a few simple steps.
We previously announced the launch of robotic programs at both the Mayo Clinic and Massachusetts General Hospital. We also debuted a video documentary featuring Dr. Vijay Iyer, who has adopted robotic-assisted PCI after suffering from multiple back surgeries as a result of working in the cath lab.
All in all, 2015 was an exciting year in interventional cardiology. We are looking forward to seeing what 2016 brings for the future of robotic technology and interventional medicine!
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