ITN Editor Dave Fornell takes a tour of some of the most innovative new technology that was displayed on the expo floor at the 2017 Healthcare Information and Management Systems Society (HIMSS) annual meeting. The two most significant technology advances are discussed in Fornell's blog "Two Technologies That Offer a Paradigm Shift in Medicine at HIMSS 2017."

This video, provided by Tryton, demonstrates the implantation of the Tryton Side Branch Stent. It became the first bifurcation stent cleared by the FDA in March 2017. The stent is deployed in the side branch artery using a standard single wire balloon-expandable stent delivery system. A conventional drug eluting stent is then placed in the main vessel. Read the articles "FDA Clears First Dedicated Coronary Bifurcation Stent" and "New Designs May Ease Bifurcation Stenting."
 

Machine learning is now being commercialized in medical imaging products designed to help improve workflow efficiency and augment the clinical user, not replace them. Steve Holloway with the U.K.-based healthcare market intelligence firm Signify Research discussed the expanding roles of artificial intelligence in imaging applications at the 2017 HIMSS healthcare IT conference. Read the article from HIMSS 2017 "How Artificial Intelligence Will Change Medical Imaging."

The supplies you use in your cath lab are complex and very valuable. Protecting your investment and uncovering new opportunities to cut waste and help improve the total cost of care means it’s more important than ever before to have a strong pulse on your inventory. Using data analytics, you can uncover trends for product standardization, optimize par levels and better control costs.

This video, provided by BioVentrix Inc., demonstrates how to implant the Revivent TC System to reduce the volume of the left ventricle (LV) in heart failure patients. Reducing the size of the LV can help make pumping more efficient, helping to reduce the workload of a failing heart. It is a minimally invasive, catheter-based, closed-chest alternative to conventional surgical ventricular restoration (SVR). It uses catheter-deployed anchors designed to exclude scarred myocardial tissue from the LV to help restore its more natural conical shape. Read about the system gaining European approval.  Read about system starting its U.S. clinical trial. 

Detailed imaging is needed to support complex interventions for the assessment and procedure guidance.  See how the GE Healthcare cardiovascular ultrasound systems fit into the in Interventional space – from the Vivid E95 with cSound premium system to the Vivid iq compact system. For more information, go to www3.gehealthcare.com/en/products/categories/ultrasound/vivid/vivid_e95.

This video, provided by Valtech, demonstrates the Cardioband transcatheter mitral annuloplasty system. It allows transcatheter repair of functional mitral regurgitation (FMR). It has a CE mark in Europe and a study to evaluate its safety and efficacy is planned in the United States. Read the article “Transcatheter Annuloplasty For Repair Versus Replacement in Functional Mitral Regurgitation.”
 

At RSNA 2016, the key buzzwords were “deep learning,” “machine learning” and “artificial intelligence.” Vendors and major academic centers are developing a wide array of artificial intelligence neuro networks to aid radiologists in clinical diagnosis and clinical decision support. Here are two examples of how the IBM Watson system examines a mammography and cardiac patient imaging studies. Watch the VIDEO “Development of Artificial Intelligence to Aid Radiology,” an interview with Mark Michalski, M.D., director of the Center for Clinical Data Science at Massachusetts General Hospital, explaining the basis of artificial intelligence in radiology.

Emanuel Kanal, M.D., director of MRI services and professor of radiology and neuroradiology at the University of Pittsburgh Medical Center, explains what is known about MRI contrast retention in the brain and other MRI safety concerns. He spoke to ITN at RSNA 2016. Read the article "Gadolinium May Remain in Brain after Contrast MRI."

Shimadzu's latest generation interventional lab angiography imaging system, the Trinias, enables advanced imaging capabilities, including reduced patient dose, 3-D rotation angiography acquisitions table side, and stent enhancement software. This video tour of the system was created at the 2016 Transcatheter Cardiovascular Therapeutics (TCT) meeting.  For more information: www.shimadzu.com/med/products/angio/index.html.

DAIC Editor Dave Fornell takes a video tour of some of the most innovative new interventional cardiology technologies he found at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 meeting. Watch the related VIDEO “Editor's Choice of the Most Innovative New Technologies at TCT 2015.”

A discussion with guidewire expert Dimitri Karmpaliotis, M.D., Ph.D., FACC, about the basics of interventional guidewire design and function. He is, assistant professor of medicine, Columbia University Medical Center, and director of chronic total occlusion (CTO), complex and high-risk angioplasty program at the Center for Interventional Vascular Therapy, NewYork Presbyterian Hospital. He spoke with DAIC at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting.

Related Interventional Guide Wire Content:

Understanding the Design and Function of Guidewire Technology

Guidewire Product Comparison - create a free login tyo access

The Basics of Guide Wire Technology

DAIC Guidewire News Channel 

A discussion with Simon Dixon, M.D., MBChB, on the use of fractional flow reserve-computed tomography (FFR-CT) to evaluate chest pain patients in the emergency department. He is chairman of the Department of Cardiovascular Medicine at Beaumont Health System and a professor of Medicine at the Oakland University William Beaumont School of Medicine. He discussed the first year of experience with FFR-CT at Beaumont Hospital in Royal Oak, Mich., during the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. Read the article “Clinical Applications of FFR-CT.”

William Abraham, M.D., FACC, discusses advances in heart failure device treatment technologies at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He is director of the division of cardiovascular medicine and a professor of internal medicine, physiology and cell biology at The Ohio State University Wexner Medical Center. He also served as principal investigator of the CHAMPION Trial for the CardioMEMS device. Read the article "Reducing Heart Failure Readmissions."

Juan Granada, M.D., executive director and chief scientific officer of the Cardiovascular Research Foundation's Skirball Center for Innovation, explains the shortcomings of the first bioresorbable stent on the U.S. market, proper patient selection and what new BRS technologies are in development. Granada presented numerous sessions on bioresorbable scaffolds at TCT 2016. Read more about bioresorbable stents in "Tempering the Bioresorbable Stent Euphoria Following FDA Clearance of the Absorb."

Krishna Rocha-Singh, M.D., Prairie Vascular Institute, Springfield, Ill., explains advancements in device therapy for hypertension at the Transcatheter Cardiovascular Therapeutics (TCT) 2016 annual meeting. He was involved in the SYMPLICITY HTN-3 denervation trial and is the principal investigator for the ongoing Rox Coupler arteriovenous device trial.  Watch the VIDEO “New Approaches to Denervation Therapy.”

Studies have shown transcatheter aortic valve replacement (TAVR) has an increased risk of stroke and cerebral damage due to emboli released during the procedure. Recent clinical data show the extent of this damage on MRI. Several TAVR embolic protection systems are being developed to reduce this damage. This video explains one of those systems. Read about trial data presented at TCT 2016 "Delirium Significantly Associated With Brain Lesions in Patients Post-TAVR."  Read the article, “TAVR Embolic Protection Did Not Reduce Emboli Brain Lesions,” which was a second trial presented at TCT 2016.  

Experts who explain in the video why embolic protection is needed in TAVI include Raj Makkar, M.D., Cedars-Sinai Medical Center; Los Angeles, Daryl Gress, M.D., University of Nebraska Medical Center; J. Schofer, M.D., Albertine heart Center, Hamburg, Germany; and P.R. Stella, M.D., 
 

This video, provided by Zoll, demonstrates how cardiologists can explain sudden cardiac death to patients. It is critical to educate patients who are at risk of sudden cardiac arrest (SCA), so Rahul Doshi, M.D., director of electrophysiology, associate professor of clinical medicine, Keck Medical Center of University of Southern California, explains sudden cardiac death (SCD) to his patients using a simple illustration. Visit SCDFacts.org for additional resources for you and your team to support the SCD conversation with your patients. One in five post-AMI patients have been shown to be at high risk of dying after PCI.1 The majority of mortality in AMI patients post-PCI occurs in the first three months — one out of every 10 high-risk patients die, with about 60 percent of this mortality due to SCD.[1,2] 

1. Halkin A, et al. Prediction of Mortality After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: CADILLAC Risk Score. JACC 2005;45:1397–1405.

2. Stone G, et al. Prevention of Sudden Cardiac Arrest Post PTCA in High-Risk Patients. Medscape. April 2011. https://www.medscape.org/viewarticle/741503_transcript

With bundled payments putting increased pressure on hospitals to manage supply costs while providing quality patient care, there is no room in your cath lab for high-value medical device waste. An automated inventory management solution could help you find and reduce the waste hiding in your supply chain while helping to improve your total cost of care. Visit cardinalhealth.com/CIMS. 

This video, provided by Respicardia, demonstrates the Remede System is a pacemaker-like implantable device. It is designed to improve cardiovascular health by restoring natural breathing during sleep in patients with central sleep apnea. In this video from The Ohio State University, William Abraham, M.D., director of the Division of Cardiovascular Medicine at The Ohio State University Wexner Medical Center, explains how the technology works and highlights one patient case involved in a recent study of the device.