Podcasts about Angioplasty

Send us a text"We had no tools. We just had to improvise. In a way, like you said, that was what made us think, 'How can I do this?' Because you had no tools, you had to think of ways to use what you had available to do procedures that otherwise you wouldn't have been able to do back then." —Wilfrido R. Castaneda-Zuniga, MD, FSIR, on innovation in early interventional radiologyIn this episode, part of the ongoing celebration of the Society of Interventional Radiology (SIR) 50th anniversary, hosts Keith Horton, MD, FSIR, and Hector Ferral, MD, FSIR, speak with interventional radiology pioneer Wilfrido R. Castaneda-Zuniga, MD, FSIR, reflecting on lessons learned working with Kurt Amplatz, MD, FSIR, and others, stories of how their most seminal work came into being, the importance of peer mentorship, and more.  Related resources:View the society's 50th Anniversary celebration page"Mechanics of angioplasty: an experimental approach" by Wilfrido R. Castaneda-Zuniga, MD, FSIR, et al.SIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

Dr Ashwin Mehta's Journey from Learner to Leader in Retrograde Angioplasty by TheRightDoctors

DAD Catheter: An Angioplasty Apparatus for Facilitating Accurate Placement of a Lumen Stent for Dilating Ostial Stenosis

In this episode of Audible Bleeding, Jamila, Anh, and Naveed discuss the LifeBTK Trial with Principal Investigator Dr. Brian DeRubertis, where we discuss the new Abbott Esprit everolimus-eluting resorbable scaffold for the below-knee popliteal space. Guest: Dr. DeRubertis, is the Principal Investigator of the LIFE-BTK trial. He is the Chief of the Division of Vascular & Endovascular Surgery at New York-Presbyterian and Weill Cornell Medicine in New York City. Audible Bleeding Team Dr. Jamila Hedhliis a general surgery resident at the University of Illinois. Anh Dang, (@QuynhAnh_Dang), is a fourth year medical student at the University of Pennsylvania.  Dr. Naveed A. Rahman, (@naveedrahmanmd), is a Vascular Surgery Fellow at the University of Maryland.    References: Drug-Eluting Resorbable Scaffold versus Angioplasty for Infrapopliteal Artery Disease (LIFE-BTK). Advances in Endovascular Treatment of CLTI: Insights From the LIFE-BTK Trial. Diversity, Equity, and Inclusion in the LIFE-BTK Trial Evaluating the Esprit™ BTK Drug-Eluting Resorbable Scaffold for the Treatment of Infrapopliteal Lesions in Patients with Chronic Limb-Threatening Ischemia, VIVA 2024. Sirolimus-eluting stents vs. bare-metal stents for treatment of focal lesions in infrapopliteal arteries: a double-blind, multi-centre, randomized clinical trial (YUKON). Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease (DESTINY).  A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease (ACHILLES). Sex Differences in Outcomes Following Endovascular Treatment for Symptomatic Peripheral Artery Disease: An Analysis From the K- VIS ELLA Registry. Drug-Coated vs Uncoated Percutaneous Transluminal Angioplasty in Infrapopliteal Arteries: Six-Month Results of the Lutonix BTK Trial.  Paclitaxel-Coated Balloon in Infrapopliteal Arteries: 12-Month Results From the BIOLUX P-II Randomized Trial (BIOTRONIK'S-First in Man study of the Passeo-18 LUX drug releasing PTA Balloon Catheter vs. the uncoated Passeo-18 PTA balloon catheter in subjects requiring revascularization of infrapopliteal arteries).  The IN.PACT DEEP Clinical Drug-Coated Balloon Trial: 5-Year Outcomes.     Follow us @audiblebleeding Learn more about us at  https://www.audiblebleeding.com/about-1/ and provide us with your feedback with our listener survey.

N Engl J Med 2003;349:733-742Background: In patients with ST elevation myocardial infarction, treatment with balloon angioplasty improved outcomes compared to fibrinolysis, as seen in the Primary Angioplasty in Myocardial Infarction Study Group trial. Other trials showed similar findings. However, these trials were relatively small in size and mainly conducted at hospitals with high experience in angioplasty.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.At the time this trial was conducted, limited number of hospitals offered angioplasty. Transporting patients with ST-elevation myocardial infarction to these centers posed a significant challenge, and sometimes resulting in delays in treatment.The DANAMI-2 investigators sought to conduct a community-wide trial comparing on-site fibrinolysis vs transferring the patients for primary angioplasty.Patients: Eligible patients had ST-segment elevation myocardial infarction with symptoms lasting for at least 30 minutes but less than 12 hours. The EKG criteria were cumulative ST-segment elevation of at least 4 mm in at least two contiguous leads.Exclusion criteria were many and included contraindication to fibrinolysis, left bundle branch block, acute myocardial infarction and fibrinolytic treatment within the previous 30 days, pulseless femoral arteries, renal failure defined as creatinine > 2.83 mg/dL, life expectancy less than 12 months due to non-cardiac disease, and more. Patients were also excluded if they were high risk for transportation because of cardiogenic shock, persistent life-threatening arrhythmias, or a need for mechanical ventilation.Baseline characteristics: The trial randomized 1,572 patients – 790 randomized to angioplasty and 782 to fibrinolysis. A total of 1129 patients were randomized at referral hospitals, and 443 patients were randomized at invasive-treatment centers.The average age of patients was 63 years and 73% were men. Approximately 20% had hypertension, 7% had diabetes, 11% had prior myocardial infarction, and 58% were current smokers.Among patients who underwent angiography and data were available, 53% had single vessel disease, 25% had two vessel disease and 14% had three vessel disease. Approximately 3% had left main involvement.Procedures: Patients were randomly assigned in a 1:1 ratio to undergo fibrinolysis or angioplasty. Patients were recruited from 24 referral hospitals without angioplasty facilities and 5 invasive-treatment hospitals with angioplasty facilities. For patients recruited from referral hospitals, transfer to angioplasty center had to be completed within 3 hours. A physician accompanied the patient. The participating hospitals served 62% of the Danish populationPatients assigned to fibrinolysis received 300 mg of aspirin orally, beta-blocker intravenously, tissue plasminogen activator (alteplase, given as a 15-mg bolus and an infusion of 0.75 mg/kg over 30 minutes, followed by an infusion of 0.5 mg/kg for 60 minutes), and an intravenous bolus of unfractionated heparin (5000 U), followed by a 48-hour infusion of unfractionated heparin.Patients assigned to angioplasty received 300 mg of aspirin intravenously, beta-blocker intravenously, and 10,000 U of unfractionated heparin bolus, with additional heparin during the angioplasty procedure to achieve an activated clotting time of 350 to 450 seconds.Angioplasty was only performed for target-vessel related infarct.Endpoints: The primary end point was a composite of death from any cause, clinical reinfarction or disabling stroke, at 30 days. Procedure-related reinfarction was not counted in the primary end point.The trial was designed with two parallel sub-studies: One involving patients randomized at referral hospitals and the other involving patients randomized at invasive-treatment centers.Analysis was performed based on the intention-to-treat principle. Sample size calculations assumed that the combined primary endpoint would occur within 30 days in 16% of patients assigned to fibrinolysis, 10% of those assigned to angioplasty at referral hospitals, and 9% of those assigned to angioplasty at invasive-treatment centers. Based on these assumptions, 1100 patients were needed to be enrolled at referral hospitals and 800 patients at invasive-treatment centers.Results: Among the 4,278 patients screened for inclusion, 1,572 (36.7%) were randomized. The study was stopped early after the third interim analysis demonstrated superiority of angioplasty in the referral-hospital sub-study. The median time from the onset of symptoms to randomization was 135 minutes. The median distance patients were transported from a referral hospital to an invasive-treatment center was 50 km. The time from randomization at the referral hospital to arrival in the catheterization laboratory was under 2 hours in 96% of the patients. There were no deaths during transportation.Among the patients randomized to fibrinolysis, 99% received the assigned treatment. Among the patients randomized to angioplasty, 98% underwent angiography. Angioplasty was attempted in 89.4% of the patients, and among them, stents were implanted in 90.4%.Angioplasty reduced the primary composite endpoint among all patients (8.0% vs 13.7%; p

N Engl J Med 1993;328:673-679Background: Previous trials established that thrombolysis improves mortality in patients with acute myocardial infarction, as seen in the GISSI-1 and ISIS-2 trials. However, thrombolysis has limitations, including an increased risk of bleeding and the inability to achieve arterial patency in approximately 20% of the cases. As a result, there was a growing interest in the use of percutaneous transluminal coronary angioplasty (PTCA).Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Primary Angioplasty in Myocardial Infarction Study Group sought to test the hypothesis that PTCA compared to thrombolysis, improves outcomes and reduces bleeding in patients with acute myocardial infarction.Patients: Eligible patients presented within 12 hours of ischemic chest pain and had ST elevation of at least 1 mm in two or more contiguous electrocardiographic leads. Patients were excluded if they had dementia, LBBB, cardiogenic shock or elevated bleeding risk.Baseline characteristics: The study enrolled 395 patients – 195 assigned to the PTCA arm and 200 assigned to the thrombolysis arm. The average age of patients was 60 years with 73% being men. Approximately 14% had prior myocardial infarction, 43% had hypertension, 12% had diabetes and 2% had congestive heart failure. The average ejection fraction 52%.The infarct was anterior in 34% of the patients, inferior in 59% and lateral in 8%.Procedures: All patients were given 325 mg of aspirin plus 10,000-unit bolus of intravenous heparin. After that, patients were randomly assigned to thrombolytic therapy or PTCA. The thrombolytic agent used was tissue plasminogen activator (t-PA) at a dose of 100 mg (or 1.25 mg/kg of body weight for patients weighing less than 65 kg) over three hours. Patients randomly assigned to PTCA underwent immediate diagnostic catheterization.Angiographic criteria for exclusion from PTCA included left main stenosis of more than 70%, infarct-related vessel was patent, three-vessel disease, morphologic features of the lesion known to indicate high risk, small infarct-related vessels or stenosis 70 years or admission heart rate > 100 bpm. PTCA reduced in-hospital mortality in the “not low risk” group (2.0% vs 10.4%; p= 0.01) but not in the low risk group (3.1% vs 2.2%; p= 0.69).Conclusion: In patients with ST-elevation myocardial infarction, PTCA compared to t-PA reduced death and reinfarction at the hospital and at 6 months with a number needed to treat of approximately 14 and 12, respectively.This was one of the trials that established the foundation for the use of PTCA in patients with acute myocardial infarction. While the treatment effect was large, there are important considerations to keep in mind. First, the sample size was small. In comparison, GISSI-1 had almost 12,000 patients and ISIS-2 had over 17,000. The results of small trials are not always replicated in larger pragmatic trials. Second, the use of aspirin + heparin + t-PA likely increased bleeding in the t-PA arm as heparin plus thrombolysis compared to thrombolysis without heparin increased bleeding without improving outcomes, as seen in the GISSI-2 and ISIS-3 trials. Third, two thirds of the patients had inferior or lateral infarcts and these subgroups did not benefit from thrombolysis in the GISSI-1 trial. Finally, standalone angioplasty is infrequently performed nowadays and patients often receive a stent which has improved vessel patency.In the current era, patients with ST-elevation myocardial infarction receive early revascularization with stent placement, which improved outcomes in these patients. We discussed the limitations above to help readers and learners appraise clinical trials, as these limitations were important at the time of this trial's publication.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber. Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

In this episode, Dr. Valentin Fuster discusses the findings of a major randomized trial examining the use of drug-coated balloons (DCB) in treating side branch stenosis during coronary bifurcation procedures. The study suggests that DCBs offer better one-year outcomes compared to non-coated balloons, showing a significant reduction in myocardial infarction rates, but highlights ongoing challenges in managing bifurcation lesions, especially considering the high cost and potential risks.

DCB-BIF: Comparison of Noncompliant Balloon with Drug-Coated Balloon Angioplasty for Side Branch Stenosis After Provisional Stenting for Patients with True Coronary Bifurcation Lesions

ECLIPSE: A Large-Scale, Randomized Trial of Orbital Atherectomy vs. Conventional Balloon Angioplasty in Severely Calcified Coronary Arteries Prior to DES Implantation

Author Shao-Liang Chen, MD, FACC, and JACC Associate Editor Celina M. Yong, MD, FACC, discuss patients with simple and true coronary bifurcation lesions undergoing provisional stenting. Main vessel stenting with a DCB for the compromised side branch resulted in a lower 1-year rate of the composite outcome compared with an NCB intervention for the side branch. The high rates of periprocedural myocardial infarction, which occurred early and did not lead to revascularization, are of unclear clinical significance.

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The Lancet Volume 391, Issue 10115, 6–12 January 2018, Pages 31-40Background:  For decades, cardiologists commonly used percutaneous coronary intervention (PCI) for the relief of angina. It made sense because PCI resulted in near complete resolution of blood flow through a stenosed vessel. The problem facing evidence-based clinicians was that no previous trial had compared PCI to a placebo (sham) procedure. Instead, previous trials had compared PCI (a procedure) to tablets. In the absence of blinding, a procedure will exert a larger placebo effect than tablets.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The Objective Randomized Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina (ORBITA) trial was designed to assess the effect of PCI versus placebo on exercise time in patients with stable ischemic symptoms.ORBITA met ethical criteria because previous trials, primarily the COURAGE trial, had found that PCI in addition to medical therapy did not reduce hard outcomes, such as myocardial infarction or death due to cardiovascular causes, compared to medicine alone. In other words, PCI in patients with stable coronary artery disease was not a disease-modifying therapy; it was used to relieve symptoms.Patients:  Patients had to have single-vessel coronary artery disease (≥ 70% stenosis) that was appropriate for PCI and angina or equivalent symptoms. The authors published in the appendix pictures of every patient enrolled in the trial. Exclusion criteria included acute coronary syndrome, previous bypass surgery, left main stenosis, chronic total occlusions, severe valvular disease or left ventricular dysfunction, moderate or severe pulmonary hypertension, or life-expectancy less than 2 years.  Baseline Characteristics: The mean age of patients was 65 years. More than 79% were male. Almost 90% had normal left ventricular function. Canadian Cardiovascular Society class included about 60% with class 2 symptoms and nearly 40% with class 3 symptoms. Angina had been present for a mean of 9 months. Trial Procedures: ORBITA had two phases. First was a 6-week medical optimization phase wherein patients were optimally treated with medical therapy. They had a questionnaires, dobutamine stress echo, and a cardiopulmonary exercise test.  They then had the blinded procedure with either PCI or placebo.All PCI was done with drug-eluting stents. The procedure included measures to insure blinding, such as headphones during the procedure, sedation and a measure of hemodynamics such as fractional flow reserve. The second phase was a 6-week period of blanking in which patients underwent follow-up assessment. Testing procedures were similar to the pre-procedure protocol.At all times, the staff were blinded to the procedural data. This included procedural details as well as post-procedural assessment. The recovery staff were well rehearsed in their role of maintenance of blinding. Patients and subsequent medical caregivers were also blinded to treatment allocation. The study physicians present during the procedure had no further contact with the patient during the study.By the time of randomization, in the PCI group, 103 (98%) of 105 patients were taking aspirin, 103 (98%) were taking a second antiplatelet, and 99 (94%) were taking a statin, compared to 93 (98%), 94 (99%), and 91 (96%) of 95 patients, respectively, in the placebo group. At the same timepoint, in the whole study population, 156 (78%) of 200 patients were taking β blockers and 182 (91%) were taking calcium channel antagonists.The mean number of antianginal medications in the PCI group was 0·90 (SD 0·8) at enrollment, 2·8 (1·2) at pre-randomization, and 2·9 (1·1) at follow-up, compared to the placebo group in which the mean number of medications was 1·0 (0·9; p=0·357), 3·1 (0·9; p=0·097), and 2·9 (1·1; p=0·891), respectively.Endpoints: The primary endpoint of ORBITA was the difference between PCI and placebo groups in the change in treadmill exercise time. The power calculation relied on previous trials wherein PCI had resulted in a 48-55 second increase in exercise time over medicine. ORBITA authors designed the trial to detect a 30 second increase in exercise time.They estimated that a sample size of 100 patients per group had more than 80% power to detect a between-group difference in the increment of exercise duration of 30 seconds, at the 5% significance level, using the two-sample t test of the difference between groups. This calculation assumed a between-patient standard deviation of change in exercise time of 75 s. Since there had been no previous placebo-controlled trials of PCI, the authors initially allowed for a one-third dropout rate in the 6-week period of medical optimization between enrollment and randomization and therefore planned to enroll 300 patients. But the dropout rate was much lower, so only 230 patients had to be enrolled. The primary endpoint was continuous, and it was calculated as a difference between groups. They also measured secondary endpoints, including measures of angina severity and quality of life.Results: A total of 368 patients were screened for eligibility, and 200 were randomly assigned. Most were excluded from randomization because they declined to participate. There were 105 allocated to PCI (all but one had PCI) and 95 to placebo (4 patients had PCI due to a procedural complication).Across all patients, the mean area stenosis by quantitative coronary angiography was 84·4% (SD 10·2), mean FFR was 0·69 (0·16), and mean iFR was 0·76 (0·22). 57 (29%) patients had FFR greater than 0·80 and 64 (32%) had iFR greater than 0·89.The median length of stent implanted was 24 mm (IQR 18–33). After PCI, the mean FFR improved to 0·90 (SD 0·06; p

For full review of the trials, please visit https://cardiologytrials.substack.com/ Get full access to Cardiology Trial's Substack at cardiologytrials.substack.com/subscribe

N Engl J Med 2007;356:1503-1516Background: By the turn of the 21st century more than 1 million coronary stent procedures were performed each year in the United States and approximately 85% were undertaken electively in patients with stable coronary artery disease. This pattern evolved without a single clinical trial demonstrating a concrete improvement in hard endpoints with percutaneous coronary intervention (PCI) compared to optimal medical therapy (OMT) alone. We have already reviewed several of these trials including ACME, RITA-2 and the Atorvastatin vs Angioplasty trial. Each trial was relatively small and none showed a significant benefit for revascularization compared to medical therapy on death or MI.Previous trials involving PCI compared to standard care or OMT included less than 3,000 patients altogether, did not broadly use intracoronary stents (instead using balloon angioplasty only) and they did not employ what would be considered a contemporary standard of medical management. Thus many questions involving the efficacy and safety of PCI versus OMT alone for managing stable CAD remained unanswered.The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial was designed to test the hypothesis that up front PCI plus OMT would significantly reduce the risk of death and nonfatal MI compared to OMT alone in patients with stable CAD.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Patients: Eligible patients had stable CAD defined as either 1) a coronary stenosis of >/= 70% in one or more proximal epicardial coronary arteries and objective evidence of myocardial ischemia (based on the resting ECG or with exercise or pharmacologic vasodilator stress testing) or 2) a coronary stenosis of >/= 80% and classic angina without provocative testing. Patients were excluded if they had persistent Canadian Cardiovascular Society (CCS) class IV angina, a markedly positive stress test defined by substantial ST-segment depression or hypotensive response during stage 1 of the Bruce protocol), refractory heart failure or cardiogenic shock, an EF /=50% (4%).Patients in the trial were adherent with medical interventions and motivated to improve diet and lifestyle. For all patients, BP and cholesterol were improved and activity levels increased over the course of the study. For example, in the OMT group, baseline SBP and LDL were 130 mm Hg and 102 mg/dl at baseline and declined to 122 mm Hg and 72 mg/dl at 5 years, respectively. Similar reductions were seen in the PCI group. Fifty five percent of patients performed moderate physical activity at baseline and this increased to 77% at 5 years. Dietary adherence improved across the board and smoking decreased. Patients were followed for a median time of 4.6 years and 9% were lost to follow up with no significant difference between group. Overall, PCI + OMT did not reduce the primary endpoint of death or nonfatal MI compared to OMT alone (19.0% with PCI vs 18.5% with medical therapy; HR 1.05; 95% CI 0.87-1.27). Periprocedural MI was numerically more frequent in the PCI group whereas spontaneous MI was nearly identical between groups (statistics not provided). There were no statistically significant differences noted in any of the endpoints reported with the exception of revascularization during the follow up period, which occurred less frequently in the PCI group (20% vs 30%; p

A new trial assessed whether balloon angioplasty plus aggressive medical management was superior to aggressive medical management alone for patients with symptomatic intracranial atherosclerotic stenosis. Author Zhongrong Miao, MD, PhD, from Beijing Tiantan Hospital, discusses the BASIS randomized clinical trial with JAMA Deputy Editor Christopher C. Muth, MD. Related Content: Balloon Angioplasty vs Medical Management for Intracranial Artery Stenosis Is Balloon Angioplasty the Future for Intracranial Stenosis? Read Transcript

Commentary by Dr. Zhi-Cheng Jing

Commentary by Dr. Dong Oh Kang

Commentary by Dr. Emile Daoud

Comparison of Intravascular Ultrasound-Guided versus Angiography-Guided Angioplasty on the Outcomes of Drug-Coated Balloon Treatments in Femoropopliteal Artery Disease

Drug-Coated Balloons vs Drug-Eluting Stents or Plain Old Balloon Angioplasty for In-Stent Restenosis: A Nationwide Segment-Level Analysis from SCAAR of 7987 Patients

Bypass surgery and angioplasty are two of the most widely-used treatments for coronary artery disease, and they have a long track record in medicine. Bypass surgery was first done in 1960, while the first coronary angioplasty was done in 1977. What are the differences between these procedures, and how do doctors determine which procedure is more suitable for individual patients? We discuss these with Dr Jayakhanthan Kolanthaivelu, Consultant Cardiologist, Cardiac Vascular Sentral KL.

Fresh off an abrupt diagnosis that throws his life into disarray, Bill Fitzpatrick is admitted to the hospital to receive a stent. Fitzpatrick guides the audience into a frantic hospital scene that ultimately results in a discharge home, though more health obstacles remain in his way outside the four walls of the hospital. His family provides an intimate look at the fear and uncertainty that accompanies a heart disease diagnosis and how perilous the road to recovery looks.Dr. Rohit Vuppuluri, a cardiologist based in Chicago, details the clinical process behind a coronary angioplasty and how stents are used to treat blocked arteries.Dr. Suzanne Steinbaum, a preventative cardiologist, spokesperson for Go Red for Women initiative through the American Heart Association and founder of Adesso, a heart prevention and wellness program for women, talks about what the recovery timeline looks like for patients who receive treatment for heart disease.MM+M, in conjunction with Cardiology Advisor, presents Me and My Heart, a special four-part podcast series delving into Fitzpatrick's turbulent patient journey, the persistence of heart disease and issues surrounding access to care in America. Check us out at: mmm-online.com Follow us: YouTube: @MMM-onlineTikTok: @MMMnewsInstagram: @MMMnewsonlineTwitter/X: @MMMnewsLinkedIn: MM+M To read more of the most timely, balanced and original reporting in medical marketing, subscribe here.

CME credits: 4.75 Valid until: 30-11-2024 Claim your CME credit at https://reachmd.com/programs/cme/balloon-pulmonary-angioplasty-issues-and-perspectives/16508/ The Midwest Regional Pulmonary Hypertension Summit occurred on October 14, 2023, in Chicago, IL. The event highlighted the management of PH with other coexisting comorbidities. Leading experts discussed the appropriate risk stratification, management of PH, updates on ERS/ERC guidelines, and optimal patient care practice.

Primary Outcomes of a Pivotal Multicenter Randomized Trial Comparing the AGENT Paclitaxel-Coated Balloon with Conventional Balloon Angioplasty for In-Stent Restenosis

In this week's episode from SCAI 2023, Dr. Aimee Armstrong of Nationwide Children's Hospital joins Dr. Pass in a live session from the annual scientific sessions of SCAI. Professor of Pediatrics at UC Davis, Dr. Frank Ing, reviews his experience with recanalization of central veins in a large pediatric cohort. Who is a candidate for this intervention? When are stents preferred vs. angioplasty alone? Should all patients having central lines removed be evaluated to prevent venous occlusion? What sort of radiation dose is associated with this intervention? Dr. Ing shares his deep knowledge in a live "Pediheart" session from Phoenix, Arizona on 5/19/23 at SCAI 2023. https://doi.org/10.1016/j.jscai.2022.100547

Commentary by Dr. Candice Silversides

What role do genetics, diet, exercise and cholesterol play in preventing and treating diseases of the heart? Learn about advances in the prevention and treatment of heart disease, coronary artery disease and heart attacks, abnormal rhythms such as atrial fibrillation, cardiac arrest, the failing heart, and diseases of the heart valves. In this program, Dr. Krishan Soni discusses interventions such as angioplasties and stents to treat heart attacks. Series: "Mini Medical School for the Public" [Health and Medicine] [Show ID: 38484]

What role do genetics, diet, exercise and cholesterol play in preventing and treating diseases of the heart? Learn about advances in the prevention and treatment of heart disease, coronary artery disease and heart attacks, abnormal rhythms such as atrial fibrillation, cardiac arrest, the failing heart, and diseases of the heart valves. In this program, Dr. Krishan Soni discusses interventions such as angioplasties and stents to treat heart attacks. Series: "Mini Medical School for the Public" [Health and Medicine] [Show ID: 38484]

What role do genetics, diet, exercise and cholesterol play in preventing and treating diseases of the heart? Learn about advances in the prevention and treatment of heart disease, coronary artery disease and heart attacks, abnormal rhythms such as atrial fibrillation, cardiac arrest, the failing heart, and diseases of the heart valves. In this program, Dr. Krishan Soni discusses interventions such as angioplasties and stents to treat heart attacks. Series: "Mini Medical School for the Public" [Health and Medicine] [Show ID: 38484]

What role do genetics, diet, exercise and cholesterol play in preventing and treating diseases of the heart? Learn about advances in the prevention and treatment of heart disease, coronary artery disease and heart attacks, abnormal rhythms such as atrial fibrillation, cardiac arrest, the failing heart, and diseases of the heart valves. In this program, Dr. Krishan Soni discusses interventions such as angioplasties and stents to treat heart attacks. Series: "Mini Medical School for the Public" [Health and Medicine] [Show ID: 38484]

What role do genetics, diet, exercise and cholesterol play in preventing and treating diseases of the heart? Learn about advances in the prevention and treatment of heart disease, coronary artery disease and heart attacks, abnormal rhythms such as atrial fibrillation, cardiac arrest, the failing heart, and diseases of the heart valves. In this program, Dr. Krishan Soni discusses interventions such as angioplasties and stents to treat heart attacks. Series: "Mini Medical School for the Public" [Health and Medicine] [Show ID: 38484]

Commentary by Dr Duk-Woo Park

Commentary by Dr. Valentin Fuster

A client reports that she has a femoral artery stent, placed in 2017. Her doctor and nurse think massage is fine. All systems go, right? Maybe, maybe not. It turns out this topic is a lot more controversial than we knew, and a lot depends on what kind of stent she got.   Sponsors:   Books of Discovery: www.booksofdiscovery.com      Host Bio:          Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist's Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP's partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner's books are available at www.booksofdiscovery.com. And more information about her is available at www.ruthwerner.com.                                   Recent Articles by Ruth:          “Unpacking the Long Haul,” Massage & Bodywork magazine, January/February 2022, page 35, www.massageandbodyworkdigital.com/i/1439667-january-february-2022/36. “Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33, http://www.massageandbodyworkdigital.com/i/1402696-september-october-2021/34.           “Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32, www.massageandbodyworkdigital.com/i/1384577-july-august-2021/34.       Resources:    Pocket Pathology: https://www.abmp.com/abmp-pocket-pathology-app   Adlakha, S. et al. (2010) ‘Stent fracture in the coronary and peripheral arteries', Journal of Interventional Cardiology, 23(4), pp. 411–419. doi:10.1111/j.1540-8183.2010.00567.x.   Al-Nouri, O. et al. (2012) ‘Failed superficial femoral artery intervention for advanced infrainguinal occlusive disease has a significant negative impact on limb salvage', Journal of Vascular Surgery, 56(1), pp. 106–111. doi:10.1016/j.jvs.2011.10.108.   Angioplasty and stent placement - peripheral arteries - discharge : MedlinePlus Medical Encyclopedia (no date). Available at: https://medlineplus.gov/ency/patientinstructions/000234.htm (Accessed: 5 April 2022).   Angioplasty and stent placement - peripheral arteries: MedlinePlus Medical Encyclopedia (no date). Available at: https://medlineplus.gov/ency/article/007393.htm (Accessed: 5 April 2022).   Cerino, V., July 15, U. public relations |, and 2015 (2015) Researchers study failed stents for peripheral artery disease, University of Nebraska Medical Center. Available at: https://www.unmc.edu/news.cfm?match=17216 (Accessed: 5 April 2022).   How Do Stents in Legs Help Unblock Arteries to Treat PAD? (no date). Available at: https://www.webmd.com/heart-disease/what-to-know-stents-legs-peripheral-artery-disease (Accessed: 5 April 2022).   Kerr, H.D. (1997) ‘Ureteral stent displacement associated with deep massage', WMJ: official publication of the State Medical Society of Wisconsin, 96(12), pp. 57–58.   Martin, R. et al. (2021) ‘Common Femoral Artery Stenting: Computed Tomography Angiography Based Long-Term Patency', Journal of Vascular Surgery, 74(2), p. 676. doi:10.1016/j.jvs.2021.05.003.   Peripheral Vascular Stent Insertion: Background, Indications, Contraindications (no date). Available at: https://emedicine.medscape.com/article/1839716-overview (Accessed: 5 April 2022). Schillinger, M. and Minar, E. (2009) ‘Past, present and future of femoropopliteal stenting', Journal of Endovascular Therapy: An Official Journal of the International Society of Endovascular Specialists, 16 Suppl 1, pp. I147-152. doi:10.1583/1545-1550-16.16.I-147.

Fixing coronary blockade without opening the chest is an attractive option to patients and their families… No surprise, Percutaneous coronary intervention PCI growing steadily since 1980s. 4 million PCIs are performed annually round the globe. A market size of 10 billion dollars!! What's the best practice in PCI? Access, Assessment, gadgets, adjunctive medications. Let's see what does the ACC/AHA guidelines recommend….

Olive oil, breastfeeding and CV health, informed consent during stroke, and controversy regarding revascularization guidelines are the topics John Mandrola, MD, covers in this week's podcast. This podcast is intended for healthcare professionals only. To read a partial transcript or to comment, visit: https://www.medscape.com/twic I – Olive Oil - Olive Oil Intake Tied to Reduced Mortality https://www.medscape.com/viewarticle/966366 - Consumption of Olive Oil and Risk of Total and Cause-Specific Mortality Among U.S. Adults https://www.jacc.org/doi/full/10.1016/j.jacc.2021.10.041 - Can Small Amounts of Olive Oil Keep the Death Away? https://www.jacc.org/doi/10.1016/j.jacc.2021.11.006 II – Breastfeeding and CV Maternal Health - Breastfeeding Linked to Lower CVD Risk in Later Life https://www.medscape.com/viewarticle/966767 - Breastfeeding Is Associated With a Reduced Maternal Cardiovascular Risk: Systematic Review and Meta‐Analysis Involving Data From 8 Studies and 1 192 700 Parous Women https://www.ahajournals.org/doi/10.1161/JAHA.121.022746 - Meta-analysis: pitfalls and hints https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868184/ III – Informed Consent - New Guidance on Consent in Acute Ischemic Stroke https://www.medscape.com/viewarticle/966889 - Consent Issues in the Management of Acute Ischemic Stroke https://n.neurology.org/content/98/2/73 - The Case Against Thrombolytic Therapy in Stroke https://www.medscape.com/viewarticle/895159 - tPA in Stroke: 'The Facts Are Clear' https://www.medscape.com/viewarticle/895370 IV – Controversy in Revascularization Guidelines - 'Incomprehensible' CABG Recommendation Raises Concerns https://www.medscape.com/viewarticle/966819 - Surgical Groups Push Back Against New Revascularization Guidelines https://www.medscape.com/viewarticle/966153 - Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration https://doi.org/10.1016/S0140-6736(94)91963-1 - Ten-Year Follow-Up Survival of the Medicine, Angioplasty, or Surgery Study (MASS II) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.911669 - What constitutes an appropriate empirical trial of antianginal therapy in patients with stable angina before referral for revascularisation? https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02045-6/fulltext - Initial Invasive or Conservative Strategy for Stable Coronary Disease https://www.nejm.org/doi/full/10.1056/nejmoa1915922 You may also like: Medscape editor-in-chief Eric Topol, MD, and master storyteller and clinician Abraham Verghese, MD, on Medicine and the Machine https://www.medscape.com/features/public/machine The Bob Harrington Show with Stanford University Chair of Medicine, Robert A. Harrington, MD. https://www.medscape.com/author/bob-harrington Questions or feedback, please contact news@medscape.net

Coronary revascularization; the bread and butter of modern cardiology practice and it got new guidelines! Jointly issued by the American Heart Association, American College of cardiology and the sky, and also reviewed by American Association for Thoracic Surgery, the guideline document was published simultaneously in JACC and in circulation less than a month ago. Noteworthy that these are first guidelines on the topic in 10 years. Several practice-changing trials were published in the same period.  This long-waited document comes to replace or retire five guidelines partially or totally, not only 2011 PCI and CABG guidelines, but also will replace sections in STEMI guidelines, ACS guidelines and stable IHD guidelines. So this is a document not to miss!

Interventional Cardiologist Behnam Tehrani and Interventional Radiologist Reha Butros from Inova Health System tell us about their team approach to endovascular treatment of chronic thromboembolic pulmonary hypertension (CTEPH) with Balloon Pulmonary Angioplasty (BPA). --- CHECK OUT OUR SPONSOR RADPAD® Radiation Protection https://www.radpad.com/ --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs: https://earnc.me/TCTEY3 --- SHOW NOTES In this episode, interventional radiologist Dr. Reha Butros, interventional cardiologist Dr. Behnam Tehrani, and our host Dr. Michael Barraza discuss chronic thromboembolic pulmonary hypertension (CTEPH) and medical, endovascular, and surgical treatment options for CTEPH. CTEPH affects patients of all different ages and medical histories. While it has been associated with prior pulmonary embolism, it can also arise in patients due to blood clotting disorders and infected pacemakers. Both Dr. Butros and Dr. Tehrani stress the importance of collaborating with pulmonary hypertension experts to identify CTEPH patients before right sided heart failure occurs. CTEPH is diagnosed with dual energy CT, which shows perfusion, and right heart catheterization, which measures blood pressure. The three treatment options discussed are medical management, balloon pulmonary angioplasty (BPA), and pulmonary thromboendarterectomy (PTE). Medical management is discussed as an initial treatment for CTEPH, while PTE can be appropriate for good surgical candidates. Finally, Dr. Butros and Dr. Tehrani present BPA as an appropriate treatment for patients of all ages. BPA over multiple sessions and increasing balloon size has been shown to be effective at promoting pulmonary artery remodeling and dilation. The doctors share their own experiences with learning BPA technique, noting that it has a learning curve, but it is ultimately rewarding when patients' quality of life is improved.

Dr. Nick West is the Chief Medical Officer and DVP Global Medical Affairs for Vascular at Abbott.  With the launch of the Ultreon software 1.0, Abbott is bringing a new level of analysis to their Optical Coherence Tomography intracoronary imaging tool. Nick explains, "And the idea of this software package is, on top of this best-in-class in terms of resolution imaging technology to help physicians, the Ultreon software augments physician decision-making to effectively enable them to do a better job, but more easily."  "Optical Coherence Tomography already existed. A very powerful tool, as I said. A very high degree of precision and accuracy in measurement. However, one of the issues with OCT is that, as well as understanding how to actually physically use the catheter, which is reasonably straightforward, it's very similar to other devices that interventional cardiologists use, but they then have to learn to interpret the images you get out. So acquiring the pictures is relatively straightforward, but then how do you interpret these detailed pictures?" "You still need to know how to use the catheter, but the Ultreon 1.0 software uses machine learning algorithms. That's artificial intelligence, if you like, where we've taught the software over hundreds and hundreds of different OCT pictures. We taught it - what is calcification? What is that hardened narrowing? And also, where is what we call the external elastic lamina?" @AbbottCardio #OCT #OpticalCoherenceTomography #angiograms #UltreonSoftware #medicalimaging #Angioplasty #coronaryhealth Abbott.com Download the transcript here

How do governmental vaccine mandates mirror an episode of the Twilight Zone I saw as a kid? How are officials going around the Constitution to censor freedom? What does "enlightened despotism" mean? The Bible teaches God is sovereign. Given evil's existence, how is that possible? Is God a puppet-master kind of king? What does belief in God's utter control do to social engagement?

Angiogram and Angioplasty at the Vascular Center... --- Support this podcast: https://podcasters.spotify.com/pod/show/dialysisdiaries/support

Stent, Angioplasty, Atherectomy, CABG and Peripheral Bypass Grafts

Welcome back to "The Wonder of the Stent", an original podcast series from Wondr Medical. In the 2nd episode of this season, we're continuing on the journey that Charles Dotters had set us on. At the time, a young physician called Andreas Grüntzig would attend a talk about "Dottering" at a clinical conference in Frankfurt. What he heard would blow him away, and lead him to go-on and shape the future of... the Stent. Discover more at Wondr Medical Stay up-to-date with Rohin This Podcast was inspired by Thomas Morris' book "The Matter of the Heart" - Available at all major retailers. If you enjoyed this podcast, make sure to subscribe so we can bring you more seasons of "The Wonder of" soon! Already craving another Podcast from Wondr Studios? Listen to our other new series "Abstract Heart" with Professor Chris Gale. Thanks for listening.

Would you like to know how to treat a blocked coronary artery using a guitar string, a rubber glove, a children's toy and a set of dentures? Introducing "The Wonder of the Stent", an original podcast series from Wondr Medical. In the first episode of this mini-series, we'll be taking a look at the mind behind one of the most effective and frequently performed procedures in modern medicine today: Percutaneous Coronary Intervention (PCI), or as it's known outside the hospital, Stenting. Discover more at Wondr Medical Stay up-to-date with Rohin This Podcast was inspired by Thomas Morris' book "The Matter of the Heart" - Available at all major retailers. If you enjoyed this podcast, make sure to subscribe so we can bring you more seasons of "The Wonder of" soon! Already craving another Podcast from Wondr Studios? Listen to our other new series "Abstract Heart" with Professor Chris Gale. Thanks for listening.

KYW Newsradio's Lynne Adkins talked about elective angioplasty with Dr. Ronald Fields, director of the cardiac catheterization lab at St. Mary Medical Center in Langhorne.​ See omnystudio.com/listener for privacy information.

Ep. 141 DEB vs. Balloon Angioplasty Alone for Dysfunctional HD Access with Dr. Eric Therasse by BackTable

Episode - 67 Dr. Taher is a practicing physician in Gadsden, Alabama. He was raised in Mumbai, India, and trained in family medicine at the Flower Hospital in Sylvania, Ohio. He was a physician, a couch potato, and a pampered consumer who feasted over the best foods without worrying about unhealthy consequences for most of his life. In August 2009, at the age of 61, open-heart surgery knocked at his door and his world came crumbling down.  Instead of wallowing in his troubles, he decided to completely change my life. A year after his bypass surgery, he undertook a mountaineering trek to Mount Kailash (altitudes of 19,000 feet) in Tibet.  In October 2011, he ran my first full marathon and in September 2012 he climbed Mount Kilimanjaro, the highest free-standing mountain in the world. If this episode doesn't get you pumped up to the possibilities for your life check your pulse… Contact Dr. Taher on his website: www.AkilTaher.com  Grab a copy of his book “Open Heart, The Transformational Journey of a Doctor Who, After Bypass Surgery at 61, Ran Marathons and Climbed Mountains”    Check Out Tim's Favorite, HIGHEST QUALITY Health Product Recommendations: Best Infrared Saunas & Healing Lamps: To Save $100 & learnCLICK HERE Water Purification/Restructuring System: Book FREE ConsultCLICK HERE Best Magnesium Product: Use code “HealthHero” save 10%CLICK HERE Pure Liposomal CBD Oral Drops, Salves & Eyedrops & Pets! CLICK HERE Best Non Toxic Home Building Materials: Save money CLICK HERE  Best Toxic Free Skin Care: Use code “HealthHero” save 15% CLICK HERE Non-Toxic Cleaning Products: Save $25 with this linkCLICK HERE  EMF & Radiation Blockers for Home & Vehicle: Save 5% CLICK HERE    See omnystudio.com/listener for privacy information.

This week we play a live podcast session from SCAI 2021 (April 30, 2021) on the topic of balloon angioplasty for native aortic coarctation in infants aged 3-12 months. We speak with the senior author of this recent work from Toronto Sick Children's Hospital - Professor Rajiv Chaturvedi. How often were complications encountered? How do results compare with surgical repair? Is high pressure required for these dilations? Professor Chaturvedi provides all the answers and more this week! doi: 10.1161/CIRCINTERVENTIONS.120.008938

Interview with Dr. Ruchit Shah, Cardiologist, IndiaLeaders from companies worldwide have expressed to me their confusion and concern around Covid 19- To help us clear many of our doubts and misconceptions and be on track for growth and good health we have with us today on this episode of The Payal Nanjiani  Leadership  Podcast - Dr Ruchit Shah who will talk to us about - Unmasking Covid- the facts you and your team must knowDr. Ruchit is a well-known Cardiologist Attached to Breach Candy, Jaslok, Saifee hospital. He is Trained in LA, the USA, and S. Korea. Dr. Shah specializes in Specialises in Angioplasty, Pacemaker, and Valve procedures. He has presented papers at national and international conferences. His motto is to give the best possible treatment to his patient.  Dr. Shah talks about:What are some of the most common myths about COVID-19✅How can we establish effective safety protocols at work?✅What steps can people take to build their immunity and stay healthy during the COVID-19 pandemic?✅What are some mental health concerns leaders must take care of during this time?……………………and much more.Live on any of your favorite podcast channels, on ALEXA and www.payalnanjiani.com

What do physicians and stent companies have to say for themselves, given that they are promoting expensive, risky procedures with no benefit?

Most heart attacks are caused by nonobstructive plaques that infiltrate the entire coronary artery tree. There is no such thing as “1-vessel disease,” “2-vessel disease,” or “left main disease.” Atherosclerotic plaque is continuous throughout the coronary arteries of heart attack victims.

There are demonstrably no benefits to the hundreds of thousands of angioplasty and stent procedures performed outside of an emergency setting. They don’t prevent heart attacks, enable you to live longer, or even help with symptoms any more than placebo (fake) surgery.

Talk to a Dr. Berg Keto Consultant today and get the help you need on your journey (free consultation). Call 1-540-299-1556 with your questions about Keto, Intermittent Fasting, or the use of Dr. Berg products. Consultants are available Monday through Friday from 8 AM to 10 PM EST. Saturday & Sunday from 9 AM to 6 PM EST. USA Only. Get Dr. Berg's Veggie Solution today! • Flavored (Sweetened) - https://shop.drberg.com/veggie-solution-flavored-sweetened?utm_source=Podcast&utm_medium=AGM(Anchor) • Plain (Unflavored) - https://shop.drberg.com/veggie-solution-plain?utm_source=Podcast&utm_medium=AGM(Anchor) Take Dr. Berg's Free Keto Mini-Course! Dr. Berg talks about stents and the cascade effect problems that occur when you get a stent. Angioplasty is a procedure where they put a thin tube that has a tiny balloon on the end through a blood vessel to restore blood flow through the artery. The problem with this is you'll develop a condition called restenosis or regrowing of the tissue. A stent is a metal mesh that goes into the arteries to create more space. The problem with the stent is also the regrowing of the tissue, not as much but still too high. Then they added the drug-eluting stent that causes another side effect which is called thrombosis or clotting. And then came up with another solution to fix the clotting by dual antiplatelet therapy that could still cause inflammations of the heart, the risk for bleeding increase, and more problems. Things to know: • It is not just a plumbing problem. • There is always an originating lesion or damaged arteries that starts the cascade effect in the first place where there is an inflammation • Nutrient Deficiency • Low Vitamin K2 • On Coumadin • High Insulin Vitamin K2 Dr. Eric Berg DC Bio: Dr. Berg, 51 years of age is a chiropractor who specializes in weight loss through nutritional & natural methods. His private practice is located in Alexandria, Virginia. His clients include senior officials in the U.S. government & the Justice Department, ambassadors, medical doctors, high-level executives of prominent corporations, scientists, engineers, professors, and other clients from all walks of life. He is the author of The 7 Principles of Fat Burning. FACEBOOK: fb.me/DrEricBerg?utm_source=Podcast&utm_medium=Anchor TWITTER: http://twitter.com/DrBergDC?utm_source=Podcast&utm_medium=Post&utm_campaign=Daily%20Post YOUTUBE: http://www.youtube.com/user/drericberg123?utm_source=Podcast&utm_medium=Anchor DR. BERG'S SHOP: https://shop.drberg.com/?utm_source=Podcast&utm_medium=Anchor MESSENGER: https://www.messenger.com/t/drericberg?utm_source=Podcast&utm_medium=Anchor DR. BERG'S VIDEO BLOG: https://www.drberg.com/blog?utm_source=Podcast&utm_medium=Anchor

In today's episode, I'll be sharing with y'all my third week of my ICU rotation which actually ended up taking me to both TOC and the cath lab! I share with you all my discharge counseling experience throughout the hospital and well as witnessing my first angioplasty. This week our cohort attended a conference about all things residency, I worked up my ICU team solely off the patient list, presented my journal club for my midpoint presentation, and so much more! Listen along as I take on ICU Week 3! --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

Modern pharmaceuticals and lifestyle change can be as effective as invasive coronary stents or cardiac surgery in addressing stable coronary artery disease, according to results from a landmark international clinical trial. Professor Joseph Selvanayagam who was a member of the research team talks to Kulasegaram Sanchayan. - தற்போது அறுவை சிகிச்சை செய்வதன் மூலம் மட்டுமே நலமடையலாம் என்ற பல இதய நோயாளிகள், இனிமேல் அறுவை சிகிச்சை செய்யாமலே, மருந்து மூலம் நலமடையலாம் என்று ஒரு பன்னாட்டு ஆராய்ச்சி கண்டறிந்துள்ளது. இந்த ஆராய்ச்சியில் ஈடுபட்டவர்களில் ஒருவரான ஆஸ்திரேலிய மருத்துவர், பேராசிரியர் ஜோசெஃப் செல்வநாயகம் தனது ஆராய்ச்சி குறித்தும் அவரது பின்னணி குறித்தும் குலசேகரம் சஞ்சயனுடன் உரையாடுகிறார்.

EJVES Editor's Choice

Commentary by Dr. Valentin Fuster

In this podcast, I’ll discuss the two main surgical methods of treatment for CHD; angioplasty and Coronary Artery Bypass Grafting (CABG). The term ‘angioplasty’ refers to the use of a balloon to stretch open a narrowed or blocked artery. Most modern angioplasty procedures involve the use of a stent, a small, metal mesh-like device that acts as a support or scaffold, in keeping the vessel open. CABG is a surgical procedure in which arteries or veins from elsewhere are grafted to the coronary arteries to bypass atherosclerotic narrowing and improve blood supply to the myocardium.

This week, we finish off our history of cardiac surgery. We invent two new procedures to deal with blockages in coronary arteries: one goes through the blockages, and the other goes around. Then, some brilliant folks invent pacemakers, and then implantable defibrillators. Check out our website!E-mail me!Say hi on Facebook!Transcripts and Sources here!

Recorded before the American Heart Association (AHA) Scientific Sessions 2019, Ankur is joined by Rasha K Al-Lamee, Interventional Cardiologist at Imperial College Healthcare NHS Trust in London and Study Director of the Objective Randomised Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) trial. Rasha talks about how she got into academia, the significance of her end-of-training PhD, and what led to the genesis of ORBITA. Ankur and Rasha also discuss the findings and unanswered questions of ORBITA, and how recent research in coronary revascularisation and stable ischemic heart disease has (or has not) changed their clinical practice. Finally, in anticipation of its presentation at AHA 2019, Rasha gives an overview of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA). Submit your question to Ankur via: podcast@radciffe-group.com. Hosted by @AnkurKalraMD. Produced by @RadcliffeCARDIO.

Paul talks with consultant cardiologist Dr Tom Keeble, about what happens in a catheter lab (cathlab). There are rules in the Cathlab, but fortunately it isn't the same as Fight Club so we can talk about them and Dr Keeble takes us through Angiograms, Angioplasty, Stents and the difference between an emergency patient an elective one. Dr Keeble is a consultant cardiologist and researcher at the Essex Cardiothoracic Centre, Southend Hospital and Anglia Ruskin University. If you enjoy listening to Dr Keeble check out episode #002, episode #007 or episode #021 where he talks more about his work, gives advice on medications and improving the future for those affected by a cardiac arrest. Presented by Paul Swindell and edited by Matt Nielson. Recorded November 2019 See acast.com/privacy for privacy and opt-out information.

In this episode, we discuss some basics of cardiovascular anatomy, physiology, disease states, testing and treatment. This is meant to provide basic information that will help in discussing cardiovascular health with your physician or your family. Anatomy and physiology. (Remember this is basic) The heart is a muscular organ that is the pump of the circulatory system. Blood comes into the heart from the lungs where it is resupplied with oxygen that is needed by all of our cells. The blood then goes back to the heart where this freshly oxygenated blood is pumped to the rest of the body. Arteries are the blood vessels that carry the fresh blood to the body and veins are the blood vessels that carry the blood that is now out of oxygen back to the heart. The heart, just like the other organs of the body, needs fresh blood to maintain health and function. The first arteries that leave the heart are called coronary arteries and these supply fresh oxygenated blood to the heart. Disease states (there are many others, remember this is very basic) When arteries of the circulatory system become diseased (narrowed and blocked due to plaque build up) the organs that are fed by these arteries suffer from poor circulation and are unable to function normally. Coronary artery disease (CAD), also called heart disease occurs when the coronary arteries become narrowed or blocked by plaque buildup. This leads to chest pain with activity, myocardial infarction (heart attack), and heart failure. Cerebrovascular disease is this process in the brain and leads to strokes. Peripheral arterial disease (PAD) is the same process in the legs and leads to pain with activity that improves with rest, poor wound healing, and amputations. Heart failure occurs when the heart cannot pump enough blood to keep up with the needs of the body. Testing EKG or ECG- electrocardiogram. This is a test and measure of electrical activity as it goes through the heart. It gives information about heart rate, heart rhythm, heart size, and blood supply. ECHO- echocardiogram. This is an ultrasound of the heart. It uses sound waves to evaluate how well the heart pumps and how well the valves work. It can also give indirect information about the pressures in the heart. Heart cath. This test is used to evaluate the blood supply to the heart, how well the heart is pumping and can measure the pressures in the heart. A catheter is placed in an artery in the groin and is threaded up to the heart. When in the right place, dye is injected and xrays are used to take images. Treatments Angioplasty or stent placement. This is used to treat coronary arteries that have decreased blood supply. Angioplasty is used to stretch area of narrowing and a stent is used to permanently open it. This is done through the heart cath procedure. Coronary artery bypass graft surgery, also called CABG. When a blockage of a coronary is too severe or there are multiple arteries affected a bypass surgery is performed. This is done by using blood vessels that are harvested from a different part of the body (usually the leg) and then surgically placing that piece of vessel above and below the blockage to go around or bypass it. Heart transplant. This is done to treat severe heart failure. --- Send in a voice message: https://anchor.fm/realhealthchats/message

In this episode we will discuss heart stents as a way of repairing clogged arteries. Stents help keep coronary arteries open and reduce the chance of a heart attack.  Our guest today is Mike M., a retired Fire Chief from the Suburbs of Chicago.  

This week we discuss the rationale for intervening for unilateral proximal PA stenosis with a stent or angioplasty. In the setting of normal RV function or pressure, are there exercise data to support intervening and if so, at what degree of maldistribution should such an intervention be considered? How should this decision be made? Is this safe? We review these and other questions with the first author of this work, Gurumurthy Hiremath MD who is the director of the pediatric catheterization laboratory at the University of Minnesota. doi: 10.1016/j.jcin.2018.11.042

This week we discuss the rationale for intervening for unilateral proximal PA stenosis with a stent or angioplasty. In the setting of normal RV function or pressure, are there exercise data to support intervening and if so, at what degree of maldistribution should such an intervention be considered? How should this decision be made? Is this safe? We review these and other questions with the first author of this work, Gurumurthy Hiremath MD who is the director of the pediatric catheterization laboratory at the University of Minnesota. doi: 10.1016/j.jcin.2018.11.042

In this interview, William Boden and Rasha Al-Lamee discuss insights from ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina), the first placebo-controlled trial of percutaneous coronary intervention in stable coronary artery disease.

This episode is underwritten by HealthIQ, and we couldn't be happier to have them! See, one of the things I'm so passionate about when I talk about how I use my ADHD to my advantage is exercise, right? It's obvious that a workout in the morning greatly boosts my brainpower and lets me use my faster brain to do great things. But here's the other benefit of exercise: Engagement in high-intensity exercise once per week decreases risk for cardiovascular mortality by 39% for men and 51% for women, and according to a 2009 Study in the International Journal of Sports Medicine, men who did high-intensity exercise have a 35% lower risk of all-cause mortality. For women the risk reduction is 44%. THAT'S HUGE. If you're exercising to improve how you manage your ADHD, AND you're getting the extra benefits of a much healthier body, then guess what: You should be paying less for your life insurance! That's where Health IQ comes in. Health IQ uses science & data to secure lower rates on life insurance for health conscious people including runners, cyclists, strength trainers, vegans, and more. 56% of Health IQ customers save between 4-33% on their life insurance, and these savings are exclusive to Health IQ. They save their customers up to 33% because physically active people have a 56% lower risk of heart disease, 20% lower risk of cancer and a 58% lower risk of diabetes compared to people who are inactive. Like saving money on your car insurance for being a good driver, Health IQ saves you money on your life insurance for living a health conscious lifestyle. Learn more and get a free quote at healthiq.com/FTN   Hello everybody and thank you for listening!  This week week we're visiting with former ADHD Cardiovascular Nurse/Clinician, Photographer, Artist, and current Theater Marketing/Promotions coordinator, Beth Manley.  I know right? That's a lot of stuff right there!  So, if you or a family member has ever dealt with ‘heart stuff' (not heartBreak.. our Valentine's Day episode has already come & gone this year), but real the nitty-gritty, surgery required type of stuff like- Angioplasty, Stents, Multiple Bypass- that kind of heart stuff- then I think you will appreciate Beth's unique view ‘from the other side'.  Please take care of yourself and enjoy this one!    In this episode, Peter and Beth talk about: 00:43- Thank you Health IQ for sponsoring this podcast! 2:41- Welcome and introducing Beth 3:18- How does one with ADHD bridge from being a “Cardiovascular Nurse and Clinician” to “Theater Marketing and Promotions Coordinator” at Dominican High School in Milwaukee, WI?  5:24- How did you go about dealing and preparing for such a high pressure job?  5:56- Putting in the time to accomplish what you need to accomplish 6:53- How did you avoid the fear of forgetting something or messing up, especially during one of the most traumatic moments of another family's life? 8:28- Facts, analogies, structure, making a photographic/illustrative bridge. 9:53- Keeping your brain engaged, focused and the art of adaptation. 11:21- Remember the phrase: She/He is such a type “A” personality? 12:28- Kinetic learning 14:20- When are you at your best? Should we be getting badges for multi-tasking, perhaps? 15:00- Photographer, Henri Cartier Bousson 15:50- States of flow. Varying your physical activities and how experimentation is never a waste. 16:45- How can we find you if we'd like to talk a little more Beth?  BethMalney@mac.com 17:00- Thank you Beth! 17:24- Faster Than Normal Podcast contact info and credits

Commentary by Dr. Valentin Fuster

Dr. C. Michael Gibson discusses the trial findings with Dr. Zuzana Motovska and Dr. Ota Hlinomaz at AHA 2017

Life can throw you curve balls and today's guest shares with us her family's journey in the world of special needs and how it's change her life.  Sue Bassett believes everything happens for a reason and decided early on to turn her obstacles into opportunities.  Listen to find out how Sue views change as she shares her story and provides tips on how to get through challenging times. In this episode: 2:45 - Meet Sue 7:57 - Sue talks about her journey with her daughter 10:34 - Open Heart Surgery, Angioplasty, 1500 needles, 32 blood transfusions, 400 tests and x-rays, 25 holidays in hospital and still smiling and laughing 13:38 - Life's hiccups and real talk about how she gets through 16:15 - Why she chooses to be "real" on social media 17:36 - Mother's intuition and her son's journey with being gifted, having a non-verbal learning disability and ADD 23:25 Sue talks about her decision to found Opening Hearts 30:19 How Sue has become a motivational speaker - Positively Sue 32:11 Sue talks about CHANGE - Choose Having Abundance New Growth Experiences   Connect with Sue www.positivelysue.com www.openinghearts.ca   Connect with Tracy www.palsnetwork.ca p.a.l.s@palsnetwork.ca www.tracysherriff.com  

The big thing now is: Fake News. On the political front, this is a huge problem, as our major media has capitulated almost entirely to the liberal side, and only broadcasts and prints stories that advance their own particular left wing agenda. Facts be damned! Fortunately, now we have the internet, and we can actually fact check what is being broadcast to us. We also have Fox news, which really is “Fair and Balanced”, as they advertise, and talk radio to tell us the other side, the real news. Fake Medical and Health news is just as real of a phenomenon, and keeps most of us totally in the dark as it concerns our health and well-being! As a paleo practitioner, you are probably becoming aware of this, if you don’t know it already. Ironically, the vast majority of traditional medical doctors dismiss the paleo lifestyle and diet completely; and do so without reading the recent research on the subject, the clinical trials, or anything else- just like those who follow the New York Times follow its dictates blindly, like lemmings, so too do most medical doctors, nurses, and everyone else follow 40 year old medical science just as blindly. Most heart procedures are not only incredibly expensive and dangerous, but they don’t really work as advertised. Only in a life threatening situation, where the patient has already had a heart attack are they helpful at all! As a preventive measure, for instance when the doctor’s “tests” lead him to pronounce that ‘Your arteries are 95% blocked,’ or some such statement, and then he says you need a stent to prop your arteries open. Well, that’s not how it works. If you go through with this incredibly dangerous procedure, and it you live through it, the benefits are very temporary. Your arteries will fill right back up, narrowing again. It’s kind of like bailing out a leaking boat, without first fixing the leak that the water is pouring in! You need to fix your lifestyle and diet- go paleo, in other words, and heal your body from the inside out- the body heals itself, not the physician. This goes for the drugs everyone is being sold- the statin drugs are toxic drugs with all kinds of side effects, and they are pushed to sell in the many billions of dollars. They are supposed to help control cholesterol, when it has been overwhelmingly shown that high cholesterol is not a problem for the vast majority. The drug sales just make the pharmaceutical companies, and the medical clinics, lots and lots of money! Even in small ways, you can avoid toxic drugs like aspirin and Tylenos, ibuprofen and all the other NSAID drugs that perforate your gut lining (just as does wheat!), and make you susceptible to all of the autoimmune diseases that are destroying our whole population. Take white willow bark if you need to treat pain; not only is it very effective, it is actually good for you- artificial aspirin is actually quite harmful, since it is an isolation of the acetylsalicylic acid that is one component of the white willow bark. If you take the whole product, instead of the chemically produced version, it is far gentler on your stomach and intestines, and actually a real food type of product. The main takeaway is to not take any drugs. Really- legal or illegal- they all have really bad side effects. ALL. And clean up your diet, getting rid of the grains and sugars, and the processed foods. Eat real, God-made foods, like pastured meats, dairy and eggs. LOTS of green veggies- a green smoothie is very helpful in this regard. Exercise daily, including lots of stretching, and do not run long distances or lift heavy weights- both will wear out your joints. Do bodyweight, and especially the Perfectly Paleo Exercise of virtual resistance exercise! Walk barefoot, and rebound daily as part of your morning routine. Sleep 8-9 hours per night. Use intermittent fasting on a regular basis, practice not eating skipping supper, or breakfast, or both.

Hello and welcome to the Health Hits podcast. Today we’ll be learning about heart attack, how the heart works and some of the pioneers of modern medical techniques, including an inspiring guitarist. The podcast covers common medical issues, how they develop and how to treat them. It explores the history of medicine and looks to future advances.

Angioplasty and stents, how do you know if that's enough or if you are going to need open heart surgery. Dr. Stephen Chan will help to sort it all out. He's an invasive cardiologist at Kaiser Permanente and will be sharing his expertise on how to treat a blockage, and what happens if you need to have a surgery.

Commentary by Dr. Valentin Fuster

Death of the stethoscope? Mike Malin demonstrates the power of bedside ultrasound, unique applications, and future directions.

Hugh Marcus from the University of Cambridge discussing a Review on stroke and TIA in the posterior territory.

Dr. Matthew Certain. Andreas Gruentzig, Angioplasty & Emory: A History. Recorded 2013-02-22.

From Living Torah (Volume 64, Episode 256)The Lubavitcher Rebbes were emphatic that children be taught the Hebrew letters and vowels separately, and only afterwards how to pronounce them together — for example, to recite: "Kumatz-Alef — Uh". Each individual letter, vowel and sound was given at Sinai, and therefore, each must be articulated in its own right.My father-in-law explained the meaning of Kumatz-Alef — Uh: It instills within the child the first letter of the Ten Commandments, the Alef of “Anochi — I am the Lord your G-d.” “Anochi” encapsulates the whole first Commandment, which encapsulates all Ten Commandments, which encapsulate the entire Written Torah, which includes the entire Oral Torah… This is all included in the Alef of "Anochi."The letters of "Anochi" themselves form initials: "Ana Nafshi Ksovis Yehovis – I have inscribed and given My Soul in Torah.” The Alef of "Ana — I” refers to G-d A-lmighty’s very Essence. At that level vowels are entirely immaterial, for a vowel is already commentary on the letter. Children, therefore, must first be given the chance to absorb the Alef on its own — representing G-d’s absolute oneness, and this forms the very foundation of their Judaism. Also in this Episode:* Reb Levik’s Niggun* Angioplasty* Kumatz-Alef — Uh

Peripheral Arterial Disease (PAD) treatment topics covered are Medications, Angioplasty, Bypass Surgery, and Thrombolytic Therapy. (January 2009)

Mark Hlatky discusses the research article comparing bypass surgery with PCI for coronary artery disease.

David Wood discusses the EUROASPIRE III study, highlighting the need for greater prevention efforts for cardiovascular disease.

Guest: William S. Weintraub, MD, MACC, FAHA, FESC Host: Matthew J. Sorrentino, MD, FACC, FASH The COURAGE trial suggested that optimal medical therapy and angioplasty are equivalent in reducing major cardiovascular events for patients with coronary artery disease. Dr. William Weintraub, the John H. Ammon Chair of Cardiology and director of the Center for Outcomes Research at the Christiana Care Health System in Newark, Delaware, will describe his research on the impact of angioplasty on the quality of life for participants in the COURAGE trial and show that the patients with severe angina received the greatest benefit from angioplasty. Hosted by Dr. Matthew Sorrentino

Guest: William S. Weintraub, MD, MACC, FAHA, FESC Host: Matthew J. Sorrentino, MD, FACC, FASH The COURAGE trial showed no substantial difference in cardiovascular outcomes among patients who received either optimal medical therapy or optimal therapy plus a percutaneous intervention. Dr. William Weintraub, professor of medicine at Chrisitana Care Health System in Newark, Delaware, describes his cost-benefit analysis of this trial and how cost effectiveness should be measured and evaluated in this patient population. Hosted by Dr. Matthew Sorrentino.

Interview with Dr van't Hof on tirofiban administered in the ambulance setting after myocardial infarction.

Drug-eluting stents revolutionised interventional cardiology owing to their pronounced ability to reduce restenosis compared with bare-metal stents. Attention has now shifted to safety of these devices because of evidence suggesting an association with late stent thrombosis. In a review, Anthony Bavry and Deepak Bhatt assess current evidence from randomised trials, and propose guidelines for the appropriate use of drug-eluting stents in clinical practice. Deepak Bhatt discusses the history of stents and assesses our current knowledge and considers treatment options for cardiologists and patients in this week's podcast.

A review highlights how moderate hypothermia - reducing core body temperature to around 35C - is underused in clinical practice after traumatic events such as heart attack, stroke, and traumatic brain injury. Author Kees Polderman discusses the potential of moderate hypothermia in this week's podcast.

Audio Journal of Cardiovascular Medicine, November 6th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Eptifibatide as Effective as Abciximab in Primary PCI for Acute ST Elevation Myocardial Infarction: EVA-AMI Study UWE ZEYMER, Herzzentrum Ludwigshafen, Germany REFERENCE: Late Breaking Clinical Trials Session 1 The glycoprotein 2B 3A antagonist eptifibatide has performed as well as standard abciximab therapy in patients receiving primary angioplasty for acute myocardial infarction. So according to Uwe Zeymer who presented findings on this it can be used in this setting just as it is already being used in elective PCI. Sarah Maxwell interviewed Dr Zeymer at the Orlando conference.

Audio Journal of Cardiovascular Medicine, November 5th, 2007 Reporting from: American Heart Association Scientific Sessions, 4-7 November, 2007, Orlando, Florida Stable Angina: Add PCI To Medical Therapy If Guided by SPECT-Detected Ischemia? COURAGE Nuclear Sub-Study Results LESLEE SHAW, Emory University, Atlanta COMMENT: DANIEL JONES, AHA President, University of Mississippi, Jackson REFERENCE: Late Breaking Clinical Trials, Session 1 Some patients with stable angina may be best treated by adding percutaneous intervention to optimal medical therapy. This is the finding of a "nuclear sub-study" of the COURAGE (Clinical Outcomes Using Revascularization and Aggressive Drug Evaluation) trial. Although the study found no benefit of adding angioplasty in most patients, the AHA conference heard from Leslee Shaw that if myocardial ischemia is monitored using Single Photon Emission Computed Tomography (SPECT), there could be a role for angioplasty in a subgroup of patients. Peter Goodwin talked with Dr Shaw after her presentation and then asked the American Heart Association President, Daniel Jones, for his assessment.

Dr. Das on Angioplasty: Does it lack value or is medication better You saw the headlines this week saying that angioplasty, the 'artery-opening operation' that thousands of Americans have done every year, lacks value, that it is no better than just taking medication. Today, as Paul Harvey would say, it is time for the rest of the story.  Our special guest, Dr. Tony Das, is one the top cardiologists in the country. He will explain in detail what was right and what was wrong with the study, and more importantly, what you need to know as a patient or as a potential patient.

Audio Journal of Cardiovascular Medicine Reporting from American College of Cardiology, New Orleans, March 24-27, 2007 "COURAGE" Trial Assessed: New Guidelines for Patients with Stable Coronary Disease? REFERENCE: ACC 2007 & N Engl J Med 356: March 2007 HARVEY WHITE, Auckland City Hospital The finding from the COURAGE trial: that angioplasty adds no benefits to optimal medical therapy alone for patients with stable coronary disease, should give pause for thought among clinicians all over the world, according to Harvey White, who discussed the new data with Peter Goodwin.

Audio Journal of Cardiovascular Medicine The Wingspan Stent: Safe Intra-Cranial Angioplasty? REFERENCE: Abstract 102 FELIPE ALBUQUERQUE, Barrow Neurological Institute, Phoenix The Wingspan stent is a new approach to keeping open the atherosclerotic intracranial vessels of stroke and TIA patients. Early results presented to the San Francisco Conference suggest that it doesn’t harm patients, but that it seemed to block fairly quickly, Felipe Albuquerque talked to Helen Morant about these much anticipated results.