Podcasts about stents

"It's not entirely unique to IR, but it's something that's encountered more because it is so fast-moving, and it's what kind of drew me into the specialty. But having done this project has given me a new perspective on the importance of good, quality research and engaging with it."—Hayley Briody, MB, BCh, MSCIn this Journal of Vascular and Interventional Radiology (JVIR) audio episode, lead author Hayley Briody, MB, BCh, MSC, speaks with journal Managing Editor Ana Lewis about her October 2024 paper, Mortality, Safety, and Effectiveness of Paclitaxel-Containing Balloons and Stents in the Femoropopliteal Artery: Systematic Review and Meta-Analysis of Randomized Controlled Trials since 2018."Related resources:Read the original article, "Mortality, Safety, and Effectiveness of Paclitaxel-Containing Balloons and Stents in the Femoropopliteal Artery: Systematic Review and Meta-Analysis of Randomized Controlled Trials since 2018," by Haley Briody, MB, BCh, MSc; Conor A. Kearns, BA (Mod), MSc, MRes; and Michael J. Lee, MB, BCh, MScRead the related commentary, "Paclitaxel Meta-Analyses in the Lower Limbs: Missing the Trees for the Forest," by Konstantinos Katsanos, MD, PhDContact 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

Darshan H. Brahmbhatt, Podcast Editor of JACC: Advances, discusses a recently published meta-analysis of 3-year outcomes of drug-coated balloons versus drug-eluting stents for small-vessel coronary artery disease.

This recording features audio versions of October 2024 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Mortality, Safety, and Effectiveness of Paclitaxel-Containing Balloons and Stents in the Femoropopliteal Artery: Systematic Review and Meta-Analysis of Randomized Controlled Trials since 2018 ReadEffect of Filtered Blood Return on Outcomes of Pulmonary Aspiration Thrombectomy ReadThe Predictive Value of Qanadli and Miller Index Scores in Patients with Intermediate-High–Risk and High-Risk Pulmonary Emboli Undergoing Aspiration Thrombectomy ReadImageable Radioembolization Microspheres for Treatment of Unresectable Hepatocellular Carcinoma: Interim Results from a First-in-Human Trial ReadMagnetic Resonance Imaging–Guided Cryoablation of Prostate Cancer Lymph Node Metastasis ReadCorrelation of Ablation Volume with Renal Function Loss after Cryoablation in Solitary Functioning Kidneys ReadIntra-arterial Pressure-Enabled Drug Delivery Significantly Increases Penetration of Glass Microspheres in a Porcine Liver Tumor Model ReadJVIR and SIR thank all those who helped record this episode:Host:Manbir Singh Sandhu, University of California Riverside School of MedicineAudio editor:Sonya Choe, University of California Riverside School of MedicineAbstract readers:Melissa Millett, MD, Southeast HealthSonya Choe, University of California Riverside School of MedicineAlena Khalil, Nova Southeastern University Dr. Kiran Patel College of Osteopathic MedicineAndrew Brandser, Frank H. Netter MD School of MedicineMark Oliinik, Loma Linda University School of MedicineDaniel Roh, Loma Linda University School of MedicineMillennie Chen, University of California Riverside School of MedicineSupport the showSupport the show

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Jack and David consider the fracturing of the Audioverse all through the Podverse as 20th Season continues with "The Fourth Ambit" episode 1: Stents, part 2 and a very special Sonic Workshop Bonus! Learn more about your ad choices. Visit megaphone.fm/adchoices

Jack and David consider the fracturing of the Audioverse all through the Podverse as 20th Season continues with "The Fourth Ambit" episode 1: Stents, part 2 and a very special Sonic Workshop Bonus! Learn more about your ad choices. Visit megaphone.fm/adchoices

Jack and David mourn the loss of the TORDIS and consider that the audioverse has already forgotten about the Sonic Society. The 20th Season begins with the Audie bringing us "The Fourth Ambit" episode 1: Stents, part 1! Learn more about your ad choices. Visit megaphone.fm/adchoices

Jack and David mourn the loss of the TORDIS and consider that the audioverse has already forgotten about the Sonic Society. The 20th Season begins with the Audie bringing us "The Fourth Ambit" episode 1: Stents, part 1! Learn more about your ad choices. Visit megaphone.fm/adchoices

The use of drug-coated balloons (DCBs) for peripheral arterial disease has been controversial in the past. However, new data and updated FDA guidance have helped these devices regain popularity. In this episode of the BackTable Podcast, Dr. Ally Baheti hosts a discussion with Dr. Sahil Parikh, an interventional cardiologist in New York City, and Dr. John Park, a vascular surgeon in Omaha. --- CHECK OUT OUR SPONSOR BD Lutonix https://www.bd.com/en-us/products-and-solutions/products/product-families/lutonix-drug-coated-balloon-pta-catheters --- SYNPOSIS They review the historical controversy surrounding the potential late-mortality risks associated with Paclitaxel-coated devices, discuss more recent literature on the safety and efficacy of DCBs, and examine the implications of the FDA's updated guidance in 2023. This update was made possible through collaborative efforts across specialties and regulatory bodies to establish best practices for vascular interventions. They also delve into patient selection criteria, lesion characteristics, and practical considerations for choosing between DCBs and other revascularization options. Each provider shares their treatment algorithm for DCB use in peripheral arterial disease. Dr. Park uses DCBs as a first-line treatment for patients with complete occlusions, CLTI symptoms, or lifestyle-limiting claudication, with adjunctive stenting sometimes required afterwards. In his experience, DCBs work best in lesions shorter than 100 mm and are preferable in locations where stenting is not feasible, such as across the knee joint. Dr. Parikh similarly prefers DCBs over plain balloon angioplasty and places stents in longer lesions. He notes that Hunter's canal is a challenging area to treat with DCBs alone and may require atherectomy or intravascular lithotripsy. He recommends considering drug-eluting stents as a proactive measure to prevent more costly interventions for future restenosis. --- TIMESTAMPS 00:00 - Introduction 02:14 - History of DCB and Controversy 07:46 - Updated Research and 2023 FDA Guidelines 16:44 - Importance of Collaboration and Patient Preference 26:34 - DCB Treatment Algorithms 33:31 - Drug-Eluting Stents 35:46 - Approach for Patients with Claudication 37:22 - DCB Sizing and Dose --- RESOURCES Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials (2018): https://www.ahajournals.org/doi/10.1161/JAHA.118.011245 FDA- Treatment of Peripheral Arterial Disease with Paclitaxel-Coated Balloons and Paclitaxel-Eluting Stents Potentially Associated with Increased Mortality–Letter to Health Care Providers (2018): www.fda.gov/medical-devices/letters-health-care-providers/update-treatment-peripheral-arterial-disease-paclitaxel-coated-balloons-and-paclitaxel-eluting FDA- Paclitaxel-Coated Devices to Treat Peripheral Arterial Disease Unlikely to Increase Risk of Mortality - Letter to Health Care Providers (2023): https://www.fda.gov/medical-devices/letters-health-care-providers/update-paclitaxel-coated-devices-treat-peripheral-arterial-disease-unlikely-increase-risk-mortality Mortality in randomised controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis (2023): https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/abstract

Toni Sant presents the 677th in a series of podcasts featuring music by performers in or from Malta. Artists featured in this podcast: PART 1Avenue Sky - EternitàThe JoyGivers - Fir-Ramla l-ĦamraThe Stents - Over the MoonAidan - HeroWalletking - Jail On My MindRobert Farrugia + Welleda Muller - Long Wait (Medieval Rework)PART 2Mr. M - Let GoMr. M - Genesis live set in GdanskPART 3Featured album:  Reroot by Eyes to Argus >> Details about this podcast [in Maltese] See also: - MMI Podcast: YouTube playlist - MMI Podcast: Facebook Page - MMI Archive on Mixcloud | @tonisant on Twitter - M3P: Malta Music Memory Project - Mużika Mod Ieħor ma' Toni Sant on Facebook (MP3)

“Se podrían apagar los monitores en caso de no llegar a un acuerdo: por 2 días no se colocarían stents ni se practicarían angioplastias en Argentina”. Con esta frase, los cardiólogos intervencionistas, pertenecientes al Colegio Argentino de Cardioangiólogos Intervencionistas (CACI), anunciaron la medida que tendrá lugar el próximo 13 y 14 de agosto. “Este llamado de atención va a ser en las prácticas que son programadas. La gente no va a dejar de estar atendida en lo que es la urgencia”, aclaró a Infobae el doctor Alfredo Bravo (MN 70.119), vicepresidente del Colegio Argentino de Cardioangiólogos Intervencionistas (CACI). En ese sentido, el doctor Juan José Fernández (MN 79.510), también vicepresidente del CACI, agregó: “Esto es una continuación de la problemática que, hace un mes y medio aproximadamente, ya habíamos planteado: nos vamos a quedar sin cardiólogos intervencionistas que coloquen stents. La situación es bastante grave”. Pablo Díaz, cardiólogo de nuestra ciudad, pasó por el aire de Radio 5 para hablar sobre esta realidad que le toca vivir a él y mucho colegas en todo el país.

In this episode of the DeviceTalks Weekly podcast, Host Tom Salemi speaks with Dr. Janar Sathananthan, chief medical officer of Boston Scientific's interventional cardiology therapies business about the coronary artery disease, stenting and its AGENT drug-coated balloon. This episode is sponsored by Freudenberg Medical. For more information, please visit www.freudenbergmedical.com. MassDevice's Chris Newmarker and Sean Whooley join the Newmarker's Newsmakers section to talk about the big MedTech story of the week as well as the news coming out of the American Diabetes Association annual meeting. Salemi also shares some thoughts from the Annual Meeting of the Society of Robotic Surgery. Thank you for listening to the DeviceTalks Weekly Podcast. Subscribe to the DeviceTalks Podcast Network so you don't miss an episode.

Entrevistado: Marcelo Hatanaka Apresentador: Rafael Arantes Nosso convidado para esse bate-papo e altíssimo nível é o Dr. Marcelo Hatanaka, que explica de maneira objetiva aspectos como Goniotomias, Stents e MIBS, Ciclofotocoagulação micropulsada, Dispositivos filtrantes entre outros.

Si eres una persona interesada en la innovación médica y la IA, tienes que escuchar este episodio. En el episodio de esta semana hablamos con Oriol Iborra, doctor y co-fundador de Nimble Diagnostics. Oriol, además de ser un experto en cardiología, también es un innovador que está transformando la forma en que se monitorean los stents cardiovasculares. Si algo destaca en Oriol es su capacidad de combinar tecnología avanzada con cuidado clínico para mejorar la vida de los pacientes. En esta charla vas a descubrir cómo: Una tecnología no invasiva puede evaluar stents en segundos. La información precisa puede prevenir complicaciones cardíacas. La colaboración entre ciencia y medicina está revolucionando el cuidado de la salud. Estos son los momentos más importantes de la charla: [00:00] - Introducción [00:03:03] - Problemas actuales en el monitoreo de stents. [00:06:04] - Enfoque reactivo en el monitoreo de stents. [00:10:11] - Tecnología "wave" como solución. [00:12:26] - Interpretación de resultados del monitoreo. [00:14:05] - Empoderamiento de pacientes. [00:14:34] - Implementación progresiva en hospitales. [00:25:53] - Origen y colaboración del proyecto. [00:27:15] - Desarrollo y financiación inicial. [00:28:38] - Proceso de desarrollo de la tecnología. [00:29:42] - Importancia de las ayudas públicas. [00:30:33] - Decisión de emprender. [00:32:18] - Recomendaciones para emprendedores. [00:33:53] - Inestabilidad laboral y riesgos. [00:57:21] - Diferencias de financiación entre Europa y EE. UU. [00:59:20] - Financiación pública y privada. [01:00:07] - Costos de desarrollo y ayudas públicas. [01:02:25] - Valor potencial de la tecnología. [01:04:52] - Estrategias de crecimiento. [01:05:59] - Inteligencia artificial en la salud. [01:09:57] - Beneficios de la IA en medicina. ….. Dale al play y disfruta de la escucha Linkedin Orio Iborra:  https://www.linkedin.com/in/oriol-iborra-egea-phd-52144593/?originalSubdomain=es ✅ Este podcast está patrocinado por Growth Hacking Course (https://www.growthhackingcourse.io/curso-online)

durée : 00:02:38 - Des stents magiques à l'hôpital de Saint-Nazaire

Glaucoma Stents have been around for a few years now but maybe not every person who has Glaucoma knows about the treatment and how it helps to drain some of the extra fluid that builds up in patients eyes.  RNIB Connect Radio's Toby Davey was joined by Leon Au, consultant ophthalmologist from Manchester Royal Eye hospital who is also a member of the Glaucoma UK Clinical Advisory Panel to explain a bit more about Glaucoma stents and how the treatment helps people with Glaucoma. To find out more about Glaucoma Stents do call the Glaucoma helpline on 01233 64 81 70, email helpline@glaucoma.uk or visit their website - https://glaucoma.uk   (Image shows RNIB logo. 'RNIB' written in black capital letters over a white background and underlined with a bold pink line, with the words 'See differently' underneath)

Physiological Performance of Drug-Coated Balloons or Drug-Eluting Stents in Small Coronary Arteries: The PICCOLETO II UFR Study

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

N Engl J Med 2008; 358:2218-2230Background The use of percutaneous coronary intervention (PCI) is associated with improved outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Nonetheless, there was a need to further improve survival rates. As seen in OASIS-6, the 30-day mortality in the control arm was still high at 8.9%. Glycoprotein IIb/IIIa inhibitors emerged as a potential solution. US clinicians widely adopted these agents; their use soared to over 90% of STEMI cases undergoing primary PCI. But IIb/IIIa inhibitors increase the risk of bleeding and thrombocytopenia.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Bivalirudin, a direct thrombin inhibitor, has been shown to reduce bleeding when used instead of heparin plus glycoprotein IIb/IIIa inhibitors in patients with ACS without ST segment elevation. The Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial sought to test the hypothesis that bivalirudin is superior to the combination of heparin plus glycoprotein IIb/IIIa inhibitors in patients with STEMI who were undergoing primary PCI.Patients Patients were enrolled if they were within 12 hours from the onset of symptoms and had ST-segment elevation of 1 mm or more in two or more contiguous leads, new left bundle-branch block or had posterior myocardial infarction. There were numerous exclusion criteria including bleeding diathesis, coagulopathy, intracerebral mass, prior hemorrhagic stroke, platelet count< 100,000 cells/ ml, hemoglobin< 10 g/dl plus many more.Baseline characteristics The trial enrolled 3,602 patients. The average age of patients was 60 years and 77% were men. About 53% had hypertension, 43% had hyperlipidemia, 16% had diabetes, 11% had prior myocardial infarction and 46% were current smokers. The majority of patients were stable, with 91.5% classified as Killip class I. Primary PCI was performed in about 93% of the patients and coronary artery bypass graft surgery in 1.7%.Heparin before coronary angiography was administrated in 76.3% in the heparin plus glycoprotein IIb/IIIa inhibitor arm and 65.8% in the bivalirudin arm. During coronary angiography heparin was administered in 98.9% patients in the heparin plus a glycoprotein IIb/IIIa inhibitor arm and 2.6% in the bivalirudin arm. Glycoprotein IIb/IIIa inhibitors were given to 94.5% patient in the heparin plus glycoprotein IIb/IIIa inhibitors arm and 7.2% in the bivalirudin arm.Procedures The trial was open-label and patients were randomly assigned 1:1 to receive unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor or bivalirudin alone. Heparin was administered to keep activated clotting time of 200 to 250 seconds. An initial intravenous bolus of 60 IU/ kg was given followed by boluses as needed. Bivalirudin was administered intravenously with an initial bolus of 0.75 mg/kg followed by an infusion of 1.75 mg/kg/hour. A glycoprotein IIb/IIIa inhibitor was administered before PCI in all the patients in the heparin group. It was also administered in selected patients in the bivalirudin group if there was no reflow or there was a large thrombus after PCI. The main glycoprotein IIb/IIIa inhibitors used were abciximab or eptifibatide.Endpoints The study had two primary endpoints at 30-days. The first endpoint was major bleeding not related to coronary artery bypass graft surgery. The second endpoint was a composite endpoint of major bleeding, all-cause death, reinfarction, target-vessel revascularization for ischemia or stroke.Analysis was performed based on the intention-to-treat principle. Assuming a 30-day event rate of 9% for the first endpoint and 12% for the second endpoint in the heparin plus glycoprotein IIb/IIIa inhibitor group and 6% for the first endpoint and 9% for the second endpoint in the bivalirudin group, a sample size of 1,700 patients in each group would have 99% power to show superiority of bivalirudin for the first endpoint and 80% power for the second endpoint.Results The study randomized 1,802 patients to the heparin plus glycoprotein IIb/IIIa inhibitor group and 1,800 patients to the bivalirudin group.The first primary endpoint was significantly lower with bivalirudin (4.9% vs 8.3%, RR: 0.60, 95% CI: 0.46 - 0.77; p

DISCLAMER >>>>>>    The Ditch Lab Coat podcast serves solely for general informational purposes and does not serve as a substitute for professional medical services such as medicine or nursing. It does not establish a doctor/patient relationship, and the use of information from the podcast or linked materials is at the user's own risk. The content does not aim to replace professional medical advice, diagnosis, or treatment, and users should promptly seek guidance from healthcare professionals for any medical conditions.                                                  >>>>>> The expressed opinions belong solely to the hosts and guests, and they do not necessarily reflect the views or opinions of the Hospitals, Clinics, Universities, or any other organization associated with the host or guests.                                                                                  Disclosures: Ditch The Lab Coat podcast is produced by (Podkind.co) and is independent of Dr. Bonta's teaching and research roles at McMaster University, Temerty Faculty of Medicine and Queens University. Welcome back to "Ditch the Labcoat," where today we debunked heart health myths with the remarkable Dr. Michael Ward. Did you know stress can literally break your heart? Dr. Ward broke down the realities of Takatsubo cardiomyopathy, stressed the importance of timely intervention in heart attacks, and shared his insights on the Mediterranean diet for cardiac wellness. Plus, we got a glimpse into the high-stakes world of interventional cardiology—straight from the operation room. Stay heart-smart and catch the full episode for a deep dive into the art and science of keeping your ticker ticking! Remember, a healthy heart is a healthy start. Don't miss it!00:00:03 Understanding Takotsubo Cardiomyopathy and Broken Heart Syndrome with Dr. Michael WardDr. Mark Bonta discusses Takotsubo cardiomyopathy, also known as broken heart syndrome, with Dr. Michael Ward. They explore how the condition is often triggered by emotional stress, such as the loss of a loved one, leading to acute heart failure.00:01:03 Discussion on the Heart as a Muscle and Cardiac ConditionsDr. Michael Ward discusses the heart as a muscle that pumps and the various cardiac conditions patients may face, such as heart attacks, heart failure, and heart rhythm problems. The conversation emphasizes the importance of understanding the basic function of the heart for better management of cardiac health.00:02:26 Discussion with Dr. Michael Ward on Interventional Cardiology and Hypertrophic CardiomyopathyDr. Michael Ward is an expert in interventional cardiology who helps people prevent and recover from heart-related issues. He also focuses on hypertrophic cardiomyopathy, a genetic condition affecting the heart. With a background in both medicine and research, he is a valuable asset at Western University in London, Ontario.00:03:50 Interview with Dr Michael Ward, Interventional CardiologistDr. Michael Ward, an interventional cardiologist with both an MD and a PhD, discusses his background in cell-based gene therapy and his interest in cardiovascular medicine. He shares insights on heart health, the importance of vacations for mental health, and his balanced lifestyle.00:07:18 Insight into the Fascinating Aspects of the Heart from an Interventional Cardiology PerspectiveDr Mark Bonta, an interventional cardiologist, shares his perspective on the intricate nature of the heart, highlighting how it responds to various stimuli and stressors. He emphasizes the role of the cardiovascular system in determining life and death outcomes and the potential for improving quality of life through cardiology interventions.00:11:14 Discussion on Interventional CardiologyDr. Mark Bonta discusses their work in interventional cardiology, including responding to emergencies like heart attacks and performing procedures in the catheterization laboratory. They describe the challenges faced by patients with heart conditions and the range of cases they handle.00:13:26 Understanding Cardiovascular System with Dr. Michael WardDr. Michael Ward talks about atherosclerosis as the accumulation of plaque in the arteries, which can lead to heart issues like angina and heart attacks. The discussion also touches on the difference between chronic accumulation of plaque and acute blockages causing heart attacks.00:18:01 Understanding Acute Heart Attacks and Plaque Ruptures in ArteriesAcute heart attacks can occur when plaque ruptures inside an artery, leading to a clot that blocks the artery and causes the heart attack. Platelets play a crucial role in responding to the rupture and forming clots to heal the affected area.00:19:44 Importance of Timely Intervention in Heart AttacksDuring a conversation between Dr. Mark Bonta and Dr. Michael Ward Interventional Cardiology, they discussed the critical importance of timely intervention in heart attacks. Dr. Bonta mentioned that when a heart attack occurs, time is of the essence as the muscle of the heart is deprived of blood flow. Historically, patients were given aspirin and blood thinners but no interventional procedures were done immediately.00:21:20 Advanced Cardiac Care Protocols in CanadaIn Canada, there are advanced protocols in place for managing ST-elevation myocardial infarction (STEMI) cases, including direct ambulance transportation to hospitals with cath labs. Time is crucial in treating cardiac emergencies to minimize heart muscle damage.00:23:51 Patient Experience in the Cath Lab: What to ExpectThe patient experience in the cath lab involves inserting a needle with a wire into their arteries, either through the wrists or groin. Patients may not feel much during the procedure, but there might be some sensations of discomfort or awareness of the procedure taking place.00:26:56 Understanding the Process of Opening Blocked Heart VesselsIn the conversation between Dr Mark Bonta and Dr Michael Ward Interventional Cardiology, they discuss the process of opening blocked heart vessels during angioplasty procedures. They talk about using topical lidocaine for anesthesia and how temporary discomfort may be felt when the blockage is being opened up. Dr Ward explains that a stent is not a rigid pipe but a meshwork that is placed in the living system of the coronary artery.00:29:41 Understanding Interventional Cardiology and StentingInterventional cardiology involves using contrast dye and x-ray cameras to map arteries and identify blockages. Stents are used to provide support and prevent arteries from narrowing, improving blood flow to the heart muscle. The decision to place a stent is based on the degree of blockage and the impact on blood flow.00:34:10 Discussion on Heart Health Interventions and Medical ManagementThe conversation between Dr. Mark Bonta and Dr. Michael Ward Interventional Cardiology delves into the topic of heart health interventions and the importance of medical management in cardiac care. They discuss the limitations of interventions like stents in treating moderate blockages and emphasize the significance of lifestyle changes and medications in preventing heart attacks and strokes.00:38:32 Preventing Cardiovascular Disease Through Exercise and MedicationsDr. Mark ...

Join me on the Flex Diet Podcast as I sit down with the esteemed cardiologist Dr. Michael Twyman to tackle the vital subject of cardiovascular health and the power of early risk detection. We discuss the significance of functional testing and specific scans that could revolutionize your approach to heart disease prevention. Listen in as Dr. Twyman shares his transformation from invasive to preventative cardiology and learn about the essential tests he recommends for gaining invaluable insights into your heart health.For Dr. Twyman's top 4 takeaways, go to https://miketnelson.com/flex4. Special thanks to Flex Diet Podcast sponsor LMNT. Choose LMNT for all your hydration needs. Check out https://drinklmnt.com/mikenelson.Episode Chapters:(0:00:00) - Cardiovascular Health and Early Detection(0:06:22) - Cardiovascular Risk and Plaque Development(0:12:37) - Understanding Heart Health and Cholesterol(0:19:13) - Understanding Lipoproteins and Cardiovascular Health(0:27:54) - Functional Testing for Arterial Health(0:36:32) - Nitric Oxide and Arterial Health(0:44:18) - Understanding the Calcium Score Test(0:50:34) - The Importance of Circadian Rhythms(1:00:47) - Optimal Red Light Therapy Parameters Connect with Dr. Twyman:InstagramWebsite 

In this episode of the BackTable Podcast, host Dr. Sabeen Dhand interviews Dr. Eric Secemsky about the efficacy of drug eluting technologies in vascular interventions, with Dr. Secemsky offering insight into his own practice. Dr. Secemsky is an interventional cardiologist practicing at Beth Israel Deaconess Medical Center in Boston. Dr. Secemsky believes that drug coated technology is a game-changer in the endovascular space since it improves patient outcomes by reducing the risk of needing additional procedures. Dr. Secemsky highlights the importance of various trials such as IMPERIAL and EMINENT, which compare the effectiveness of different stents. He also speaks about the significance of the Cook Medical prediction model to calculate intervention success rates and the role of disease site-specific interventions. Dr. Secemsky ends the podcast by sharing his thoughts about advancements in the near future, including the use of bioabsorbable stents and sirolimus drug-coated balloons. --- CHECK OUT OUR SPONSOR Cook Medical Zilver PTX https://www.cookmedical.com/peripheral-intervention/zilver-ptx/ --- SHOW NOTES 00:00 - Introduction 09:31 - Understanding Drug Coated Balloons and Stents 14:29 - The Paclitaxel Controversy 19:30 - Stenting Algorithm for Fem-Pop Disease 23:55 - Impact of Lithotripsy on Drug Delivery 26:02 - Predictability Models for Revascularization 29:14 - Economic Considerations in Drug Eluting Stent Usage 31:33 - Highlighting Trials on Drug Coated Technology and Drug Eluting Stents 37:08 - Future Technologies: Drug on Stent Grafts and Spot Stenting --- RESOURCES Zilver PTX Cook Prediction Model: https://cooksfa.z13.web.core.windows.net/ Risk of Death Following Application of Paclitaxel‐Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials: https://www.ahajournals.org/doi/full/10.1161/JAHA.118.011245 Durable Clinical Effectiveness With Paclitaxel-Eluting Stents in the Femoropopliteal Artery: 5-Year Results of the Zilver PTX Randomized Trial: https://pubmed.ncbi.nlm.nih.gov/26969758/ Mortality in randomized controlled trials using paclitaxel-coated devices for femoropopliteal interventional procedures: an updated patient-level meta-analysis: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02189-X/fulltext Outcomes of Stented vs Nonstented Femoropopliteal Lesions Treated With Drug-Coated Balloon Angioplasty: https://pubmed.ncbi.nlm.nih.gov/35179065/ Drug coated balloon improves outcomes of sub-optimal Supera deployment in the intermediate term: https://pubmed.ncbi.nlm.nih.gov/36494491/ Directional Atherectomy Followed by a Paclitaxel-Coated Balloon to Inhibit Restenosis and Maintain Vessel Patency: Twelve-Month Results of the DEFINITIVE AR Study: https://pubmed.ncbi.nlm.nih.gov/28916599/ Intravascular Lithotripsy for Peripheral Artery Calcification: 30-Day Outcomes From the Randomized Disrupt PAD III Trial: https://pubmed.ncbi.nlm.nih.gov/34167675/ Efficacy of a Drug-Eluting Stent Versus Bare Metal Stents for Symptomatic Femoropopliteal Peripheral Artery Disease: Primary Results of the EMINENT Randomized Trial: https://pubmed.ncbi.nlm.nih.gov/36254728/ A polymer-coated, paclitaxel-eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomized, non-inferiority trial: https://doi.org/10.1016/S0140-6736(18)32262-1 SPORTS Clinical Trial Results Boston Scientific: https://www.bostonscientific.com/en-EU/medical-specialties/vascular-surgery/drug-eluting-stent-drug-coated-balloon/eluvia/sports-rct.html

Happy Holidays! As we wrap up the year, join us for the final "pea-cast" of 2023 in this special episode of Heart Doc VIP with Dr. Joel Kahn. But don't worry; we're already gearing up for an exciting weekly lineup in 2024!  In this episode, Dr. Kahn explores a medley of intriguing topics. First, he sheds light on the surprising benefits of statin medications, not just for your heart but for your brain health and blood clot prevention. Then, we delve into a recent study examining the effectiveness of stents in alleviating angina pain. But that's not all – we also take a deep dive into the lesser-known aspects of heart catheterization, focusing on the critical issue of inter-observer variability. This discussion underlines the importance of seeking a second opinion whenever possible. Here's to a heart-healthy and enlightening 2024!

Polymer-Free Amphilimus-Eluting Stents vs. Biodegradable-Polymer Everolimus-Eluting Stents in All-Comers Undergoing PCI: 1-Year Results of the PARTHENOPE Trial

Today, I am blessed to have Dr. Robert Lufkin. He is a distinguished physician and a respected medical school professor with affiliations at UCLA and USC. His primary focus lies in applied science, where he passionately explores the intersections of health, longevity, and consciousness. Join our upcoming 5 day keto virtual event for FREE: https://www.ketokamp.com/keto-challenge Dr. Lufkin is also a prolific author and influential figure in healthcare and education. With a remarkable portfolio of achievements, he has authored over 200 peer-reviewed scientific papers and 14 books, which have been translated into six different languages, making his knowledge accessible to a global audience. His influence extends beyond the written word. He has been recognized as a renowned speaker, delivering invited lectures and keynotes at prestigious events worldwide. His ability to share valuable insights and expertise has earned him recognition as one of the '100 Most Creative People in Los Angeles' by Buzz Magazine. Dr. Lufkin's mission is to empower people to live fully through a holistic and proactive approach to health and wellness. In this episode, Dr. Lufkin talks about modern medicine. Tune in as he discusses and answers questions about the root causes of chronic diseases, mTOR, weight loss, diabetes, and much more! Pre-Order Dr Robert Lufkin's book Lies I Taught In Medical School here: https://robert-lufkin.mykajabi.com/a/2147657220/463CbhYu / / E P I S O D E   S P ON S O R S  Wild Pastures: $20 OFF per Box for Life + Free Shipping for Life + $15 OFF your 1st Box! https://wildpastures.com/promos/save-20-for-life-lf?oid=6&affid=132&source_id=podcast&sub1=ad BonCharge: Blue light Blocking Glasses, Red Light Therapy, Sauna Blankets & More. Visit https://boncharge.com/pages/ketokamp and use the coupon code KETOKAMP for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. Join our upcoming 5 day keto virtual event for FREE: https://www.ketokamp.com/keto-challenge [05:19] Addressing the Root Causes of Chronic Diseases: A Wake-Up Call for Modern Medicine ·    Mainstream medicine often treats chronic diseases with drugs that alleviate symptoms but do not address the root causes. ·    Chronic diseases extend beyond the well-known four and include obesity, type two diabetes, cardiovascular disease, heart attacks, strokes, cancer, Alzheimer's disease, and aging. ·    Stents and medications like statins do not adequately address the underlying damage to blood vessels, which continues to progress. ·    Lifestyle changes are crucial because they tackle the root causes and can slow down or even reverse these chronic diseases, unlike prescription drugs that mainly manage symptoms. [11:07] Decoding the Significance of mTOR: A Key Player in Health and Longevity ·    mTOR, a crucial biological molecule, regulates cell growth and repair based on nutrient availability. ·    mTOR is linked to numerous chronic diseases and is pivotal in determining longevity and aging. ·    Balancing mTOR activation and deactivation is crucial for overall health. Modern civilization and food availability have disrupted this balance, with mTOR often remaining constantly active. ·   Excessive mTOR activation, primarily due to frequent carbohydrate consumption, is associated with chronic diseases and accelerated aging. ·   Understanding mTOR's role offers insights into preventing chronic diseases and promoting longevity through lifestyle and dietary choices. [21:39] Rethinking Weight Loss: Why Conventional Approaches Aren't Working ·    The traditional "eat less and exercise more" approach is ineffective in combating weight gain. ·    Weight gain is primarily driven by the hormone insulin, not just the total calorie intake. ·    Insulin signals the body to store fat, so certain macronutrients like carbohydrates and glucose play a significant role in fat storage. ·    Reducing calories from these specific macronutrients, rather than simply reducing overall calorie intake, can be more effective in promoting weight loss. [33:42] The Impact of Insulin and Other Diabetes Drugs on Longevity ·    High insulin levels, primarily caused by dietary factors, contribute to various chronic diseases and health risks. ·    While insulin is life-saving for people with type one diabetes during acute episodes, it has long-term adverse effects related to chronic diseases like cancer, heart attack, and Alzheimer's disease. ·    The manipulation of glucose levels in the body through certain drugs such as Metformin, Rapamycin, and Acarbose highlights their potential for impacting longevity and preventing chronic diseases. However, further research is needed to fully understand their mechanisms and effects on humans.   [43:58] Reevaluating the Relationship Between Dietary Fat and Cardiovascular Disease ·    Blood cholesterol's role in heart attack risk is relatively small compared to factors like type 2 diabetes, insulin resistance, metabolic disease, and smoking. ·    Statins, drugs designed to lower blood cholesterol, slightly reduce heart attack risk, but other factors have a more substantial impact. ·    The low-fat dietary experiment that began in the 1960s and 70s, along with increased sugar consumption and seed oils, may have contributed to the current epidemic of chronic diseases and obesity. AND MUCH MORE! Resources from this episode: ●  Check out Dr.Lufkin's Website: https://www.robertlufkinmd.com Pre-Order Dr Robert Lufkin's book Lies I Taught In Medical School here: https://robert-lufkin.mykajabi.com/a/2147657220/463CbhYu ○ LinkedIn: https://www.linkedin.com/in/robertlufkinmd/ ○  Facebook: https://www.facebook.com/robertlufkinmd/ ○  Twitter: https://twitter.com/robertlufkinmd/ ○  Instagram: https://www.instagram.com/robertlufkinmd/ ●  Join the Keto Kamp Academy: https://ketokampacademy.com/7-day-trial-a Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Join our upcoming 5 day keto virtual event for FREE: https://www.ketokamp.com/keto-challenge / / E P I S O D E   S P ON S O R S  Wild Pastures: $20 OFF per Box for Life + Free Shipping for Life + $15 OFF your 1st Box! https://wildpastures.com/promos/save-20-for-life-lf?oid=6&affid=132&source_id=podcast&sub1=ad BonCharge: Blue light Blocking Glasses, Red Light Therapy, Sauna Blankets & More. Visit https://boncharge.com/pages/ketokamp and use the coupon code KETOKAMP for 15% off your order.  Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list. // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

En este episodio de BackTable, la Dra. Sara Lojo Lendoiro entrevista a la Dra. Eva Criado, radióloga intervencionista del Hospital Parc Taulí de Sabadell, Barcelona, sobre el manejo de las estenosis benignas en vía biliar y los stents biodegradables. --- EARN CME Reflect on how this Podcast applies to your day-to-day and earn free AMA PRA Category 1 CMEs: https://earnc.me/zVailz --- SHOW NOTES En primer lugar la Dra. Criado explica la clasificación de las estenosis biliares y las diferentes etiologías de las estenosis benignas, como causas iatrogénicas, procesos autoinmunes, inflamatorio-infecciosos, isquémicos o post-transplante hepático. Es crucial saber reconocer este tipo de estenosis y diagnosticar su etiología, ya que su no reconocimiento, o su tratamiento inadecuado deriva en complicaciones con riesgo vital para los pacientes. Las pruebas de imagen como la ecografía, el TC o la RM y colangioRM juegan un papel importante para la detección de estenosis biliares, su precisión diagnóstica y por tanto para su manejo y la planificación prequirúrgica A continuación la Dra. Criado resume las diferentes alterativas terapéuticas para la estenosis biliar benigna, como la cirugía y los tratamientos mínimamente invasivos, tanto endoscópicos como percutáneos, como son la dilatación y la colocación de stents. Ella enfatiza que la decisión sobre qué método utilizar debe de ser valorada de manera individualizada en función de la etiología, tipo y localización de la estenosis y factores de riesgo de cada paciente. Ambas doctoras destacan el hecho de que no existen unas guías de consenso entre las distintas sociedades que faciliten el manejo estandarizado con protocolos para el manejo de esta patología, lo cual sería muy Valioso. Adicionalmente, la Dra. Criado explica las posibilidades terapéuticas que ofrece la radiología intervencionista: la bilioplastia percutánea o dilatación, así como sus resultados y complicaciones, como la alta tasa de re-estenosis. Posteriormente pasa a evaluar los distintos tipos de stents, y específicamente los stents biodegradables, comentando las tasas de éxito técnico en su colocación, su permeabilidad primaria y la baja tasa de complicaciones que han demostrado en estudios multicéntricos a largo plazo, uno de los cuales es el registro Biella, un registro multicéntrico en el que han participado 11 centros españoles. También realiza un resumen de los diferentes tipos de stents biodegradables que hay hoy en día en el mercado y comenta las principales características mecánicas de los mismos. La Dra Criado concluye el episodio comentando su experiencia personal en el tratamiento de estenosis biliares benignas con stents biodegradables dando una serie de consejos prácticos para la liberación de estos stents y para prevenir complicaciones, así como las principales contraindicaciones y el tipo de seguimiento recomendado. También destaca la importancia de valorar cada caso individualmente y tomar decisiones bajo el marco de un equipo multidisciplinar. Finalmente comparte sus predicciones para el futuro de los stents biodegradables.

Es lief alles recht gut im Leben meines heutigen Gastes. Der 1973 in der Pfalz zur Welt gekommene Bas Kas studierte Psychologie und Biologie, wurde Wissenschaftsjournalist und Bestseller-Autor mit Titeln wie „Die Liebe und wie sich Leidenschaft erklärt“, er kündigte seine Festanstellung und wurde Vater dreier Kinder. Eine männliche Bridget Jones war er lange, mit Schokolade zum Frühstück, aß haufenweise Chips oder Kroketten. Bis sich sein Herz eines Tages meldete, Angina Pectoris, Notaufnahme, 2 Stents. Bas Kast wälzte fortan alle nur erdenkliche Literatur zum Thema „Ernährung“, brachte nach 3 Jahren Recherche 2018 den zum Megaseller gewordenen „Ernährungskompass“ heraus und hätte eigentlich gesund und glücklich bis an sein Lebensende…wenn da nicht irgendwann diese innere Leere gewesen wäre. Was war denn nun los? Wo waren Leichtigkeit und Freude? Kast machte sich erneut auf die Suche, dabei heraus kam diesmal der Kompass für die Seele. Und da auch die Seelengesundheit viel mit Ernährung zu tun haben kann, ist Bas natürlich ein wunderbarer Gesprächspartner für TOAST HAWAII. *** WERBUNG Toast Hawaii wird unterstützt von dmBio, die Bio-Lebensmittelmarke von dm-drogerie markt. Ganz nach dem Motto „Natürlich lecker erleben“ bietet dmBio mit mehr als 550 Produkten eine vielfältige Auswahl – von leckeren Snacks für zwischendurch bis hin zu original italienischen Tomatensaucen. Haben auch Sie eine dmBio-Geschichte, die im Podcast erzählt werden soll? Dann schreiben Sie uns gerne unter toasthawaii@studio-bummens.de ÖKO-Kontrollstelle: DE-ÖKO-007

For more information, contact us at 859-721-1414 or myhealth@prevmedheartrisk.com. Also, check out the following resources: ·Newsletter Sign Up·Purchase an Appointmen Today!·PrevMed's Locals·PrevMed's Rumble·PrevMed's website·PrevMed's YouTube channel·PrevMed's Facebook page·PrevMed's Instagram·PrevMed's LinkedIn·PrevMed's Twitter ·PrevMed's Pinterest

From ureteral injury to ureteral stents to urologists, join Alex, Avery, Biddy, Jon and Sam as they share case stories and explore the how, when and why of ureteral stents.    OUR CO-HOSTS Alex Jenny Ky, MD, FACS, FASCRS New York, NY Dr. Ky has been in practice for 22 years and is one of the busiest surgeons in her hospital.  She is a former president of the New York Colon and Rectal Society and currently serves as president-elect of the Chinese American Medical Society.  Married for 29 years, she is the proud mom of 3 children and in her spare time she enjoys playing golf and squash. Avery Walker, MD, FACS, FASCRS El Paso, TXAvery Walker is dually board-certified in General Surgery and Colorectal Surgery. He earned his medical degree at the University of Illinois in Chicago, his General Surgery residency at Madigan Army Medical Center in Tacoma, Washington, and his Fellowship in Colon and Rectal Surgery at The Ochsner Clinic in New Orleans. A former active-duty officer in the United States Army, Dr. Walker served 13 years as a general and colorectal surgeon with his most recent duty station in El Paso, TX at William Beaumont Army Medical Center. While there he was the Chief of Colon and Rectal surgery as well as the Assistant Program Director for the general surgery residency program. He currently practices colon and rectal surgery at The Hospitals of Providence in El Paso, TX. Dr. Avery Walker is married and has two daughters aged 13 and 9.   Biddy Das, MD, FACS Houston, TXDr. Bidhan “Biddy” Das has board certifications for both colon and rectal surgery, and general surgery. His passion for medical education and medical process improvement has resulted in book chapters and publications, and national and regional presentations on those subjects. Highlighting his medical expertise on fecal incontinence, he has been featured on patient education videos and national and international television and radio as a featured expert on these colorectal conditions. Dr Das also has a particular interest in surgeons redefining their careers -- he serves as both a software consultant and private equity consultant in Boston, New York City, and Houston.   Jonathan Abelson, MD, MS Arlington, MADr. Abelson was born and raised in Scarsdale, New York in the suburbs of New York City.  He has 2 older brothers and both of his parents are dentists.  Dr. Abelson went to college at University Pennsylvania, took 2 years off between college and medical school to work in healthcare consulting.  He then went to medical school at University of Virginia, returned to New York for general surgery residency at Weill Cornell on the upper east side of Manhattan.  Dr. Abelson then did colorectal fellowship at Washington University in St. Louis and am now at Lahey clinic in Burlington, Massachusetts for my first job after training. He is 2 years into practice and has a wife and two sons. His wife works in wellness consulting and they have a dog named Foster who we adopted in St. Louis.   Sam Eisenstein, MD La Jolla, CA   Sam Eisenstein is an Assistant Professor of Colon and rectal surgery and director of Inflammatory Bowel Disease surgery at UC San Diego Health.  He has worked there for the past 8 years after graduating both residency and fellowship at The Mount Sinai Medical Center in New York.  Sam is best known as the founder and organizer of the IBD-NSQIP collaborative, a large multi institutional data collaborative examining outcomes after IBD surgery, but he also is involved in several clinical trials for perianal Crohn's and has extensive experience with stem cell injections for anal fistulae. He is also on the scientific advisory board for the Crohn's and Colitis Foundation for his work on the next big IBD data collaborative, IBD-SIRQC (Surgical Innovation, Research and Quality Collaborative).  Sam has a Wife and 3 kids (6,8, and 3) and spends most of his free time running around after them these days, but also enjoys traveling and getting out into nature with his family.

Episode: 2726 Rigid Origami — much more than a decorative art.  Today, we fold rigid origami.

Wayne called us this morning to tell us about the time he remained awake as doctors put a couple stents in his heart!

Commentary by Dr. Valentin Fuster

Book an in-person consultation with Dr. Hurst today!   Welcome back to another episode of "The Healthspan Podcast" with your host, Dr. R. Todd Hurst. Today, we're joined by the phenomenal Dr. Rebecca Chester, an expert in interventional cardiology, who shares her insights into her daily practices, the fascinating world of stents, and the misconceptions surrounding chest pain.   In this conversation, Dr. Chester talks about her journey to becoming an interventional cardiologist. Despite the current imbalance with fewer women in cardiology, she shares her experiences and the key influences that guided her career path.   We delve into what her role as an interventional cardiologist entails, demystifying the intricacies of cardiac procedures. Dr. Chester explains that inserting catheters into hearts, while sounding risky, is generally safe and often crucial in saving lives.   One key topic we cover is the common assumption that blockages in heart arteries need to be fixed. Dr. Chester explains the difference between stable and unstable coronary artery disease, and how the approach to treatment varies between the two. She discusses the guidelines she uses to decide whether a patient is a suitable candidate for percutaneous coronary intervention (PCI), clarifying many common misconceptions.   Moving on, we explore the often-misunderstood realm of chest pain. Dr. Chester sheds light on the warning signs that someone experiencing chest pain or shortness of breath should seek medical attention and helps listeners discern heart-related chest pain from other causes.   For those with a history of heart attack or stent placement, we cover how often they should seek follow-up care and what they can expect during these visits.   Next, we discuss screening methods, including stress testing in asymptomatic people and CT calcium scoring. Dr. Chester explains the situations in which she recommends CT calcium scoring and how it informs her treatment decisions.   Finally, we look into the future with Dr. Chester sharing her thoughts on the most promising emerging technologies or techniques in interventional cardiology, what she loves most about her practice, and her crucial advice for patients who have experienced a heart attack or received a stent.   This episode is filled with invaluable insights and expert advice from one of the leading figures in interventional cardiology. Join us on "The Healthspan Podcast" with Dr. R. Todd Hurst for this enlightening conversation with Dr. Rebecca Chester.   Subscribe to The Healthspan Podcast now and join us on this journey towards a healthier and more fulfilling life. Don't forget to book your appointment directly with Dr. Hurst! 

Dr. Jack Wolfson discusses his Paleolithic approach to Cardiology with Dr. Ben Weitz. [If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]    Podcast Highlights 2:13  Conventional cardiology tells us that consuming saturated fats, such as found in red meat and butter, raises LDL cholesterol levels, which leads to cholesterol plaques forming in our arteries, which leads to heart attacks and strokes.  Dr. Wolfson believes that this view is completely wrong, since it is based on flawed studies that supposedly show that cardiovascular disease is caused by saturated that it can be cured with pills and procedures. 4:09  Advanced lab testing.  To diagnose cardiovascular disease, there are better tests than just the standard lipid profile.  Dr. Wolfson believes that HsCRP (High sensitivity C-Reactive Protein) is the most important marker to assess overall health, since it is the best marker for inflammation. But if it is elevated, you have to ask why are you inflamed and what can you do about it?  The reason that the body lays down cholesterol in the arteries as plaque is to protect the artery walls against inflammation, like putting spackle on the wall to make the wall smooth if there is a hole or irregularity. If we correct the reason for the inflammation, that is how we will end heart disease. 8:27  Dr. Wolfson does not recommend the coronary artery calcium scan, because he does not like exposure to radiation. He does like to look at advanced lipid analysis, lipoprotein (a), homocysteine, and uric acid. He also likes to test for intracellular vitamins and minerals and omega-3s, including intracellular vitamin K2. 10:02  Dr. Wolfson currently prefers using Vibrant America lab and some of the panels that he likes include the Leaky Gut Panel, which includes looking for gluten sensitivity, that includes the anti-actin antibody, which just shows that your immune system is attacking the actin protein found in all muscular tissue.  And all cells that divide contain actin protein, including the smooth muscle of the arteries.  Dr. Wolfson also likes running the toxic testing (Total Tox Burden) that includes heavy metals, environmental toxins like pesticides, phalates, parabens, VOCs, and plastics, and mold mycotoxins. 15:13  Dr. Wolfson does not like coronary calcium scans and he also does not recommend CT angiograms or nuclear stress tests because he is against radiation. He also feels like these scans get patients in the door and then when they find blockages, they are sent for a stress test and then they end up needing a stent or bypass surgery, even though they may have no symptoms and these procedures do not prevent heart attacks or save lives.  The conventional thinking is that you have a 30, 50, 70% blockage that was discovered by testing and you do an angioplasty and stent and you are saving them from a heart attack. But you actually take an unstable plaque and may be making it unstable. And then you find yourself on a bunch of pharmaceuticals that you were not on before and you have not done anything to address the cause of the problem. Stents do help reduce cardiovascular symptoms like chest pain and shortness of breath.  Dr. Wolfson's advice to people is to eat well, live well, think well. Part of living well is avoiding electromagnetic fields and manmade radiation exposure. Radiation causes heart disease, cancer, and dementia. 20:17  Diet.  While there is much disagreement about which diet is best, we should all agree to eat organic food so we can get the chemicals out of our food.  Dr. Wolfson believes that wild seafood is healthy and will provide good levels of the omega-3 fatty acids, DHA and EPA. He also recommends nose to tail, grass-fed, grass-finished, pasture raised animals, including the organs, liver, heart, et cetera.  Dr.

The Most Ethical, Science-Based Viewpoint On Balloons, Stents, Or Bypass Surgery Joel K. Kahn MD • https://drjoelkahn.com/ • Book - The Plant-Based Solution Dr. Sarina Pasricha • http://www.docsarina.com Baxter Montgomery, MD • https://montgomeryheart.com/ • Book - The Food Prescription for Better Health Robynne Chutkan, MD • http://www.digestivecenterforwellness.com • Book - The Microbiome Solution Dr Janese Laster, M.D • http://www.GutTheoryHealth.com • Book – Gut Theory Total Digestive Care #PlantBasedDoctors #Obesity,#GastrointestinalDisease #HeartDisease  Dr Joel Kahn is a Practicing Medical Doctor, Podcaster and Author. He works as an independent Holistic Cardiologist and manages the Kahn Center for Cardiac Longevity, ** focused on early detection and reversal of heart diseases. In addition to that, Joel is a Columnist at The Huffington Post and Readers Digest. One of the world's top cardiologists, Dr. Joel Kahn has treated thousands of acute heart attacks during his career. Dr Kahn is an acclaimed author whose most recent book is Lipoprotein(a),: The Heart's Quiet Killer: A Diet and Lifestyle Guide. An estimated one in five people have elevated levels of a type of cholesterol called lipoprotein(a) which can increase the risk for cardiovascular disease, including blocked arteries, blood clots, and stroke. To Contact Dr. Joel Kahn go to DrJoelKahn.com  Dr. Sarina Pasricha is a Harvard trained nationally recognized Delaware gastroenterologist focused on gut health, the gut microbiome, and the brain-gut connection. She graduated cum laude from Harvard University in biological anthropology with a focus on nutrition. She has published extensively in the most respected gastroenterology journals and has given more than 40 national presentations. She has received numerous teaching awards including best mentor award as an internal medicine resident. She has also received the IFAB Women of the World award and was voted as a Delaware Today's Top Doctor 2019. She is a Presidential Scholar and has been honored by President Clinton at the White House twice. Dr. Pasricha's research background allows her to best use evidence-based medicine to treat her patients. She takes a holistic approach toward managing gastrointestinal diseases. To Contact Dr. Sarina Pasricha, M.D. go to docsarina.com Dr. Baxter D. Montgomery is an Author and Board-Certified Cardiologist with years of experience in the latest medical practices and nutritional health. Combining his medical practice with a food-driven lifestyle intervention, Dr. Montgomery introduces patients to a novel food classification system that helps reverse chronic conditions such as heart disease, hypertension, obesity and diabetes without medications or surgeries. He has refined this process over the past 10 years with profound positive results in severely ill patients. In addition to running Montgomery Heart & Wellness, Dr. Montgomery manages arrhythmias and coronary disease, performs angiographies, defibrillator implants and other hospital procedures, and teaches young physicians. To Contact Dr. Baxter Montgomery Go to MontgomeryHeart.com      Dr Robynne Chutkan is a doctor of integrative gastroenterology and the author of the multiple digestive health books Gutbliss, The Bloat Cure and The Microbiome Solution. Her most recent book The Microbiome Solution: A Radical New Way to Heal Your Body from the Inside Out is a Live Dirty, Eat Clean—because every serious disease or chronic ailment begins in our gut. The microbiome—the collective name for the trillions of bacteria that live in our digestive tract—is today's hottest medical news topic. Dr. Robynne Chutkan explains how the standard Western diet and our super-sanitized lifestyle are starving our microbes, depleting the “good bugs” that are crucial for keeping us healthy, and encouraging overgrowth of exactly the wrong types of bacteria. To Contact Dr. Robynne Chutkan go to digestivecenterforwellness.com Dr Janese Laster, M.D is board certified in Internal Medicine, Gastroenterology, Obesity Medicine, and nutrition. She completed both her Internal Medicine residency and Gastroenterology fellowship training at Georgetown University Hospital in Washington, DC.  During her Gastroenterology fellowship she became interested in nutrition and bariatric endoscopy and sought out additional training. She completed the Nestle Clinical Nutrition fellowship program and then an advanced endoscopic bariatric training fellowship with an international expert. Dr Laster's goal is to help you achieve and sustain healthy weight loss through an evidence-based approach for long term success. To Contact Dr Janese Laster go to  GutTheoryHealth.com Disclaimer:Medical and Health information changes constantly. Therefore, the information provided in this podcast should not be considered current, complete, or exhaustive. Reliance on any information provided in this podcast is solely at your own risk. The Real Truth About Health does not recommend or endorse any specific tests, products, procedures, or opinions referenced in the following podcasts, nor does it exercise any authority or editorial control over that material. The Real Truth About Health provides a forum for discussion of public health issues. The views and opinions of our panelists do not necessarily reflect those of The Real Truth About Health and are provided by those panelists in their individual capacities. The Real Truth About Health has not reviewed or evaluated those statements or claims. 

What Are Some Of The Reservations To Consider Around Stents And Bypass Surgery? Kim Williams, MD •Book Foreword - Healthy at Last T. Colin Campbell, PhD • https://nutritionstudies.org/ • Book - China Study Caldwell B. Esselstyn Jr. MD • http://www.drEsselstyn.com• Book - Prevent and Reverse Heart Disease Dr. Heather Shenkman • http://www. drheathershenkman.com • Book – The Vegan Heart Doctor's Guide #PlantBased#Doctors  #HeartDisease  #Cancer Dr Kim Williams Sr. is an American cardiologist, professor and author. He has been vegan since 2003;His enthusiasm for plant-based diets is based on his interpretation of medical literature and his own experience lowering his own cholesterol by removing dairy and animal protein. He has board certifications in internal medicine, cardiovascular diseases, nuclear medicine, nuclear cardiology, and cardiovascular computed tomography. He has served on the faculty of the Pritzker School of Medicine, the Wayne State University School of Medicine in Detroit, Michigan, and at Rush University Medical Center in Chicago, where he is the head of the cardiology department. To Contact Dr Williams go to doctors.rush.edu/details/1728/kim-williams-sr-cardiovascular_disease-chicago-oak_park Dr. T. Colin Campbell, PhD has been dedicated to the science of human health for more than 60 years. His primary focus is on the association between diet and disease, particularly cancer. Although largely known for the China Study — one of the most comprehensive studies of health and nutrition ever conducted and recognized by The New York Times as the “Grand Prix of epidemiology” — Dr. Campbell's profound impact also includes extensive involvement in education, public policy, and laboratory research. He has delivered hundreds of lectures around the world, and he is the founder of the T. Colin Campbell Center for Nutrition Studies and the online Plant-Based Nutrition Certificate in partnership with eCornell. To Contact Dr. T. Colin Campbell, Ph.D.  go to nutritionstudies.org Dr. Caldwell Esselstyn Jr. is a world-renowned surgeon and the acclaimed author of the game-changing book, Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure.This Book outlines a groundbreaking program backed by the irrefutable results from Dr. Esselstyn's 20-year study proving changes in diet and nutrition can cure heart disease. He's been featured on many television programs and in very popular documentaries on health and nutrition. Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet since 1984. Dr. Esselstyn presently directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute. To Contact Dr. Esselstyn Jr go to DrEsselstyn.com Dr. Heather Shenkman is an author of her book The Vegan Heart Doctor's Guide to reversing heart disease, losing weight, and reclaiming your life. If you suffer from heart disease, you are all too familiar with the standard treatment plan of pills, doctor s appointments, and tests. But interventional cardiologist Heather Shenkman, MD, says what happens inside medical offices and hospitals is only a tiny part of what it really takes to heal heart disease. Most conventional doctors barely mention lifestyle. And yet, what you eat and how much you move are central to attaining optimal health. Shenkman says a plant-based diet, plenty of exercise, and a whole-hearted approach to living make up the best prescription of all. And in The Vegan Heart Doctor s Guide to Reversing Heart Disease, Losing Weight, and Reclaiming Your Life, she lays out a simple, manageable protocol for transitioning to a vegan diet and safely leaving your former, sedentary self in the dust. Dr Shenkman is an interventional cardiologist in practice in Tarzana, California. To Contact Dr Heather Shenkman drheathershenkman.com Disclaimer:Medical and Health information changes constantly. Therefore, the information provided in this podcast should not be considered current, complete, or exhaustive. Reliance on any information provided in this podcast is solely at your own risk. The Real Truth About Health does not recommend or endorse any specific tests, products, procedures, or opinions referenced in the following podcasts, nor does it exercise any authority or editorial control over that material. The Real Truth About Health provides a forum for discussion of public health issues. The views and opinions of our panelists do not necessarily reflect those of The Real Truth About Health and are provided by those panelists in their individual capacities. The Real Truth About Health has not reviewed or evaluated those statements or claims. 

Endovascular 101 Authors: Sebouh Bazikian - MS4 at Keck School of Medicine of University of Southern California Sukgu Han - Associate Professor of Surgery at the University of Southern California. Co-director of Comprehensive Aortic Center at Keck Hospital of USC. Program Director of the Integrated Vascular Surgery Residency and Vascular Fellowship Editor: Yasong Yu Reviewers: Matt Chia and Kirthi Bellamkonda   Core Resources: Rutherford's Vascular and Endovascular Therapy 10th Edition Chapter#26-28 Additional Resources: Relevant Audible Bleeding episodes Holding Pressure Case Prep - AKA/BKA Journal Review in Vascular Surgery: Introduction to Endovascular Surgery – A Prime Peter A. Schneider, MD and Endovascular Skills - history, personal techniques and updates in the 4th Edition Closure devices:  Angioseal Mynx Proglide Endovascular procedures are minimally invasive techniques used to treat conditions affecting blood vessels, such as aneurysms, stenosis, or occlusions, by accessing the affected vessels through an incision in a peripheral artery and using imaging guidance to navigate catheters and devices through the blood vessels to the treatment site.  Endovascular procedures can be broken down into 4 key steps Establishing arterial access Navigating to target treatment zone or vessel Treating the lesion Closure Basic definition of wire, sheaths, and catheters Wires are thin, flexible metal devices used to navigate through blood vessels and to guide other devices, such as catheters or sheaths, to the target location. They are measured in thousands of an inch A 0.018 wire is 0.018 inch in diameter There are two categories of wires: Flexible and support Flexible wires are soft and hydrophilic. They are considered the “workhorses” because they are useful for navigating through vessels. A common type of wire is called the Glidewire which is  slippery and useful in traveling across tortuous vascular anatomy. Support wire are generally a lot stiffer and not hydrophilic. For that reason they are used to deliver and deploy devices A common type of support wire is called the Lunderquist which is used for the deployment of stent grafts in endovascular aortic repair Catheters are flexible hollow tubes used in conjunction with wires to navigate vascular anatomy Various characteristics include the degree and shape of the taper, the lengths, and the stiffness. They are inserted inside the sheath  Sheaths are hollow tubes of various diameters that are inserted into a blood vessel to provide a pathway for catheters or wires.  They have a one way valve to prevent backflow of arterial blood and a side port that permits aspiration and administration of fluids.  They also come with a dedicated dilator which is used to fill the lumen of the sheath and allows the surgeon to insert the sheath safely into the vessel.  If the wire is the rail and the catheter is the train, the sheath is the ground. Sheaths and catheters sizing Both are measured in French 1 French equals 0.33 mm. French size divided by 3 equals the approximate diameter in millimeters.  Another way to think about Fr is roughly the circumference in mm. Divide by 3 instead of 3.14 to get the diameter Sheaths are defined by their inner diameter (ID) Catheters are defined by their outer diameter (OD) This is because catheters go inside the sheath, so the size of a catheter must be smaller or equal to the size of the sheath for it to fit inside.For example, a 5 Fr sheath can accommodate 5 Fr catheter/devices Of note, the hole in the artery will roughly be 2-4Fr larger than the sheath size. This is important when considering the type of closure that will be used at the end of the procedure.  Step One: Establishing Arterial Access Preop preparation:  During physical exam, make sure there's a palpable femoral pulse to rule out iliofemoral disease Review the CT if available for high femoral bifurcation or presence of vessel disease  Patient positioning on the angio table, depends on the access site of choice. Typical position (for retrograde femoral artery access) is supine, arms tucked.   Alternative access sites (ie. radial, brachial, carotid) may require arms to be out and prepped.   How do you choose arterial access, location? Depends on location of lesion you are trying to treat and complexity of the path from the access site Size of the access vessel and device size must be considered when deciding on the access site The most common is retrograde femoral artery access When would other access points be used? Radial artery, brachial, antegrade femoral access. The goal, target location, and path complexity defines the access point. Arterial puncture Femoral access: Look for pulsatile vessel on the US (vein is medial, artery is lateral; “venous penis”) Usually access at the level of femoral head for common femoral artery Seldinger technique is  used to establish access to a vessel or cavity using needle, wire, catheters, and sheath. E.g. using the micropuncture kit: contralateral arterial CFA access with s 21 gauge needle .018” guidewire is passed through the needle Needle is removed and a short 4 or 5 Fr microcatheter with an inner dilator is passed over the guidewire The dilator and guidewire are removed leaving the catheter in place to maintain access Bigger wire is inserted through the catheter, which is then removed over the wire A sheath is inserted over the wire The overall purpose is to start with smaller arterial puncture and exchange to larger size to minimize complication should the access fail Often, percutaneous closure devices are preloaded at this step.  We will discuss this later.   Step Two:  Navigating to treatment zone or vessel With sheath in place, a guidewire is inserted into the vessel under fluoroscopic guidance. Continuous fluoroscopy is taken with the C-arm during key steps to visualize wire movement The C-arm can be portable or built into the room X rays are emitted from the X-ray generator below the patient And the subsequent image is generated from the image intensifier above the patient Radiation safety:  wear protective gear which is made of lead. In addition, use the tableside lead shield whenever possible minimize use of continuous fluoroscopy whenever possible limit use of magnification, and digital subtraction angiography keep the image intensifier as close to the patient as possible to minimize scattering The C-arm can rotate around the patient to get optimal viewing of the vessels Frequently used terminology: 30 degrees RAO which stands for right anterior oblique, describing the  relationship of image intensifier to the patient Common projections used for lower extremity angiograms Iliacs: 20-30 degrees contralateral anterior oblique Femoralsl: 20-30 degrees ipsilateral anterior oblique Trifurcation and tibials: anatomic anterior-posterior or 20 degrees ipsilateral anterior oblique with feet in neutral supine position Thoracic aorta/distal aortic arch: 30~45 degree LAO Renals: AP maximizing image quality by limiting patient movement and with breath holding and collimating Contrast  Two types of contrasts: Iodinated contrast vs carbon dioxide Iodinated contrast has better resolution but patients can have allergic reactions and are at risk of contrast induced renal injury. Therefore, CO2 is preferred for patients with compromised renal function in which an image is created by transiently displacing blood. The downside is that it has lower image resolution than iodinated contrast, and rare but potentially serious complications of air locking.  Power injection vs manual injection When using power injection, you have control over pressure, the amount of contrast, timing, and rate or rise of injection. It allows for rapid filling of large arteries at high flow rates. Manual injection is more efficient for small vessels since you can control dilution and volume Types of Wires Characteristics: wire tip, stiffness, diameter, and length Guide wires To assist in catheter placement, navigate different arteries, cross lesions, and deliver devices.  The most common sizes used in vascular surgery  Large .035” - generally used for the aorta and iliac. Small .014”/.018” - used for smaller branches like the SFA Length: from 120 to 360cm Based on distance from access site to the lesion Long enough to reach target lesions and beyond (inside pt) and deliver catheters (outside pt) but not too long that it's falling off the table and slowing down exchange Flexible vs stiff/support wires How do you decide which wire to use? Typically, you start with flexible wire inside an angle tip catheter to navigate to the target vessel.  Once you reached and crossed the target vessel, the wire is exchanged to a stiff/support wire, which allows you to deliver common brands and models used that every medical student should know and the settings they are used in? Example answer: Glidewire (Tumero): a floppy wire with a  hydrophilic coating which is useful for navigating stenosis and tortuous vessels and is used in a variety of different vessels. Lunderquist (Cook): it is very stiff and used for endovascular repairs of AAAs Rosen wire: support wire with a J tip with intermediate stiffness. Less stiff than Lunderquist. Used to catheterize visceral and renal arteries. Bentson: starter wire, that's short in length with a very long floppy tip that prevents vessel trauma. Types of Catheters  Main purpose of the catheters Allows to approach the target vessel based on the shape of the catheter Allows wire exchange from flexible to stiff Sizes are based on Fr (4-5) 5 Fr are the most common. Microcatheters are for embolizations (2.5Fr) Nonselective (Angiographic catheter) Common types are omni flush, pigtail, and straight They have multiple side holes along the tip so they can inject high volume of contrast into large blood vessels like the aorta Selective catheters/Guide (shape) catheters Have an end hole only with no side holes so they can cannulate specific branch vessels A variety of lengths and shapes depending on the curvature and tortuosity of the pathway to the target vessel. Catheter with specific shapes can align your vector (the force you are exerting by pushing the wire forward at the access site) to the stenotic lesion. Type of catheter that can be used to cross to the contralateral side at the aortic bifurcation – generally the omni.  Types of sheaths Size range: 4-26Fr (larger available for endografts) Size is decided by the device you have to deliver to the target lesion Length is based on the support required from the procedure. The distance from the access site to the target site determines the length of the sheath required.  Common lengths range from 5 to 110cm What are some of the common sheaths used and for which procedure? For endovascular aortic repairs, Dryseal sheaths range from 12Fr ~ 26Fr with lengths of 33cm to 65cm. For visceral and renal artery intervention, Ansil or Raabi sheaths range from 5Fr to 9Fr, with lengths of 45cm to 90cm. For lower extermity work, Ansil, Raabi, Balkin sheaths ranging from 4Fr to 7Fr with lengths of 45cm to 110cm. Steerable sheaths can actively articulate the shape of the sheath, allow you to navigate and treat more challenging anatomy. Step Three: Treating the lesion The lesion has to be crossed with wire and catheters before treating the lesion. They may require the need to exchange sheath Stent and balloon sizing is measured by diameter in millimeters x length in centimeters Balloons Generally need to exchange wire to stiff support wire through the catheter, then the catheter is exchanged over the wire with the balloon mounted catheter Balloons have a wide variety of diameters and lengths Nominal vs Burst pressures Nominal: pressure is where the balloon will inflate to the labeled diameter Burst: pressure where 99.9% of tested balloons ruptured Typically you inflate to nominal but can go higher depending on the type of lesion Compliant balloon vs a semi-compliant vs non-compliant balloon Most of the time, we use a compliant balloon, but in certain situations where we need high pressure dilation, we use non-compliant balloon.  This has to do with the nature of the lesion and risk of vessel rupture. Additional features  Cutting balloons have microblades on the wall. So the idea is to perform control rupture of calcified atherosclerotic lesions, so that the expansion happens more evenly. Drug coated balloons are coated with paclitaxel to reduce the risk of neo-intimal hyperplasia  So, it is sometimes used in peripheral cases where the surgeons feel that the lesions are more prone to developing neo-intimal hyperplasia or areas that have restenosed.  Stents small mesh-like device made of metal that is used to prop open a blocked or narrow blood vessel. It is inserted through a catheter and deployed at the site of the blockage to improve blood flow and reduce the risk of future blockages.  balloon expandable vs self-expanding stents Balloon expandable Better radial force at the time of deployment More accurate deployment Mounted on balloons, so it is more difficult to track them across tight stenosis. May cause damage to the surrounding tissue due to balloon inflation. Self-expanding Usually more flexible in tortuous vessels More resistant to kinking  Higher risk of migration or dislodgement during deployment Post-dilation is often needed covered stents vs bare metal stents Covered stents Covered by PTFE, polyurethane, or silicone May be more resistant to in-stent restenosis, compared to bare metal stents. useful in ruptured vessel EVAR/TEVAR/FEVAR devices are essentially fancy covered stents.   Step Four: Closure Hole in the artery is outer diameter of the sheath, and is bigger than the sheath size since sheath is measured by inner diameter Manual compression Direct pressure with fingertips Enough pressure without bleeding, but not too much that it cuts off circulation No peeking! Timing depends on sheath size, coagulation status, and vessel health. Closure devices Extravascular plug Angio-seal: sandwiches the arteriotomy with a biodegradable anchor and collagen sponge. https://www.youtube.com/watch?v=XhgAs2SxNjA Mynx: utilized a small balloon to create temporary hemostasis within the artery and covers the outside with a polyethylene glycol sealant. https://www.youtube.com/watch?v=_kcJM1lnQo8 Suture-based Sometimes placed at beginning of the case for large bore access Proglide: https://www.youtube.com/watch?v=Wol22SlEpxE Complications What are the most common complications that you experience and how do you mitigate them? Access site Hematoma, pseudoaneruysm, AV fistula, occlusion,  infection Navigation related Dissection, perforation, thromboembolism Systemic Contrast induced AKI  —----------------------------------------------------------------------------------------------------------------------- Please share your feedback through our Listener Survey! Follow us on Twitter @audiblebleeding Learn more about us at https://www.audiblebleeding.com/about-1/ and #jointheconversation.

Comprehensive, relevant and insightful conversations about health and medicine happen here… on MedStar Health Doc Talk.By the time we reach our 40's, about 10-million Americans have some degree of plaque build-up in the arteries, called atherosclerosis. Deposits of that plaque in the arteries can impede or block the blood flow to the legs. It's called peripheral artery disease, or P-A-D, PAD- and you may not even know you have it.  To make an appointment with Jason Crowner, MD, FACS at the MedStar Heart and Vascular Institute, call: 443.444.3431.For more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.

On this episode, Steve is discussing applying polymeric covers to stents and laser cut hypotubes with our guest Elad Einav, CEO of Medibrane based in Rosh HaAyin, Israel.Medibrane is a contract manufacturer of polymeric covers for medical stent devices. They offer a variety of covering materials and technologies such as; Silicone, Polyurethane, ePTFE and Dacron polymeric covers, implemented using dipping, spraying or lamination technologies. Cutting down the supply chain; Medibrane collaborates with its partners to oversee the project as a whole; cover and stent.For more information, visit on www.medibrane.comHost: Steve Maxson | Innovation & Business Development Manager | US ExtrudersGuest : Elad Einav | CEO | MedibraneAnnouncer: Bill Kramer | President | US ExtrudersProducer/ Editor/ Original Music: Eric Adair | Marketing Manager | US ExtruderFor video episodes visit www.us-extruders.com/podcasts

Michelle Sheely shares her story of three stents and open-heart surgery for myocardial bridging of her LAD. She also shares about WomenHeart: The National Coalition for Women with Heart Disease. Boots and Michelle's conversation focuses on advocacy as well as the effect of hormones on the heart. Thank you for listening!0:00 intro1:50 Michelle shares her story of suffering and how she advocated for herself to get help with several stents put in place.3:30 She changed her diet and lifestyle.3:55 She has a cardiac ablation.4:30 She is back in the ER and learns she has a myocardial bridge.5:00 Michelle meets with Dr. Schnittger at Stanford and fiercely advocates for herself.6:20 Self advocacy is so important especially in women.7:00 Michelle has unroofing surgery. Her recovery has been difficult and stressful.9:00 Reflecting on when she was young versus now.9:40 Using social media for advocacy.10:15 Why it can take so long to get heart surgery.14:00 Medication is working now but it was a journey to get here.16:00 Hormones were playing a role. She is "biohacking" her way through it.18:00 There just isn't enough knowledge about myocardial bridges.18:30 Various non-heart medications were causing Michelle's vasospasms. 19:20 "Western medicine will save me; Eastern medicine will sustain me."22:40 Boots asks about those with heart issues who do not know how to advocate for him/herself.26:00 Women, we are the authorities of our own bodies.27:00 Read your own doctor's notes on your health portal!28:30 It is ok to fire your doctor!29:00 Doctors respond to data, not feelings.31:00 Vasospasms aren't just related to the heart but related to the biochemistry of the body.31:30 Michelle has worked to retrain her body and is seeking support.33:00 Finding support is so important.34:00 Michelle explains what WomenHeart is, her role and how to connect.39:00 How Michelle's heart disease has affected her daughter and the importance of mental health therapy for the child(ren).Website: The Heart Chamber (theheartchamberpodcast.com)Transcript: Joyful Beat | The Heart Chamber (theheartchamberpodcast.com)The Heart Chamber (@theheartchamberpodcast)Thanks to Michael Moeri for being my right hand man. Michael Moeri - Audio Editor, Podcast Producer and Marketing DirectorThanks to Denise Hardy for your support and believing in me. linkedin.com/in/denise-hardy-30a51086

In this episode, Dr. Chris Beck interviews vascular access surgeon Dr. Ari Kramer about his management of arteriovenous (AV) access for dialysis patients. We cover his preferred imaging for identifying and deciding to treat stenoses, the protracted angioplasty technique, and the evolution of research in drug coated balloons (DCB) and stent grafts. --- CHECK OUT OUR SPONSORS Medtronic Chocolate PTA Balloon https://www.medtronic.com/peripheral BD Rotarex Atherectomy System https://www.bd.com/rotarex --- SHOW NOTES Dr. Kramer starts by describing his vascular access practice. He is the sole operator within a hospital-based practice where he creates and maintains AV access. When evaluating a patient for possible intervention, duplex ultrasound, physical exam findings, patient history, and information from the dialysis center all play roles in determining whether the patient is eligible for a fistulagram. Dr. Kramer offers fistulagram tips: he obtains access above the arterial anastomosis in order to avoid occlusion of outflow, and he first shoots contrast into the venous tract first and works his way up to the arterial system. Depending on the findings of the fistulagram, stenotic lesions in the venous outflow tract can be treated. Dr. Kramer generally treats the lesion if the stenosis limits flow by more than 50%. Additionally, he treats any lesion resulting in a luminal diameter of 2mm or less. In an AV fistula circuit, Dr. Kramer describes his procedure, which is largely informed by the most current clinical trials. He first employs the FLEX Vessel Prep system to reduce circumferential fibromuscular tension. Next, he performs protracted plain old balloon angioplasty (POBA) for 90 seconds. This helps Then, he re-images the vessel to ensure there was no injury and utilizes a DCB to deliver paclitaxel. We discuss the clinical trials outcomes of the two current DCBs that have been approved for use in AV management, IN.PACT and Lutonix. Dr. Kramer also notes the significant cost of DCBs and lack of access to treatment for the most at-risk patients. He encourages clinicians to unite to advocate for increased reimbursement for this treatment that has been proven to show the highest standard of care. Additionally, we address treatment of non-autogenous AV circuits with stent grafts. Dr. Kramer prefers self-expanding covered stents, such as Viabahn or Covera, since they are conformable and resistant to kinks. Overall, Dr. Kramer emphasizes the importance of the operator staying up to date on clinical trials that show data for diverse tools with various indications, knowing their own skill and comfort, and incorporating the best treatments based on their patient and practice context. --- RESOURCES Ep. 139 AV Fistula Graft Management: https://www.backtable.com/shows/vi/podcasts/139/av-fistula-graft-maintenance FLEX Vessel Prep System: https://www.venturemedgroup.com/ KDOQI Clinical Practice Guideline for Vascular Access, 2019 Update: https://www.ajkd.org/article/S0272-6386(19)31137-0/fulltext Fahrtash, F., Kairaitis, L., Gruenewald, S., Spicer, T., Sidrak, H., Fletcher, J., Allen, R., & Swinnen, J. (2011). Defining a significant stenosis in an autologous radio-cephalic arteriovenous fistula for hemodialysis. Seminars in dialysis, 24(2), 231–238. Haskal, Z. J., et al. (2010). "Stent graft versus balloon angioplasty for failing dialysis-access grafts." New England Journal of Medicine 362(6): 494-503. Bard Peripheral Vascular. Covera vascular covered stent instructions for use. Rev.4 / 08-18. http://www.bardpv.com/eifu/uploads/BAWB05872R4-Covera-Vascular-Covered-Stent-IFU.pdf. The Fight Doctors: https://thefightdoctors.com/about/ Find this episode on BackTable.com for all resources mentioned in this podcast, including references to journal articles.

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]

The Mortality Of People Getting Stents And Heart Bypass Surgeries Caldwell B. Esselstyn Jr. MD • http://www.drEsselstyn.com• Book - Prevent and Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure #CaldwellEsselstyn#ReversingHeartDisease #NutritionBasedCure #HeartDisease Dr. Caldwell Esselstyn is a world-renowned surgeon and the acclaimed author of the game-changing book, Prevent And Reverse Heart Disease: The Revolutionary, Scientifically Proven, Nutrition-Based Cure. This Book outlines a groundbreaking program backed by the irrefutable results from Dr. Esselstyn's 20-year study proving changes in diet and nutrition can actually cure heart disease. *PREVENT AND REVERSE HEART DISEASE*offers readers the same simple, nutrition-based plan that dramatically changed the lives of his patients forever. With this eating plan, sufferers of heart disease will maintain cholesterol levels low enough to ensure that they will never have a heart attack. Best of all, the book offers more than 150 delicious recipes that Dr. Esselstyn and his wife, Ann Crile Esselstyn, have developed over the years He's been featured on many television programs and in very popular documentaries on health and nutrition. Caldwell B. Esselstyn, Jr., received his B.A. from Yale University and his M.D. from Western Reserve University. He was awarded a gold medal at the Olympic Games. He was trained as a surgeon at the Cleveland Clinic and at St. George's Hospital in London and as an Army surgeon in Vietnam, he was awarded the Bronze Star. Dr. Esselstyn has been associated with the Cleveland Clinic.• He has served as President of the Staff and as a member of the Board of Governors; • chaired the Clinic's Breast Cancer Task Force and headed its Section of Thyroid and Parathyroid Surgery• and is a Fellow of the American College of Cardiology. His career spans decades of countless prestigious awards:2005 He was the first recipient of the Benjamin Spock Award for Compassion in Medicine. 2009 received the Distinguished Alumnus Award from the Cleveland Clinic Alumni Association 2010 He received the Greater Cleveland Sports Hall of Fame Award2013 Deerfield Academy Alumni Association Heritage Award In Recognition of Outstanding Achievement & Service2013 He received the Yale University George H.W. Bush '48 Lifetime of Leadership Award. 2015 Plantrician Project Luminary Award, the Case Western Reserve University School of Medicine 2016 The American College of Lifestyle Medicine 2016 Lifetime Achievement Award. Dr. Esselstyn also has over 150 scientific publications throughout his career. Dr. Esselstyn and his wife, Ann Crile Esselstyn, have followed a plant-based diet since 1984. Dr. Esselstyn presently directs the cardiovascular prevention and reversal program at The Cleveland Clinic Wellness Institute. The Esselstyns have four children and ten grandchildren. To Contact Dr. Esselstyn Jrgo to  DrEsselstyn.com Disclaimer:Medical and Health information changes constantly. Therefore, the information provided in this podcast should not be considered current, complete, or exhaustive. Reliance on any information provided in this podcast is solely at your own risk. The Real Truth About Health does not recommend or endorse any specific tests, products, procedures, or opinions referenced in the following podcasts, nor does it exercise any authority or editorial control over that material. The Real Truth About Health provides a forum for discussion of public health issues. The views and opinions of our panelists do not necessarily reflect those of The Real Truth About Health and are provided by those panelists in their individual capacities. The Real Truth About Health has not reviewed or evaluated those statements or claims. 

01/22/23The Healthy Matters PodcastSeason 2 - Episode 04 - Stayin' Alive!  A Q&A with a CardiologistThere's been a lot of talk about cardiac arrest in the past few weeks, and well, it turns out our hearts are pretty important to us!  But what actually happens when things go wrong?  Does a daily aspirin really help?   And what's the best disco song to perform CPR to?From Damar Hamlin's on-field scare, to cholesterol, to emergency procedures, there's certainly no shortage of things to talk about when it comes to the heart.  In episode 4, we'll talk with Dr. Lou Kohl, an interventional cardiologist at Hennepin Healthcare, to go over the basics of heart function, ways to keep our hearts healthy, the wide world of stents, and whole lot more.  Join us!Got a question for the doc?  Or an idea for a show?  Contact us!Email - healthymatters@hcmed.orgCall - 612-873-TALK (8255)Twitter - @drdavidhildenFind out more at www.healthymatters.org

Commentary by Dr. Valentin Fuster

Be part of our community by joining our Facebook group: https://www.facebook.com/groups/thoughtbehindthings In tonight's conversation with our special guest, Dr. Murtaza Najabat Ali. What is biomedical engineering? What is its scope in Pakistan? What was Murtaza's early life and education like? When did he write the letter to the president? His work experience in NESCOM? Why did he go back to UK ? When did he join NUST & what are his contributions towards it? What was the stent scandal? How did he inaugurated MDDC at NUST? What is N - ovative health technology? Private sectors & medical tech industry? What is the DRAP & triple helix model? What is the science & technology park at NUST? The importance of equality based partnerships? Exporting & Importing in the medical tech industry? What is the raw material market? What are the price differences in it? How important is it to experiment with different ideas? Murtaza's health scare & how did he overcome it? His spiritual side? What is his aim & purpose of life? Why is there a lack in religious academia? How does Murtaza envision Pakistan in 2050? Catch this and much more in tonight's episode. Do not forget to subscribe and press the bell icon to catch on to some amazing conversations coming your way Connect with us: • https://www.instagram.com/thoughtbehindthings • https://www.instagram.com/muzamilhasan Dr. Murtaza's LinkedIn: https://www.linkedin.com/in/prof-dr-murtaza-najabat-ali-ceng-uk-mimeche-pe-55a4469/ Dr. Murtaza's Instagram: https://www.instagram.com/murtazamutahir/?hl=en One8nine Media: https://www.youtube.com/channel/UC6akyz6EpkwyzBmKh0L2rSQ Support our podcast: https://anchor.fm/syed-muzamil-hasan-zaidi3/support You can also audio stream our podcast on the following platforms: • Spotify: https://spoti.fi/3z1cE7F • Google Podcast: https://bit.ly/2S84VEd • Apple Podcast: https://apple.co/3cgIkfI --- Support this podcast: https://anchor.fm/syed-muzamil-hasan-zaidi3/support

Can you really have "3 Doors" to choose from if you have advanced heart disease? Optimal Medical Therapy (OMT), stent placement, or bypass surgery? This week, Dr. Kahn discusses a recent patient visiting the Kahn Center and the process of informed consent, research, and advice regarding this crucial decision. Are there too many stents and bypass operations performed? You listen and decide.

Thoughts of esophageal perforations keeping you up at night? Actual esophageal perforations keeping you up at night?  Drs. Brian Louie, Peter White, and Megan Lenihan discuss both the tried-and-true and the cutting-edge management of this challenging problem. Learning Objectives - Understand basic principles of management - Review differences in management based on different underlying pathology and location - Learn indications and techniques for advanced endoscopic interventions for perforations - Discuss nutrition planning  Referenced Material - Thornblade LW, Cheng AM, Wood DE et al. A Nationwide Rise in the Use of Stents for Benign Esophageal Perforation. Ann Thorac Surg 2017; 104(1):227-233. DOI: 10.1016/j.athoracsur.2017.03.069 http://dx.doi.org/10.1016/j.athoracsur.2017.03.069 - Watkins JR and Farivar AS. Endoluminal Therapies for Esophageal Perforations and Leaks. Thorac Surg Clin 2018; 28(4):541-554. DOI: 10.1016/j.thorsurg.2018.07.002 https://doi.org/10.1016/j.thorsurg.2018.07.002 Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.