Cath Lab Digest - February 2008 - (Page 17)

17 rate an extra 10%. In other words, in order to get success rates in the mid-to-high 80’s to the low 90s, you have to have facility with the retrograde technique. Are there any additional applications for the CT overlay technology beyond CTO usage? If you think about it, you can apply it to anything. A very high percentage of patients coming into the lab already have CTs. So you could, for example, take the CTO overlay to any angioplasty you are doing, and just use the overlay to guide the wire, traversing the vessel, and not have to do repeated injections. The other applications where we are using this technology are not in coronaries. We are working on the ability to take these volume renderings and segment them out. We are then applying them to structural heart disease. There are two potential applications we are exploring: intramyocardial injections, i.e., stem cell work, and the potential for guiding transseptal catheterization by having the septum and the fossa ovale visualized and superimposed on the fluoroscopy. How long have you been involved in the development of this technology? We started this project about a year ago. We have the luxury and the good fortune of a pre-clinical laboratory at the Cardiovascular Research Foundation, the Skirball Center. We have the same Innova system at Skirball, so a great deal of the development work can be initiated there, and then we can move in to Columbia. This is a technology that I do believe will move forward rapidly. It is actually a hardware issue; there are no issues with patient safety or extra radiation exposure, so I think that after it is finalized in development, this technology will soon be dispersed widely in the cath labs.■ Dr. Moses can be contacted at jmoses@crf.org 1. Einstein AJ, Henzlova MJ, Rajagopalan S. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography. JAMA 2007 Jul 18;298(3):317-323. 2. Earls et al. Prospectively gated Axial Coronary CT Angiography: Improved Quality and Reduced Radiation Dose as Compared to Retrospectively Gated Helical Technique. Accepted in Oct 07 for publication in Radiology (pending publication). 3. Londt et al. Dose reduction of up to 89% while maintaining image quality in cardiovascular CT achieved with prospective ECG gating. Proceedings of the SPIE Mar 2007;6510:65102S. 4. Hsieh J, et al. Step-and-shoot data acquisition and reconstruction for cardiac x-ray computed tomography. J Med Phys Nov 2006:33(11):42364248. References A B Figure 4A-B. From the live case performed at TCT 2007. Overlay of computed tomographic image over live fluoroscopy with entire tree (a) or only the proximal part of the right coronary artery (b) as a roadmap for the guidewire. (Investigational software, limited by U.S. Federal Law to investigational use only. Not available for sale.) http://modulardevices.com http://modulardevices.com

Table of Contents Feed for the Digital Edition of Cath Lab Digest - February 2008

Cath Lab Digest - February 2008 Bay Regional Medical Center ENDEAVOR IV: A Zotarolimus-Eluting Stent Versus a Paclitaxel-Eluting Stent in a Randomized Clinical Trial A 3D CT Vessel “Roadmap” Over Live Fluoroscopy for Chronic Total Occlusions Contents Clinical Editor’s Corner An Evaluation of Cath Lab Turnaround Time Commentary: An Evaluation of Cath Lab Turnaround Time Excerpts from Chapter 19. STEMI Interventions – Future Perspectives The Potential Clinical Utility of Intravascular Ultrasound Guidance in Patients Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents The Ten-Minute Interview with…Debbie Charlton, RN The Society of Invasive Cardiovascular Professionals (SICP) at Transcatheter Cardiovascular Therapeutics (TCT) 2007 The Cath Lab is a Business: Do You Have the Knowledge to Stay Afloat? Incidence and Predictors of Vascular Complications after Invasive Coronary Procedures: A Prospective Analysis Ask the Clinical Instructor: A Q&A Column for those New to the Cath Lab Volunteer Survey SICP* Section Meetings Calendar What Do You Think? CEU Education Center Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - February 2008

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