Cath Lab Digest - September 2007 - (Page 9)

9 anti-platelet therapy. Clearly, patients that cannot be treated with long-term dual anti-platelet therapy, e.g. because they are scheduled for surgery shortly after the percutaneous coronary intervention (PCI) procedure or because of an increased risk of bleeding, may benefit from Genous stent placement. The time the patients are on dual-antiplatelet therapy is also captured in the eHEALING Registry. Of course, we will also look at patient subsets that have high risk of clinical restenosis, such as diabetics or patients with long lesions or small vessels. Can you share details of a case or two where you have used the Genous stent? As a matter of fact, I treated two patients with a Genous stent this morning. One patient was going to undergo major bowel surgery because of a carcinoma, and the surgeons wanted to treat him as soon as possible. We put in a long Genous stent in the right coronary artery. The patient is going to be on dual antiplatelet therapy for two weeks and then we stop the clopidogrel. The surgeon is willing to operate with aspirin treatment, but he doesn’t want to do the operation with the patient on dual anti-platelets. This means the patient is ready for his bowel surgery in two weeks plus five days. The other patient was a patient that had large aneurysms in the dominant right coronary artery. The presence of these aneurysms signifies an increased risk of stent thrombosis, which was one of the reasons that I treated this patient with a Genous stent. I expect it to be less thrombogenic than a drug-eluting stent. A large aneurysm which is due to possible remodeling is an anatomical situation which is not infrequent. Sometimes in the past we Genous Case #1 (Figures 1-4) • • • • Male 67 years old Angina NYHA 3/4 Statin, beta-blocker, nitrate, ASA • Occlusion LAD • Multiple lesions, dominant RCA with two aneurysms (anticipated high stent thrombosis risk) Figure 1. LAD pre procedure Figure 2. LAD post procedure, 3.0 x 18 mm Genous Figure 3. RCA pre procedure Figure 4. RCA post procedure, 3.5 x 33 mm Genous

Table of Contents Feed for the Digital Edition of Cath Lab Digest - September 2007

St. Dominic Hospital The Genous Bio-engineered R Stent Percutaneous Treatment of Peripheral Arterial Chronic Total Occlusions: Device Options and Clinical Outcomes Contents Clinical Editor’s Corner Percutaneous Revascularization of Peripheral Chronic Total Occlusion — Which Patients, Why, and How? Myocardial Infarction and Syncope: A Manifestation of the “Raynaud-Prinzmetal Syndrome”? Essential Technical Components of the Transradial Approach If You Build It, Will They Come? Evidence-Based Medicine with Drug-Eluting Stents Back to School: The Value of Education in Cardiovascular Services The ACVP Standards and Competencies: Are You Using Them Effectively? What Do You Think? My Experience with Fibromuscular Dysplasia and Stroke A Brief Review of Fibromuscular Dysplasia Letter to the Editor A Look at On-the-Job Training: Perceptions, Reality and Our Profession Doing the Wave: Inventory Management with RFID The Ten-Minute Interview with… Paul Pinsker, RCIS CLD’s Annual Salary Survey Harrisburg Area Community College Volunteer Survey CEU Education Center SICP* Section Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Clinical & Industry News

Cath Lab Digest - September 2007

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