Cath Lab Digest - October 2007 - (Page 33)

33 Step 1. Insertion: Boomerang Catalyst Wire is inserted through the existing arterial sheath Figure A. 3 weeks post manual compression; visible scarring seen (Photo courtesy of Dr. David Allie). Figure B. Elastic recoil clamping down on Boomerang Catalyst Wire 4 minFigure B. Elastic recoil clamping down on Boomerang Catalyst Wire 4 minutes after sheath removal. (Photo courtesy of Nilesh Goswami, MD). utes after sheath removal. (Photo courtesy of Nilesh Goswami, MD). Step 2. Deployment: The device is deployed, and opens into a low-profile, biocompatible, conformable disc Step 3. Placement: Sheath removal positions disc against ateriotomy for a light block, and immediate tamponade of the arteriototamy to the hands and wrists of cath lab staff. Manual compression also requires staff to bend over patients, sometimes leading to back and neck injuries. Kelley Weakley knows this only too well: “I’ve worked in the cath lab for 15 years and had one patient who needed over an hour of hand pressure. I injured my neck on that case and needed surgery.” These types of injuries can have serious staffing and financial consequences for cath lab operations. Prairie Heart Cath Lab Manager Sheryl Friedrich noted, “If we can decrease the hand-hold time for patients, we will decrease the number of staff injuries and workers’ comp cases. I have someone right now who’s out with a wrist injury.” Achieving Hemostasis Using Vascular Closure Devices The need to evolve beyond manual compression has been exacerbated in recent years due to the use of larger sheaths for new percutaneous access procedures and more patients requiring repeated procedures, which increased the potential for arterial damage. VCDs began to be developed in the late 1980’s to stop femoral artery bleeding immediately following diagnostic or interventional procedures. Clinical trials assessing the safety and effectiveness of these devices compared to manual compression produced mixed results regarding the short-term risk of serious adverse events, such as hemorrhage, since they most often meas- Step 4. Removal: In conjunction with manual compression, the disc is collapsed, removed, and compression maintained until hemostasis achieved. achieved The need to evolve beyond manual compression has been exacerbated in recent years due to the use of larger sheaths for new percutaneous access procedures and more patients requiring repeated procedures, which increased the potential for arterial damage.

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

Saints Medical Center Fibromuscular Dysplasia in Children and Adolescents Cerebral Vascular Accident Following a Pulmonary Embolism: Search for the Hidden Patent Foramen Ovale Contents Clinical Editor’s Corner Meetings Calendar CEU Education Center Radiation Tracking in the Cardiac Catheterization Lab Letter to the Editor Carotid Stenting: An update Release from Stent-jail: Beneficial Snow-Plowing? Patient Management Guidelines Searching for a Cardiovascular Position? Tips for Creating a ‘Stand-Out’ Resume Long-Term Implications of Short-Term Closure Decisions – The Evolution to Vascular Access Management and the Boomerang Catalyst System The Ten-Minute Interview with… Angie Bowles, RN, CCRN CMS Issues Final FY 2008 IPPS Rule ACVP• Membership Page Experience with a New Workhorse Guidewire Ask the Clinical Instructor: Q&A for Those New to Cath Lab A Glimpse of the Future of Clinical Education: Boston Scientific’s SimSuite Bus Visits Carnegie Institute 2007 Educational Fair Held at the Washington Hospital Center Research Update: Original Contribution Abstracts from The Journal of Invasive Cardiology What Do You Think? A Virtual Cath Lab Viewer (VCL): The Development of an Online 3D C-arm Simulator and Coronary Anatomy Viewer Clinical & Industry News Cost-Effectiveness of the Radial versus Femoral Artery Approach to Diagnostic Cardiac Catheterization

Cath Lab Digest - October 2007

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