Cardiovascular Business - January/February 2009 - (Page 13)

InterventIonal Update › By DaviD E alliE, MD Emerging Technologies recent studies suggest the staggering clinical and economic costs of critical limb ischemia can be reduced by utilizing newer treatment technologies Editor’s Note: This is Part 1 of a two-part series. look for Part 2 in the March/april issue of Cardiovascular Business. in peripheral vascular Interventions A t the 2008 New Cardiovascular Horizons conference held in New Orleans, we created several visionary sessions titled “Treating the Infrapops Like the LAD” and “Treating PAD Like CAD.” We designed these sessions to focus on the emerging interventional strategies and technologies to treat peripheral arterial disease (PAD) and, especially, critical limb ischemia (CLI), the end-stage of lower extremity PAD. The costs in morbidity, mortality and dollars are astonishing regarding CLI. In the last two decades, the amputation rate has increased from 19 to 30 per 100,000 persons, with diabetics most at risk. Annual costs of treating CLI in the U.S. could top $20 billion. Follow-up, long-term care and treatment for one homebound amputee is about $49,000 per year compared with $600 per year after limb salvage. A 25 percent reduction of amputations could save more than $3 billion yearly in U.S. healthcare costs. These significant clinical and economic costs are staggering, especially with multiple published experiences appearing over the last three to four years reporting 85 percent to 95 percent limb salvage rates at 12 and 24 months utilizing contemporary peripheral vascular interventional (PVI) technologies. I believe it is time we “treat PAD like CAD” and “treat infrapops like the LAD” with both refined PVI technologies and strategies that will indeed improve outcomes. I will review some of the emerging PVI strategies and technologies I have found clinically promising and have the potential to improve outcomes, especially in CLI. Vessel imaging and sizing Multidetector CT angiography (CTA) has been revolutionary in our PVI practice, not only in diagnosing but also in the overall interventional management of the PAD patient. We have found that CTA helps with accurate diagnosis, safer access site identification/management, procedural and device choice planning, as well as understanding vessel morphology and size. It also helps to lessen overall case time, as well as Peripheral CTa has totally replaced traditional diagnostic catheter peripheral angiography at louisiana Cardiovascular and limb Salvage Center in lafayette, la. Dr. allie is director of louisiana Cardiovascular and limb Salvage Center, aPMC, lafayette, la. CardiovascularBusiness.com Cardiovascular Business 13 http://www.CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - January/February 2009

Cardiovascular Business - January/February 2009 Contents First Word Electrophysiology Roundtable Forum: A Candid Conversation about Profits, Procedures and Patients Heart Failure Care Gets Boost from Technology Emerging Technologies in Peripheral Vascular Interventions Stent vs. Graft: Choosing the Best Path for the Diabetic Patient with Multivessel Disease Cardiology Groups and Hospitals Strive to ‘Connect’ Seamlessly CT Beyond 64 Slices Clinical Study Digest: Kidney Disease & PCI; Women and Valve Disease Compact Echo Systems Come Up Big in Cardiac Care News & Views Reader Resources The ACC Corner

Cardiovascular Business - January/February 2009

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