U.K. PCI study sparks U.S. debate
On Wednesday, November 1, results from the Objective Randomized Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina (ORBITA) study were published in The Lancet.
The next day, this article was published in the New York Times:
"A procedure used to relieve chest pain in hundreds of thousands of heart patients each year is useless for many of them," it began... "The new study, published in the Lancet, stunned leading cardiologists by countering decades of clinical experience. The findings raise questions about whether stents should be used so often—or at all—to treat chest pain."
Without further knowledge, the debate may start right here—the New York Times article had little in the way of medical detail to satisfy invasive cardiovascular professionals and may have further generalized results in a misleading manner.
But let's hold off on reacting, look at the debate surrounding this particular study and also place the findings in a wider context (part two). Note: this isn't the first time it has been suggested that stents are overused.
Continue reading Stents not effective? Study sparks debate pt. 1
In 2011, the Society of Cardiovascular Angiography and Interventions published new guidelines for a Radiation Safety Program for the Cardiac Catheterization Laboratory.
With regards to procedures, they recommended limiting exposure duration, reducing dosage, limiting high-dose high contrast use, reducing magnification, and increasing distance from the x-ray beam to name a few.
Mayo Clinic reduced doses by 40 percent over a 3-year period in a case study released in 2012, where researchers noted that "the physician's expectations [had to] change from a desire for excellent image quality to a desire for low radiation dose and acceptance of clinically adequate image quality."
Technology itself might not be able to change culture, but it can significantly improve many relevant factors, as demonstrated by trials and testimonials of Corindus's CorPath system.
Continue reading Special Report (4): Robotics improve efficiency and reduce radiation exposure
Most references to musculoskeletal pain suggest they are best treated by identifying and treating the cause of the pain. But what if the cause of pain is work-as-usual for cardiovascular professionals in the Cath Lab?
In our special report series we've already discussed the recent research that showed non-physician Cath Lab personnel reporting more musculoskeletal pain due to interventional procedures involving radiation. We also shared pieces from Dr. James Goldstein's editorial on the subject, discussing the importance of the issue and suggesting ways to advocate and educate. We're also planning on discussing new technological applications that allow cardiovascular professionals to avoid radiation during procedures.
But in this piece, we'll take a lighter look at ways to mitigate musculoskeletal pain including stress reduction techniques and some alternative approaches.
Continue reading Special Report (3): Mitigating Work-Related Musculoskeletal Pain
Last Thursday, we discussed the ground-breaking study that found non-physician Cath Lab personnel reporting more work-related musculoskeletal pain. Today we'll discuss editorial comments from Dr. James Goldstein in the Journal of the American College of Cardiology and explore ways to advocate and educate about work-related pain from procedures involving radiation in the Cath Lab.
Continue reading Special Report (2): Advocating and Educating about Work-Related Pain in the Cath Lab