November/December 2015

Endovascular treatment has emerged as the best thing since intravenous tissue plasminogen activator (IV t-PA) for acute ischemic stroke after five recent studies showed positive outcomes. Stent retrievers starred in the trials, with imaging playing a critical supporting role. But in clinical practice, which neuroimaging method best identifies likely beneficiaries is up for debate.

Mary Tierney

Every year, more than 795,000 Americans suffer a stroke—with 665,000 people surviving the episode. The annual cost of stroke in the U.S. tops $33.6 billion (Circulation. 2015 ;e29-322.) and one out of six Americans will have a stroke in their lifetime. Stroke is our leading cause of disability.

Prompt response to cardiac arrest is critical; seconds lost reduce the chances for patient recovery. While other rescue procedures like CPR do help and buy rescuers time, when a shock is needed, it’s imperative for the equipment to work well and, in some cases, provide rescuers with feedback.

University of Washington Medical Center heart team

The University of Washington Medical Center in Seattle, already a major national referral center, has recently undergone a significant culture shift. The change began when Robb MacLellan, MD, joined as chief of cardiology of UW Medicine Regional Heart Center in 2011.

The stars appear to be aligned for drugs that reverse the effect of novel oral anticoagulants (NOACs). Regulators in the U.S. have moved them forward, anxious to provide emergency physicians an antidote in cases of life-threatening bleeding. But the ultimate beneficiaries may be patients who need but don’t take anticoagulants because of bleeding fears.

Mobile health

Tools that help patients adhere to doctor’s recommendations improve patient outcomes—it’s simple math with a host of benefits.

Gary Idelchik, Saratoaga Hospital

Growth seeded the need for a dedicated PCI program at Saratoga Hospital that went live in January along with a complete technology overhaul: cath lab, hemodynamic monitoring, echocardiography and a fully integrated cardiovascular information system. The PCI program, close to 100 interventions later, is now considered a jewel of the county and a model for other facilities considering a technology refresh.

Robotics

Once just a feature of science fiction, robotics is now an integral part of the current healthcare landscape. With the advent of robotic-assisted percutaneous coronary intervention (PCI), interventional cardiology may be poised to experience a tectonic shift.

Steven D. Pearson, MD

As the healthcare industry shifts towards a more value-based system, payers, physicians, patients and pharmaceutical companies are paying more attention to the costs and benefits of new treatments. Steven D. Pearson, MD, has been interested in those topics for a long time and has emerged as a leading voice when it comes to comparative effectiveness research and health policy.

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