36
INTERVENTIONAL CARDIOLOGY
Intravascular lithotripsy - coronary and peripheral use
Coronary use The intravascular lithotripsy system ( IVL ) was first used in Texas for coronary intervention of heavily calcified coronary arteries at Baylor Scott & White Heart and Vascular Hospital – Dallas . Led by principal investigator and medical director for the cath lab / co-medical director of cardiology , Robert Stoler , MD , FACC , FSCAI , the Dallas campus participated in the worldwide clinical trial to evaluate the safety and effectiveness of the IVL .
The investigational technology uses a balloon catheter system designed to enhance stent outcomes by enabling delivery of the calcium disrupting capability of lithotripsy prior to balloon dilatation at low pressures . The single-use sterile catheter contains multiple lithotripsy emitters enclosed in an integrated balloon . The emitters create sonic pressure waves in the shape of a sphere , creating a field effect to disrupt and fracture calcium in the affected artery .
Peripheral use Available to treat peripheral artery disease , interventional cardiologists and vascular surgeons on the medical staff of Baylor Scott & White Heart and Vascular Hospital – Dallas were also the first specialists in North Texas to use the IVL in peripheral cases . Peripheral IVL use was approved during fiscal year 2020 , was shown to be effective in addressing the most difficult to treat patients with intimal and deep wall medial calcium .
Chronic total occlusion stenting
Baylor Scott & White Heart and Vascular Hospital is a referral center for high-risk patients with coronary artery disease seeking treatment for totally occluded arteries using chronic total occlusion ( CTO ) stenting , an option to bypass surgery or traditional stenting . During fiscal year 2022 , Baylor Scott & White Heart and Vascular Hospital - Dallas participated in the CTO Progress Registry , a national database of elite cardiac centers nationwide that share data to identify best practices and best outcomes . Additionally , patients benefit from CTOrelated studies including various research trials to drive innovation .
With the intravascular lithotripsy use , there are sizes capable of treating above and below the knee and is also being used in patients with heavily calcified iliac arteries in order to facilitate the transfemoral delivery of sophisticated devices in TAVR , EVAR and TEVAR and high-risk PCIs that require a left ventricular assist device . The new technology enables this patient group to benefit from this innovative technology when they would otherwise be ineligible for the procedure or would be at an increased risk for procedural complications .
Peripheral vascular and percutaneous intervention The interventional cardiologists and vascular surgeons share the use of the cath labs for peripheral vascular and percutaneous peripheral intervention . Using specialized fluoroscopy of the cath lab , peripheral vascular intervention ( PVI ) procedures are performed to help restore blood flow to the lower extremities . Percutaneous peripheral intervention ( PPI ) may also be performed in the cath lab . PPI is another treatment option for peripheral artery disease . With the prevalence in PAD , the volume of these procedures has steadily increased .