• Controlled and selective infusion of physicianspecified fluids , including thrombolytics , into the peripheral vasculature
• Infusion of solutions into the pulmonary arteries
• The ultrasound facilitated , controlled and selective infusion of physician-specified fluids , including thrombolytics , into the vasculature for the treatment of pulmonary embolism
• The treatment of pulmonary embolism patients with ≥ 50 % clot burden in one or both main pulmonary arteries or lobar pulmonary arteries , and evidence of right heart dysfunction based on right heart pressures ( mean pulmonary artery pressure ≥ 25 mmHg ) or echocardiographic evaluation
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Baylor Scott & White Heart and Vascular Hospital - Dallas | 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 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 for PAD Available to treat peripheral artery disease ( PAD ), 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 was shown to be effective in addressing the most difficult to treat patients with intimal and deep wall medial calcium .
With the intravascular lithotripsy use , there are sizes capable of treating above and below the knee . The technology 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 .
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 . PAD cases are on the rise , and the medical staff are involved in numerous clinical trials and studies involving PAD .
Endovascular treatment for pulmonary embolisms
The Dallas campus was one of the first sites in the US to deploy endovascular treatment for pulmonary embolism in calendar year 2018 . Endovascular treatment brings together a multidisciplinary team of specialists including interventional cardiologists , radiologists , cardiothoracic surgeons , vascular surgeons , heart failure specialists and pulmonologists for the treatment of pulmonary embolism and deep vein thrombosis . The technology helps improve the efficiency of the thrombolytic process and reduce the treatment time and total lytic dose thereby reducing the associated bleeding risk and overall cost of therapy .
The use of this technology is indicated for :
• Controlled and selective infusion of physicianspecified fluids , including thrombolytics , into the peripheral vasculature
• Infusion of solutions into the pulmonary arteries
• The ultrasound facilitated , controlled and selective infusion of physician-specified fluids , including thrombolytics , into the vasculature for the treatment of pulmonary embolism
• The treatment of pulmonary embolism patients with ≥ 50 % clot burden in one or both main pulmonary arteries or lobar pulmonary arteries , and evidence of right heart dysfunction based on right heart pressures ( mean pulmonary artery pressure ≥ 25 mmHg ) or echocardiographic evaluation
Renal denervation : Dallas campus leading critical studies
For several years , there have been and continue to be studies for renal denervation conducted on the Baylor Dallas campus , including Spyral On Med , Spyral Off Med and Spyral Dystal . This catheterbased treatment for hypertension will be an option in addition to pharmacologic management . Additional studies are in review . The Spyral On Med trial completed enrolling at the end of March 2022 . With the increasing number of Americans living with hypertension , the Dallas cardiovascular medical staff and the team for the Hypertension Center will be following the outcomes closely .