• The treatment of pulmonary embolism patients with evidence of right heart dysfunction based on right heart pressures ( mean pulmonary artery pressure ) or echocardiographic and CT evaluation
• Controlled and selective infusion of physicianspecified fluids , including thrombolytics , into the peripheral vasculature to dissolve thormbus
• For patients with significant clot burden and contraindications to lytic therapy , catheter directed thrombectomy is generally preferred to remove thrombus
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Baylor Scott & White Heart and Vascular Hospital — Dallas | Interventional Cardiology
Intravascular lithotripsy
Intravascular lithotripsy - 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 .
Intravascular lithotripsy - peripheral use
Available to treat peripheral artery disease ( PAD ), interventional cardiologists and vascular surgeons on the medical staff at 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 .
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 or obligate the need for thrombolytic therapy for patients who have contraindications .
The use of this technology is indicated for :
• The treatment of pulmonary embolism patients with evidence of right heart dysfunction based on right heart pressures ( mean pulmonary artery pressure ) or echocardiographic and CT evaluation
• Controlled and selective infusion of physicianspecified fluids , including thrombolytics , into the peripheral vasculature to dissolve thormbus
• For patients with significant clot burden and contraindications to lytic therapy , catheter directed thrombectomy is generally preferred to remove thrombus
Subhash Banerjee , MD , FACC , FSCAI , led the creation of a national multicenter registry to capture data for peripheral arterial disease interventions and outcomes . Known as XLPAD , this study received National Quality Registry designation from the Centers for Medicare and Medicaid Services ( CMS ) and is endorsed by the Society of Coronary Angiography and Interventions ( SCAI ). For more information , please refer to the Clinical Trials and Research section .