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Interventional Cardiology, continued...
Closures for PFO, VSD, ASD
Deborah interventional cardiologists are actively involved and very experienced in the treatment of structural heart disease. More specifically, we can treat abnormal communications or holes between the left and right side of the heart (including ASDs –atrial septal defects; PFO’s –patent foramen ovale; VSDs –ventricular septal defects) non-surgically using special closure or occluder devices inserted through a small puncture in the groin. From a patient’s perspective, it is similar to undergoing a heart cath or angioplasty. We can also non-surgically repair leaks around prosthetic aortic and mitral valves using similar devices.

TAPAS™ Catheter
The TAPAS Catheter is designed for use in peripheral vascular disease treatment. It is an innovative system with two compliant occlusion balloons that can deliver a controlled therapeutic -- or diagnostic -- agent and dose. This therapeutic infusion system has an adjustable length, so that long vessels can be treated with one device. It also offers the capability of extracting the medicine out of the vascular treatment zone if necessary, so there is no drug run-off during a localized intravascular treatment. The TAPAS Catheter can be used in conjunction with other interventional devices.

For many patients with vascular disease, walking one city block is impossible. The pain in the legs and feet associated with vascular disease is often unbearable; the patient must stop and rest to relieve the pain, which returns upon resumption of exercise. The balloon angioplasty procedure does not always offer long-term success in the legs, especially in the femoral artery in the thigh. For reasons still unknown to physicians, this artery is prone to renarrowing after interventional procedures to open it – as many as 60 percent of patients will experience reoccurring blockages. Stents, which could help support the artery walls, are not a desirable option in this artery because scar tissue is highly likely to form within the stent, causing further blockages.

Bypass surgery is costly and invasive, and grafts to this artery are prone to occlusion themselves. Often, vascular disease patients have no option for bypass surgery because the saphenous vein has been used previously to bypass the coronaries.

Deborah Physicians Expand
Use of Wrist Catheterizations

Deborah has been a regional leader in performing Transradial Artery Catheterizations – wrist caths -- instead of through the groin. Deborah’s physicians have now expanded the use of wrist caths to treat peripheral vascular disease in different vascular distributions. Blockages of the shoulder artery (Subclavian), kidney artery (Renal), abdominal artery (Superior Mesenteric Artery), and arteries to the legs (Iliac, External Iliac, and Femoral) can be treated through the wrist approach in appropriate patients.

wrist cath

This new application is a tremendous plus for patients who have diseased and blocked leg arteries, and who face a much higher risk of bleeding and complications when treating peripheral artery disease with a traditional groin catheterization.

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Silverhawk Excision System
Most Americans are familiar with clogged arteries in the heart, increasing risk of stroke or heart attack. The body’s delicate circulation system can also get clogged with plaque too. This type of clogging, called Peripheral Artery Disease, or PAD, is often signaled by pain in the legs with walking, relieved with rest. Other symptoms include numbness or tingling, cold extremities, wounds that don’t heal, and weakness in the legs and arms.

If left untreated it can increase the risk of serious heart problems, as well as leading to amputation or death. Last year alone, over 150,000 amputations were performed in the U.S. for patients with critical PAD. At Deborah Heart and Lung Center, the endovascular team is on the cutting edge of technology to treat blockages in these peripheral arteries.

The Silverhawk Excision System is a device which is inserted into a clogged peripheral artery through a catheter inserted into the groin. Once in place the Silverhawk uses a rotating blade to shave away the plaque. The plaque is stored in a nosecone, and when full, the nosecone is pulled out and emptied, and then reinserted to scrape more plaque. The device has had a stellar success rate, offering a minimally invasive procedure with immediate and long-term benefits. The Silverhawk system offers an excellent alternative for PAD sufferers, with disease that would be difficult to treat with more conventional devices. For many suffering with PAD, those handicapped by the pain of walking or facing limb amputation, the Silverhawk system can provide a new outlook on life.

Rotational Atherectomy or Rotablator
Rotational atherectomy or Rotablator is a tiny football shaped diamond coated burr which comes in various sizes to match the vessel size being treated. It spins anywhere from 110,000 to 180,000 RPM (depending on the size) and is designed to cut away heavily calcified blockages. It works on the principle of differential cutting (like a cast saw), where the heavily calcified and fibrosed tissue is cut, but the healthy tissue is left unaffected. The ablated material is cut into 4 to 6 micron bits (smaller than a red blood cell) which essentially percolates away in the blood stream and is eventually cleared from the blood by white blood cells called macrophages. Rotational atherectomy is usually not a “stand alone” procedure; rather it is used as an adjunct to clear the tough, heavily calcified blockage, make the vessel more compliant, and therefore make it easier to balloon dilate or stent the vessel.