July/August 2005 November/December 2004
The Society for Cardiovascular Angiography and Interventions
SCAI Scientific Sessions Shine in Ponte Vedra Beach
or a few days in May, the sun played games in beautiful Ponte Vedra Beach, FL, hiding behind light cloud cover for a few hours and then pouring its rays down on the picture-perfect beaches and golf courses for which it is known. Meanwhile, inside the lovely Sawgrass Marriott Resort, SCAI trained the spotlight on a diverse, outstanding faculty whose members are recognized worldwide for their expertise in invasive and interventional cardiology. Assembled by Program Committee Chair Ted A. Bass, M.D., FSCAI, and his co-chairs, Marco Costa, M.D., FSCAI, and J. Jeffrey Marshall, M.D., FSCAI, Pediatric Co-chairs Jose A. Ettedgui, M.D., FSCAI, and Robert N. Vincent,
M.D., FSCAI, and Melvin P. Judkins Symposium Chair Warren K. Laskey, M.D., FSCAI, the Society’s 28th Annual Scientific Sessions drew a record number of professional attendees as well as a full exhibit hall. The meeting in Ponte Vedra Beach continued SCAI’s strong, years-old tradition of solid, steady growth. Attendance has climbed incrementally each year, allowing the Society to focus on delivering excellent scientific education while also providing a comfortable, collegial setting for attendees to catch up with friends and network within the scientific community.
Education Beyond Compare The learning never stopped at the 28th Annual Scientific Sessions. (continued on page 2)
SCAI Presents Distinguished Service Awards
CAI Past President Joseph D. Babb, M.D., FSCAI, and Trustee J.J. Adolfo Cosentino, M.D., FSCAI, were each presented with SCAI’s highest honor, a Distinguished Service Award. SCAI Board of Governors Chair Christopher U. Cates, M.D., FSCAI, presented Dr. Babb with his award, noting that the honor could not be more appropriate. A longtime dedicated volunteer and excellent SCAI honored Joseph D. Babb, M.D., FSCAI clinician, Dr. Babb (left), and J.J. Adolfo Cosentino, M.D., FSCAI (center), for distinguished service to SCAI and has worked tirelessly the field of interventional cardiology. SCAI on behalf of the President Michael J. Cowley, M.D., FSCAI (right), congratulated both Fellows. Society and his pro-
fession. In the past decade, he has spearheaded hugely successful efforts to expand SCAI membership, earn the Society ACCME accreditation, and make SCAI a go-to Society for policymakers at all levels of government. As chair of the Society’s Education Committee, Dr. Babb set a high bar for SCAI programs, insisting that all SCAI-branded education must be unbiased, In This Issue... objective, clear, and useful to practicing physi- President's Message: Is the Society cians. During his presi- American or Global? . . . . . . . . . . . . . 6 dency, he also brought Scientific Sessions Further together representatives SCAI International Collaboration. . . . . . . . . 7 of all the international medical societies focused ADVOCACY NEWSFLASH: Call to on interventional cardiol- Action on Medicare Fee Schedule. . . 10 ogy, launching a “cardiolPDA Lesion-Classification Tool ogy round-table” that New Handy in Clinic and Cath Lab . . . . . . 14 (continued on page 5)
Kicking Off a Great Meeting and Making Plans for Next Year. From left: New President Barry F. Uretsky, M.D., FSCAI; 2006 Program Co-chair David Kandzari, M.D., FSCAI; 2006 Program Co-chair William O'Neill, M.D., FSCAI; SCAI Director of Membership and Meetings Rick Henegar; Immediate Past President Michael Cowley, M.D., FSCAI; Past President Carl Tommaso, M.D., FSCAI; and SCAI Secretary Bonnie Weiner, M.D., MSEC, MBA, FSCAI.
CCI Editor Makes Headlines. Christopher J. White, M.D., FSCAI, made headlines when he presented results of the BEACH trial during Saturday's sessions dedicated to peripheral arterial disease. Dr. White also chaired the CCI Editorial Board meeting, held for the first time in many years as part of SCAI's Annual Scientific Sessions.
Unique Opportunities to Socialize With Colleagues. SCAI hosted a reception at the spectacular Lightner Museum in St. Augustine. Morton Kern, M.D., FSCAI, Barry F. Uretsky, M.D., FSCAI, and Dr. Uretsky’s bride-to-be, Sandi Berg, were joined by a motley crew straight from the museum’s gilded age” exhibit.
Ponte Vedra Beach (continued from page 1) From Thursday morning’s Founders’ Lecture by Patrick Serruys, M.D., about drug-eluting stents, through Saturday’s sessions dedicated to peripheral arterial disease (PAD), attendees found the “Best of the Best in Interventional Cardiology” waiting for them in every classroom. The program featured a variety of different formats, all designed to optimize interaction between faculty and audience and all focused on state-of-the-art care. Attendees came away from SCAI’s annual meeting thoroughly updated on the latest scientific and clinical breakthroughs. For example — • The Society was honored to welcome Gary S. Roubin, M.D., Ph.D., FSCAI, who gave the Hildner Lecture on the fast-evolving topic of carotid artery stenting. • SCAI Past President Warren K. Laskey, M.D., FSCAI, chaired the Melvin P. Judkins Cardiac Imaging Symposium, during which attendees caught up on the latest advances in flat-panel imaging, EBCT, IVUS, radiation safety, and more. • Pediatric Program Chairs Jose A. Ettedgui, M.D., FSCAI, and Robert N. Vincent, M.D., FSCAI, assembled a comprehensive program on congenital heart disease, including Controversies debates, a session titled, “I Blew It!” and discussion of angiographic and hemodynamic dilemmas. • Martin Leon, M.D., FSCAI, and Gregg W. Stone, M.D., FSCAI, moderated the TCT Symposium, a focused update on developments with drug-eluting stents since the TCT meeting last fall.
SCAI News & Highlights is published bimonthly by The Society for Cardiovascular Angiography and Interventions 9111 Old Georgetown Road, Bethesda, MD 20814-1699 Phone 800-992-7224; Fax 301-581-3408; www.scai.org; email@example.com Barry F. Uretsky, M.D., FSCAI President Morton Kern, M.D., FSCAI Editor-in-Chief Norm Linsky Executive Director Congratulations on a Successful Meeting! More than 1,000 attendees came to Ponte Vedra Beach, FL, for the “Best of the Best” in invasive/interventional cardiovascular education. Scientific Sessions Program Chair Ted Bass, M.D., FSCAI (center), and Co-chairs Marco Costa, M.D., FSCAI (right), and J. Jeffrey Marshall, M.D., FSCAI (left), mixed up the perfect recipe for success: outstanding faculty, comprehensive program, a beautiful locale, and time to catch up with colleagues.
Wayne Powell Senior Director, Advocacy and Guidelines Bea Reyes Director, Administration Rick Henegar Director, Membership and Meetings Sarah Jones Membership Coordinator
Andrea Frazier Publications & Committee Operations Coordinator Anne Marie Smith Educational Programs Betty Sanger Sponsorship and Development Kathy Boyd David Managing Editor Touch 3 Design & Production Imaging Zone Printing
Better Learning Through Simulation. Peter Angelopoulos, M.D., FSCAI, tried out the latest simulation technology in the SimSuite bus stationed in Ponte Vedra Beach.
• SCAI Past President Ted Feldman, M.D., FSCAI, chaired a session on percutaneous valve therapies, including updates on treatment of mitral stenosis, mitral regurgitation, and aortic valve disease. • Ron Waksman, M.D., FSCAI, conducted a workshop on bifurcation, including discussion of crushing technique, provisional stenting, and dedicated stenting.
Learning on an International Scale The meeting’s more than 1,000 attendees also found an unprecedented opportunity to explore breakthrough advances underway in countries far from the United States. Seven of SCAI’s sister interventional cardiology societies held symposia at the Scientific Sessions, setting a new standard for international collaboration. For two days, attendees learned from experts in Latin America, Argentina, the Asia-Pacific region, Japan, Italy, Europe, Brazil, and Spain about new devices, techniques, and indications that may soon join the therapeutic armamentarium in the United States. “Because of the restrictions the United States places on research, much of the cutting-edge work in medicine begins in other countries and then comes here later,” said Dr. Costa. “The SCAI Scientific Sessions provided an invaluable experience for all of us to hear from opinion leaders from all over the world and get a sense of what is coming our way.” SCAI Committees: Volunteers Hard at Work As always, SCAI held a full slate of committee meetings during the Scientific Sessions. A testament to SCAI’s uniquely participatory approach to conducting business, almost all committee meetings are open to all members in good standing and are usually very well-attended by members interested in becoming more involved in their Society. This year was no exception: the meetings were productive, the discussions lively, and the recommendations substantive. CCI Editorial Board Comes Home It has been a long time since SCAI has hosted the annual CCI Editorial Board meeting, but that changed when Editor-in-Chief Christopher J. White, M.D., FSCAI, reported on the growth of the Journal in Ponte Vedra Beach. “The Journal has never been stronger,” he announced, citing a record-high impact factor as well as submission rates that are outpacing acceptances. “We haven’t changed the number of studies we publish, (continued on page 5)
Better Than Ever! Year after year, attendees report that the Melvin P. Judkins Cardiac Imaging Symposium keeps getting better. Long-time symposium chair and SCAI Past President Warren K. Laskey, M.D., FSCAI (shown here with J.J. Adolfo Cosentino, M.D., FSCAI, on right), “mixes things up a bit” every year, so that the program is always fresh and current. “We don’t go over the same ol’ stuff from year to year!” he stressed.
SCAI Congratulates Its First Couple. What a year! Barry F. Uretsky, M.D., FSCAI, was installed as president of SCAI during the Scientific Sessions. Just three weeks later, he and Ms. Sandi Berg were married.
Strategic Planning Underway. The Congenital Heart Disease Working Group was among many committees that held productive meetings during the Scientific Sessions. This relatively new committee has been active and enthusiastic from the start. From left: 2005 Pediatric Program Chair Jose Ettedgui, M.D., FSCAI; the group’s chair Julie Vincent, M.D., FSCAI; Thomas Jones, M.D., FSCAI; Charles Mullins, M.D., FSCAI; and Ziyad Hijazi, M.D., FSCAI.
Get Your SCAI Attire Here! SCAI Past President and CCI Founding Editor Frank J. Hildner, M.D., FSCAI, joined staffer Andrea Frazier at the Society’s booth, where business was brisk. In addition to souvenirs from the meeting, attendees visited to obtain information about future educational programs and membership benefits.
THANK YOU The Society for Cardiovascular Angiography and Interventions expresses deep appreciation to the following companies for their support of the 28th Annual Scientific Sessions and Melvin P. Judkins Cardiac Imaging Symposium. VISIONARY
Cordis GE Healthcare TRUSTEE
Boston Scientific Corporation PRESIDENT
Aventis Pharmaceuticals, Inc., a member of the sanofi-aventis Group Bristol-Myers Squibb/Sanofi Pharmaceuticals Partnership Guidant Corporation Medtronic Vascular SUSTAINER
The Medicines Company ACHIEVER Berlex Laboratories, Inc. Guilford Pharmaceuticals John Wiley & Sons, Inc. SUPPORTER Abbott Vascular AGA Medical Corporation B. Braun Medical Inc. Eli Lilly and Company FRIEND Ceres Medical Systems SPECIAL APPRECIATION IS EXPRESSED TO: John Wiley & Sons, Inc., for support of the Founders’ and Hildner Lectures
SCAI ALSO THANKS: GE Healthcare, for its support of the 2005 SCAI/GE Healthcare Fellows Grant Program for Research in Cardiovascular Angiography and Imaging Cordis, for its support of the 2005 SCAI/Cordis Research Program for Interventional Cardiology Cordis Endovascular, for its support of SCAI’s Carotid Stenting Educational Initiatives
Ponte Vedra Beach (continued from page 3) which means that we’re being more selective about what we accept. That’s an indicator of increasing quality,” said Dr. White. He also announced the launch of EarlyView, a new strategy for dramatically reducing publication delays associated with printing. Articles are now posted online (go to scai.org and click on “CCI Online”) as soon as they are finalized. Dr. White credited the hard work of the Editorial Board with CCI’s achievements. Records Set The 2005 Scientific Sessions added a number of new records to SCAI’s books: • Abstract submissions, up an amazing 57 percent over last year; among those abstracts was one singled out as the meeting’s best: Dr. Valter Lima’s presentation titled, “Coronary Vasomotricity Four Hours After Elective Stenting” • Attendance, up significantly, although not so much that the meeting became unmanageable for attendees • Exposition, sold out and bustling with steady traffic throughout the meeting (continued on page 15)
Distinguished Service Awards (continued from page 1) addresses the common, overriding concerns that affect interventional cardiologists, and their patients, regardless of where they practice. This effort was instrumental in the development of a new organization, the Coalition of Cardiovascular Organizations, or CCO, which Dr. Babb chaired in 2004. Most recently, Dr. Babb has become an expert on advocacy issues relevant to SCAI members and their patients. He understands the most complicated issues pertaining to physician reimbursement and has on many occasions been called upon to translate the concerns of SCAI members into focused messages for regulatory agency officials and other policymakers. “Dr. Babb has been willing to go anywhere, anytime to further the mission of SCAI,” said SCAI President Barry F. Uretsky, M.D., FSCAI. “We owe him and his wife, Margo Babb, a great deal.” Dr. Babb took the podium not only as awardee but also as presenter, honoring his good friend Dr. Cosentino with a Distinguished Service Award. Dr. Cosentino served as a trustee of the Society from 1992 to 2002 and is its longtime Governor in Latin America. “In addition to being a skilled cardiologist and investigator,” said SCAI Immediate Past President Michael J. Cowley, M.D., FSCAI, “Dr. Cosentino has built bridges
The Learning Never Stops at SCAI Scientific Sessions! The exhibit hall was busy throughout the meeting, with attendees stopping to browse among the booths of the specialty’s leading publishers, device manufacturers, and pharmaceutical companies.
Next Generation of Congenital Heart Disease Specialists Gathers ’Round a Pioneer. One of the world’s original congenital heart disease interventionalists, Charles Mullins, M.D., FSCAI, took time to meet with a group of cardiologists who are following his footsteps. SCAI organizes its Scientific Sessions so attendees have time for such interaction. In fact, collegiality has become one of the hallmarks of the meeting.
Substantive, Productive Committee Meetings to Kick Off the Meeting. Al Raizner, M.D., FSCAI, spoke out during SCAI's well-attended CME Committee meeting.
for the exchange of scientific information throughout the western hemisphere. He understands the importance of international partnerships in medicine and has been a model for his colleagues throughout the world.” Dr. Cosentino has served as SCAI’s ambassador, representing the Society at many international medical meetings and encouraging collaborative efforts by SCAI and its sister societies. SCAI’s international membership has expanded dramatically in recent years, due in large part to Dr. Cosentino’s efforts. Today, SCAI has members in 68 countries. Dr. Cosentino has remained a dedicated volunteer, serving as an active member of the Education, International, Programs, and various clinical guidelines committees. “Dr. Cosentino and his wife, Mariella, have been dedicated supporters of SCAI and its mission,” noted Dr. Babb, “and the Society is grateful to have them working on our behalf throughout Latin America.” ■
Watch Your Mail! The next issue of SCAI News & Highlights will feature the recipients of the 2005 SCAI/Cordis Research Fellowship Awards and the 2005 SCAI/GE Healthcare Fellowship Awards. Visit www.scai.org for information on how to apply for the 2006 awards.
MESSAGE FROM THE PRESIDENT
Is the Society American or Global?
s invasive cardiologists throughout the world, dedication to do so. Realistically, it’s not clear if the we may work in different health care systems Society would be able to function at present by our curand speak different languages, but our fundarent committee structure if we rotated meetings outside mental calling is the same. The mission of the Society the United States. thus applies globally. That said, many of the barriers to a functioning The Society was charglobal society have decreased. Electronic communicatered in 1978 by 77 foundtions have allowed rapid, long-distance discussion on ing members, all but two important issues. The Society’s leadership routinely from the United States. The uses this approach. This rapid communication is applimission statement, on the cable worldwide and increases the possibility to develother hand, has no nationalop a truly global leadership. What still remains a chalistic elements. The Society lenge is the need for face-to-face meetings, and the difwas, and still is, dedicated to ficulties, both financial and logistic, of arranging a regoptimizing quality in the ular meeting of a global leadership. cath lab — no matter where Major issues facing the Society are how to increase that facility exists. This is the number of international members; which areas the our fundamental goal wheSociety should address in global interventional cardither we live and work in ology; the relationships between the Society and variBoston, Berlin, or Bangkok. ous national, regional, and continental interventional Barry F. Uretsky, M.D., FSCAI I suspect that if we polled cardiology organizations; and the formal standing of our members and asked, “Is the Society an American or the international member in the Society. international organization?” most would have trouble The ability for the international member to become answering because both answers are partially true. The involved — at least at present — is more challenging historical events surrounding the Society’s birth occurred than for those of us in the U.S. However, distance in the United States. The bylaws allow leadership posishould be no obstacle — the communication tools are tions to be filled by any qualified individual from any available, and the need is great. With the exception of country, although to date the leadadvocacy and “pocketbook” issues ership positions have been filled (which are unique to each nation), with Americans. The Society’s the Society’s core issues are global membership is truly international ones — timely clinical guidance, with members from 68 countries. excellence in education, and, above Our Committees and the Board of all, quality care for our patients. Trustees have had, and continue Thus, the Society leadership is to have, international members, committed to “internationalize” the some of whom have exerted their Society. SCAI encourages members influence in greatly expanding the from every part of the world to particmembership of the Society on Dr. Uretsky and International Committee Chair ipate, and I pledge to you that we will Joseph D. Babb, M.D., FSCAI (center), got acquainted their continents. do everything possible to provide with many international members in Ponte Vedra The practicalities of operating Beach, including Robaayah Zambarhari, M.D., president opportunities for our international the Society have skewed it to of the Asia-Pacific Society of Interventional Cardiology. colleagues to participate fully. We owe remain largely American in leadership. The Committees a particular debt to those international members who are composed of Society members who volunteer their have worked for the Society under often-difficult cirtime and expertise. Typically these Committees and the cumstances. The challenge is how to most effectively Board of Trustees have met during national meetings of involve members and improve the quality of interventhe AHA, ACC, TCT, and the Society’s own meeting, tional cardiology practice globally. all occurring within the United States. Members from I would be grateful to hear from any member on this Europe, South America, and Asia who have attended issue. Please send me your thoughts at president @scai.org ■ these organizational sessions have shown extraordinary
SCAI Scientific Sessions Further International Collaboration
Asia-Pacifi Cardiologyc Society of Interventi onal (APSIC)
ciety of I) Brazilian Sonal Cardiology (SBHC o ti n e Interv
or two days, during the SCAI 28th Annual Scientific Sessions, Ponte Vedra Beach, FL, became the international hub for information exchange and education in invasive and interventional cardiology. SCAI hosted seven 11⁄2-hour international symposia, welcoming more than 25 international faculty, who gave updates on new devices, techniques, and indications. Nearly 200 attendees traveled from points all over the globe to participate in the Scientific Sessions. The symposia were very well-attended, offering opportunities for cardiologists to discuss the issues facing their specialty and their patients, regardless of where they live. “The interventional cardiology community is a global one,” said Program Co-chair Marco Costa, M.D., FSCAI, “and it is crucial that we have a forum for
sharing information and problem-solving together.” SCAI was honored to act as host as seven of its sister societies gathered in the United States. “These sessions illustrate SCAI’s commitment to working in partnership with the world’s other interventional cardiology societies for the rapid dissemination of scientific information impacting clinical care,” said the Society’s newly installed president, Barry F. Uretsky, M.D., FSCAI. “SCAI has members in nearly 70 countries, and our responsibility is to support high-quality education for all of them. The international symposia, offered for the first time at our Scientific Sessions, provided an excellent venue for members to interact with opinion leaders from all over the world. It was a huge success, and it furthered SCAI’s mission.” ■ European So ciety of
Spanish Society of ology Interventional Cardi
ciety of Japanese Soal Cardiology (JSIC) n o ti Interven
Cardiology (E SC)
erican Society of Latin Amiologists (SOLACI) rd Ca l na io nt rve Inte
Italian Society of Interventional Cardiology (GISE)
SCAI Leadership Changes Hands
New President Inspires. Barry F. Uretsky, M.D., FSCAI, was installed as president in Ponte Vedra Beach, FL. “I recognize the unique value of the ‘small’ cardiovascular society, and I believe that we must manage our Society’s growth in a way that melds the best opportunities of a small organization with the demands of a larger one,” he said. “This is the major challenge — and opportunity — facing us today.”
e Society, of the entir .D., . On behalf Michael J. Cowley, M t. ar Ye y us B d en a id ke es an of pr th d I, as En CA rvice The ., FS Cates, M.D dedicated se lead role in Christopher r his hard work and a n ke ta s ha veral , fo FSCAI (left) wley’s leadership, SCAI initiatives, including se re l ica Co na r. io ed D at M uc er e th ed nd U d fix advocacy an enting and efforts to st numerous rotid artery related to ca schedule. e physician fe
SCAI Thanks Trustees for Service
SCAI Launches Online Job Bank
During the 28th Annual Scientific Sessions, SCAI expressed its gratitude to two Trustees whose terms have ended. Neal S. Kleiman, M.D., FSCAI Associate Professor of Medicine Baylor College of Medicine Medical Director, Cardiac Catheterization Laboratories The Methodist DeBakey Heart Center The Methodist Hospital Houston, TX
Rita M. Watson, M.D., FSCAI Practicing Physician Monmouth Cardiology Associates, LLC Long Branch, NJ
The Society also welcomed aboard one new Trustee: Carlo DiMario, M.D., FSCAI Royal Brompton Hospital London, England
Are you looking for an invasive/ interventional cardiologist to join your practice? Are you an invasive/ interventional cardiologist looking for a new position? You’ll find NEW OPPORTUNITIES at scai.org! Visit SCAI’s new Online Job Bank by logging on to www.scai.org. Submit an online job ad, or read descriptions of available positions. For more details, contact Andrea Frazier at firstname.lastname@example.org or 800-992-7224.
SCAI Activates Grassroots Advocacy: Time to Fix Medicare Fee Schedule Call to Action: Ask Your Congressional Representatives to Co-sponsor “The Preserving Patient Access to Physicians Act of 2005”
CAI is urging all members to contact their Congressional representatives as soon as possible. The message to Senators and Representatives: Please cosponsor The Preserving Patient Access to Physicians Act of 2005. In the Senate, this bill is S. 1081; in the House of Representatives, it is H.R. 2356. These companion bills have the potential to reform the Medicare physician payment system and reverse the 4.3 percent physician pay cut scheduled to go into effect Jan. 1, 2006. If passed, the new law would repeal the deeply flawed physician-payment formula known as the sustainable growth rate, or SGR, and instead enact a 2.7 percent increase in physician payments in 2006 and another similar increase in 2007. The law would also avert cuts slated for 2006–11 that would slash physician pay rates by a total of 26 percent. “At stake in the short run is a 6.0 percent increase over the projections for 2006,” said SCAI Advocacy Committee Chair Joseph D. Babb, M.D., FSCAI. “In the long run, Medicare payment rates could drop to little more than half of what they were in 1991, after adjusting for inflation. If we don’t prevent these cuts, patient care will suffer because physicians simply cannot continue to absorb the costs. We owe it to our patients, and ourselves, to do all we can to get this bill passed.”
An Uphill Fight It’s not going to be easy, continued Dr. Babb, because the federal budget passed in May allocates no funds to avert the projected fee cuts. “Legislation is our only option at this point,” he explained. “Monies can still be appropriated, but it is going to be extremely challenging. The physician community needs to work together to educate our elected representatives so this problem gets fixed.” SCAI is working closely with the American Medical Association as well as its sister cardiology societies, such as the ACC, to convince Capitol Hill staff that the SGR is a misguided approach to calculating physician fees. “A major problem with the SGR,” said SCAI Senior Director for Advocacy and Guidelines Wayne Powell, “is that it encompasses the costs of the medications Medicare patients take, and physicians simply cannot
influence those costs. The bills before Congress right now replace the SGR with a new formula that reflects changes in the Medicare Economic Index.“ SCAI has worked hard on this issue and will continue to do so, said SCAI President Barry F. Uretsky, M.D., FSCAI. “However, this is the time for a true grassroots effort. Our strength on this issue lies in our numbers. If every U.S.-based SCAI member would take a few minutes this week to call their Senators and Congressional representative and ask them to support ‘The Preserving Patient Access to Physicians Act,” we could make a real difference. Our representatives in Washington need to hear from us that patient care is jeopardized by the flawed Medicare system.” To download talking points on S. 1081 or H.R. 2356 or for help sending an e-message directly to your elected Congressional representatives, visit http://www.ama assn.org/ama/pub/category/6583.html.
CMS Considering All Options to Reduce Imaging Growth
ollowing rapid growth in Medicare costs in 2004, the Centers for Medicare and Medicaid Services (CMS) told Washington advocates that the agency has not yet decided how to curtail spending. Nor has CMS taken any options off the table, reported the agency’s deputy administrator. Among CMS’s likely targets for cost containment is imaging services, an area whose growth has been measured in the double digits, depending on who is interpreting the data and whether shifts in the sites of service and other relevant variables are appropriately accounted for. The Coalition for Patient-Centered Imaging (CPCI), of which SCAI is a member, has argued that growth in imaging services are significantly lower than those alleged by radiology. Fueling the firestorm is a major campaign by the radiological community to lay blame for the growth at the doors of specialists other than themselves, including cardiovascular specialists, who often conduct imaging procedures in their offices in order to expedite patient treatment. SCAI, as part of CPCI, has continued to argue persuasively that growth in imaging services is both necessary and appropriate because new technological advances have permitted physicians to incorporate imaging into
routine care. The Coalition has pointed out that, in many cases, much more invasive and costly procedures, such as exploratory surgery, are avoided because physicians can use imaging techniques for diagnostic purposes. CMS officials are exploring the idea of facility accreditation as a means to contain the growth of imaging services. SCAI is concerned that this approach to cost containment will limit patients’ access to care, foster monopolies by radiologists in hospitals, and slow down patient diagnosis and treatments. The benefit of in-office imaging is that it usually leads to quicker diagnosis and treatment while lowering patient costs and hassles.
The Latest Medicare Data, at a Glance: Trends in Invasive Cardiology
• The number of single-vessel stent placements grew 15 percent • The number of multiple-vessel stent placements grew 18 percent • More than 82 percent of stent placements were in a single vessel • The number of balloon angioplasties without stent placements dropped 32 percent • The number of diagnostic cardiac catheterization procedures grew 8 percent — reversing a trend that saw those numbers peak in 2001 • The number of peripheral stent procedures grew 16 percent Stay tuned to scai.org! More robust data on these trends in invasive cardiology — plus analysis of what they mean for your practice and your patients — coming soon. ■
Preliminary 2004 Medicare data show that—
On TASC: New PAD Document Coming Soon
CI Editor-in-Chief Christopher J. White, M.D., FSCAI, is representing SCAI on an international effort aimed at distilling and disseminating the information available on peripheral arterial disease (PAD). In addition to SCAI, 16 other medical societies from Europe, North America, Australia, South Africa, and Japan are participating in the project, which is known as TASC, or the TransAtlantic Inter-Society Consensus Document on Management of PAD. Christopher J. White, The effort follows on the heels of a M.D., FSCAI
document published in 2000, called TASC-I. Rapid advances in PAD research, combined with the group’s desire to broaden the international collaboration to include as many countries as possible, have prompted the formation of the TASC-II writing group. Included are specialists in health economics, health outcomes, and evidence-based medicine. Among the group’s goals for the new document, said Dr. White, are to focus on key aspects of PAD document and management and to grade recommendations according to levels of evidence. Stay tuned for updates on scai.org and in this newsletter. ■
SCAI.ORG TIP OF THE MONTH scai.org: Your Portal to Membership Benefits
hen you visit www.scai.org, don’t forget to log in. Taking just 30 seconds to enter your username and password turns the SCAI home page into a member’s gateway to a variety of member-only benefits, including – • CCI Online: Your favorite journal available at your fingertips weeks before you get your print copy by snail-mail.
• Membership Directory: The best way to locate colleagues. • New List-Servs: Pick your topic and “talk” about the issues of the day. • Slide Library: Download slides for educational and training purposes. Don't remember your password? NO WORRIES! Go to www.scai.org and have it automatically e-mailed to you. ■
SCAI Members on the Move After 15 years on the East Coast,
pheral Invasive Laboratories at the Carolinas Heart Institute in heading back to the West. A native Charlotte. His has been an active of northern California, Dr. Bersin is member of SCAI for 15 years, havlooking forward to joining the ing co-directed both the 2000 newly formed Cardiovascular ConScientific Sessions and this year’s Cardiovascular Conference at Snowmass. His clinical interests focus on the treatment of peripheral artery disease, including carotid stenting. He wrote SCAI’s response to Blue Cross/Blue Shield’s technical assessment of the procedure. He is also on the faculty of the SCAI Core Curriculum in Carotid The Snowmass conference's new co-director is Robert M. Bersin, Stenting and served on the M.D., FSCAI (left), shown here with Snowmass Director John H.K. Vogel, M.D., FSCAI, MACC (center), and Co-director Spencer B. Society’s 2005 Scientific King, III, M.D., FSCAI, MACC (right). Sessions faculty. For more information sultants of Washington (CCW). about Cardiovascular Consultants This practice is a merger of Seattle of Washington, call 206-215-4545. Cardiology and Bellevue Cardi❦ ology, as well as with several other At press time, former SCAI independently practicing cardioloTrustee E. Magnus Ohman, M.D., gists in the region to form the FSCAI, was about to begin a new largest cardiology enterprise in the chapter in his career. After four Seattle metro area. Dr. Bersin will years as Chief of the Division of practice at both Swedish Medical Cardiology at the University of Center and Overlake Hospital North Carolina (UNC), Dr. OhMedical Center. When he starts man has joined Duke University as there in July, he will don three hats the Director of the Program for Adfor CCW: Director of Endovascular vanced Coronary Disease. The deciServices, Director of Clinical Ression to move on was a difficult one, earch, and Director of the Medical said Dr. Ohman, in part because of Research Foundation. “We’re brinthe excellent ging together most of the practicing team at UNC cardiologists in the region — a total and the accof 25 initially — in this new venomplishments ture,” said Dr. Bersin. “It’s an excitthey achieved ing opportunity for me to be part of in a relatively starting something new. It has the short time. Dr. potential to have a tremendous impact on cardiovascular care in a Ohman is parthriving region.” ticularly proud of the UNC Until recently, Dr. Bersin has E. Magnus Ohman, Heart Center, served as the Director of the PeriM.D., FSCAI Robert M. Bersin, M.D., FSCAI, is
which was established under his leadership. He was also pleased to have UNC recognized by United Health Care as a Center of Excellence and by the NIH for excellence in cardiovascular clinical and basic research. Dr. Ohman is looking forward to new challenges at Duke. One of his major goals is to develop a multidisciplinary program for advanced coronary disease. “Caring for the sickest patients of North Carolina has been my interest for many years,” he explained, “and this is an opportunity to concentrate on the needs of that fragile population.” He also plans to continue his work on quality-improvement initiatives in the CRUSADE-QI project. ❦ An update from the Cardiovascular Research Foundation’s (CRF) Center for Interventional and Vascular Therapies and Columbia University Medical Center: LeRoy Rabbani, M.D., FSCAI, reports that he is Director of Cardiac Inpatient Services and the Cardiac Intensive Care Unit. Also at CRF and Columbia are Warren Sherman, M.D., FSCAI, who directs Cardiac Cell-based Endovascular Therapies; Robert Sommers, M.D., FSCAI, Director of Adult Invasive Congenital Heart Services; and William Gray, M.D., FSCAI, Director of Endovascular Services. ❦ Send your Members on the Move updates to us by email: email@example.com. ■
New PDA Lesion-Classification Tool Handy in Clinic and Cath Lab
very day in the clinic and in the cath lab interventional cardiologists calculate the balance between risk and benefit. Having the SCAI coronary lesion-classification system at their fingertips is making that job easier and more accurate. Just ask the more than 800 SCAI members who have already downloaded the new lesion-classification program into a personal digital assistant (PDA). The third set of PDA-based guidelines available from SCAI, the lesion-classification system provides immediate feedback on the outcomes associated with specific types of lesions. “This helps the doctor in making clinical decisions, it helps in talking with patients and families, and it helps the cath lab document the risk profile for each patient,” said Lloyd Klein, M.D., FSCAI, who chairs the SCAI Interventional Committee and directs Clinical Cardiology Associates at Gottlieb Memorial Hospital in Melrose Park, IL. “I think it’s among the most useful tools we have in a handheld device.” The downloadable program puts at the fingertips a simplified classification schema for predicting the likelihood of success and complications following coronary interventions. This system was developed by Ronald Krone, M.D., FSCAI, and colleagues using data from the SCAI Registry. It streamlines lesion classification by focusing on high-risk lesion characteristics and has been shown to be more
accurate in predicting outcomes than the older American College of Cardiology/American Heart Association classification system. That makes the PDA an important research tool, too, said Dr. Krone, a professor of medicine at Washington University School of Medicine in St. Ronald Krone, Louis, MO. “When M.D., FSCAI reporting data, it is critical that everyone uses a uniform set of criteria for rating a lesion. Having the criteria in hand reduces inconsistency among operators and makes lesion classification more accurate.” Anne Marie Smith, SCAI’s education advisor, explained that the lesion-classification system can be downloaded free of charge to any Palm or Pocket PC-based PDA. Go to www.scai.org, scroll down to “Guidelines and Quality,” click on “PDA Tools,” then on the link to “Apprisor,” the viewing software that users download first. In addition to the three SCAI downloadable documents, the Apprisor site offers a drop-down menu of additional documents from other medical societies. “Because the Apprisor site is used by so many medical societies, it’s a very efficient and easy way to find other guidelines that might be of interest,” Ms. Smith said. SCAI would like to know what you think about PDA-based tools. Please direct comments firstname.lastname@example.org, attention: Anne Marie Smith. ■
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Ponte Vedra Beach (continued from page 5) Breaking New Ground The meeting in Ponte Vedra Beach also saw the start of new opportunities for education and interaction. For example, SCAI offered, for the first time, a full, uninterrupted day of sessions on PAD. Chaired by Dr. White and co-chaired by Dr. Marshall, the sessions addressed noninvasive evaluation of PAD, interventions in specific vascular beds, imaging technologies, new techniques and specialized treatments, and cerebral interventions. Dr. White made headlines when he announced late-breaking results of the much-anticipated BEACH trial, evaluating the benefits of carotid artery stenting with embolic protection in patients at high risk for carotid endarterectomy. Dr. White presented data through the first year of the study, focusing on a composite one-year endpoint for cumulative mortality and morbidity. “The results are well within the trial objectives we hoped to meet,” said Dr. White. “They suggest that carotid artery stenting with embolic protection is a viable treatment option in the high-risk
patients represented in this study.” Another ground-breaking event held during the Scientific Sessions was the Interventional Training Directors’ Symposium, moderated by Joseph D. Babb, M.D., FSCAI, Thomas M. Bashore, M.D., FSCAI, and David Kandzari, M.D., FSCAI. SCAI was honored to host this annual event and has received positive feedback from ACGME representatives who attended. It is likely that SCAI’s Scientific Sessions will become home to this important annual gathering on issues important to training the next generation of interventionalists. Among the topics discussed this year were workforce and certification issues and new directions for training.
Save the Date SCAI’s 28th Annual Scientific Sessions were an unqualified success, and now your Society is focused on next year. Mark your calendar for May 10–13, 2006, in Chicago. Program Chairs William O’Neill, M.D., FSCAI, and David Kandzari, M.D., FSCAI, are planning a meeting that will live up to SCAI’s “Best of the Best” tradition. Visit www.scai.org soon for details. ■
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Published on Dec 14, 2011
Action on Medicare Fee Schedule. . . 10 Handy in Clinic and CathLab. . . . . . 14 American or Global?. . . . . . . . . . . . . 6 Internation...