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www.scai.org

January/February 2006

The Society for Cardiovascular Angiography and Interventions

May 10–13, 2006

SCAI Scientific Sessions Packed With Special Events

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rom kick-off to wrap-up, SCAI’s 29th Annual Scientific Sessions are packed with opportunities for “Best of the Best” educational and collegial interaction. The invasive/interventional cardiology community will gather in Chicago, May 10–13, 2006. Program Chair Ted Feldman, M.D., FSCAI, noted, “In contrast to larger meetings, where no matter how many sessions you attend you feel you missed most of it, the SCAI annual meeting offers a chance to completely catch up on the stateof-the-art in interventional cardiology.” And, added Dr. Feldman, SCAI has continued a pattern of record-breaking abstract submissions. In fact, the number of abstracts submitted this year surpassed all previous years.

Wednesday, May 10th In accordance with tradition, SCAI will start the meeting by convening its full roster of committee meetings throughout the day on Wednesday, May 10th. Un(continued on page 2)

CHICAGO

Carotid Stenting Education

Back by Popular Demand: Core Curriculum Coming Soon: Integrated Online Education

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n response to widespread demand as well as positive feedback from past attendees, SCAI will again offer the popular Core Curriculum in Carotid Stenting. The intensive didactic and interactive course is slated for March 29–31, 2006, in Atlanta. Course Directors Christopher U. Cates, M.D., FSCAI, and Michael J. Cowley, M.D., FSCAI, have re-assembled the program’s world-renowned faculty. “The positive response to the Core Curriculum has come from all over the world,” said Dr. Cates. “In recent months, we have offered abbreviated versions of the course in several countries. As a result, the course keeps getting better and better. I really believe we’re setting a new standard for educating physicians in evolving therapies.”

As in the past, attendance will be limited. “This is a very focused, intense educational experience, which is why we keep the group on the small side,” said Dr. Cates. “I urge ev- President’s Message: APIA Conference: eryone to sign up early. Start of Collaboration in Australia and Asia-Pacific....................................................... 4 We expect the course to fill up fast.” CME From SCAI and Partners.................. 5 To register or obtain more information, log SICP Contributes to Success in Cath Lab..................................... 7 on to www.scai.org or Advocacy and Guidelines Update: call 800-992-7224.

In This Issue...

(continued on page 3)

Infection Control, Radiation Safety, PCI.........................................................

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SCAI Scientific Sessions (continued from page 1) like most professional medical societies, SCAI has long maintained an open-door approach to getting business done. The philosophy behind the policy is simple: the more members who participate in day-to-day activities, the more productive the Society. The full committee schedule will be posted online at scai. org. Members are invited to pick the areas that interest them most and stop by. No need to RSVP. Also on Wednesday, SCAI will host the Second Annual Interventional Training Program Directors’ Symposium, chaired by Joseph D. Babb, M.D., FSCAI. Special guests will include representatives from the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Internal Medicine (ABIM). Among topics to be addressed will be strategies for a successful ACGME audit and visa issues pertinent to fellows-intraining from outside the United States. The highly regarded Judkins Cardiac Imaging Symposium, chaired by Warren K. Laskey, M.D., FSCAI, will be held all day May 10th, providing attendees with a thorough review of the latest advances in flat-panel imaging, EBCT, IVUS, radiation safety, and more. A new offering on Wednesday will be the all-day Hemodynamic Symposium, chaired by Zoltan Turi, M.D., FSCAI, and Morton Kern, M.D., FSCAI. The doors of the Exposition will open Wednesday, May 10th, and close Friday, May 12th. The Society expects that the exhibit hall will, as in years past, be sold out, giving attendees opportunities to interact with SCAI’s industry partners. SCAI’s Exposition is big enough to attract the companies that are developing the latest devices and drugs for treatment of cardiovascular disease but not so large that attendees find it overwhelming or difficult to navigate. Starting Wednesday and running throughout the Scientific Sessions, a variety of Satellite Symposia will also be held, making for education that continues into the evenings. Thursday, May 11th Opening Thursday’s educational program, Richard

Stack, M.D., will present the Founders’ Lecture. The two-day Congenital Heart Disease (CHD) Interventional Program, chaired by Zijad Hijazi, M.D., FSCAI, and Carlos Ruiz, M.D., FSCAI, will get underway Thursday, May 11th. Sessions will focus on patent ductus arteriosus, percutaneous closure of ventricular septum defects, critical aortic valve stenosis in the neonate, and management of branch pulmonary artery stenosis. The always-popular session titled “I Blew It” will be back again this year, demonstrating common pitfalls in the treatment of CHD and, importantly, how expert physicians avoid and/or correct them. The CHD Interventional Program will again feature a combined session for congenital and adult cardiologists, which will be of special interest to interventionalists involved with structural heart disease. Also starting on Thursday and running through the program will be Taped-Cases Sessions, wherein experts from around the world will present some of the most challenging cases they have (continued on page 10) 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; info@scai.org Barry F. Uretsky, M.D., FSCAI President Morton Kern, M.D., FSCAI Editor-in-Chief Norm Linsky Executive Director Wayne Powell Senior Director, Advocacy and Guidelines Bea Reyes Director, Administration Rick Henegar Director, Membership and Meetings

Andrea Frazier Publications & Committee Operations Coordinator Anne Marie Smith Educational Programs Betty Sanger Sponsorship and Development Kathy Boyd David Managing Editor

Sarah Jones Membership Coordinator

Touch 3 Design & Production

Jen Wool Promotions Coordinator

Imaging Zone Printing




Carotid Stenting Education (continued from page 1)

lum or registered to do so will soon receive a password Around the Corner: Integrated Online Education that delivers them through the online education portal at www.scai.org. One of the many strengths of SCAI’s Core CurricuThose who complete the program will earn approxilum in CAS is that it is one component of the Society’s mately nine hours of CME credit and get a real sense of new three-tiered model for physician education. The their individual strengths and weaknesses in the cognitive model’s first tier is the didactic Core Curriculum, which aspects of CAS, said Dr. Weiner. A series of self-assessment dovetails neatly with tier 2, questions appears at the the comprehensive online end of each module, and a educational program SCAI comprehensive test wraps will introduce early this year. up the program. Again, to By integrating the didactic make the most of online course with online learning, learning, the Society has SCAI prepares physicians set no expiration date on for the third tier of the prothe passwords. “Users can gram: simulator training. come back and review SCAI’s innovative apthe parts of the program proach to physician eduwhere they need work,” cation is uniquely suited said Dr. Weiner. for introducing new proAnd they can log on cedures, which, like CAS, wherever and whenoften require that physi- Some of the faculty of SCAI’s Core Curriculum in Carotid Stenting, from left: ever it is convenient for Ted Feldman, Ken Rosenfield, Nick Hopkins, Michael Cowley, Christopher cians have advanced cogni- Drs. them. That’s one of the Cates, Frank Criado, Suku Thambar, Khusrow Niazi, Michael Bacharach, John tive knowledge and superior Spencer, and Robert Bersin. greatest benefits of ontechnical skills. It is fitting line medical education, that the Society’s first major step into online educa- said Karl Wilkens, president of MultiWeb Commution is focused on CAS, said SCAI President Barry F. nications, the Cleveland firm that is building the Uretsky, M.D., FSCAI. “The Society has taken a lead- educational site. “A great benefit of this program is ership role in carotid stenting since the procedure was that physicians don’t have to take time away from approved by the FDA,” he said. “Because SCAI co- their practices and their patients.” authored multispecialty recommendations for clinical (continued on page 9) competence in CAS, it follows that the Society should also offer physicians the tools they need to achieve and CAS Programming: maintain competence.” Modules Online at scai.org Each tier of the program is de1 Stroke signed to play to its own strengths. 2 Anatomy Bonnie Weiner, M.D., MBA, MSEC, FSCAI, editor of SCAI’s online CAS 3 Arch Type and Variations program, explained that users will find 4 Carotid Artery Disease the online education to be invalu5 Hemodynamic Monitoring able, both for reinforcing what they 6 Patient Selection learned in the Core Curriculum and Bonnie H. Weiner, MD, FSCAI 7 Patient Assessment for expanding their cognitive knowledge of CAS. “There is some overlap, and some areas 8 Diagnostic Imaging are re-emphasized because they are very important,” she 9 Adjunctive Pharmacotherapy explained, “but the online program makes the most of 10 Planning the Procedure virtual learning, namely 24/7 availability, interactive 11 Accessing the Carotid Artery programming, especially for demonstrating catheter 12 Distal Protection Devices and wire motion; effectively combined graphics and text; and plenty of opportunities for self-assessment.” 13 Stent Selection

Access by Password The online program is divided into 16 modules (see table). Everyone who has attended the Core Curricu-

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EPD Management

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Post-Procedure Care

16

Complications




message from the president

APIA Conference: Start of Collaboration in Australia and Asia-Pacific

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ast month, I had the honor of delivering the welcoming address at the first Asia-Pacific Interventional Advances (APIA) Conference. I believe this meeting was the start of a new tradition of collaboration between SCAI and our colleagues in the Asia-Pacific region, and Australia in particular. As I pointed out in my talk to the meeting’s more than 400 attendees, we interventional cardiologists have much in common, whether we practice in Newcastle, Australia (site of the APIA Conference); Newcastle, England; or New Castle, Delaware, USA. We face many of the same challenges, such as how best to incorporate new technologies into our practice of medicine—a fact that drives home the value of meetings like APIA. Such global gatherings present Barry F. Uretsky, M.D., FSCAI us with unique venues for working together to overcome challenges and respond to opportunities. The vision for the APIA meeting came from Dr. Suku Thambar, who chaired the meeting along with Dr. Rohan Jayasinghe. Dr. Thambar describes his vision for this meeting as a kind of recipe, with a few key ingredients. First, he assembled an excellent faculty drawn from all over the world, experts who were willing to, as Suku puts it, “roll up their sleeves and fill in for those who at the last minute were unable to get there.” Next, he developed an impressive educational program, including a series of excellent live cases transmitted from sites as far away as New York City and South Korea. He also assembled impressive support from industry partners, companies large and small that are committed to furthering physician education throughout the world. Dr. Thambar reached out to organizations such as SCAI, the World Heart Federation, and the AsiaPacific Society of Cardiology for help and input. The result was a truly global event, with attendees from at least 14 countries, including faraway Russia. I enjoyed the APIA Conference for many reasons, including the opportunity to learn from, and teach alongside, a new group of friends. The meeting was also important to me because it represents SCAI’s growing

involvement in educational activities globally. Your Society’s role as a co-sponsor of this conference also reflects its growing reputation and credibility as an international organization, one with a great deal to offer our sister organizations throughout the world. As an example, as part of APIA, Drs. Chris Cates, Joe Babb, and I ran the first carotid stenting workshop to be held in Australia. It was an honor and pleasure for us to be able to make this contribution to the meeting. Recently, the position of co-chair of SCAI’s International Committee opened up, and I volunteered to fill the job. Dr. Babb, the committee’s chair, and I share a vision for continuing to globalize your Society in the years to come. Doing so is an important next step in the growth of SCAI and one that I am proud to be a part of. I believe that it will enhance the value of SCAI membership for all of us, no matter where we practice. Please share your thoughts on this and other topics with me by emailing president@scai.org. n




History of Catheterization Lecture Now Available Online

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id you miss the “History of Catheterization” lecture Frank J. Hildner, M.D., FSCAI, presented at SCAI’s 28th Annual Scientific Sessions? It’s not too late. Now you can hear Dr. Hildner’s lecture and see his slides online at http://www.scai.org/ drlt3.aspx?PAGE_ID=4140. SCAI extends thanks to John Wiley & Sons, Inc., for supporting Dr. Hildner’s presentation, both at the Annual Scientific Sessions and online. The lecture was born when Dr. Hildner realized that many fellowsin-training weren’t aware of the field’s history. Some physicians “come into training and assume that everything has been there forever,” explained Dr. Hildner, who founded Catheterization Frank J. Hildner, and Cardiovascular Interventions and MD, FSCAI served as the Journal’s editor for 25 years. “They don’t realize how difficult times were in getting to where we are now.” The approximately hour-long lecture traces catheterization’s history from its beginning in 1929, when Dr. Werner Forssman inserted a catheter into his own

arm and became the subject of the world’s first cardiac catheterization, to the present day. Telling a compelling story of progress and setbacks, the lecture divides catheterization’s history into five eras: the beginning (1929–38), initial clinical applications (1938–48), the left heart era (1949–58), the coronary arteriography era (1959–77), and the therapeutic catheterization era (1977–present). Along the way, the lecture introduces such pioneers as Drs. F. Mason Sones, Melvin P. Judkins, Charles Dotter, and Andreas Gruentzig. The lecture also presents SCAI’s own history. And cardiologists aren’t the only ones tuning in to Dr. Hildner’s lecture on scai.org. The Society recently heard from a theater professor who came across the lecture while surfing the Web. In a note thanking SCAI for making the presentation available, he wrote that Dr. Hildner’s “excellent presentation of the history of catheterization … reminded me that I will observe next June the fiftieth anniversary of my open-heart surgery to correct congenital pulmonic stenosis…. It was exceedingly gratifying to get to know those pioneers whose efforts have given me those fifty healthy and satisfying years of life.” n

SCAI Members on the Move Congratulations to the course directors of CardioVillage! Lawrence W. Gimple, M.D., FSCAI, received the Dean of University of Virginia School of Medicine’s Special Award for TeachLawrence W. Gimple, ing Excellence. M.D., FSCAI The award recognizes Dr. Gimple’s vision and committed service to CardioVillage. Dr. Gimple co-founded CardioVillage and is Chief of the Division of Cardiovascular Medicine at the University of Virginia. Michael Ragosta, M.D., FSCAI, who created and is the primary author of CardioVillage’s

Diagnostic Catheterization and Interventional Curriculum, was recently promoted to Director of the cardiac catheterMichael Ragosta, ization laboratoM.D., FSCAI ries at the University of Virginia Health System. Dr. Ragosta was instrumental in forging the partnership between SCAI and the University of Virginia School of Medicine, sponsor of CardioVillage. S Richard E. Stewart, M.D., FSCAI, has moved his practice to Rockford, IL, where he is special-

izing in coronary and endovascular interventions. He is a Clinical Associate Professor of Medicine at St. Louis UniverRichard E. Stewart, sity Health SciM.D., FSCAI ence Center and The Rockford Cardiology Research Foundation. Dr. Stewart reports that he is enjoying being part of a highvolume endovascular practice and hopes to intensify his clinical and research efforts in peripheral vascular interventional medicine. n




SICP Contributes to Success in Cath Lab

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n 1993, the Society of Invasive Cardiovascular tributes to the highest standards for patient care, said Professionals (SICP) was established to help cardi- Ms. Simpson. ologists achieve their goal of delivering the highest “All invasive cardiologists work as part of a team of quality patient care in the cath lab. SICP was formed at ICPs, and everyone is vital to the performance of the prothe urging of several SCAI leaders who perceived that cedure and the lives of the patients,” explained Dr. Kern. their nonphysician teammates in the cath lab would “We can only be as good as our team; therefore, we are be well-served by organized representation, education, thankful for dedicated FSICPs who strive for excellence.” and credentialing tailored to their specialty. Today, “In a cath lab, everybody functions as one, as a cardiologists working with SICP members know that team, and we need to present ourselves as a unified they are flanked by a competent and capable team. force and integrate the technician side with the phy“SICP provides our cath lab staff with a source for sicians in order to move forward with technology and credentialing and education. It gives them a voice in legislation,” added Ms. Simpson. the larger professional world and a sense of professionalSICP has fostered relationships between its memism in the laboratory,” said SCAI Past President Mor- bers and cardiologists by holding meetings in conjuncton Kern, M.D., FSCAI. “An SICP credential means tion with SCAI, exhibiting at SCAI programs, and the individual is motivated, knowlfeaturing SCAI members as speakedgeable, and well-trained, all very at educational courses. “We can only be as ersThe important characteristics in a cath relationship between SCAI lab professional.” good as our team; and SICP works both ways, said SICP is committed to providDr. Kern. “Just as SCAI provides its therefore, we are ing educational and networking members with a forum and structure opportunities for all cardiovascu- thankful for dedicated to educate, share breakthroughs, and lar professionals, explained SICP set standards, so, too, does SICP proPresident Tracy L. Simpson, RCIS, FSICPs who strive for vide its members with such a forum,” FSICP. “The technology of our field he said. excellence.” is constantly evolving, and there is –Dr. Kern Achieving the Gold Standard an increasing need for credential recognition. These two factors creSICP holds the registered cardioated a need for a society to represent invasive cardio- vascular invasive specialist, or RCIS, credential as the vascular professionals (ICPs) and help us to stay current gold standard for noncardiologists who work in cath with the latest trends in cardiovascular technology.” labs because it brings together the various technology Ms. Simpson continued: “SICP fulfills the need for credentials under one. Cardiovascular Credentialing an organization that can manage professional stan- International awards the RCIS credential to invasive dards, promote continuing education, and act as an cardiovascular technologists upon their graduation advocate for cardiovascular technologists. In short, from an accredited Cardiovascular Invasive TechnolSICP is at the forefront of keeping the cath lab a ogy program and successful completion of the Invasive cross-trained entity.” Registry Exam and Cardiovascular Science Exam. An important part of the SICP mission is to advoTeaming Up in Pursuit of Quality cate for education and challenge members to pursue Key to a strong cath lab team is a shared body of knowl- the RCIS credential, which has only been available edge, stressed Ms. Simpson. “Each member of the cath lab for about 15 years, making it one of the newer allied team brings individual expertise to create a multidisci- health professions specific to cardiology. plinary team that supports the invasive cardiologist.” SCAI and ACC both recognize RCIS as the creBy the same token, SICP’s strength is its inclusive- dential of choice for ICPs, said Ms. Simpson, who ness. The society represents many the disciplines that hopes that physicians from both organizations will contribute to the cath lab team: nurses, cardiovascu- support the growth of SICP. “We need the doctors to lar and radiology technicians, respiratory therapists, stand up for the RCIS and make it know that they and other allied health professionals. Although SICP want technicians and nurses with the RCIS credenmembers hold a variety of different credentials, they tial next to them at the cath table,” she stressed. “A all work together under the direction of the cardiolo- unified front of physicians and SICP members can gist. And this diversity strengthens the team and con- help keep the cath lab a cross-trained entity.” n




ADVOCACY and guidelines update

SCAI Updates Infection-Control Guidelines to Address Both Patients and Healthcare Personnel in the Cath Lab

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CAI’s newly revised infection-control guidelines for the cardiovascular cath lab take a comprehensive approach to protecting both patients and healthcare staff. Published in the January 2006 issue of CCI, the guidelines update was spurred in part by the growing complexity of interventional cardiology procedures. “With all of the implantable devices and advanced procedures, it is becoming difficult to distinguish the cardiac catheterization laboratory from the surgical suite,” said Charles E. Chambers, M.D., FSCAI, lead author of the new guidelines and chair of SCAI’s Cath Lab Standards Committee. “Infections in the cardiac cath lab are very uncommon, and we want to keep it that way.” Implantable devices are increasingly used not only in stenting but also in percutaneous valve procedures and closure of patent foramen ovale and atrial septal defects. At the same time, it is critically important to protect cath lab staff against blood-borne pathogens. “The personnel who work in the cath lab need to be better protected from exposure to bodily fluids,” said Peter Block, M.D., FSCAI, co-chair of the committee. “We need to be aware of Universal Precautions and follow those rules.” SCAI members themselves identified the need to update the 1992 infection-control guidelines. In a member survey, nearly 80 percent of respondents called for SCAI to issue new recommendations. The updated document includes the following recommendations: • Avoid patient hair removal at the catheter access site unless it directly interferes with the procedure; if necessary, use a clipper or depilatory, rather than a razor. • Begin each day with at least two to three minutes of hand scrubbing, followed by use of an antiseptic solution or foam before each subsequent case. Avoid repeated hand scrubbing. • Wear a sterile, nonporous gown; cap; mask; gloves; and protective eyewear to minimize both the risk of patient infection and the potential for operator or staff exposure to bodily fluids. • Double-glove when performing interventional procedures on high-risk patients, such as those infected with HIV or hepatitis. • Wear shoe covers to prevent cross-contamination between cath lab suites. • Change containers of contrast material or flush solutions between patients, unless an approved device is used to prevent backflow. • Ensure that the cath lab is completely cleaned daily and spot-cleaned after each case.

• Ensure that the ventilation system provides at least 20 air exchanges per hour, and that air vents are cleaned at least monthly. The guidelines also provide detailed information on the selection of antibacterial soap, the circumstances under which patients should receive antibiotics, catheterization techniques to minimize infection, special precautions when using vascular closure devices, and proper handling of fixed and disposable laboratory equipment. “As we evolve toward more procedures involving structural heart disease and are more closely involved with our surgical colleagues, we will become increasingly rigorous about making the cath lab more like an operating room than it has been in the past,” Dr. Block said. The updated guidelines prepare cath labs for that future, Dr. Chambers said. “These guidelines are more comprehensive than the earlier version and demonstrate SCAI’s continued commitment to the safety of our patients and staff in the cardiovascular cath lab.”

SCAI Testifies on Radiation Safety

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CAI and ACC teamed up to give testimony at a meeting convened by the Food and Drug Administration (FDA) on the subject of radiation safety. The FDA has issued a radiological health program plan that addresses diagnostic and therapeutic uses of ionizing radiation. SCAI Trustee and Cath Lab Standards Committee Chair Charles E. Chambers, M.D., FSCAI, represented both SCAI and ACC. He stressed that cardiologists are knowledgeable about radiation safety and how to optimize protection for both patients and operators. He urged FDA officials to work with the cardiovascular community on any efforts related to education, training, monitoring, and standard setting. SCAI is urging the FDA to coordinate with the Nuclear Regulatory Commission and the Occupational Health and Safety Administration to ensure that the three agencies’ regulations are consistent and do not overlap. SCAI is following progress on this and other efforts to make certain that the radiology community does not use the regulatory process to curtail the access of nonradiologists to advanced imaging techniques.  To read Dr. Chambers’s testimony, visit http://www. scai.org, and click on “Advocacy.”

ACC, AHA, SCAI Update PCI Guidelines

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n November, SCAI joined ACC and AHA in presenting the 2005 Guideline Update on Percutaneous Coronary Interventions (PCI). SCAI acted as a full partner in the development of the new guidelines. The Society was officially represented by four SCAI Fellows: Ted (continued on page 12)




THANK YOU SCAI expresses appreciation for major support from:

Cordis Endovascular a Johnson & Johnson company

for SCAI’s carotid stenting educational initiatives SCAI also expresses deep appreciation to the following companies for their generous support of the 2005 Core Curriculum in Carotid Stenting Programs:

Abbott Vascular Devices, Boston Scientific, Cordis Endovascular, Cook, Inc., The Medicines Company, Medtronic, Inc.

Carotid Stenting Education (continued from page 3) Dr. Weiner was quick to acknowledge the contributions of MultiWeb Communications. “The firm has a rare combination of excellent technology skills combined with a thorough understanding of the scientific context that we work in,” she explained. “Users will appreciate how seamlessly the site works.” Onward to Simulation, Then New Technologies After successfully completing both the Core Curriculum and the online program, physicians move on to the

third tier of SCAI’s new educational model: proficiencybased simulator training. “Some of the simulation will be metric-based, including opportunities to practice what was learned in the first two tiers of the program in order to achieve technical proficiency,” said Dr. Cates. If you’re looking for a very complete, very comprehensive educational experience in carotid artery disease and stenting, SCAI’s program is the answer, said Dr. Weiner. And, perhaps more important, she said, this new tiered model for professional education will offer a new training method to a host of new areas, such as percutaneous valve procedures and patent foramen ovale/atrial septal defect closures. “There are no other online medical educational systems that I’m aware of that are part of a more comprehensive educational model,” she stressed. “This model is going to work on a broader scale for our members, and for others, so that we’re training operators who understand the disease process, patient selection, risks and benefits, how to deal with complications — the whole gamut of things we get trained in as fellows but that we have to learn on our own once we’re out in practice and medicine keeps evolving. It’s definitely not for CAS training only.” n

Phenomenal Income Potential– Interventional Cardiologists! To further expand and compliment its existing staff, Springfield Clinic located in Springfield, Illinois, is recruiting additional Interventional Cardiologists to join its 173-physician organization. Unlike most multispecialty groups, Springfield Clinic utilizes a cost accounting system that provides a much higher salary potential than most other multispecialty – and single specialty – groups! The clinic is proud to announce the opening of its new Springfield Clinic 1st facility, scheduled to open in late 2005. Located adjacent to Memorial Medical Center and Southern Illinois University School of Medicine, this site will house approximately 60 Springfield Clinic physicians, including the Cardiologists and surgical-based specialties. Springfield, the capital of Illinois with a metro population of 170,000, is home to beautiful Lake Springfield. Located only 90 minutes north of St. Louis, and 3 1/2 hours to both Chicago and Indianapolis, the region provides exceptional academic, cultural, shopping, recreational, and housing options that will suit every taste! To learn more, contact Pam at (800) 528-8286, extension 4102, e-mail pam.buckalew@stratummed.com, or fax (217) 3374181. Not J-1 eligible. ADVERTISEMENT ADVERTISEMENT


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SCAI Scientific Sessions (continued from page 2) encountered. A panel of renowned interventionalists will examine each case, discussing how various clinical strategies apply to the case at hand as well as other scenarios. Past, present, and future Presidents of SCAI will host the Presidents’ Banquet on Thursday evening. Following the educational smorgasbord of the day, this event is a fun, social event perfect for catching up with colleagues and friends and making new acquaintances. The banquet is held in the exhibit hall, so attendees can peruse the booth displays at their leisure.

Saturday, May 13th The Society’s respected Peripheral Symposium, chaired by David Kandzari, M.D., FSCAI, will be held all day Saturday, May 13th. Attendees will hear from leaders in the field about the latest developments in renal artery stenosis, limb ischemia, noninvasive evaluation of peripheral arterial disease, carotid stenting, numerous alternatives to stenting, and much, much more. Also on Saturday, the Society of Invasive Cardiovascular Professionals (SICP) will host a full-day symposium to give cath lab nurses and technologists a comprehensive review (see related story on page 7). Register Today! SCAI is accepting registration for the Scientific Sessions. For the convenience of members, a registration form is included in this newsletter, or register online at www.scai.org. For more information, call 800-992-7224. n

21st Annual Cardiovascular Conference at Hawaii February 13–17, 2006 Mauna Lani Bay Hotel Kohala Coast, Big Island, Hawaii

Program Director: John H.K. Vogel, M.D., MACC, FSCAI, and C. Richard Conti, M.D., MACC

Photo courtesy of Mauna Lani Resort

Friday, May 12th SCAI Trustee Gregg W. Stone, M.D., FSCAI, will launch Friday’s educational program with the Hildner Lecture. Dr. Stone will discuss “Prospects for the Invasive and Non-Invasive Identification of Vulnerable Plaque.” He is professor of medicine at Columbia University, director of Cardiovascular Research and Education at the University’s Center for Interventional Vascular Therapy, and vice-chairman of The Cardiovascular Research Foundation. The Society’s eagerly anticipated Annual Banquet will be held Friday evening. There, new SCAI Fellows (FSCAIs) will receive both a special welcome from President Barry F. Uretsky, M.D., FSCAI, and their official certificates. In addition, the Society and two of its industry partners will recognize the medical excellence and promise of four interventionalists-in-training. SCAI and Cordis, a Johnson and Johnson company, will present two interventional fellows-in-training with grants of up to $25,000 each in support of their research. SCAI and GE Healthcare will also recognize two interventional fellowsin-training, awarding them grants of $20,000 to support their research in cardiovascular angiography and imaging. Friday also marks the beginning of a new event at SCAI’s Scientific Sessions. SCAI is proud to host the Third Annual Interventional Fellows Complex Coronary Complications (C3) Summit, which promises to be a phenomenal educational opportunity for interventional fellows in their last year of training. This program will immerse fellows in a comprehensive review of cases, including those they may not have seen in training but will eventually see in practice. An educational grant provided by Cordis, a Johnson and Johnson company, will enable all eligible fellows to attend the C3 Summit; the grant covers Scientific Sessions registration fees as well as hotel accommodations and coach airfare to and from Chicago. Registrants will be invited to present the most challenging cases they encountered during training, and a faculty of experts will recognize the best presentations. The C3 Summit is a unique op-

portunity for fellows to test their skills and meet leaders in interventional cardiology. The C3 Summit will run through noon on Saturday, May 13th.


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Advocacy and Guidelines Update (cont. from p. 8) Feldman, M.D., FSCAI, John W. Hirshfeld, Jr., M.D., FSCAI, Morton Kern, M.D., FSCAI, and Douglass Morrison, M.D., FSCAI. In fact, SCAI members comprised two-thirds of the writing committee. “The equal participation of SCAI in the development of these guidelines greatly strengthens their recommendations,” said SCAI President Barry F. Uretsky, M.D., FSCAI. “The document reflects both the detailed focus of interventionalists and the broad view of generalists.” The result is a substantial revision of the 2001 guidelines published by ACC and AHA. Recommendations on drug-eluting stents and distal embolic protection devices are two significant additions. The guidelines also expand the anatomic indicators for PCI to include patients with left main coronary artery disease who are ineligible for coronary artery bypass graft surgery. The guidelines also set the challenging goal of door-toballoon time of 90 minutes or less for primary PCI. Writing Committee Chair Sydney C. Smith, M.D., explained the thinking behind this objective: “The science shows that patients truly benefit from a ‘door-to-balloon time’ of 90 minutes or less. We have consistently looked at where the science says we should be, and challenged ourselves.” Among other challenges are rigorous monitoring and management of PCI patients. Recommendations include risk-factor modification for all patients; a regimen of aspirin and clopidogrel for most patients; ACE inhibitors for patients with coronary artery disease,

left ventricular dysfunction, or hypertension; at least 6 months on beta-blockers for AMI or other acute conditions; aggressive lipid lowering for high-risk patients; and, for diabetic patients, glucose-lowering therapies aimed at bringing HbA1c levels to less than 7 percent. Two controversial recommendations in the guidelines pertain to annual operator volumes and surgical backup for elective angioplasty. The guideline advises the primary and elective PCI should be offered by experienced operators, with experience defined as at least 75 elective procedures performed each year at high-volume centers and “high volume” defined as more than 400 procedures annually. On the subject of surgical backup, the 2005 update maintains the same recommendation from four years ago, that elective PCI should not be performed at institutions that do not have onsite cardiac surgery facilities. “While SCAI supports this 2005 Guideline Update in general, the Society recognizes the reality that such an approach has developed in multiple locations both in the United States and other regions of the world,” said Dr. Uretsky. “The Society feels that discussion of this important subject should ultimately revolve around what is in the best interest of the patient.” To that end, SCAI is assembling information on this subject so that discussion can be focused on the true risks and benefits of this approach within the realities of each health care system. n

MAGIC Is in the Air

D

o you despair about there being no multi-institution practice-based evidence for the success of procedures in the cath lab for children? Would you like to pool the results from your cath lab into a larger database to help determine the long-term outcomes of catheter-based therapies for congenital heart disease? Try MAGIC, Allen D. Everett, M.D., FSCAI, says. Most of the cardiac catheterizations for congenital heart disease performed today are therapeutic, yet there has been no way to broadly analyze outcomes of these procedures, said Dr. Everett, associate professor at Johns Hopkins. “Existing large databases, such as the one managed by the American College of Cardiology, do not address patients with congenital heart disease. As a result, our therapeutic decision making for these patients is guided by relatively small numbers from single institutions, rather than by multi-institution, evidence-based approaches,” he said. To remedy this situation, Dr. Everett and fellow SCAI

pediatric cardiologists at Johns Hopkins, University of Virginia, Duke University, and Vanderbilt University developed MAGIC (Mid-Atlantic Group of Interventional Cardiology). The MAGIC data-entry program uses a modification of PedCath™, an existing congenital heart disease cardiac catheterization database used worldwide. “We’ve worked with the developer to rewrite the software to function as a data-submission tool. The data can be sent out in a HIPPA-compliant manner to a single data repository here at Hopkins. We then do a complex analysis and send that analysis back out to investigators on a weekly basis,” said Dr. Everett. There’s power in numbers, he added. “Cardiologists who practice at any size center can use the power of all of us being linked together to run their own research study.” For more information about MAGIC, go to www. magicgroup.com, or contact Dr. Everett at 410-502-0699, or aeveret3@jhmi.edu. n


Newsletter_2006-1  

As in the past, attendance will be limited. “This is a very focused, intense educational experience, which is why we keep the group on the s...

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