We have 18 full-time clinical staff, consisting of RNs, RT(R)s, and CVTs. The staff that are employed here all have significant amounts of interventional radiology, cath lab, and cardiology experience. The average experience for our staff is over five years in the lab.

What type of procedures are performed at your facility?

We perform everything from diagnostic heart caths to complex interventional cases. We have the AngioJet® (Possis Medical, Inc., Minneapolis, MN) and X-Sizer® thrombectomy system (ev3 Inc., Plymouth, MN). We use intra-aortic balloon pumps on many of our ST-

Approximately how many are chronic total occlusion (CTO) patients?

Eight to ten percent are CTO attempts.

What is your crossing success rate?

Our crossing rate now is in the range of 80%. There are nine interventionalists working at the St. Luke’s laboratories, so that percentage represents the average success rate for the group.

Why is it important to treat CTOs? Should all CTOs be treated?

There are two really compelling reasons why CTOs should be attempted. One reason is that there is some very good data now showing that you can improve left ventric

Launched February 24, 2006 at the Third International Chronic Total Occlusion Summit (New York, NY) the Asahi Tornus® specialty catheter (Abbott Vascular Devices, Redwood City, CA) is a new catheter for crossing chronic total occlusions in both coronary and peripheral vasculature. Its design consists of several hair-thin stainless steel strands braided together, along with a safety-release valve at the proximal end to indicate when the device has reached maximum rotation, and a tapered distal tip with a radiopaque marker. The device is available in both 2.1 Fr for accessing lesions that are m

Presented at the Cardiovascular Research Foundation’s third international CTO Summit, held in February 2006, several renowned investigators highlighted new methods and success rates for crossing chronic total occlusions with the latest innovative approaches. The clinical and angiographic factors predicting success and failure of CTO revascularization, summarized by Dr. Jeffery Moses, continue to emphasize what little has changed in the anatomy of the CTO over the past 20 years of percutaneous coronary intervention. The newest technical approaches employ novel support catheters such as the T

Patient Selection and Safety

David E. Kandzari, MD, Duke University Medical Center, Durham, NC, addressed patient selection by discussing results showing improvement of left ventricle (LV) function after CTO recanalization.1 In a study analyzing the potential for LV recovery after successful CTO revascularization, patients with the most severe LV dysfunction experienced the greatest increase in LV ejection fraction (25% increase over baseline; p < .001). Preserved microvasculature was also a positive predictor of improvement in LV function, whereas reocclusion was a negative predicto

Hello fellow RCISs,

I worked in the cath lab for 23 years before going on worker's comp due to excessive lead apron time. The last lab I worked in had a huge turnover due to physician interference, favoritism and good ideas falling on deaf ears. I frequently scrubbed multiple cases unless a doctor requested someone else they knew better or longer no matter what my credentials were or what I had proven I could do. My specialty was cardiology, but I worked in a radiology suite because they needed me and promised I would be transferred to cardiology, or at the very least be able to tr

Nearly 20 percent of all percutaneous coronary interventions (PCI) are performed at a bifurcation. Moreover, bifurcation and ostial lesions remain one of the more challenging coronary interventions faced by interventional cardiologists in our drug-eluting stent (DES) era.

There are two schools of thought regarding how ostial and bifurcation lesions should be approached and treated. Some favor a systematic (or two-stent) approach, such as T-stenting, while others favor a provisional T-stenting (stenting the main branch first and only performing balloon angioplasty in the side branch if ne

Mark A. Turco, MD, FACC, FSCAI is an interventional cardiologist who is the Director of the Center of Cardiac & Vascular Research at Washington Adventist Hospital, Takoma Park, Maryland. He has significant experience in clinical trial research, with areas of interest including acute coronary syndromes, interventional cardiology drugs and devices, and myocardial infarction.

Dr. Turco is a Philadelphia native who received his undergraduate degree from the University of Pennsylvania. He received his medical degree and internal medicine training at the George Washington University in Washingt

They had not seen each other since the meeting last year, but as good long-time friends, their conversation flowed spontaneously, as if they saw each other every day. They are: Bob, a senior cardiovascular product line manager from the southeastern part of the United States; Bob’s cath lab manager, Susan; Mary, an administrator from New Hampshire; Jack, a vice-president and executive director of a large program in the midwest, and Gina, a former heart program executive director, now CEO of a large cardiology group in Tennessee.

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