Special Issue on Intervention published: Cardiovascular Innovations and Applications
Cardiovascular Innovations and Applications (CVIA) has just published its third issue which is available online now. http://www.ingentaconnect.com/content/cscript/cvia/2016/00000001/00000003
This new issue has a special focus on Intervention and was guest edited by R. David Anderson of the Division of Cardiovascular Medicine at the University of Florida Medical School. This CVIA special issue brings together contributions from leading cardiologists from Europe, the United States and China.
This is the CVIA volume 1 issue 3 cover. Credit: CVIA
CVIA is the official journal of the Great Wall International Congress of Cardiology (GW-ICC) and its first issue was published in October 2015 to coincide with the GW-ICC meeting in Beijing, China.
Featured papers in this issue include:
Reports of a possible causal link between brain, head, and neck tumors and radiation exposure during coronary interventional procedures: a sobering look at the data by Ryan Reeves and Ehtisham Mahmud (DOI 10.15212/CVIA.2016.0014.
This paper explores the hazard posed by radiation exposure for both patients and physicians during fluoroscopically-guided procedures. Drs. Ryan and Mahmud write '' Invasive cardiologists are exposed to high levels of scatter radiation and both increasing procedural complexity and higher operator volumes contribute to exposure above recommended thresholds. Standard shielding does not offer sufficient protection to the head and neck region and the potential for negative biological, subclinical, and clinical effects exists. Large population studies suggest that cranial exposure to low dose radiation increases the risks of tumor development. In addition, modest doses of therapeutic cranial radiation have been linked with the development of brain cancer. Although a causal association between scatter radiation in the cath lab and brain cancer does not currently exist, given the known detrimental effects of radiation exposure to the head and neck region, support a focus on potential methods of protection for both the patient and the operator.''
Renal Denervation: Past, Present, and Future by Negiin Pourafshar, Ashkan Karimi, R David Anderson, Seyed Hossein Alaei-Andabili and David E Kandzari (DOI 10.15212/CVIA.2016.0016)
Over the past decade, percutaneous renal denervation has been vigorously investigated as a treatment for resistant hypertension. The SYMPLICITY radiofrequency catheter system (Medtronic CardioVascular Inc., Santa Rosa, CA, USA) is the most tested device in clinical trials. After the positive results of small phase I and II clinical trials, SYMPLICITY HTN-3 (a phase III, multi-center, blinded, sham-controlled randomized clinical trial) was completed in 2014, but did not show significant blood pressure lowering effect with renal denervation (RDN) compared to medical therapy and caused the investigators and industry to revisit both the basic science elements of RDN as well as the design of related clinical trials. This review summarizes the SYMPLICITY trials, analyzes the SYMPLICITY HTN-3 data, and provides insights gained from this trial in the design of the most recent clinical trial, the SPYRAL HTN Global clinical trial. Other than hypertension, the role of RDN in the management of other disease processes such as systolic and diastolic heart failure, metabolic syndrome, arrhythmia, and obstructive sleep apnea with the common pathophysiologic pathway of sympathetic overactivity is also discussed. The authors conclude that ''In the past decade there has been a significant increase in renal denervation (RDN) devices with proprietary design using various energy sources, and as investigators strive to discover the role of RDN in the management of hypertension, there is a future need for direct comparative study between these technologies to identify the safest and most effective device.''
source: Cardiovascular Innovations and Applications