Research News at St. Francis Hospital

St. Francis Hosts Major Medical Conference on Cardiovascular Imaging

The fifth annual Intravascular Imaging and Coronary Physiology Workshop 2019 conference took place March 8th  and 9th at the Conrad New York. It was the biggest intravascular imaging conference to date, attracting close to 400 attendees as well as world-renowned faculty from around the globe.  Under the direction of Dr. Richard Shlofmitz, Chairman of Cardiology at St. Francis, attendees learned about state-of-the-art intracoronary image interpretation using optic coherence tomography and intravascular ultrasound, best practice for coronary physiology, the algorithm of precision PCI, and newer techniques and emerging research evidence in the field of coronary imaging and physiology. The highlight was two Live Cases telecast from the Cath Lab at St. Francis Hospital, where attendees could witness coronary interventions and ask questions of the physicians performing.

Cath Lab Corner

By Susan V. Thomas, Research Associate

St. Francis Hospital, The Heart Center has become the first hospital in the U.S. to enroll patients for the landmark study Disrupt CAD III, using an innovative and minimally invasive Intravascular Lithotripsy (IVL) system to break up calcified lesions for those needing stents.  The Disrupt CAD III study will enroll approximately 400 patients at 50 centers worldwide and is designed to assess the safety and effectiveness of the IVL system which is considered investigational in the U.S.  #WarOnCalcium

Cath Lab Team
Led by Principal Investigator and Chairman of Cardiology Richard A. Shlofmitz, M.D. FACC (second from left), St. Francis Hospital successfully enrolled its first Disrupt CAD III patient on Jan. 9, 2019.

A Conversation with the PI

We had the opportunity to talk to Dr. Richard Shlofmitz on calcium and its effect on coronary artery disease (CAD). He did not shy away from emphasizing the pivotal role intravascular imaging plays in identifying the varying morphology of calcified   lesions. For severely calcified lesions (deep calcium, with an arc greater than 180° and 5 mm of length), it is difficult to open these lesion areas with just angioplasty or stenting. Not properly breaking the calcium prior to stenting can cause restenosis (closed stents) and not have the same luminal gain as expected.

How does IVL technology work?

Dr. Shlofmitz: You cross the lesion, place the IVL balloon in the area of calcium based on imaging, go to 4 atmospheres. Once you activate the shock wave, the balloon opens up completely after the calcium is fractured and becomes more compliant. There’s no set number of shock wave pulses but you can give about 20-40 pulses and see how the lesion responds to the waves. Intravascular imaging is done before and after the shock waves and after stenting. Not only is this technology providing a clinical need for fracturing deep calcium lesions, but it provides an easy-to-use workhorse wire technique that physicians are comfortable with, allowing for better control, positioning, and safety. The lithotripsy unit is delivered from inside the balloon, which is easy for any physician to use.

St. Francis Hospital is the first U.S. site to enroll into the clinical trial Disrupt CAD III. What made this study interesting to you?

Dr. Shlofmitz: St. Francis was approached to be the first site in the U.S to use Intravascular Lithotripsy (IVL) for coronary disease through Disrupt CAD III and we accepted the opportunity. We have the expertise and largest volume of intravascular imaging, especially through Optical Coherence Tomography (OCT), cardiologists with leadership in OCT based studies as well as tremendous experience in orbital atherectomy (for calcium modification). We also have great research staff and interventional cardiologists eager to improve patient outcomes through research, which makes the study an exciting opportunity.

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