Click the image above, or click here to access the video.
In partnership with Radcliffe Cardiology, ACIST recorded a case discussion with Dr. Ali, an Interventional Cardiologist at St. Francis Hospital & Health Center, Dr. Daemen, an Interventional Cardiologist at the Erasmus University Medical Center, Rotterdam, the Netherlands, and Dr. Jeremias, Associate Director, Cardiac Cath Lab at St. Francis Hospital and Heart Center, at EuroPCR 2023. The case covers the use of various ACIST products and the value they bring to the cath lab. These include ACIST CVi™ Contrast Delivery System, ACIST HDi® HD IVUS System and Kodama® HD IVUS Catheter, and ACIST RXi® Rapid Exchange FFR System along with Navvus®II Rapid Exchange MicroCatheter. CVi® is known for its ability to manage contrast dose and waste, but this case discussion also incorporates the roles imaging and physiology play in the larger contrast management conversation. Overall, its an informative video exploring the use of ACIST’s advanced technologies and best practices in coronary interventions. Watch the video above to hear more.
Note: See full resource above for complete citations and references.
The ACIST CVi® Contrast Delivery System is designed for the precise administration of radiopaque contrast media during angiographic procedures. It delivers contrast media to a catheter at a flow rate determined by the user. The hand controller and other necessary items are included in angiographic consumable kits. The CVi® system is easily installed, serviced, and upgraded due to its modular design. It is comprised of the injector head, control panel, power supply, and other essential components. Keep reading to gain further insights into the ACIST CVi® and its utilization.
“The CVi® is intended to be used for the controlled infusion of radiopaque contrast media for angiographic procedures. The CVi® System is an angiographic injection system used in interventional cardiology, radiology, or intravascular surgical procedures utilizing an endovascular technique. The CVi® System supplies radiopaque contrast media to a catheter at a user determined variable flow rate that can be instantaneously and continuously varied.”
Note: See full resource above for complete citations and references.
The ACIST CVi® Contrast Delivery System is designed for the precise administration of radiopaque contrast media during angiographic procedures. It delivers contrast media to a catheter at a flow rate determined by the user. The hand controller and other necessary items are included in angiographic consumable kits. The CVi® system is easily installed, serviced, and upgraded due to its modular design. It is comprised of the injector head, control panel, power supply, and other essential components. Keep reading to gain further insights into the ACIST CVi® and its utilization.
“The CVi® is intended to be used for the controlled infusion of radiopaque contrast media for angiographic procedures. The CVi® System is an angiographic injection system used in interventional cardiology, radiology, or intravascular surgical procedures utilizing an endovascular technique. The CVi® System supplies radiopaque contrast media to a catheter at a user determined variable flow rate that can be instantaneously and continuously varied.”
Note: See full resource above for complete citations and references.
Dr. Joost Daemen, an Interventional Cardiologist at the Erasmus Medical Center, Rotterdam, the Netherlands and Jurgen Ligthart, a Percutaneous Imaging Specialist at Erasmus, are the hosts of this informative webinar series. The primary focus is on enhancing PCI (percutaneous coronary intervention) using FFR (fractional flow reserve) and HD-IVUS (high-definition intravascular ultrasound). The series addresses the pressing need to mitigate the long-term risk of target vessel failure (TVF) following contemporary PCI procedures. To achieve this, the webinar series explores the utilization of the ACIST HDi® HD IVUS System and Kodama® HD IVUS Catheter in conjunction with the Rxi® Rapid Exchange FFR System and Navvus®II Rapid Exchange MicroCatheter. Through an examination of diverse imaging, real-life cases, and corresponding outcomes, the effectiveness of the HDi® System for optimizing PCI is evaluated. Join us in this session to gain insights into the potential of the HDi® System in driving PCI optimization.
Background:
- The long-term risk of target vessel failure (TVF) after contemporary PCI remains concerning
- Post-PCI FFR <.90 has been linked to an increased rate of major adverse cardiac events
- Post-PCI FFR values can be increased by additional treatment
- Whether additional optimization improves outcome remains unknown
“The Navvus® MicroCatheter, which is a thin monorail micro catheter with optical sensor technology, allowing a physiological lesion assessment over any type of routine guidewire. So that is the big advantage of this system. With the optical technology that really limits the amount of drift you will encounter and with the ability to do a pullback without losing wire position. I think that is a critical advantage of this product that can be used as we will demonstrate to you both pre as well as post procedurally.” – Dr. Daemen
Note: See full resource above for complete citations and references.
Dr. Arnold Seto, Chief of Cardiology Long Beach VA Medical Center, discusses the advancements in pressure sensor wires and catheter technologies. Specifically, he highlights the enhancements made to the ACIST Navvus II® Rapid Exchange FFR MicroCatheter compared to its predecessor, Navvus®. The Navvus II® microcatheter provides several advantages over conventional FFR pressure wire technology, including the flexibility to select a guidewire of your preference.
“There have been multiple improvements in the Navvus® Catheter, which have a smoother entry profile and improved flexibility by reducing the size of the measurement segment.” – Dr. Seto
Note: See full resource above for complete citations and references.
In this informative video, product specialist Guy Nothem introduces the RXi® Rapid Exchange FFR System. The RXi® system, combined with the Navvus® Rapid Exchange Micr0Catheter, employs a cutting-edge fiber optic transducer to ensure precise FFR measurements. Notably, interventional cardiologists can utilize their preferred 0.014″ wire while maintaining optimal wire position within the coronary artery throughout the procedure. The Navvus® MicroCatheter boasts several key characteristics, including an entry profile of just 0.016″, a tapered tip for smooth transition through any coronary disease. The plug-and-play monitor is effortlessly set up by plugging it in and zeroing it once initially. It displays essential patient information such as Pa (proximal pressure), PD (distal pressure), Pd/Pa, FFR (Fractional Flow Reserve), case summary, and much more. A standout feature of the RXi® system is its ability to easily input PV, setting it apart from other FFR systems. Watch the video to delve into comprehensive insights about the RXi® Rapid Exchange FFR System, including its components, applications, and setup procedure.
“The fiber optic transducer is positioned just five mm from the tip of the catheter which is our competitive advantage. Pressure wires have a transducer set back 30mm from the tip which requires much more real estate to get their transducer beyond a coronary stenosis. The Navvus® has a 26 cm monorail segment which is similar to most angioplasty balloon systems. The Navvus® has two femeroal markers. One at 80 and one at 100 cm.” – Guy Nothem
Note: See full resource above for complete citations and references.
Dr. Wilson, Interventional Cardiologist and founder of ACIST Medical Systems, discusses the importance of minimizing radiation scatter within the catheterization lab. Until recently, little was known about the specific risks that cath lab professionals could encounter due to radiation exposure and what this means for workplace and provider safety. Consequently, Dr. Wilson and his team have chosen to maintain thorough records of radiation measurements in cath labs to better analyze radiation scatter and its effects on individuals in the cath lab.
“We got to reduce the occupational exposure for radiation for people working in cath labs, because they are really in a sense guinea pigs right now. They are the only people of any profession that are getting this kind of radiation every day. And it takes 30 years to know what happens and its been 30 years, and we know what happens isn’t good. So we decided that we were going to start making detailed measurements for radiation around the table.” – Dr. Wilson
Note: See full resource above for complete citations and references.
From Euro PCR Dr. Joost Daemen, an international cardiologist at Erasmus University Medical Center, Rotterdam, the Netherlands, discusses the concept of post PCI FFR guided by IVUS.
“By using IVUS to assess post-PCI results we were able to optimize the procedure in 80% of the cases. By adding either additional stents, in 30% of the cases, or doing additional optimization of the previously implanted stent in 1/3 patients” – Dr. Joost Daeman
In the trial there was only one periprocedural complication which was a minor dissection that was resolved with an additional stent. Dr. Joost and his colleagues concluded that post-PCI optimization is a safe maneuver/procedure when directed by IVUS.
Design: Prospective, single center, randomized controlled trial
Objective: to evaluate if FR guided PCi optimization detected by HD-IVUS in patients with post-PCI FFR < .90 will improve clinical outcome
Primary endpoint: target vessel failure at 1 year
Current status: 82% inclusion
Note: See full resource above for complete citations and references.
