Intravascular Ultrasound (IVUS) provides images of the insides of blood vessels for the diagnosis and treatment of cardiovascular disease. Although the roots of IVUS date back a quarter century, it is only recently that physicians have begun to take serious cognizance of its potential.
Improving PCI outcomes
The growth in interest in IVUS is being driven by changes in the way for treating acute coronary syndrome (ACS). ACS is a common complication of coronary heart disease, which is the leading cause of death in industrialized countries.
The typical approach to treat ACS consists of percutaneous coronary intervention (PCI): catheter angiography, balloon angioplasty and the use of stents. However, the proponents of IVUS have been making a strong case about its utility to improve PCI outcomes, including those offered by the latest generation of drug-eluting stents (DES).
IVUS consists of a miniaturized ultrasound imaging device. This is mounted on a catheter which is threaded across an artery to provide both cross-sectional and longitudinal views. It thus reveals not only the shape and amount of plaque but the deployment and expansion of a stent, too. Such information is not accessible via standard angiography. The main area for application is coronary arteries. Growing (if still far smaller) areas consist of peripheral arteries as well as intra-cardiac imaging.
State-of-the-art IVUS systems use spectral backscatter and frequency analysis to classify plaque (distribution, burden and calcification) and are claimed to achieve up to 97% accuracy. They are also used to plan for treatment with stents
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Machine intelligence in the OR: optimizing the effectiveness of surgeons with IT tools
, /in Featured Articles /by 3wmediaMedicine is undergoing a historic transition, moving away from a trial-and-error model of care, towards individualized treatment strategies based on patient-specific knowledge management of disease and treatment. Not only the biomedical systems sciences and engineering, mathematics, medical imaging and medical informatics but also the discipline of machine intelligence and in a wider sense computer assisted radiology and surgery (CARS) are enablers of this new paradigm. With an appropriate ICT platform, for example, medical workstations for domain-specific applications, they provide the methods and tools for knowledge management and specifically for a patient-specific medicine.
Important aspects of these dramatically evolving and ICT based methodologies and tools are possibilities for:
With an appropriate employment of these methods and tools, they become enablers of intelligent infrastructures and processes in medical diagnosis and therapy, hopefully making complex situations and processes in healthcare more comprehensible, visible, reproducible, transparent and understandable for the human, i.e. for the physician and patient……
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Cardiovascular disease: the need for more R&D in Europe
, /in Featured Articles /by 3wmediaAlthough cardiovascular disease, predominantly coronary heart disease (CHD) and stroke, is still the leading cause of mortality in Europe (around 47% of deaths), deaths from CHD have more than halved since the 1980s. There have been steady reductions in mortality from the disease in both genders and in most European countries, largely due to tests that allow timely diagnosis, as well as treatment with the new anti-thrombotic drugs. The major concern now, though, is that this steady reduction in mortality is beginning to plateau in many EU countries, particularly in younger people, and even more alarming is that an actual rise in mortality has recently been demonstrated in populations in Romanian, Greece and Lithuania. The danger is that such increases will be sustained and will begin to occur in other European countries, fuelled by the diabetes and obesity
The coming of age of intravascular ultrasound
, /in Featured Articles /by 3wmediaIntravascular Ultrasound (IVUS) provides images of the insides of blood vessels for the diagnosis and treatment of cardiovascular disease. Although the roots of IVUS date back a quarter century, it is only recently that physicians have begun to take serious cognizance of its potential.
Improving PCI outcomes
The growth in interest in IVUS is being driven by changes in the way for treating acute coronary syndrome (ACS). ACS is a common complication of coronary heart disease, which is the leading cause of death in industrialized countries.
The typical approach to treat ACS consists of percutaneous coronary intervention (PCI): catheter angiography, balloon angioplasty and the use of stents. However, the proponents of IVUS have been making a strong case about its utility to improve PCI outcomes, including those offered by the latest generation of drug-eluting stents (DES).
IVUS consists of a miniaturized ultrasound imaging device. This is mounted on a catheter which is threaded across an artery to provide both cross-sectional and longitudinal views. It thus reveals not only the shape and amount of plaque but the deployment and expansion of a stent, too. Such information is not accessible via standard angiography. The main area for application is coronary arteries. Growing (if still far smaller) areas consist of peripheral arteries as well as intra-cardiac imaging.
State-of-the-art IVUS systems use spectral backscatter and frequency analysis to classify plaque (distribution, burden and calcification) and are claimed to achieve up to 97% accuracy. They are also used to plan for treatment with stents
A faltering pulse at the heart of the matter
, /in Featured Articles /by 3wmediaIn 2012 there were 1.9 million cardiovascular related deaths within the European Union and 4 million deaths in Europe with the higher rate of deaths to be found in the Central and Eastern European countries. During June 2013, the European Society of Cardiology (ECS) released the results of their study comparing death from a cardiac event between the 1980s and the present. At a glance, the report appears to make happy reading. On average, the rate of heart disease related deaths have halved during that period within the European Union countries. This rate applies to both sexes as well as most age groups.
Dr Melanie Nichols, a Research Associate from the British Heart foundation Health Promotional Research Groups and her colleagues in the Oxford Research Group have looked at trends in death from coronary heart disease between 1980 and 2009 in both sexes and four age groups: under 45, 45-54, 55-64 and 65 years and over [1].
Lack of comparable data in Europe
One of the problems that Dr Nichols and her group have faced in assessing the data is the differences in the way that countries record and code data. That Europe suffers from a lack of data and comparable data is evident when reading the European Cardiovascular Disease Statistics published by the European Heart Network [2]. This is especially true for incidence rates, rates of surgical procedures as well as effects of regional diets etc. To better serve assessments such as this report, the European Union has the task of developing standard methods for collecting information and procedures for calibration of locally appropriate methods and questionnaires.
Nevertheless, while working within these constraints, Dr Nichols and colleagues found that:
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