Cath Lab Digest

Tell me about your recently published study regarding the use of catheter-directed ultrasound-accelerated thrombolysis for the treatment of pulmonary embolism.

This is a really exciting new thing for me, and actually a new thing for the world for that matter, in the treatment of pulmonary embolism. Pulmonary embolism can be and frequently is a life-threatening condition and we’re taking patients now with a significant clot burden, a significant degree of debility from pulmonary embolism, and treating them with ultrasound-assisted thrombolysis, which means that we are using a drug to dissolve blood clots in combination with ultrasound technology.

Tell me about the Find the AAAnswers campaign and how it began.

There are about 1 and a half million people in the United States who have an undiagnosed problem called an abdominal aortic aneurysm. If they are under- or undiagnosed during the patient’s lifetime, there is a significant chance that they may rupture, and if they rupture, about 90% of the patients die.

Your recently published article in the Journal of Neurosurgery describes a new study that made you the first to report successful use of ultrasound technology to treat hemorrhagic stroke. How did the study get started?

The study got started due to the fact that a company in the Seattle area called EKOS had an exciting new technology involving ultrasound for breaking up blood clots and they designed a number of catheters for breaking up blood clots in different areas of the body.

Tell me about the latest advances in endovascular aneurysm repair.

It’s hard to believe that this technology has been around for more than 20 years now. What’s equally amazing is that while there have been tremendous changes and advances in the technology, much of the pitfalls and challenges identified and predicted by Dr. Parodi and his colleagues in Argentina in 1991 persist today.

Tell us where things stand presently with treatment options for diabetics with critical limb ischemia (CLI).
The majority of diabetics with CLI have foot wounds which are very often complicated with infection. The target in these patients is to avoid major amputations (limb salvage). TASC II indicates revascularization as the first-choice treatment for CLI (recommendation no. 24). We know from direct experience and from the literature that endovascular treatment is actually considered the first choice and that this treatment should be part of a multidisciplinary approach.