Staying True to Form: Merit Announces the Launch of Its Cutting-Edge Reshapable Guide Wire

Merit Medical is thrilled to announce the launch of the True Form™ Reshapable Guide Wire, an innovative addition to our Interventional Oncology & Spine Delivery Systems Portfolio. The True Form is uniquely designed with a shapeable tip that can be shaped and reshaped multiple times for vessel cannulation, making it the go-to guide wire during endovascular intervention procedures.

“The ability of the True Form Guide Wire to be shaped multiple times and keep its shape allows me to use the same guide wire, decreasing the need to use additional guide wires,” says Dr. Shinichi Hori, Chief Physician and Director at Gate Tower Institute for Image Guided Therapy in Osaka, Japan.

Other noteworthy features include a stainless steel core that provides excellent support for devices and a flexible shaft for navigation through tortuous anatomy. When compared to competing guide wires, the True Form hydrophilic coating is up to 7 times more lubricious, resulting in less guide wire drag.1

The True From is also compatible with several microcatheters, including the Merit Maestro®. With a flexible, hydrophilic-coated distal region, nylon ribbon braiding, and a Swan Neck designed tip, the Maestro provides superior pushability, trackability, and flexibility.

Merit knows that having a reliable microcatheter during embolization will enhance procedural efficiency and provide the outcomes expected for small vessel embolization. This is exactly why we’re prepackaging the Maestro Microcatheter 2.4F with the True Form Reshapable Guide Wire.  

Delivering this dynamic duo together in one box affords both convenience and ease of use from start to finish. Ordering is effortless when a preferred guide wire and microcatheter can be bought together with only one purchase order. What’s more, supplying these tools in a prepackaged form removes the unnecessary step of finding a guide wire and microcatheter that fit because clinicians already know the True Form and Maestro are compatible. Storing is also made simple by only needing to stock and pull one box from the shelf.

The True Form Reshapable Guide Wire comes in several lengths to match diverse patient anatomy. For more information, visit https://www.merit.com/interventional-oncology-spine/accessories/guidewires/true-form-steerable-guide-wire/ or talk to your Merit representative today.

  1. Data on file

For more information please refer to Instructions for Use. Consult product labels for any indications, contraindications, potential complications, warnings, precautions and directions for use. Dr. Hori is a paid consultant of Merit Medical Systems, Inc.

Know Your Direction: Merit’s HeartSpan® Steerable Sheath Facilitates Catheter Navigation

Patients suffering from atrial fibrillation (AF) have a minimally-invasive curative treatment option thanks to advancements in cardiac ablation catheter technology. The use of one such advancement, the steerable sheath, has resulted in higher clinical success rates in comparison to using a traditional fixed sheath.1 But despite its clinical success, operating the steerable sheath has its challenges, such as knowing a sheath’s position when under fluoroscopy.

In an effort to anticipate clinicians’ needs, Merit Medical has designed a procedural solution called the HeartSpan® Steerable Sheath. It allows a clinician to move the distal tip from 0° and 180° to achieve the desired curve within the atrial chamber. Unlike any other steerable sheath on the market, the HeartSpan facilitates catheter navigation by offering a Neutral Position Indicator and a tactile click at the neutral position. For ease of use, its ergonomic handle displays two arrows that indicate the directional plane of the curve as the handle turns.

Reaching the desired catheter position by way of a steerable sheath has been shown to have several benefits. A randomized controlled study by Piorkowski et al. investigated the clinical outcomes of using a steerable sheath in comparison to a fixed sheath.1 The study prospectively included 130 patients with paroxysmal or persistent drug-refractory AF undergoing interventional cardiac ablation for the first time.

Results published in Circulation Arrhythmia and Electrophysiology showed that single procedure success was significantly higher in patients ablated with a steerable sheath (78% vs. 55% after 3 months; 76% vs. 53% after 6 months).1 Additionally, fluoroscopy time was lower in the steerable sheath group (33+/-14min vs. 45+/-17min). The authors concluded that using a steerable sheath improved catheter stability and catheter-to-tissue contact when compared to the traditional fixed sheath.

In addition to the Neutral Position Indicator, the HeartSpan has other state-of-the-art features that support procedural success. For navigating anatomical variations, the HeartSpan is available in three curl sizes. Its braided construction offers kink resistance and curve durability. A lower crossing profile enables seamless dilator to sheath transition for smooth advancement across the atrial septum. Radiopaque marker bands enhance visibility, and an atraumatic tip reduces the risk of atrial wall perforation. The HeartSpan’s shaft body is smooth and lubricious for easy vessel insertion.

Contact your Merit Representative for a clinical evaluation. Because when it comes to cardiac ablation catheters, you should always know your direction.

REFERENCES

  1. Piorkowski, C., Eitel, C., Rolf, S. et al. (2011). Steerable versus non-steerable sheath technology in atrial fibrillation ablation: a prospective randomized study. Circ Arrhythm Electrophysiol, Apr; 4(2): 157-65.

Merit Medical is pleased to sponsor an accredited webinar for Critical Care Nurses

Hemodynamic Monitoring is Monitoring Life

Watch the webinar

Earn: 1.00 CERP credit*

Course objective: Hemodynamic monitoring can be challenging, even for experienced nurses. This course establishes foundational knowledge related to the anatomy, physiology, and clinical care of patients on hemodynamic monitoring.

Speaker: Terry M. Foster, RN, MSN, FAEN, CCRN, CPEN, TCRN, CEN, Nurse Humorist

Terry M. Foster holds a Master’s Degree in Critical-Care and Trauma Nursing from the University of Cincinnati College of Nursing and Health, having previously earned his LPN and RN. His primary areas of nursing experience have always been in the Emergency Department and Critical-Care Units, holding several national certificates. Terry has lectured on a wide variety of clinical topics at nursing seminars and conferences throughout the USA, having given a total of over 5,000 formal presentations. He has authored more than 40 professional publications and is currently the Critical-Care Clinical Nurse Specialist in the six Emergency Departments at St. Elizabeth Healthcare in Edgewood, Kentucky. Read more about Terry Foster.

*This Program Has Been Approved by the American Association of Critical-Care Nurses (AACN) for 1.00 Synergy CERP Category A, File Number 21722.

The New Go-To: PreludeEASE™ Resists Compression Better Than the Leading Competitor

At Merit Medical, we’re dedicated to using the most advanced materials, designs, and manufacturing techniques with the goal of delivering solutions you can always depend on. Our PreludeEASE™ Hydrophilic Sheath Introducer is a perfect example of this commitment. Designed for strength, data shows the PreludeEASE resists compression better than the leading competitor—making it the New Go-To sheath.1

Compression resistance is an essential factor when considering a new sheath. Case studies have shown that if an arterial spasm occurs during a procedure, it can lead to the sheath compressing into the catheter, entrapping it within the vessel, and making removal of the catheter from the sheath difficult.2

Some thin-walled sheaths can be prone to compression and kinking that could result in difficult catheter manipulation. In the event of radial spasm, the catheter and sheath may need to be removed. Using a product with robust sheath tubing, like the PreludeEASE, may help clinicians avoid this problem. When tested against the leading competitor, the PreludeEASE displayed excellent compression-resistance performance.1

Other PreludeEASE advanced features include a large inner diameter for easier transitions and increased device compatibility and hydrophilic coating to facilitate insertion and removal as well as patient comfort.3 Moving smoothly from wire to dilator and dilator to sheath, the PreludeEASE streamlined design requires up to 30% less insertion force in comparison to the leading competitor.1

To accommodate varying patient anatomy, the PreludeEASE is available in multiple size configurations that range from 4F-7F diameters and can be customized in kits and packs to include other tools you need to achieve radial success.

Explore the New Go-To PreludeEASE and all it has to offer by visiting the PreludeEASE product page or talk to a knowledgeable Merit representative today.

REFERENCES

  1. In-House Data
  2. Popma, J. (2013). Radial Artery Complication: Case Presentation. SCAI 2013. [PowerPoint slides].
  3. Kiemeneij, F., Fraser, D., Slagboom, T., et al. (2003). Hydrophilic coating aids radial sheath withdrawal and reduces patient discomfort following transradial coronary intervention: a randomized double-blind comparison of coated and uncoated sheaths. Catheter Cardiovasc Interv, Jun; 59(2): 161-164.

I Am Merit: Fred Lampropoulos, Founder, Chairman and Chief Executive Officer



Thirty years ago, Merit Medical got its start by doing one simple thing: paying close attention to the clinical needs of physicians. At a time when glass syringes were the industry standard, Merit wanted to create something better. From this vision, the polycarbonate Coronary Control Syringe was born. It was the first of its kind and it was Merit’s first manufactured medical device on the market.

We sat down with Fred Lampropoulos, Chairman, CEO, and Founder of Merit Medical, to hear the full story of how this single innovation led to the rise of an international corporation that now employs almost 5,000 individuals and generates $750 million in global revenues.

“At the time, I had left as Chairman and CEO of Utah Medical, voluntarily. I really wanted to look at my life. I had thought about going to medical school,” Lampropoulos says. “After that, I decided I was going to start up a new company.”

In order to understand the clinical needs of the cardiology world, Fred did what any eager anthropologist would do and went native. He began spending much of his time with thoracic surgeons and cardiologists, scrubbing in on cases and observing everything possible. He describes this point in his life as a time he learned most simply by watching. Doing so allowed him to anticipate the needs of physicians and flex his creative muscles.

In one memorable instance, he describes a time when he noticed clinicians taking a spike, taping it onto a bottle of contrast media with the spike not fully inserted. “I could never figure out why they were doing that,” Lampropoulos recalls.  “I asked somebody and he said, ‘The stuff in this bottle is really expensive. We want to be able to have the spike where it’s at the lowest point possible. [The spike] either falls out, or someone will just barely tap it, and it’ll fall out. And you’ve got contrast [all over], which is very messy. So, we tape it.’”

This led to Fred’s first prototype.

“I came up with an idea that we’d develop a spike that had a little [part] you could push and the teeth would come over the head of the bottle and it would hold in there. It wouldn’t fall out,” Lampropoulos explains. “It was just observing and listening.”

As time went on, the art of observing and listening—that was once the foundation of a burgeoning business plan—turned into millions of dollars in sales and what sets Merit apart in the medical device industry today.

Referring to another unforgettable case, Fred describes a time when he observed a physician using a syringe filled with contrast and blood. “He was expelling it into a metal basin and [its contents] came up over the top and rolled down on the drape. It went all over the place,” Lampropoulos describes. “I went to the plant in the morning, got a couple of engineers together and said, “This is what I observed. This is what I heard. This is what I want to do.”

In a matter of hours, Fred’s team came back with a prototype, now sold as the Merit BackStop® Disposal Systems. “It was literally from just being there,” Lampropoulos says. “I think we have sold, over the years, 100 million dollars worth of those BackStops. But more important than just selling something is the fact that we have a containment device that helps to minimize bloodborne and airborne pathogens. That was the key. You can watch and listen, but it has to meet a customer need at the same time.”

As a US military officer and combat officer, Fred learned the importance of observing and listening, while simultaneously making decisions quickly. “You take a look at the business, how you strengthen it, and how you gain an advantage over your competitors,” Lampropoulos explains. “There are a lot of pieces that go into that.”

One significant piece that Fred attributes much of his success to is that of teamwork. An avid baseball fan, he compares the well-oiled machine that is Merit Medical to a “team that can play all the positions and can deliver runs and hits.” Full of “very competent, hardworking people who share a vision,” Merit Medical has been able to expand internationally.

With facilities in the US, The Netherlands, France, Ireland, China, Mexico, Brazil, Canada, Singapore, and Australia, Fred says Merit encompasses a core philosophy no matter where they are. “We’ve been able to build a company that really has encompassed a strategy. Whether you’re in Singapore, Galway, Tijuana, or Toronto, there’s a core of beliefs, standards, and efforts on how we all fit into this puzzle that ends up very candidly looking like a masterpiece.”

One only has to read Merit’s vision to see that it’s a customer-focused company in healthcare.  Determined each day to make a difference by “delivering products that improve the lives of people, families, and communities throughout the world,” Merit prides itself on driving the cost of medicine down. “I remember our inflation devices when we first started were selling for $85,” Lampropoulos continues. “Today, they sell for $30. We’ve made tools that make it easier for a physician to treat a patient. That’s a big deal.”

By providing tools that simplify and improve patient care, Merit has been able to make several primary therapies more accessible. Peritoneal dialysis, catheter ablation, uterine fibroid embolization (UFE), and the recent FDA-approved prostatic artery embolization (PAE) are only a handful of therapies Merit supplies with state-of-the-art tools and devices. “There are a lot of things we’re doing for patients, and in some cases, they wouldn’t have an alternative,” Lampropoulos notes. “We treat and save 15,000 lives a day. That number keeps going up.”

Looking into the future, Fred believes that in order to continue this crucial work, Merit must remain a steadfast leader in emerging therapies and technologies. Uninterested in short-term business deals, Fred says Merit will maintain its vision and invest long-term. “It’s a huge advantage over others who are being consolidated or are flipping a company or just trying to be a serial entrepreneur. It’s just never what I wanted to do,” Lampropoulos clarifies. “I wanted to build something of lasting value and I think we’ve done that.”

Long-term vision is what Fred says has done more than just make money. Because of the family values Fred has infused in his company, Merit has created countless jobs, fed and educated families, and helped send their children to college. “In some cases, we’re hiring their kids now as our engineers,” Lampropoulos adds. “That is very gratifying.”

From a community standpoint, Merit has supported the arts and sciences, as well as worked with homeless and youth centers—places where Fred believes Merit has a corporate responsibility. “It’s not some newfound belief. It’s something that we started out from the very beginning. I think we have been and have tried to be, within our means, a responsible corporate leader.”

When asked if he’s proud of all he has accomplished in the last 30 years, Fred remains humble. “I don’t think much about what I’ve done because I don’t have much time to do that,” he responds. “I don’t want to look at the back window, I want to look out the front window. Did we think we would be here today? The answer is we hoped we would be.”

Happy 25th Anniversary of Transradial Access!

Today, August 24th, marks the date 25 years ago when Dr. Ferdinand Kiemeneij performed the first radial access angioplasty in the Netherlands. Merit Medical is so pleased to celebrate this landmark anniversary with the physicians around the world who practice this patient-centric technique and with patients who have had a radial intervention.

Congratulations to Dr. Kiemeneij and fellow ThinkRadial Course Directors Dr. Sandeep Nathan (IC- University of Chicago, Chicago, IL) and Dr. Darren Klass (IR – Vancouver General and UBC Hospitals, Vancouver, CAN) for your efforts to move this technique forward.

THINKRADIAL COURSE INFORMATION

Navigating through vascular anatomy with the InQwire® Amplatz Guide Wire

Navigating through difficult vascular anatomy can be challenging, and finding just the right guide wire to do so can be even more difficult.  Ultimately, clinicians need a wire that is reliable and that can get them to their destination within the vasculature, even if the path is a tortuous one. Look no further, because the new InQwire Amplatz guide wire was designed to do just that.

A firm inner core, a smooth transition and a lubricous coating are key elements for reliable guide wire navigation. With those elements in mind, the InQwire Amplatz wire was carefully designed to be a tool for precision, agility, and strength. The wire’s firm construction provides an increased level of stiffness that delivers extra support and stability within the vasculature, specifically for enhanced navigation.

A flat outer wire coil allows a larger inner core to provide added stiffness which facilitates catheter placement and advancement of other devices, such as dilatation catheters and stent catheters during contralateral access. A smooth tapered transition from the shaft to the flexible tip, allows atraumatic negotiation of the most difficult vascular anatomy.

A proprietary outer coating was added to the entire surface of the wire to facilitate smooth navigation with less resistance against vessel walls. In testing the wire’s performance against the leading competitor, the InQwire Amplatz proved to be superior and was documented as having a 20% higher lubricity rating*. The Merit InQwire Amplatz wire requires considerably lower force per grams, therefore allowing catheters to move more easily over the wire.

The InQwire Amplatz is compatible with 0.035” & 0.038” devices and for added convenience the Amplatz wires are available in multiple tip configurations to include straight-tip wires in a variety of flexible profiles including 1.0cm, 3.5cm, 4.0cm, 6cm, and 7cm. A J3mm tip configuration is also available.

For additional information visit Merit.com/Amplatz or contact your local Merit representative.

*Data on file

I Am Merit: April Sanchez, Supervisor of Strategic Accounts Contract Management

An important part of Merit Medical’s business involves working with Group Purchasing Organizations and Integrated Delivery Networks around the United States. April Sanchez, Merit’s Supervisor of Strategic Accounts Contract Management, speaks about her team’s role to provide important financial impact and analysis of Merit’s contracts with these GPOs and IDNs. The efforts of Strategic Accounts allows Merit to form lasting relationships with customers and provides them with access to products to improve and save the lives of their patients.

Why Use a Closed-Flush Blood Sampling System?

A critically ill patient may enter the ICU because of organ failure, extreme dehydration, Sepsis, or some other complicated issue. In all of these conditions, a quick response is best for a positive patient outcome. Invasive hemodynamic monitoring allows a healthcare provider to access real-time information about the patient’s cardiac health. Additionally, blood samples are a routine and vital process to assess the patient’s lung function and perfusion. Multiple blood samples per day is not uncommon in the ICU; however, providers may be unaware of the inherent risks of drawing blood.

Each time a blood sample is drawn, the potential for contamination and blood discard is present. The CDC has made recommendations for improving blood sampling, including the use of a pressure monitoring system with a closed-flush (continuous-flush) sampling system. This type of system can help prevent air-borne contaminants from entering the blood stream. In a study comparing bacterial contamination in arterial lines, the results stated: “There was less microbial contamination of intraluminal fluid when BCS [a blood conservation system] was used for arterial catheterization.”1 Another study, measuring hemoglobin and hematocrit counts of critically ill patients having multiple blood samples drawn, indicated that the use of a closed blood sampling system was able to minimize blood count value changes.2

Merit Medical is proud to offer a portfolio of critical care products including invasive hemodynamic monitoring sets. The MeritransDTXPlus® with Safedraw® closed arterial sampling helps minimize the risk of infection and unnecessary exposure with a simple, closed, in-line arterial sampling system. Unlike other pressure monitoring systems, the EasyVent™ closed zero port allows clinicians to maintain a closed system when priming or zeroing the transducer (not opening the system to the ambient environment reduces patient risk and enhances overall safety).

A new critical care catalog and a brochure are available showing Merit’s critical care portfolio.

  1. Oto J, Nakataki E, Hata M, Tsunano Y, Okuda N, Imanaka H, Nishimura M. (2012 Aug). Comparison of bacterial contamination of blood conservation system and stopcock system arterial sampling lines used in critically ill patients. Am J Infect Control, 40(6):530-4. doi: 10.1016/j.ajic.2011.08.006. Epub2011 Nov 3.
  2. Rezende E, Ferez MA, Silva Junior JM, Oliveira AM, Viana RA, Mendes CL, Toledo Dde O, Ribeiro Neto MC, Setoyama TA. (2010 Mar). Closed system for blood sampling and transfusion in critically ill patients. Rev Bras Ter Intensiva,  22(1):5-10.

SwiftNINJA® Successfully Embolizes Post-EVAR Type II Endoleaks Using Transarterial Iliolumbar Approach

Endovascular aneurysm repair (EVAR) has been linked to the formation of type II endoleaks. The transarterial iliolumbar approach to repair this complication is occasionally difficult and associated with a lower technical success rate due to the anatomical features of the area.

However, earlier this year Dr. Yunosuke Nishihara of Saga-Ken Medical Centre Koseikan in Saga, Japan, discussed two cases in which the SwiftNINJA® Steerable Microcatheter successfully embolized type II endoleaks using the iliolumbar artery approach after attempts employing other microcatheters and conventional catheterization techniques had failed.

Case 1: A 68-year-old female patient

  • EVAR was performed in January 2014, immediately followed by a persistent type II endoleak and increased diameter of the aneurysm.
  • Transfemoral transarterial embolization was attempted in March 2015 but failed because selection of the iliolumbar artery and beyond was not possible.
  • At follow up, the aneurysm size was 15 mm greater than the previous year. Transarterial iliolumbar embolization using the SwiftNINJA was performed in March 2016.
  • The SwiftNINJA was articulated to cannulate a strong angle bifurcation. Locking and unlocking the tip of the SwiftNINJA at an angle along the bifurcation allowed for easy vessel selection and advancing of the guidewire.
  • After exchanging the catheter, the tip of the selective microcatheter was guided into the aneurysm sac; the endoleak cavity and feeding artery were embolized.
  • After embolization, no blood flow into the endoleak cavity was observed. 

Case 2: A 78-year-old male patient

  • EVAR was performed in January 2014, immediately followed by a persistent type II endoleak.
  • The aneurysm size was 8 mm greater than the previous year and the patient was admitted in March 2016 to undergo embolization via the transarterial iliolumbar approach using the SwiftNINJA.
  • The SwiftNINJA was the primary microcatheter used to cannulate the aneurysm and was guided to the bifurcation without a guidewire.
  • A guidewire was then successfully placed into the aneurysms feeding vessel and the SwiftNINJA was introduced successfully.
  • After exchanging the catheter, the tip of the selective microcatheter was guided into the endoleak cavity.
  • The endoleak cavity was embolized and coil embolization was performed successfully on suspected feeding and/or outflow vessels.

Despite the complexities surrounding the transarterial iliolumbar approach, the author noted that the SwiftNINJA improved the selectivity of target vessels and provided enough support for guidewire introduction into acute bifurcating vessels to not allow catheter kickback. These device advantages can lead to other patient and clinician benefits.


“When this useful device [is] appropriately used, we can expect the reduction of operation time, X-ray exposure and the amount of contrast medium used.”

SwiftNINJA® Steerable Microcatheter

Merit Medical’s SwiftNINJA® Steerable Microcatheter is the single most advanced and only 180-degree articulating microcatheter on the market. Able to navigate difficult vasculature, the SwiftNINJA offers unparalleled performance by utilizing three main advantages: speed, control, and delivery.

To learn more about the SwiftNINJA, please click here:

https://www.merit.com/interventional-oncology-spine/accessories/microcatheters/swiftninja-steerable-microcatheter/

REFERENCE

Nishihara, Y. (2017). Embolization of post-EVAR type II endoleaks using SwiftNINJA® [White paper]. Sumitomo Bakelite Co., LTD., Tokyo, Japan: Medical Products Business Division.

Dr. Yunosuke Nishihara received payment from Sumitomo Bakelite Co., Ltd. for the performance of this study.

NextGenRadial programs and products from Merit Medical

In a press release issued last week, Merit Medical announced its Advanced ThinkRadial Program for Interventional Cardiologists (IC’s), with a curriculum focused on complex interventions accessed via the radial artery. The course will be co-proctored by Interventional Cardiologist Dr. Sandeep Nathan (University of Chicago) and special guest of honor, Dr. Ferdinand Kiemeneij (Tergooi Hospital in Blaricum, The Netherlands), the Father of Transradial Intervention. This course is unique because it focuses on moving IC’s with radial experience to the next level of radial interventions. It will include advanced case presentations, hands-on experiences, and a special presentation by Dr. Kiemeneij about left distal transradial access, the Next Generation of the Radial technique.

Merit is very fortunate to have Dr. Nathan and Dr. Kiemeneij co-proctor the upcoming Advanced Course for Interventional Cardiologists, which will be held October 13-14, 2017 at the Merit Medical Education Center in Salt Lake City, Utah. Dr. Kiemeneij will also co-proctor a total of five courses in 2018 at both the Merit Education Centers in Salt Lake City, Utah and in Maastricht, Netherlands.

Fully committed to the radial approach, Merit offers a full portfolio of radial products, from set-up and access to hemostasis, as well as the ThinkRadial Education Program. Dr. Kiemeneij recently tweeted about using the PreludeEASE for left distal transradial access, a next gen radial entry site in the hand. Read more about his statement in the press release or on twitter.

For more information about Merit Medical and the Next Generation of radial products and programs, visit Merit.com/NextGenRadial.

HeRO Graft Dramatically Reduces Infection Among Catheter-Dependent Patients

Approximately 80% of patients starting hemodialysis use tunneled dialysis catheters, while 25% of all prevalent patients have one placed as a bridge to permanent vascular access, or because all other options for permanent access have failed.1 And yet, catheter dependency still poses the risk of infection. Current research is now pointing to an alternative to catheter use among access-challenged hemodialysis patients: permanent subcutaneous arteriovenous graft devices. Data has shown that the HeRO™ (Hemodialysis Reliable Outflow) Graft is the only clinically proven permanent subcutaneous arteriovenous graft to reduce the risk of vascular access-related infections by 69% when compared to tunneled catheters.2

Unlike other graft devices, HeRO Graft technology improves long-term hemodialysis by way of a Venous Outflow component that’s placed in the right atrium, which then attaches to an adjacent ePTFE hemodialysis graft via a proprietary titanium connector. This mechanism allows for blood to return from an artery back to the heart, bypassing central venous occlusions—a common complication seen among catheter-dependent long-term dialysis patients.

When the HeRO Graft was compared to tunneled dialysis catheter use, access-related bacteremia rates were significantly lower (0.7 events/ 1000 days). Reported infection only occurred during the bridging period when a catheter was implanted prior to a HeRO Graft being used.2

In an effort to circumvent the 2-4 week bridging period and avoid this risk of infection, Merit launched the Super HeRO™ Adapter in 2016. Made with the same HeRO Graft technology, the Super HeRO Adapter has the advantage of wide range graft compatibility. In this instance, by connecting the Super HeRO Adapter to a compatible early cannulation graft, a patient can be implanted today and dialyzed the next, virtually eliminating the risk of access-related infection due to a bridging catheter.

The Super HeRO Adapter is also designed for long-term, access-challenged hemodialysis patients who still have a working Venous Outflow component but need a new graft. Available through the HeRO Ally™ Revision Kit, this option provides clinicians with the tools they need to replace an old graft with a compatible graft of their choice.

In addition, eliminating risks associated with vascular access infection can lead to healthcare cost-savings. A US healthcare model for provision of dialysis access predicted that in comparison to catheters, implementing HeRO technology could result in an average of 23% annual savings—with infection observed as one of the primary determinants of cost.3

In order to meet the diverse needs of patients, dialysis technology is continuously evolving. By taking advantage of innovative tools, clinicians can improve the dialysis experience for catheter-dependent patients, offering them better treatment and a new outlook on life.

As an option to help improve patient care and save on healthcare related costs, Merit Medical offers an in-depth, hands-on training course – THINK ACCESS – that covers techniques for HeRO graft implantation. To be considered for an upcoming THINK ACCESS course, visit the link below to sign-up.

https://www.merit.com/education/course_dates/#Hero

  1. Clin J Am Soc Nephrol. 2011;6: 2247-52.
  2. J Vasc Surg. 2009;50: 600-607.
  3. J Surg Res. 2012;177: 165-171.

SwiftNINJA® Steerable Microcatheter Should be Your “Work Horse” Device, New Case Report Suggests

In the May 2017 issue of Radiology Case Reports, Hinrichs, Marquardt, Wacker, and Meyer reviewed two potential solutions to successfully coil embolize patients with hepatointestinal collateral (HIC) vessels precluding radioembolization. The second solution presented is to use the SwiftNINJA® Steerable Microcatheter as a “work horse” device in appropriate situations, as opposed to a “problem-solving” device, as it is sometimes considered.

  • In the second case, a 59-year-old male is presented who suffers from bilobar multifocal hepatocellular carcinoma (HCC).
  • After coil embolization was performed on the right gastric artery, cystic artery and gastroduodenal artery, an angiogram revealed a small, reverse-curved HIC.
  • Radioembolization was determined to be contraindicated in the patient after catheterization of the HIC using regular microcatheters was unsuccessful.
  • After introduction to the SwiftNINJA Steerable Microcatheter®, the patient was brought back four weeks later.
  • The patient’s HIC was then accessed by positioning the SwiftNINJA® catheter tip near the origin and repeating inflection until the catheter tip hooked into the feeder. Once the SwiftNINJA® was locked in an inflected configuration, a 2-mm pushable straight coil was advanced.
  • Radioembolization was performed successfully 20 days later.

The authors note that given the numerous regular microcatheters that were used initially in the case without success, in appropriate cases it is more cost-effective to use the SwiftNINJA® first as a “work horse” device, rather than a “problem-solving” device.

“The [SwiftNINJA®] represents a new device class and has the potential to expand the armamentarium of interventional radiology in oncology patients and might be of high value in this and numerous other endovascular interventions.”

http://www.sciencedirect.com/science/article/pii/S1930043317301206

SwiftNINJA® Steerable Microcatheter

Merit Medical’s SwiftNINJA® Steerable Microcatheter is the single most advanced and only 180-degree articulating microcatheter on the market. Able to navigate difficult vasculature, the SwiftNINJA® offers unparalleled performance by utilizing three main advantages: speed, control, delivery.

To learn more about the SwiftNINJA®, please click here:

https://www.merit.com/interventional-oncology-spine/accessories/microcatheters/swiftninja-steerable-microcatheter/

REFERENCE

Hinrichs, J. B, Marquardt, S., Wacker, F. K, & Meyer, B. C. (2017). Coil embolization of reversed-curve hepatointestinal collaterals in radioembolization: potential solutions for a challenging task. Radiol Case Rep, http://dx.doi.org/10.1016/j.radcr.2017.04.006

New Interventional CRT Center of Excellence at MedStar

Merit Medical is pleased to announce a new Interventional CRT Center of Excellence at the MedStar Washington Hospital Center, Heart & Vascular Institute, in Washington, DC. Dr. Seth Worley, an internationally recognized expert in cardiac resynchronization therapy, began developing Interventional CRT techniques 18 years ago. He recently moved his practice to MedStar Washington Hospital to launch the hospital’s Interventional CRT program. Training opportunities will be available at the MedStar Center of Excellence beginning this September.

Interventional CRT is a progressive way of implanting LV leads using interventional cardiology tools and techniques. It uses an injection system and specially designed tools to facilitate CS Cannulation and LV lead placement. Utilizing these tools allows implanters to simplify their straightforward cases or provide options for challenging anatomies.

During the MedStar Center of Excellence courses, implanting physicians and fellows learn Interventional CRT techniques including CS Cannulation, Snaring, telescoping, venoplasty, visualization, and wire techniques.  Didactic presentations, hands-on workshops, and live case observations make these programs valuable for electrophysiologists looking for options for LV lead implantation.

In addition to in-person training, the Interventional CRT program offers step-by-step guides for cannulating the CS as well as an instructional video to assist implanting physicians. The Step-by-Step Guide is available as a booklet or poster that can be downloaded. New guides for Snaring and other techniques will be available soon.

MedStar Heart and Vascular Institute has been the premier destination for advanced, complex cardiovascular care in the Washington DC Metropolitan region for more than 55 years, and is consistently ranked as one of the top cardiovascular programs in the nation by U.S.News & World Report (www.medstarwashington.org).

For more information about Interventional CRT training opportunities and availability in the MedStar Center of Excellence programs, contact Marni Adams, Program Director ([email protected], 503-867-4150) or visit InterventionalCRT.com.

StabiliT Bone Cement Offers Physicians Key Clinical Advantages – An Interview with Dr. Jayson S. Brower

The success of percutaneous vertebral augmentation (PVA) relies on the quality of its bone cement. To relieve the pain that accompanies pathologic vertebral compression fractures, cement must be injected into affected vertebra with precision and control. To accomplish this, Merit Medical launched its proprietary StabiliT Bone Cement that offers physicians two significant advantages over other cements on the market.

“There are multiple factors that contribute to StabiliT Bone Cement’s advantages from my perspective as a treating clinician: extended working time and increased viscosity,” says Jayson S. Brower, MD, Radiologist at Inland Imaging Associates and Providence Sacred Heart Hospital in Spokane, WA. “With StabiliT cement, you have more control. Increased working time allows you to take your time. Because of its viscosity, you have more confidence in where you’re putting the cement into the bone.”

Using conventional high-viscosity bone cement often translates into shorter working times. Merit’s StabiliT Bone Cement maintains its high-viscosity with a working time of 35-minutes. When used with the original StabiliT Vertebral Augmentation System, higher levels of radiofrequency (RF) energy are initially applied to the cement to increase its viscosity but then taper off over the length of the procedure. This allows control of the polymerization, making the delivery of high-viscosity cement over an extended working time possible.

Maintaining this viscosity has its clinical benefits especially when managing common complications like cement extravasation. According to Dr. Brower, whether a physician is treating pathologic fractures or osteoporotic fractures, cement potentially leaking outside of the vertebral body is a widespread concern but one that a highly viscous cement can ameliorate.

“Because of StabiliT’s increased viscosity, you have confidence that this cement is far less likely to leak,” Dr. Brower explains. “If you have large fracture planes or are treating pathologic fractures due to vertebral metastatic tumors, you’re potentially concerned about cement leakage. For example, when there’s disruption of the posterior aspect of the vertebral body that reaches into the spinal canal, using StabiliT Bone Cement offers a huge advantage.”

What’s more, using bone cement that retains a high viscosity over the length of a procedure affords time to address or even revisit areas of concern. “StabiliT’s prolonged working time allows you to install a bit of cement, let it set up, go back, and place additional cement,” Dr. Brower continues. “Or if you don’t get the optimal spread, you can go back, form additional channels, and place additional cement in that same level.”

To offer these same benefits to physicians with varying clinical needs and patient requirements, Merit introduced the StabiliT MX Vertebral Augmentation System—a simplified system that only requires the use of a precision syringe to deliver high-viscosity cement.

“A great opportunity for the MX system would be in an outpatient practice, treating in an ambulatory setting,” Dr. Brower notes. “The lower cost, combined with increased control of the StabiliT Cement, would be a huge advantage. It could give a clinician the chance to use a potentially more expensive system in a cost-effective way and leverage the safety and efficacy of the MX cement in that outpatient setting.”

Limited working time and unreliable cement viscosity have often left physicians rushing to complete a procedure. StabiliT Bone Cement’s versatility and many clinical advantages, mainly its extended working time and dependable high-viscosity, have made it the bone cement of choice.

“I’ve used just about everything on the market and, through trial and error, I’ve realized there’s nothing quite like it. I use StabiliT Bone Cement exclusively,” Dr. Brower adds. “I think the clinical advantages warrant its use.”

Alicia Armeli and Dr. Brower are paid consultants of Merit Medical. For more information please refer to Instructions for Use. Consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

Targeted Vertebral Procedures for Vertebral Compression Fracture (VCF) and Metastatic Spinal Tumors

Learn the demographics, diagnoses and most current clinical evidence regarding minimally invasive procedures for the treatment of pathologic vertebral fractures and spine tumor ablation.

Announcing September Think Access™ Education Course

Have you signed up for the September Think Access™ training course yet? September’s training is the first time that superpowers have been combined, adding comprehensive training for both the HeRO®/Super HeRO® Graft and for Peritoneal Dialysis (PD) systems. We are happy to announce that training for this exclusive course will be held at the VISTA lab in Baltimore, Maryland Friday, September 15th through Saturday the 16th.

HeRO Graft and PD training at VISTA means you’ll have the opportunity to learn cutting-edge skills and have access to the latest technologies that will help support the advancement of your interventional and surgical procedures. September’s Think Access course is like no other because you’ll be able to rehearse, perfect, and perform techniques using cadavers (HeRO portion only) and simulators in a state-of-the-art facility. Broken up into two groups for more individualized instruction, training such as placing new implants and catheters as well as complications/tips and tricks will be covered. For HeRO, you’ll revisit existing implants, placement of the venous outflow component from different access sites, identifying the anastomosis and tunneling will be addressed. These topics will be put into practice again in the SIM Lab using VISTA’s advanced training models.

Clinical discussions will also be taking place throughout the course that focus on PD and HeRO Graft tips, troubleshooting, and clinical guidelines. You’ll be invited to dive into several case study discussions with other physicians, enabling you to familiarize yourself with HeRO and PD clinical scenarios that will help prepare you for challenging cases.

You’ll be taught by two of the foremost thought leaders, John H. Crabtree, MD Chair of PD University for Surgeons-North America and Jesse Garcia, MD, Vascular Surgeon at MedStar Heart & Vasculature Institute at MedStar Washington Hospital Center.

Dr. Crabtree has pioneered modifications and enhancements to the laparoscopic placement for peritoneal dialysis patients and has authored numerous articles covering dialysis catheters, implantation techniques, and resolution of dialysis access complications. He currently serves as Visiting Clinical Faculty at Harbor-UCLA Medical Center and as the Activity Director for ISPD-sponsored surgeon education programs for Europe.

Jesse Garcia, MD, is a board-certified general surgeon who specializes in vascular access surgery for patients diagnosed with kidney failure who need dialysis. His passion for practicing medicine began with his father, who led the cardiac surgery program at MedStar Washington Hospital Center into the 1980s.

Dr. Garcia is part of a team of vascular surgeons at MedStar Heart and Vascular
Institute (MHVI) that is performing the greatest volume of HeRO™ graft placements in the country. This unique new technology has made a dramatic impact on patients’ lives because it reduces significantly the risk and frequency of infection associated with the standard venous catheter use.

Sign up today to be part of September’s special Think Access training held at the VISTA Lab in Baltimore. We look forward to seeing you there!

PreludeEASE™ Hydrophilic Sheath Introducer: The New GO-TO

Merit Medical is committed to the radial approach, with a comprehensive portfolio of radial products supporting radial procedures from set-up and access through hemostasis, as well as the ThinkRadial training program for Interventional Cardiologists and Radiologists. And in this year, the 25th anniversary of radial access, we are happy to spotlight some of our key radial products, starting with the sheath used to gain access to the radial artery.

The has evolved to address the needs of radial interventionalists. The smooth transitions between wire to dilator, and dilator to sheath, have been fine tuned for patient comfort, resulting in up to 30% less insertion force, as compared to the leading competitor1. The hydrophilic coating further facilitates insertion and removal as well as patient comfort.2

Studies also show that the hydrophilic coating on sheath introducers can reduce the incidence of artery spasm and improve patient comfort during transradial diagnostic and interventional coronary procedures.3

The PreludeEASE™ maintains a robust design that resists kinking while still providing a large inner diameter for increased device compatibility. Combining a slim profile and a large inner diameter, the PreludeEASE provides optimal dimensions without compromising integrity or performance.

On May 31, 2017, Dr. Ferdinand Kiemeneij, “@ferdikiem”, tweeted about the PreludeEASE:

Available in 4F through 7F diameters and multiple lengths. Discover what the next generation of radial access products from Merit can do at merit.com/nextgenradial. #nextgenradial

  1. 6F data on file
  2. Kiemeneij F, Fraser D, Slagboom T, Laarman G, van der Wieken R. Hydrophilic coating aids radial sheath withdrawal and reduces patient discomfort following transradial coronary intervention: a randomized double-blind comparison of coated and uncoated sheaths.
    Catheter Cardiovasc Interv. 2003 Jun;59(2) 161-4.
  3. Rathore, S., Stables, R., Pauriah, M., Hakeem, A., Mills, J., & Palmer, N. et al. (2010). Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention. JACC: Cardiovascular Interventions, 3(5): 475-483. https://www.ncbi.nlm.nih.gov/pubmed/20488402

Announcing – ThinkPAE™ Education Course

Merit Medical is excited to announce the ThinkPAE™ – Interventional Techniques for Prostatic Artery Embolization education course, and the first course date on August 25-26, 2017 proctored by Dr. Shivank Bhatia.

Prostatic artery embolization (PAE) is a non-surgical treatment for lower urinary tract symptoms (LUTS) from benign prostatic hyperplasia (BPH). BPH is the most common benign neoplasm in men, with more than half of men aged 60-69 years and as many as 90% aged 70-89 years having some symptoms.1

Clinically shown to reduce BPH symptoms and improve quality of life, PAE has become a viable alternative to surgical procedures, with minimal risk of urinary incontinence or sexual dysfunction such as impotence and retrograde ejaculation. PAE also offers a shorter recovery time compared to surgical options and can be performed via the femoral or radial artery. Merit Medical recently announced FDA 513(f)(2) (de novo) classification for prostatic artery embolization (PAE) indication for symptomatic BPH.

Merit Medical’s ThinkPAE™ education course will be taught by one of the world’s leading experts in PAE, Dr. Shivank Bhatia, and will include training to perform PAE via the radial artery, preferred by many patients for interventional procedures. The first course will be hosted at the Merit Medical Education Center in Salt Lake City, UT.

Dr. Shivank Bhatia is an Associate Professor of Interventional Radiology and Urology at University of Miami Miller School of Medicine. He has extensive experience with Prostatic Artery Embolization and has built a multidisciplinary program with the Department of Urology at University of Miami. Due to his significant collaboration with the Urology Department at University of Miami, he was awarded title of Associate Professor of Urology in 2015.

What are the learning objectives of the course?

  • Prostatic Arterial Anatomy – learn to identify and work around arterial anomalies
  • PAE Technical Aspects – learn the proper tools for technical success, imaging protocols and interpretation
  • Radial Access – learn the technique and benefits of radial access for PAE
  • Peer Collaboration – discuss a multidisciplinary approach to PAE
  • Complex Cases – learn how to navigate obstacles and complex cases

For more information about this course, download the course flyer.

Interested in attending? Please complete the Interest Form online at Merit.com/Education.

Due to the high demand and limited seating in this course, we will contact you within a few weeks about availability. Future dates will be announced soon.

  1. Wei JT, Calhoun E, Jacobsen SJ. Urologic diseases in America project: benign prostatic hyperplasia. J Urol 2005; 173: 1256–1261

StabiliT Bone Cement – Trusted Cement. Simplified Delivery.

Thirty years ago, the first-generation percutaneous vertebral augmentation (PVA) system was introduced for the management of painful pathologic vertebral compression fractures. Since then, PVA treatment has had dramatic improvements in both bone cement formulations and delivery systems.

For example, higher cement viscosity has been considered desirable in recent years, but as viscosity increases, working time decreases. Therefore, conventional high-viscosity cements, with relatively short working times, often result in cement clogging the delivery system prior to the physician completing a procedure.

To address such challenges head on, Merit Medical’s portfolio of StabiliT Bone Cement with expanded delivery options in the StabiliT Vertebral Augmentation Systems has two main advancements over the competition: 35-minutes extended working time with remotely controlled delivery and trusted high-viscosity bone cement.

Merit’s unique proprietary StabiliT Bone Cement formulation offers physicians time flexibility to do a procedure in a controlled fashion, regardless of its complexity and number of levels requiring treatment. Physicians can also routinely initiate procedures with a unipedicular approach and still have adequate working time to convert to a bipedicular procedure, if required, avoiding the need to rush or mix additional cement.

Complex procedures that necessitate extended working time can also depend on StabiliT Bone Cement maintaining its high-viscosity. Bone cement viscosity has been shown to correlate to procedural success. How bone cement interacts with the fractured vertebral body determines how the cement stabilizes a fracture and/or extravasates (leaks).1 In an ex-vivo assessment of vertebral augmentation procedures, Lador et al. noted that several factors, specifically cement viscosity and rate of delivery, could influence cement flow within and leakage out of the vertebral body.1,2 Georgy reported approximately 50% less cement leakage using a controlled delivery of ultra-high viscosity cement after cavity creation with an osteotome compared to a lower viscosity cement in balloon kyphoplasty cases.3

In the original StabiliT Vertebral Augmentation System, proprietary ultra-high viscosity bone cement is heated with radiofrequency (RF) as it passes through a warming cartridge and its polymerization is accelerated just prior to being delivered into the vertebra. The controller’s software algorithm applies more RF energy initially to rapidly increase the cement viscosity and then less as time goes on, enabling the delivery of the same ultra-high viscosity over an extended working time. Delivery of this ultra-high viscosity cement is remotely controlled by the physician at an optimized delivery rate.

In response to some physicians desiring this same control but in a simplified design, Merit launched the StabiliT MX Vertebral Augmentation System. The StabiliT MX uses high-viscosity bone cement that has the same clinical benefits and same 35-minute extended working time, but it doesn’t require a controller or RF energy. The StabiliT MX provides high-viscosity cement that’s hand delivered using an ergonomic precision syringe.

The StabiliT MX delivery syringe contains a quick release clutch mechanism that allows for immediate cement flow stoppage. The use of a 3-foot hydraulic line increases the distance from which cement is conventionally hand delivered, helping to minimize a physician’s radiation exposure.4 Other features include a unique vacuum-based mixing system and articulating instrumentation for site and size specific cavity creation.

PVA treatment has been shown to significantly relieve pain of vertebral compression fractures.5 Merit is committed to providing technology that gives physicians maximum control as well as flexibility in cement and delivery options in order to optimize patient care. By using Merit’s trusted cement and simplified delivery systems, why not bring these benefits to your practice?

Alicia Armeli is a paid consultant of Merit Medical. For more information please refer to Instructions for Use. Consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

 

REFERENCES

  1. Lador, R., Dreiangel, N., Ben-Galim, P., et al. (2010). A pictorial classification atlas of cement extravasation with vertebral augmentation. Spine J, Dec; 10(12): 1118-1127.
  2. Loeffel, M., Ferguson, S. J., Nolte, L. P., et al. (2008). Vertebroplasty: experimental characterization of polymethylmethacrylate bone cement spreading as a function of viscosity, bone porosity, and flow rate. Spine, May; 33(12):1352–1359.
  3. Georgy, B. (2013). Comparison between radiofrequency targeted vertebral augmentation and balloon kyphoplasty in the treatment of vertebral compression fractures: addressing factors that affect cement extravasation and Pain Physician, Sept-Oct; 16(5): E513-518.
  4. Radiology Masterclass. (n.d.). Basics of X-Ray Physics. Retreived from http://www.radiologymasterclass.co.uk/tutorials/physics/x-ray_physics_safety
  5. Mpotsaris, A., Abdolvahabi, R., Hoffleith, B., et al. (2011). Percutaneous vertebroplasty in vertebral compression fractures of benign or malignant origin: a prospective study of 1188 patients with follow-up of 12 months. Dtsch Arztebl Int, May; 108(19): 331-338.

Dr. Ferdinand Kiemeneij Returns to Merit Medical to co-proctor the October ThinkRadial Course

Merit Medical will be hosting the next ThinkRadial Education Course on October 13-14 for Interventional Cardiologists and Radiologists. Physicians are already looking forward to this course and the opportunity to learn from the “Father of Transradial Intervention,” Dr. Ferdinand Kiemeneij.  Merit is honored to once again have Dr. Kiemeneij proctor this course, to share his extensive knowledge and experience, as he did in the April ThinkRadial Course. This course will be held at the Merit Medical Global headquarters in Salt Lake City, UT on Friday, October 13 and Saturday, October 14, 2017.

Interventional Cardiologists who currently practice the transradial access technique, who want to advance their skills for more complex interventional procedures, will be proctored by Dr. Sandeep Nathan (University of Chicago) as well as Dr. Ferdinand Kiemeneij. Interventional Cardiologists attending the course will present their own complex cases for discussion and troubleshooting as well as observe complex taped cases. These physicians will learn how to navigate potential complications and increase their use of transradial for complex interventions.

Interventional Radiologists who are new to the radial approach as well as those who want to increase their knowledge and skill will be proctored by Dr. Darren Klass (Vancouver General and UBC Hospitals). Interventional Radiologists will be taught the data and economics supporting transradial access, learn about patient selection, room set-up, and equipment selection. They will learn and practice access and hemostasis techniques and discuss how to navigate potential complications. Both groups will have the opportunity to practice the radial technique on cadavers.

Dr. Kiemeneij performed the first transradial coronary angioplasty in 1992, followed by transradial stenting in the same year and stenting on an outpatient basis in 1994.

Dr. Klass is an expert in transradial radioembolization and is developing a robust hardware platform for radial access to the liver. His practice is 90% radial for liver interventions and fibroid embolization.

Dr. Nathan describes his mindset as “radial first” and utilizes the transradial approach in more than 75% of his coronary cases. He believes that transradial “is a golden opportunity to improve patient comfort and safety, without compromising procedural efficacy.”

The October ThinkRadial Course is a full day and a half of didactic presentations, taped cases and hands-on training opportunities, complimented by a group dinner and presentation by the guest of honor, Dr. Ferdinand Kiemeneij.

To register for a course, visit our Education Page

For more information, please visit ThinkRadial.com

Accuracy matters. We help you get there.

Since Merit Medical’s founding, we’ve set out to build the world’s most customer-focused healthcare company by understanding customers’ needs and innovating a diverse range of products that improve the lives of people. Our Interventional Oncology & Spine (IOS) products illustrate just this, and we are excited to present several of them to you at the World Conference of Interventional Oncology (WCIO) 2017.

We continually hear from our physician customers that they need tools to help deliver therapies to difficult anatomy. So, our focus for this year’s WCIO is to highlight two devices that aim to provide these navigation solutions, with the ability to reach challenging anatomy with accuracy.

SwiftNINJA® Steerable Microcatheter – The SwiftNINJA® steerable microcatheter is the most advanced and only 180° articulating microcatheter on the market today. It allows for positioning and re-direction within the vessel without the need for a micro guide wire. The proprietary straight-tip catheter articulates up to 180° in opposing directions to rapidly select the most challenging and complex vasculature during embolization procedures.

“The frequent insertion and removal of guidewires during superselective catherization can be minimalized by using a microcatheter with an articulating tip. Using a SwiftNINJA® can potentially simplify and shorten the procedure.”
-Dr. Yasuaki Arai, Chief, Department of Diagnostic Radiology, National Cancer Center of Japan

STAR™ Tumor Ablation System – The STAR™ Tumor Ablation System is designed for the palliative treatment of painful metastatic spinal tumors. Included in this system is the SpineSTAR® Ablation Instrument, which allows for precise navigation through the pedicle and into the desired areas of the vertebra-containing tumor, allowing for fast, targeted tumor ablation.

“There are a number of features of the [SpineSTAR®] device that I really like. The articulating tip allows and facilitates reaching to areas in the vertebrae that are not possible with a straight fixed device.”
-Dr. Aaron Frodsham, Interventional Radiology, University of Utah Huntsman Cancer Center

Come to booth #510 to learn more about navigation with the SwiftNINJA® and SpineSTAR®.

WCIO will also be conducting several workshops where you can view these products.

Friday, June 9 | 9:15-10:45am | MSK & Spine Interventions
Saturday, June 10 | 9:15-10:45am | Ablative Therapies
Saturday, June 10 | 1:30-3:00pm | Hepatic Intra-Arterial Therapies

Click here to learn more about Merit’s WCIO attendance and workshops.

For a complete step-by-step guide to delivery, refer to Instructions for Use. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

Merit Medical loves Critical Care Nurses!

Merit Medical recently joined the Critical Care community and was pleased to attend the AACN’s National Teaching Institute and Critical Care Exposition (NTI) in Houston May 23-25, 2017. At our first-ever NTI expo booth, we met hundreds of critical care nurses over ice cream at the Merit Ice Cream Café, during in-booth educational sessions, and while discussing our critical care product portfolio.

Our booth featured the Merit Ice Cream Café, which provided a fun treat throughout each of the ExpoEd presentations. Adhering to our commitment to education, the Merit-sponsored presentations were well attended, providing CERP credits and valuable information. Nurses learned techniques for preventing CLABSIs as well as strategies for treating Sepsis successfully.

For those who wish to review the information presented on their own time, the presentations are available for download:

      • Preventing CLABSIs: Tales from the Front Line (Donna Schweitzer, RN, APN, CCNS, CCRN)
      • Sepsis Survival for Patients and Nurses (Alexander Johnson, MSN, RN, CCNS, ACNP-BC, CCRN)

We showcased our full line of safety and infection control products, including the DualCap® Disinfectant Cap, as well as our hemodynamic portfolio, including the DTXPlus® Blood Pressure Monitoring System, the SafeDraw Closed Loop Blood Sampling System, and the accessories that go with them.  You can learn more about these products and download brochures:

DualCap: https://www.merit.com/cardiac-intervention/solutions/infection-control/dualcap/
DTXPlus: https://www.merit.com/cardiac-intervention/critical-care-solutions/

In addition to discussing Merit Critical Care products, Merit Representatives in attendance at NTI also enjoyed visiting with hundreds of nurses to gather feedback about future products and innovations that we may be able to develop to support your needs at your hospitals.

Our first NTI was a memorable and fun experience. We thank all those nurses who made a stop at the Merit Medical Booth. It was impressive to see the level of sincere concern that you have for the health and safety of your patients. Our critical care and safety products provide continuity across the patient-care continuum, supporting the nurses we care about so much!

Merit Introduces InQwire® Amplatz Diagnostic Guide Wire

Elevate the Fine Art of Navigation

The right guide wire accomplishes many things. It can serve both diagnostic and interventional purposes. The right guide wire is versatile and facilitates procedures of various clinicians, including interventional radiologists, interventional cardiologists, vascular surgeons, and interventional nephrologists. But most of all, the right guide wire can help you get the job done.

That’s why Merit Medical is proud to launch the InQwire® Amplatz diagnostic guide wire.

Choosing the right guide wire starts with familiarizing yourself with its performance characteristics. The InQwire Amplatz guide wire is held at a very high standard by six pillars of performance:

Stiff Shaft Construction

Stiff guide wires provide the support needed to introduce catheters and other devices during procedures. Available in multiple lengths, the InQwire Amplatz’s larger inner core wire provides additional stiffness, which improves stability of devices within the vessels and enhances navigation of the devices throughout the vasculature. The InQwire Amplatz delivers push and navigation without compromising tip flexibility.

Multiple Tip Configurations

Tip flexibility means more tip configuration options to help navigate through tortuous anatomy. InQwire Amplatz’s straight tip wires are available in a variety of flexible profiles, including 1.0 cm, 3.5 cm, 4.0 cm, 6 cm, 7 cm, and J3 mm configuration.

Atraumatic Tip Design

The combination of the smooth transition of the distal weld joint, and the soft flexible atraumatic tip assists with negotiation of the most difficult anatomy.

Improved Lubricity

The InQwire Amplatz goes even further to support manipulation and advancement of catheters and other devices through the vessels with its proprietary PTFE coating. This feature provides improved lubricity along the entire wire surface, ensuring smooth manipulation throughout the vasculature. Data show Merit’s InQwire Amplatz is 20% more lubricious than the leading competitor.*

Device Placement Support

Not only does the lubricious coating help smooth advancement of devices through vessels, it reduces friction along the wire. Combined with this special coating, added stiffness provides extra support to facilitate advancement of devices, stability during device placement, and with exchanges during contralateral access. Highly-radiopaque material supports visibility.

Compatibility

The InQwire Amplatz is compatible with 0.035 in. and 0.038 in. devices, translating into more device options for your procedures.

And if all of these product benefits aren’t enough, Merit offers an extensive product offering to meet the needs of your most complex procedures.

Now that you’re familiar with all of InQwire Amplatz’s advantages, ask yourself:

Does your guide wire do that?

* Data on file   703991001/A

June 2017 ThinkHeRO: Gain hands-on experience with the HeRO® graft at the World-Class MITIESM Lab

Have you signed up for the June ThinkHeRO course yet? If you haven’t, you’ll want to because June’s training is the last ThinkHeRO course held in 2017 at the world-class Houston Methodist Institute for Technology, Innovation & Education (MITIESM).

What does this mean for you if you attend June’s ThinkHeRO training?

HeRO graft training at MITIE means you’ll have the opportunity to learn cutting-edge skills and have access to the latest technologies that will help support the advancement of your interventional and surgical procedures. June’s ThinkHeRO course is like no other because you’ll have the opportunity to rehearse, perfect, and perform techniques using cadavers in a state-of-the-art cadaver lab. Broken up into two groups for more individualized instruction, skills training such as placing a new implant, revising an existing implant, placing the venous outflow component from different access sites, identifying the anastomosis and tunneling will be addressed. These topics will be put into practice again in the SIM Lab using MITIE’s advanced training models.

Clinical discussions will also be taking place throughout the course that focus on HeRO graft tips, troubleshooting, and clinical guidelines. You’ll be invited to dive into several case study discussions with other physicians, enabling you to familiarize yourself with HeRO clinical scenarios that will help prepare you for challenging cases. At the end of the training, you’ll also receive help on how to build your own HeRO program.

One more reason you’ll want to reserve your seat for June’s ThinkHeRO course is that you’ll be taught by one of ThinkHeRO’s foremost leaders, Eric Peden, MD, Chief of Vascular Surgery at Methodist DeBakey Heart and Vascular Center. Dr. Peden has a rich history as both a surgeon and an instructor with vast experience and expertise that he’ll share with ThinkHeRO attendees. As the recipient of multiple accolades, Dr. Peden has been awarded the A.O.R.N. Distinguished Surgeon Award and Attending Teaching Award (Vascular Surgery Fellows). His stellar background also includes instructing at Baylor College of Medicine as Assistant Professor of Vascular Surgery before joining Methodist as Assistant Professor of Cardiovascular Surgery.

Visit us at https://www.merit.com/education/course_dates/#Hero and sign up today to be part of June’s special ThinkHeRO training held at MITIE. We look forward to seeing you there!

Your Safety Is Our Priority: Merit to Showcase Safety Products at NTI 2017

Thirty years ago, Merit Medical pioneered a clear-as-glass polycarbonate syringe to reduce the risk of a glass syringe breaking in the hand of a healthcare provider. Since our beginning, we’ve consistently prioritized solutions to procedural challenges, with the goal of making patient care safer for medical professionals like you.

Keeping up with this tradition, we’re excited to showcase our innovative safety products at the AACN’s National Teaching Institute & Critical Care Exposition (NTI) in Houston, TX, May 23-25.

Come to Booth 4300 to get an up-close look at Merit’s innovative safety products:

The DualCap System™

The DualCap System is a uniquely designed disinfecting cap system for use on both the male luer connector at the end of the IV tubing and the needle-free valve. The DualCap System consists of two caps designed to help prevent intraluminal contamination, as well as device cross-contamination.

MiniStop® Disposal Systems 

MiniStop Disposal Systems have a seal-tight lid to prevent fluid leakage after a procedure, providing quick and safe fluid waste elimination.

ShortStop® Temporary Sharps Holder 

Merit’s ShortStop was designed to prevent sharps injuries to both the clinician and the patient. With its distinctive bullseye design, the ShortStop holds needles and scalpels in a protected environment before, during, and after procedures.

BackStop® Disposal Systems

Our BackStop Disposal Systems have a seal-tight lid to prevent fluid leakage after a procedure, providing quick and safe fluid waste elimination.


Futura® Safety Scalpels

Protecting clinicians and patients, the Futura Safety Scalpel has spring retraction technology to minimize the risk of accidental cuts. Its one-handed activation combines convenience and rapid response for any surgical procedure.


Medallion® Syringes 

Medallion syringes are designed to facilitate compliance with national safety goals that require labeling of all medications on and off the sterile field. Available in seven color options with custom printing or a frosted field for writing information directly, Medallion Syringes take the guesswork out of medication labeling.


PAL™ Pen & Labels

Merit Medical’s PAL – Pen and Labels – were designed to streamline and help make labeling medication easier. PAL labels are designed to stick even when wet and can be customized with a variety of color choices for safety and convenience. The PAL pen is sterile, has a fine point, and is smear resistant.


DriPAD™ 

The DriPAD is a super absorbent pad that controls, isolates and traps biofluids while also containing and preventing the spread of odors. This premium pad can absorb up to 35x its weight in fluids, making them more efficient than the leading absorbent pad on the market. That’s up to 10x more absorption power than alternative pads!* Stop by Booth 4300 to learn about the DriPAD’s environmental, clinical, and financial advantages.


DTXPlus®

Safedraw arterial blood sampling systems are designed to reduce unnecessary blood discard and blood spillage. The system’s self-sealing, silicone septum facilitates easier blood sampling for clinical testing.


Merit Advance® Angiographic Safety Needles

The unique design of the Merit Advance Safety Needle allows clinicians to easily activate a low profile safety mechanism, shielding the needle bevel after use. The hub of this introducer needle is transparent for visibility and designed with an ergonomic feel for ease of handling.

 

Don’t forget about our in-booth presentations! Combining safety technology with education, Merit is hosting expert critical care nurses to address bloodstream infection prevention and treatment of SEPSIS:

Sepsis Survival for Patients and Nurses

Addressing the new definition of sepsis and mandatory CMS reporting.

Alexander Johnson, MSN, RN, ACNP-BC, CCNS, CCRN 

TUESDAY, MAY 23

10:45 am to 11:15 am
11:30 am to 12 noon
1 pm to 1:30 pm

Preventing CLABSIs: Tales from the Frontline

Discussing protocols to prevent bloodstream infections and how newer technologies and education have helped reduce the occurrence. A specific case will be discussed.

Donna Schweitzer, MSN, CCNS, CCRN 

WEDNESDAY, MAY 24

10:45 am to 11:15 am
11:30 am to 12 noon
3:15 pm to 3:45 pm

Click here to learn more about Merit’s NTI events, our expert critical care speakers, and to get a full list of other Critical Care and Infection Control products we’ll be showcasing.

*Data on file 

For a complete step-by-step guide to delivery, refer to instructions for Use. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

Expert panel to discuss Interventional CRT Implant Techniques at the Rhythm Theater during HRS 2017

Merit Medical and Discover Interventional CRT would like to invite physicians attending HRS 2017 to save space on their program schedules for an invaluable presentation on Thursday, May 11th from 3:15-4:15pm in Rhythm Theater #2 titled, Interventional CRT Implant Techniques.

Leading the lecture are some of the field’s top electrophysiologists: (Chair) Kenneth A. Ellenbogen, MD, of Medical College of Virginia/VCU School of Medicine in Richmond, VA.; Jagmeet P. Singh, MD, DPhil, of Massachusetts General Hospital Heart Center in Boston, MA.; Seth Worley, MD, of MedStar Washington Hospital Center in Washington, DC; and Kevin Jackson, MD, of Duke University Medical Center in Durham, NC.

Interventional CRT Implant Techniques will explore how these leading physicians are utilizing interventional techniques to overcome difficult anatomy during LV lead placement. Experts will share clinical experience, novel approaches, and discuss whether anatomy or electrical timing should determine LV lead location. For more information about this timely event, please visit https://www.merit.com/hrs2017/. We look forward to seeing you there!

NTI 2017: Partner with Us Across the Patient Care Continuum

Merit Medical is making its debut at the 2017 AACN’s National Teaching Institute & Critical Care Exposition (NTI) in Houston, TX, on May 23-25. After 30 years of bringing quality, innovative products to medical professionals, we’re continuing the Merit tradition at this year’s NTI by introducing our critical care portfolio and demonstrating how we can partner with you across the patient care continuum.

Visit us at Booth 4300 and look forward to the following events we have planned through our Merit Education Theater:

  • Earn CERP credits while learning about infection control from expert critical care nurses.
  • Get an up-close look at our Critical Care and Infection Control products.
  • Learn about our Patient Care Continuum promise to you and product continuity that spans the patient care continuum.
  • Meet the Merit team at the Merit Ice Cream Café! Enjoy ice cream on us and learn about the many ways we can partner with you.

In-Booth Presentations You Won’t Want to Miss (Booth 4300):

Sepsis Survival for Patients and Nurses
Addressing the new definition of sepsis and mandatory CMS reporting.
Alexander Johnson, MSN, RN, ACNP-BC, CCNS, CCRN 

TUESDAY, MAY 23
10:45 am to 11:15 am
11:30 am to 12 noon
1 pm to 1:30 pm

Preventing CLABSIs: Tales from the Frontline
Discussing protocols to prevent bloodstream infections and how newer technologies and education have helped reduce the occurrence. A specific case will be discussed.

Donna Schweitzer, MSN, CCNS, CCRN 

WEDNESDAY, MAY 24
10:45 am to 11:15 am
11:30 am to 12 noon
3:15 pm to 3:45 pm

Learn more about Merit’s NTI events, our expert critical care speakers, and specific Critical Care and Infection Control products we’ll be showcasing.

Alicia Armeli is a paid consultant of Merit Medical. For a complete step-by-step guide to delivery, refer to instructions for Use. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

Featuring the HeartSpan® Fixed Curve Transseptal Sheath at HRS 2017

Our excitement for HRS 2017 is building because it means we’re getting closer to showcasing some of our most exciting products.

One highly anticipated product, The HeartSpan® Fixed Curve Transseptal Sheath, is designed to provide a conduit to deliver diagnostic and therapeutic catheters to specific heart chambers and locations. Available in a kit that contains a sheath, a dilator, and a J-tipped guidewire, the HeartSpan is designed for seamless dilator to sheath transition for ease of insertion and to reduce trauma when crossing the atrial septum.

To facilitate access to a variety of cardiac structures and sites, the sheaths are available in various sizes, lengths, and tip curve configurations—including the NEW ML1 and ML0 curves with intended anterior to lateral and superior to lateral positions, respectively. Both of these curves can be used as possible pulmonary vein isolation (PVI) ablation targets.

Other key features include:

  • Integrated Hemostatic Valve
    Designed to reduce air introduction and backflow
  • Lubricious Coating
    Reduces friction when exchanging electrophysiology (EP) catheters
  • Radiopaque Dilator
    Enables visualization

To learn more about the HeartSpan and its many product features, stop by booth 1549 for hands-on demonstrations of all Merit EP products.  For a schedule of all educational opportunities offered by Merit Medical at the upcoming HRS2017, visit Merit.com/HRS2017.

We are looking forward to seeing you there!

Alicia Armeli is a paid consultant of Merit Medical. For a complete step-by-step guide to delivery, refer to instructions for Use. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

ThinkRadial and Merit Medical are Honored to Have Dr. Ferdinand Kiemeneij Co-Proctor this Week’s ThinkRadial™ Education

Today is the first day of our April ThinkRadial™ course and we couldn’t be more excited to have Guest of Honor Dr. Ferdinand Kiemeneij, MD, PhD, co-proctoring the IR and Advanced IC sections.

Dr. Kiemeneij is working side-by-side with co-proctors Sandeep Nathan, MD, MSc, FACC, FSCAI, interventional cardiologist at the University of Chicago Medical Center in Chicago, Ill., and Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, interventional radiologist at Vancouver General and UBC Hospitals in Vancouver, Canada.

Read the full article over at ThinkRadial.com

ThinkRadial and Merit Medical are Honored to Have Dr. Ferdinand Kiemeneij Co-Proctor this Week’s ThinkRadial™ Education

Today is the first day of our April ThinkRadial™ course and we couldn’t be more excited to have Guest of Honor Dr. Ferdinand Kiemeneij, MD, PhD, co-proctoring the IR and Advanced IC sections.

Dr. Kiemeneij is working side-by-side with co-proctors Sandeep Nathan, MD, MSc, FACC, FSCAI, interventional cardiologist at the University of Chicago Medical Center in Chicago, Ill., and Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, interventional radiologist at Vancouver General and UBC Hospitals in Vancouver, Canada.

Read the full article over at ThinkRadial.com

Join Us At HRS 2017!

Merit Medical and Discover Interventional CRT are pleased to announce training opportunities at HRS 2017. From May 10-12 in Chicago, Ill., HRS attendees can learn techniques and technologies from some of electrophysiology’s foremost leaders. Here’s a preview of what you can expect:

Thursday, May 11

LV Lead Delivery: Providing Options with a Simplified Approach
Booth 1549
9:45-10:15am
In-booth presentation by Dr. Seth Worley of MedStar Washington Hospital Center in Washington, DC. Dr. Worley will be available throughout the day for hands-on training.

Rhythm Theater—Interventional CRT Implant Techniques
Rhythm Theater #2
3:15-4:15pm
Dr. Kenneth A. Ellenbogen of Medical College of Virginia/VCU School of Medicine with expert panel discuss how leading physicians are utilizing interventional techniques to overcome difficult anatomy during LV lead placement.
Want more information?

Friday, May 12 

In-Booth Meet the Experts Hands-on Training
Booth 1549
9:30-10:30am and 3:00-4:30pm
Attendees have two opportunities to meet with interventional CRT experts as they share their advanced techniques for LV lead placement.

Throughout HRS, attendees will also get hands-on demonstrations for Merit EP products, including the new ML1 and ML0 HeartSpan® Fixed Curve Transseptal Sheath shapes. For more information about this year’s HRS schedule, visit https://www.merit.com/hrs2017/

10 Reasons Why IR’s and IC’s Should Attend April’s ThinkRadial™ Course

By Alicia Armeli

Twenty-five years ago, the first transradial coronary intervention was performed. This sparked the start of the Radial Revolution—a medical movement that put transradial procedures on the map as a way of treating patients without surgery. In honor of this progress, Merit Medical is hosting a special ThinkRadial® course April 21-22 for Interventional Radiologists and Interventional Cardiologists. Here’s why you won’t want to miss it.

  1. Get a Front-Row Seat to Learn from the Father of Transradial Intervention

For the first time, Merit is honored to have the “Father of Transradial Intervention” himself—Dr. Ferdinand Kiemeneij—as the special guest of honor at a US ThinkRadial course. In 1992, Dr. Kiemeneij was the first to perform a transradial coronary intervention at the Onze Lieve Vrouwe Gasthuis in Amsterdam. Attendees will be able to learn from Dr. Kiemeneij’s knowledge, expertise, and technique as he co-proctors this one-of-a-kind training opportunity. Read more about Dr. Kiemeneij in this special News Blog.

  1. Stellar Proctors: a Chance to Be Trained by the Best

Alongside Dr. Kiemeneij, well-known physicians who are experts in the transradial technique will be proctoring attendees. Interventional Radiologist Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, of Vancouver General and UBC Hospitals will be instructing Interventional Radiologists, while Sandeep Nathan, MD, MSc, FACC, FSCAI, of the University of Chicago Medical Center will be training Interventional Cardiologists.

  1. New Advanced Interventional Cardiology Curriculum

To help Interventional Cardiologists advance to the next level of transradial, for the first time, the April ThinkRadial program features an Advanced Curriculum for Interventional Cardiologists. IC attendees will be able to share and troubleshoot complex cases, learn advanced transradial techniques, and hear an invaluable presentation by Dr. Kiemeneij about new radial techniques and advancements in the field.

  1. True Hands-On Experience

Interventional Radiologists will have the opportunity to learn the radial technique through direct experience using cadavers, while Advanced Interventional Cardiologists will gain hands-on practice using ultrasound-guided access on realistic arm models.

  1. Beginner Interventional Radiologists Welcome

Everyone must start somewhere! Merit invites Interventional Radiologists with little to no transradial experience to the training course, as well as those wanting to improve their technique. Introductory information, including patient prep and room set-up, will be presented.

  1. Gain Knowledge By Learning From Each Other

Each advanced Interventional Cardiology attendee will present his/her own complex case for discussion and team troubleshooting. Learning from fellow Interventional Cardiologists can help you better understand potential complications and how to navigate them successfully.

  1. Look Ahead

Physicians attending the course will learn how to implement the procedure in more complex interventions, expanding your ability to use the transradial approach in more situations. In addition, Dr. Kiemeneij will present new transradial techniques that demonstrate what’s coming down the pipe!

  1. Visit Salt Lake City and See Where Merit Does Its Magic

The ThinkRadial course will be held in beautiful Salt Lake City, Utah, at the Merit Medical Education Center.

  1. Networking

This training event includes a group dinner where attendees can meet and greet each other, as well as listen to a memorable presentation by Dr. Kiemeneij.

  1. It’s On Us

Merit Medical will pay or reimburse for certain travel and other expenses associated with attending this program in accordance with the AdvaMed Code of Ethics and will appropriately disclose per the Sunshine Act. Travel and reimbursement information will be provided during the registration process.

To learn more about registration, visit Merit.com/Education. We hope to see you there!

Alicia Armeli is a paid consultant of Merit Medical. For a complete step-by-step guide to delivery, refer to instructions for Use. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

Want to Learn More About Transradial Access?

Two of the Leaders in IR Transradial Access Invite Interventional Radiologists to Attend a Special “Intro to Transradial” Dinner Event

By Alicia Armeli

On Monday, March 27, 2017, from 6-9p at Ristorante Morini in Midtown, NYC, Merit Medical and ThinkRadial™ will host a special “introduction to transradial” dinner event to promote clinical benefits and present introductory training information to interventional radiologists. A uniquely beneficial learning opportunity, attendees will have the chance to listen to well-known interventional radiology radialists, Dr. Aaron Fischman of Mount Sinai in NYC and Dr. Darren Klass of Vancouver General and UBC Hospitals in Vancouver, Canada, as they give informational didactic presentations over dinner.

Topics for discussion will include the clinical benefits of transradial access and fundamental tips to get started, such as case selection, patient prep, room setup, catheter selection, and hemostasis. What’s more, Dr. Fischman and Dr. Klass will share their expertise by offering a valuable Q & A radial panel discussion.

Aaron Fischman, MD, is the Director of Vascular and Interventional Radiology at The Mount Sinai Health System and Associate Professor of Radiology and Surgery at the Icahn School of Medicine at Mount Sinai. He is also Associate Professor of Radiology and Surgery in the Division of Vascular and Interventional Radiology at The Mount Sinai Medical Center. A leader of the transradial technique, Dr. Fischman has led the way using transradial for oncologic liver interventions and uterine fibroid embolization. Dr. Fischman has shared his knowledge and experience by authoring and co-authoring many peer-reviewed publications and lecturing worldwide about novel techniques for minimally invasive interventions.

Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, is a Clinical Assistant Professor at the University of British Columbia and an Interventional Radiologist with Vancouver Coastal Health, as well as Vancouver Imaging, practicing at Vancouver General and UBC Hospitals. His hospital appointments include Medical Head of MRI. Performing the first transradial radioembolization and chemoembolization of the liver in Canada, Dr. Klass has performed over 400 radial interventions, including renal and splenic interventions and embolization procedures throughout the abdomen and pelvis to treat acute hemorrhage. Well-versed in the radial technique, his current practice is approximately 90% radial access for liver interventions and fibroid embolization.

This one-of-a-kind dinner event is open to interventional radiologists who want to learn the basics of transradial access and how to get started. Merit representatives will also be available to answer any “next-step” questions physicians may have. Seating is limited!
RSVP today at Merit.com/Education

Alicia Armeli is a paid consultant of Merit Medical. For a complete step-by-step guide to delivery, refer to instructions for Use. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

“Father of Transradial Intervention,” Ferdinand Kiemeneij, MD, PhD, to be the Special Guest of Honor and Co-Proctor for Upcoming ThinkRadial™ Education Program in April

By Alicia Armeli

In order to keep up with the growth and progress of interventional medicine, Merit Medical is hosting a dynamic ThinkRadial™ training course on April 21-22 at Merit Medical headquarters in Salt Lake City, Utah. For the first time in the US, world-renowned Interventional Cardiologist Ferdinand Kiemeneij, MD, PhD, will be attending as the special guest of honor, co-proctoring the interventional radiologist and brand new advanced interventional cardiologist courses, lecturing at both training sessions.

Recognized as the “Father of Transradial Intervention,” Dr. Kiemeneij first began applying transradial access to angioplasty and stent placement procedures as early as 1992. This led to stenting on an outpatient basis in 1994. Since then, Dr. Kiemeneij has been lecturing and teaching physicians the transradial technique, as well as its many advantages over transfemoral access. More than two decades later, the European Society of Cardiology (ESC) gave the transradial approach the highest degree of recommendation over transfemoral access for coronary angiography and Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndromes (ACS).1

Sought after worldwide, Dr. Kiemeneij was invited in 2013 to build an intervention program at the Tergooi Hospital in The Netherlands. The author of numerous clinical articles and a 2016 book entitled, Transradial Coronary Interzentions, Dr. Kiemeneij has built his practice by combining writing, proctoring, lecturing, and training fellow physicians the world over.

Dr. Kiemeneij will co-proctor advanced interventional cardiologist attendees with venerated Interventional Cardiologist Sandeep Nathan, MD, MSc, FACC, FSCAI, of the University of Chicago Medical Center in Chicago, Ill. He will co-proctoring the interventional radiologist portion with esteemed Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, Interventional Radiologist at Vancouver General and UBC Hospitals in Vancouver, Canada. Dr. Kiemeneij will also share his knowledge and expertise during the groups’ hands-on trainings. Following the Friday sessions, Dr. Kiemeneij will give an invaluable presentation at a special group dinner event.

Space for this program is limited. To submit your interest in this upcoming Think Radial training course and learn from the “Father of Transradial Intervention,” talk to your Merit Representative or visit Merit.com/Education.

Alicia Armeli is a paid consultant of Merit Medical. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

  1. European Society of Cardiology. (2015). ESC Guidelines Recommend Radial Approach for Percutaneous Coronary Interventions in ACS. Retrieved February 11, 2017, from http://www.escardio.org/The-ESC/Press-Office/Press-releases/esc-guidelines-recommend-radial-approach-for-percutaneous-coronary-interventions-in-acs

Eric Peden, MD, Leads Think HeRO Graft Training Course

By Alicia Armeli

Eric Peden, MD

March 30-31 marks the start of this year’s Think HeRO Graft™ training courses. Held at the Houston Methodist Institute for Technology, Innovation & Education (MITIESM), the course will be led by HeRO® Graft pioneer Eric Peden, MD.

One of Houston’s own, Dr. Peden is Chief of Vascular Surgery at Methodist Cardiovascular Associates, Methodist Hospital at the Texas Medical Center in Houston, Texas. He also serves as Assistant Professor of Cardiovascular Surgery at the Institute for Academic Medicine—Houston Methodist and Weill Cornell Medical College in New York City, NY. Previous to these posts, Dr. Peden was an Assistant Professor of Vascular Surgery at Baylor College of Medicine.

Dr. Pedens experience with the HeRO Graft goes back over a decade. One of its principal investigators, Dr. Peden was one of the first to research the outcomes of HeRO Graft use in access-challenged patients with venous obstruction. His passion and dedication in the field of peripheral vascular disease continues as he currently oversees various ongoing outcomes projects and is principal investigator for multiple clinical trials.

At the top of his field in both surgery and instruction, Dr. Peden is a Fellow of the American College of Surgeons (FACS) and received the A.O.R.N. Distinguished Surgeon Award in 2008 and Attending Teaching Award (Vascular Surgery Fellows). In other leadership roles, he was elected to the Board of Directors of VASA in 2013, has served as a VASA Practicum lecturer, and a regular speaker at SVS and ASDIN.

Register now because space is limited! To participate in this upcoming Think HeRO Graft training course and learn from Dr. Peden himself, talk to your Merit Representative or visit Merit.com/Education.

Alicia Armeli is a paid consultant of Merit Medical. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

#NextGenRadial Provides Tools and Skills Clinicians Need for Transradial Access

By Alicia Armeli

For well over a decade, transradial access has been used for coronary interventions. In comparison to the transfemoral approach, research has linked transradial with increased patient preference and fewer vascular complications.1,2 A more cost-effective approach that has success rates similar to the transfemoral technique, transradial access is expanding into other fields of medicine.3,4

Once reserved as an alternative mode of arterial access, the interventional radiology community is now debating whether radial artery access could provide higher patient care value under the “best practices” concept.5 With the growing number of physicians choosing transradial for interventional coronary and radiology procedures, Merit Medical has developed #NextGenRadial—the only second generation of radial products on the market. Combined with their innovative hands-on ThinkRadial™ training courses, Merit provides the skills and tools physicians need to launch new radial practices or successfully bring existing practices to the next level.

The femoral artery has been the traditional access point for the majority of interventional procedures, but a recent notable shift has taken place. Just last year, the European Society of Cardiology (ESC) gave the radial approach the highest degree of recommendation over femoral access for coronary angiography and Percutaneous Coronary Intervention (PCI) in patients with Acute Coronary Syndromes (ACS).6

“New data shows that the radial approach is superior to the femoral not only in terms of vascular complications and major bleeding events but also in reducing all-cause mortality,” said Professor Marco Roffi (Switzerland), Task Force Chairperson in an ESC press release. “It is recommended that centers treating ACS patients implement a transition from transfemoral to transradial access.”6

To demonstrate its superiority, multiple studies have emerged. The well-known MATRIX Study, a 2015 randomized multicenter trial by Valgimigli et al. compared radial with femoral access in patients with ACS with or without ST-segment elevation myocardial infarction and who were about to undergo coronary angiography and PCI.7 Consisting of 8,404 patients, results showed fewer adverse events among those who underwent the transradial approach (9.8% or 410) in comparison to those who underwent transfemoral (11.7% or 486).

Given these results, the authors of the study concluded that “radial as compared to femoral access reduces net adverse clinical events, through a reduction in major bleeding and all-cause mortality” and that transradial access should be the “default approach in patients with an acute coronary syndrome undergoing invasive management.”7 Other randomized investigations provide data that show transradial access to be associated with shorter hospital stay.8 The 2011 multicenter RIVAL trial showed transradial access to be patient-preferred, with 90% of those who underwent the transradial approach designating it as their access site of choice if they needed another procedure.1

Patients undergoing transradial non-coronary interventions are also seeing benefits. A 2015 feasibility study by Posham et al. reported that transradial access was well tolerated among patients receiving a range of peripheral vascular interventions, including chemoembolization, visceral intervention, and uterine artery embolization.9 In this single-center review, 936 patients were evaluated for 1,512 transradial noncoronary procedures between April 2012 and July 2015. Results published in the Journal of Vascular and Interventional Radiology showed transradial access to have a technical success rate of 98.2%. Major complications and minor complications were minimal at 0.13% and 2.38% respectively. A total of 27 cases (1.8%) required crossover to transfemoral access.

Taking patient and clinician safety a step further, a superiority study by Khayrutdinov et al. showed that utilizing the radial technique for UFE and PAE led to reduced procedural time, thereby minimizing radiation exposure.10

From a cost benefit standpoint, the transradial approach can save money. In 2013, Amin et al. published results of a multicenter study that evaluated costs of transradial and transfemoral PCI from a contemporary hospital perspective.3 Over 7,000 procedures were performed between January 2010 and March 2011. Of these, 17% of patients underwent the transradial approach. In comparison to transfemoral, transradial was associated with shorter hospital stays (2.5 vs. 3.0 days) and fewer bleeding events (1.1% vs. 2.4%).  Total cost savings for transradial access was $830 per patient, of which $130 were procedural savings and $705 were post procedural savings. Even greater savings were seen in high-risk patients.3

Despite these findings, only 20% of interventional procedures in the US are performed via transradial access.11 Low adoption of the transradial approach may be related to challenges learning the technique. And yet, data taken from the CathPCI Registry demonstrate that operator proficiency improves with greater transradial experience. Despite the learning curve of about 30 to 50 cases, patient safety is still maintained with high procedural success and low rates of mortality, bleeding, and vascular complications.12

As awareness of the radial technique increases among patients and physicians, Merit has developed the renowned ThinkRadial training program in an effort to provide comprehensive exposure to the next generation of transradial operators. Getting its start in 2014, ThinkRadial invited the best and brightest to spearhead the course. Leading the Interventional Cardiology Courses is Sandeep Nathan, MD, MSc, FACC, FSCAI, an Associate Professor of Medicine and Medical Director of the Cardiac Intensive Care Unit at the University of Chicago Medical Center, where he also serves as the Co-Director of the Cardiac Catheterization Laboratory and Director of the Interventional Cardiology Fellowship Program.

In 2015, Merit extended its cutting-edge ThinkRadial course to interventional radiologists by bringing on Interventional Radiology ThinkRadial Course Director Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, an Interventional Radiologist at Vancouver General and UBC Hospitals, and head of the MRI Division for Vancouver Acute in Vancouver, Canada. Well-known across borders, Dr. Klass performed the first transradial radioembolization and chemoembolization of the liver in Canada.

Throughout the program, ThinkRadial attendees are split into cardiology and radiology specific tracks, but also have several opportunities to learn from each other as a combined group. In their specific tracks, they participate in didactic presentations and discuss taped cases that cover a range of topics, including patient selection, access technique, and potential complications. What’s more, hands-on training with cadavers and simulation training models provide physicians at every level of experience with radial solutions needed for their own practice.

“After attending the ThinkRadial course, I had all the tools I needed to begin transitioning my practice to radial,” said Shivank Bhatia, MD, Interventional Radiologist at the University of Miami Health System, and ThinkRadial Alumni, January 2016. “My first case post ThinkRadial was supported by Merit Medical; their reps did a great job with in-service for the entire support staff, making the introduction of radial products seamless. Using a radial approach has led to great patient experiences, reduced procedure time and overall improved patient satisfaction. I intend to be “radial first” within the next six months to one year.”13

Crossing continental lines, ThinkRadial courses are offered in Europe, South Africa, South America, and Asia—in addition to the US courses offered both at Merit Medical’s Utah headquarters and regionally.

The Course Directors emphasize providing a full radial “education,” as opposed to just a training, so that attendees have the knowledge they need to personalize the experience once they head back to their practice. “The class provided me with a template approach but the foresight to adapt the training to my practice as I saw fit,” explained Mohammad A. Bilal, MD, DABR, Director of Vascular and Interventional Radiology at John T Mather Memorial Hospital, Port Jefferson in Long Island, NY, and ThinkRadial Alumni, April 2016. “I was most excited to leave with the proper set of tools to implement the approach.”13

To fully equip this next generation of experts, Merit provides one-of-a-kind #NextGenRadial products to facilitate each step of transradial access.

Set-up: Merit Rad Board® and Accessories

The reusable Rad Board fits all cath lab and radiology procedure tables and is reversible for right- or left-side access—making it an economical choice.  Putting safety first, a section of Xenolite TB is embedded in the Rad Boards and has shown to help reduce radiation scatter exposure levels by up to 44% at waist height and up to 25% at neck height, according to an independent survey.* Convenient uprights on the sides form a reservoir with the drape to keep devices and fluids on the board. Cutout handles allow for convenient moving and transport.

Each Rad Board accessory—Rad Board Xtra™, Rad Trac™ and Rad Rest®—provide additional support for radial access procedures. The Rad Board Xtra allows for 90° perpendicular extension of the arm during access, while the Rad Trac encourages easy placement of the Rad Board when the patient is on the table. The soft Rad Rest arm cushion boosts patient comfort by providing ergonomic wrist and elbow support during radial access procedures.

Access: PreludeEASE™ Hydrophilic Sheath Introducers

PreludeEASE is Merit’s newest line of Hydrophilic Sheath Introducers. Studies show that hydrophilic coating on sheath introducers can reduce the incidence of artery spasm and improve patient comfort during transradial diagnostic and interventional coronary procedures.14

PreludeEASE kink-resistant tubing helps to provide procedural reliability. Smooth transitions between wire to dilator and dilator to sheath were designed for ease of insertion and can help enhance patient comfort. Available in 4F through 7F diameters and multiple lengths, PreludeEASE anticipates various clinical needs and diverse patient anatomy without compromising its slim profile and large inner diameter.

Diagnostics: Performa® Diagnostic Cardiology Catheters

Merit’s Performa diagnostic cardiology catheter is designed with improved shaft strength for better pushability and torque. Made from Nylon Pebax® material selected to give the Performa improved kink resistance, its flat-wire braid design offers greater stability and increased torque. A large inner lumen enables increased flow rates. The Performa’s winged polycarbonate hub offers enhanced handling and control and the radiopaque tip allows shaft visualization under fluoroscopy to ensure accurate placement. Anticipating individual patient needs, Merit’s diagnostic catheters come in radial specific shapes and lengths. Also available is the Performa Multipack, which combines all three typical workhorse catheters in one convenient package.

Hemostasis: Safeguard Radial™ Compression Device

The Safeguard Radial Compression Device is a 26-cm long self-adhesive wristband designed to assist with hemostasis following radial access procedures. The band allows for adjustable compression of the radial puncture site with an inflatable bulb and standard Luer valve for easy inflation and deflation with any standard Luer syringe.

A clear window allows for better visualization of the puncture site and the size and shape of the bulb minimizes compression of surrounding nerve structures or other areas. The one-size-fits all cloth wristband offers greater patient comfort and fits securely around the wrist.

Through evidence-based data, education, and products, Merit Medical’s #NextGenRadial toolkit provides physicians with the skills, products—and above all—the confidence they need to take full advantage of the radial approach. A technique where the data speaks for itself, radial access is no longer the future of medicine—but the present. Will you be part of the Next Generation?

Alicia Armeli is a paid consultant of Merit Medical. Please consult product labels and inserts for any indications, contraindications, potential complications, warnings, precautions and directions for use.

 

REFERENCES

  1. Jolly, S., Yusuf, S., Cairns, J., et al. (2011). Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. The Lancet, 377(9775): 1409-1420. doi: http://dx.doi.org/10.1016/S0140-6736(11)60404-2
  2. Feldman, D., Swaminathan, R., Kaltenbach, L., et al. (2013). Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention—an updated report from the National Cardiovascular Data Registry (2007–2012). Circulation, 127: 2295-2306. doi: http://dx.doi.org/10.1161/CIRCULATIONAHA.112.000536
  3. Amin, A., House, J., Safley, D., Chhatriwalla, A., Giersiefen, H., Bremer, A., Hamon, M., Baklanov, D., Aluko, A., Wohns, D., Mathias, D., Applegate, R., Cohen, D., & Marso, S. (2013). Costs of transradial percutaneous coronary intervention. Journal of the American College of Cardiology Cardiovascular Interventions, 6(8): 827-834. doi: 10.1016/j.jcin.2013.04.014. https://www.ncbi.nlm.nih.gov/pubmed/23871512
  4. Rao, S., Ou, F., Wang, T., Roe, M., Brindis, R., Rumsfeld, J., Peterson, E. (2008). Trends in the prevalence and outcomes of radial and femoral approaches to percutaneous coronary intervention—a report from the National Cardiovascular Data Registry. Journal of the American College of Cardiology Cardiovascular Interventions, 1(4). doi: 10.1016/j.jcin.2008.05.007. https://www.ncbi.nlm.nih.gov/pubmed/19463333
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*In-house data

Alicia Armeli is a freelance writer and editor who specializes in medical technology, health, and wellness.

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