Category: Cardiac Intervention
For Nearly Two Decades, Merit Compression Devices Deliver Quality and Confidence
Merit Recognizes Infection Prevention Week with a Strong History of Keeping Clinicians and Patients Safe
Merit in the News: I-CRT Featured in DAIC
Distal Transradial Access Is Taking Social Media by Storm
Dynamis AV™: A Solution for Obstructive Arteriovenous Dialysis Fistulae Lesions
Merit Hosts First ThinkRadial™ Course in Australia
Designed with You in Mind, Merit’s Trusted Guide Wires and Catheters Offer Several Advantages over the Competition
Merit Medical prides itself on proactively meeting customer needs and delivering a diverse range of high-quality products. From diagnostic and interventional wires to catheters and microcatheters, our innovative product lines are designed with you in mind, offering many advantages over competing devices. Take a look at some of our most trusted products and discover how […]
A Better Way Forward: Seth Worley, MD, Writes About the Benefits of Adopting I-CRT in June 2018 EP Lab Digest
Successfully placing the left ventricular (LV) lead in an optimal clinical location is a recognized challenge of cardiac resynchronization therapy (CRT). And although the rate of failure to place the LV lead in patients has decreased over time, there is always room for improvement. This is where Interventional CRT (I-CRT) comes in. “I-CRT…forces the operator […]
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
- 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.
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
- In-House Data
- Popma, J. (2013). Radial Artery Complication: Case Presentation. SCAI 2013. [PowerPoint slides].
- 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.
Happy 25th Anniversary of Transradial Access!
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 […]
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 […]
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
- 6F data on file
- 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. - 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
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
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!
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.
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/
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.
