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Training IRs with ThinkRadial™: Techniques in Kenya That Make a Difference

SIR 2018

SIR2018

Merit to Exhibit at SIR 2018

Merit Medical is thrilled to announce that we will be hosting several educational events during the annual Society of Interventional Radiology meeting in Los Angeles, CA from March 17-22. The events will take place at Merit Medical booth #215 where attendees will also be introduced to our recently acquired ACHIEVE®, TEMNO®, TRU-CUT® biopsy products and the ASPIRA® drainage system, have the chance to use our state-of-the-art simulator to practice Prostatic Artery Embolization (PAE) skills, and learn about our Physician Education Programs.

Products and Demonstrations available at the Merit SIR Booth

  • PAE products from start-to-finish, including the only embolic indicated for PAE
  • Radial Access start-to-finish, including the new PreludeSYNC™ Radial Compression Device, with customizable band
  • Interventional Spine products, including the new steerable balloons
  • Comprehensive Biopsy portfolio, including the recently acquired ACHIEVE, TEMNO and TRU-CUT
  • Comprehensive Drainage portfolio, including the recently acquired ASPIRA drainage system
  • Hands-on Opportunities with a PAE simulator and Vascular Mode
  • Learn about Physician Training programs: ThinkPAE™, ThinkRadial™, and ThinkInterventionalSpine™
  • Learn about patient awareness programs and tools for UFE and PAE
  • Eat and Be Educated speaker programs at the Merit Booth. See the schedule posted below, including renowned speakers in their respective areas of practice.

Eat and Be Educated at Merit Booth 215

Dr. Charles NuttingSunday, March 18 at Noon: “Launching your PAE Practice: Identifying Patients, Tools and Case Studies”

Charles Nutting, DO, FSIR, Minimally Invasive Procedure Specialists, Denver, Colorado
Dr. Nutting specializes in PAE and Liver Cancer

Monday, March 19 at 10 – 10:30 am: “Left Distal Transradial Access (LdTRA): Handing Patients Better Care”

Darren Klass, MD, PhD, MRCS, FRCR, FRCPC, Clinical Associate Professor, Vancouver General & UBC Hospitals, Vancouver, British Columbia

Michael T SerleMonday, March 19 at Noon: “Best Practices with the Merit ASPIRA® Drainage System for Placement and Maintenance in the After-care Setting”

Michael T. Serle, MS, PA-C, Pinehurst Radiology, Pinehurst, North Carolina

Tuesday, March 20 at Noon: “Targeted RF Ablative Therapy in Metastatic Spine Disease: Innovation and Clinical Evidence.”

Jack W. Jennings, MD, PhD, Associate Professor, Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri

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 […]

Announcing September Think Access™ Education Course

ThinkAccess Peritoneal Dialysis and HeRO Graft Implantation

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!

Prostatic Artery Embolization

Announcing – ThinkPAE™ Education Course

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

ThinkRadial Education Course for Interventional Cardiologists and Radiologists

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

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!

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

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

Father of Transradial Intervention Dr. Kiemeneij during lecture

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 co-proctoring advanced interventional cardiologist attendees

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 Chief of Vascular Surgery

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
  5. Guimaraes, M., Tamada, R., Anderson, et al. (2016). Radial access for interventional radiology procedures. Just an alternative access or an excellent model aligned with the upcoming changes of the healthcare reform? Journal of Vascular and Interventional Radiology, 27(3): S47-S48. doi: http://dx.doi.org/10.1016/j.jvir.2015.12.133
  6. European Society of Cardiology. (2015). ESC Guidelines Recommend Radial Approach for Percutaneous Coronary Interventions in ACS. Retrieved November 14, 2015, from http://www.escardio.org/The-ESC/Press-Office/Press-releases/esc-guidelines-recommend-radial-approach-for-percutaneous-coronary-interventions-in-acs
  7. Valgimigli, M., Gagnor, A., Calabró, P., et al. (2015). Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. The Lancet, 385(9986): 2465-2476. doi: http://dx.doi.org/10.1016/S0140-6736(15)60292-6
  8. Romagnoli, E., Biondi-Zoccai, G., Sciahbasi, A., et al. (2012). Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) study. Journal of the American College of Cardiology, 60(24): 2481-2489. doi: 10.1016/j.jacc.2012.06.017. http://www.sciencedirect.com/science/article/pii/S0735109712023662
  9. Posham, R., Biederman, D., Patel, R., et al. (2016). Transradial approach for noncoronary interventions: a single-center review of safety and feasibility in the first 1,500 cases. Journal of Vascular and Interventional Radiology, 27(2): 159-166. doi: 10.1016/j.jvir.2015.10.026. https://3g6fc347p04i2t7uf32fjw56-wpengine.netdna-ssl.com/wp-content/uploads/2016/04/Posham-Fischman-TRA-Non-Coronary-Sinai.pdf
  10. Khayrutdinov, E., Arablinskiy, A., Vorontsov, A., Moscow/RU, & Omsk/RU. (2015). The Olbert International Radiology Symposium—The benefit of transradial artery approach in patients undergoing peripheral artery embolization. Retrieved November 14, 2016, from https://3g6fc347p04i2t7uf32fjw56-wpengine.netdna-ssl.com/wp-content/uploads/2015/01/IROS-2015.pdf
  11. Bilazarian, S. (2015). Medscape. Radial Access: Get Onboard or Get Left Behind. Retrieved November 16, 2016, from http://www.medscape.com/viewarticle/837729
  12. Hess, C., Peterson, E., Neely, M., et al. (2014). The learning curve for transradial percutaneous coronary intervention among operators in the United States: a study from the National Cardiovascular Data Registry. Circulation, 129(22): 2277-2286. doi: 10.1161/CIRCULATIONAHA.113.006356. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4048735/
  13. ThinkRadial Transradial Intervention Course. (Oct 2016). Attendee Testimonial.
  14. 14. 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

*In-house data

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

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Physician Faculty to Impart their Commitment to Interventional Spine Procedures during Upcoming Education Program

Amish Doshi, MD Course Director

Amish Doshi, MD
Course Director

As an interventional neuroradiologist, Dr. Amish Doshi, Associate Professor of Radiology and Neurosurgery, Chief of Neuroradiology and the Director of Spine Imaging and Interventions at the Mount Sinai Hospital in New York City, has had the opportunity to treat a variety of disorders of the head, neck and spine.  Throughout his career, he has developed a special interest in the diagnosis and treatment of spine disorders through both imaging interpretation and spinal interventional procedures.

After years of observing benefits for his patients, he chooses to focus on vertebral augmentation and radiofrequency ablation to treat spinal fractures and spinal tumors. With improvements in cement viscosity, navigational instrumentation and use of radiofrequency technology, especially in the field of spinal tumor treatment, Dr. Doshi has increased his focus on the treatment of local tumor control and pain palliation in the setting of metastatic disease to the spine.

Dr. Doshi will imbue his knowledge of and experience in targeted vertebral procedures later this week at the Interventional spine training course hosted by Merit Medical at Mount Sinai. During the course, physicians will gain hands-on cadaver experience with the minimally invasive procedures of vertebral augmentation, vertebroplasty and spine tumor ablation, using Merit’s StabiliT® Vertebral Augmentation Systems and the STAR™ Tumor Ablation System.

Other program faculty members include Dr. Reade De Leacy, Director of Neurointerventional Spine for Mount Sinai Hospital: Dr. Ramsey. Abadir, Chairman of Radiology and Director of Interventional Radiology, Orange Regional Medical Center in Middletown, NY; Dr. Michael Hallisey, Chief, Vascular & Interventional Radiology, Hartford Hospital, Hartford, CT; Dr. Avi Beck, Quantum Imaging and Therapeutic Associates, Lewisberry, PA; and Jennifer Merhar, R.N., Jefferson Radiology, Outpatient IR Center, Hartford, CT.

Merit Medical plans to announce its 2017 schedule for Interventional spine training courses in the coming weeks. To learn more, visit Merit.com/PEC.

Merit Medical Launches Think Hero Graft Training Program

Merit Medical’s inaugural Think HeRO Graft Training Course was held at the Methodist Institute for Technology, Innovation & Education (MITIE) in Houston, TX on September 22 and 23.

ThinkHeroGraft is an education program that prepares surgeons and physicians to use the HeRO® Graft as a method for end-stage dialysis access, for patients with central venous stenosis who would otherwise be catheter-dependent.

Proctor Dr. Eric Peden, Chief of Vascular Surgery at the Houston Methodist DeBakey Heart & Vascular Center, led engaging discussions and hands-on training with a cadaver lab, which allowed attendees to practice actual implantation procedure steps.

Dr. Peden, who has over 10 years of experience working with HeRO Graft and was one of its principal investigators, shared his best practices in patient selection, implantation techniques and maintenance strategies.

Attendees learned the clinical science and healthcare economics of the Hero Graft, identification of patient candidates and contraindications, as well challenges and complications.

Please contact your Merit Representative for future Think Hero Graft training opportunities.

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Merit Medical Hosts Physician Education Course at Washington University in St. Louis

September 17th, 2017

Merit Medical hosted 12 physicians for a Physician Education Course on minimally invasive vertebral therapies on Saturday, September 17th, 2017 at Washington University in St. Louis.  The Physician Education Course program is a focused cadaver lab workshop designed to deliver detailed information on appropriate use of Merit’s technology and the minimally invasive procedures of vertebral augmentation, vertebroplasty and spine tumor ablation, using Merit’s StabiliT® Vertebral Augmentation Systems and the STAR™ Tumor Ablation System. Expert faculty is chosen to present the supporting clinical data and share their tips and tricks.

To learn more or sign up for a future course visit https://www.merit.com/pec/