- Joined
- Mar 16, 2000
- Messages
- 9
- Reaction score
- 0
Can anyone please help start me off on really good ideas for a paper presenting "What the practice of Cardiovascular Medicine will be like in the year 2050?????
IDEAS NEEDED!!!
- Thread starter Hippocratic04
- Start date
- Joined
- Jan 25, 2000
- Messages
- 420
- Reaction score
- 0
Look at the advancements that are being made in the area of ventricular assist devices. I believe Dr. DeBakey has recently developed a new one. The better these get, the longer people can wait for a heart transplant.
Also, vascular surgery is progressing very nicely. Abdominal aortic aneurysms can now be repaired through endovascular procedures. Research ways in which cardiac/vascular surgery may become less invasive...that's the future of surgery.
AS far as the medicine side of things. LEarn about new cholesterol lowering drugs, and the implications of genetic engineering on vascular disease (for example, using genetically engineered hormone to grow collateral blood supply to diseased coronary arteries.) A recent example of this is called VegF. I don't know any specifics about this though, other than initial clinical studies did not show it to be very helpful. Manipulating growth hormone to grow collateral vasculature is definitly on the howizon as a treatment for coronary artery disease though. I only have first-hand experience with the endovascular aneurysm repair I mentioned above. Everything else you will have to research on your own. E-mail me if you want to know more about endovascular aneurysm repair though. If I think of anything else, I'll post it.
Also, vascular surgery is progressing very nicely. Abdominal aortic aneurysms can now be repaired through endovascular procedures. Research ways in which cardiac/vascular surgery may become less invasive...that's the future of surgery.
AS far as the medicine side of things. LEarn about new cholesterol lowering drugs, and the implications of genetic engineering on vascular disease (for example, using genetically engineered hormone to grow collateral blood supply to diseased coronary arteries.) A recent example of this is called VegF. I don't know any specifics about this though, other than initial clinical studies did not show it to be very helpful. Manipulating growth hormone to grow collateral vasculature is definitly on the howizon as a treatment for coronary artery disease though. I only have first-hand experience with the endovascular aneurysm repair I mentioned above. Everything else you will have to research on your own. E-mail me if you want to know more about endovascular aneurysm repair though. If I think of anything else, I'll post it.
- Joined
- Feb 4, 2000
- Messages
- 5,910
- Reaction score
- 41
Hippocratic04-
I'm not real good at foreshadowing, but I think by the year 2050, humans will be no more than our heads in large jars and robotic appendages. And we will have lasers that protrude out of our midsections and....ok, that's enough.
Seriously, everything I have read about CV Medicine has to do with (as UHS said) procedures which are less invasive.
Also, talk about prevention, prevention, prevention...that's what it all comes down to.
------------------
Josh Hazelton
[email protected]
University of the Sciences in Philadelphia
"D.O. Wannabe"
I'm not real good at foreshadowing, but I think by the year 2050, humans will be no more than our heads in large jars and robotic appendages. And we will have lasers that protrude out of our midsections and....ok, that's enough.
Seriously, everything I have read about CV Medicine has to do with (as UHS said) procedures which are less invasive.
Also, talk about prevention, prevention, prevention...that's what it all comes down to.
------------------
Josh Hazelton
[email protected]
University of the Sciences in Philadelphia
"D.O. Wannabe"
- Joined
- Jan 25, 2000
- Messages
- 420
- Reaction score
- 0
In my experience, the endovascular AAA repair is done far more often by vascular surgeons. There is a bit of a rivalry between interventional radiologists and vascular surgeons because there is some overlap in what procedures they perform. X-Ray guy, could you comment on whether or not there is any truth to this? I know interventional radiologists do it, but all the procedures that I have seen (probably close to 100) were all done by vascular surgeons.
[This message has been edited by UHS03 (edited 03-16-2000).]
[This message has been edited by UHS03 (edited 03-16-2000).]
[This message has been edited by UHS03 (edited 03-16-2000).]
[This message has been edited by UHS03 (edited 03-16-2000).]
- Joined
- Mar 1, 2000
- Messages
- 14
- Reaction score
- 0
It's all a matter of numbers and availability. There are many more Vascular Surgeons than Interventional Radiologists.
The procedure itself is fully guided by the "traditional" Radiological Angiographic techniques, which the IR's do day in/day out every day of their lives.
In my institution, the procedure is done in an specially designed OR (C-Arm included) and is directed by the IR. A Vascular Surgeon opens and closes the vascular access (since, contrary to the usual transfemoral puncture, the access has to be pretty damn big for the device). And is present during the rest of the procedure. The remainder of the procedure (as it is done from inside the Aorta) is run by the IR (Aortic Runs, deployment of the device, etc.)
So, essentially, it is a team effort between the VS and IR. But the show is run by the IR. The VS is only in charge of the access.
Of course, whenever there is a successful procedure which pays well, you will see every specialty trying to get access to it somehow. Sadly, far from being a collegiate group of professionals, real world medicine is all about turf wars. The above procedure is only a teeny tiny example.
The procedure itself is fully guided by the "traditional" Radiological Angiographic techniques, which the IR's do day in/day out every day of their lives.
In my institution, the procedure is done in an specially designed OR (C-Arm included) and is directed by the IR. A Vascular Surgeon opens and closes the vascular access (since, contrary to the usual transfemoral puncture, the access has to be pretty damn big for the device). And is present during the rest of the procedure. The remainder of the procedure (as it is done from inside the Aorta) is run by the IR (Aortic Runs, deployment of the device, etc.)
So, essentially, it is a team effort between the VS and IR. But the show is run by the IR. The VS is only in charge of the access.
Of course, whenever there is a successful procedure which pays well, you will see every specialty trying to get access to it somehow. Sadly, far from being a collegiate group of professionals, real world medicine is all about turf wars. The above procedure is only a teeny tiny example.
- Joined
- Jan 25, 2000
- Messages
- 420
- Reaction score
- 0
Often, in the cases that I saw, the AAA would extend below the aortic bifurcation and sometimes even involve the internal iliac artery. In these cases, it was not uncommon for the surgeon to coil off the involved internal iliac artery and then run a bypass graft between the femoral arteries (a fem-fem bypass). I wouldn't say this happened a lot, but it happened enough (it was usually a planned part of the procedure.) Are Interv. radiologists able to do this, or does their involvement end when the endovascular deployment is done? Does your institution do a lot of these repairs? Are you guys using bifurcated grafts or mainly straight grafts? Which graft do you use? Sorry for all the questions, but when I was involved, these devices were still in the clinical trial phase (the Medtronic device was just approved last September.) I'm curious how they have translated into practice. I worked with many different brands of endoluminal graft, and I'm curious what the favorite is right now.
