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The High-Tech Heart: A New Dimension in Angioplasty


Balloon angioplasty has become one of the most common ways to remove blockages in the blood vessels of the heart. Surgeons are currently testing a new technique that can take some of the risk out of the angioplasty procedure, even though the procedure itself already has a very high success rate.”

During the conventional angioplasty procedure, surgeons inflate a small balloon inside the blockage. When the balloon inflates, it’s fairly common for particles of cholesterol plaque, blood clots and fibrin from the blockage to break off and enter the bloodstream. This particle “showering,” as it’s sometimes called, can cause a small increase in the risk of heart attack.

Capturing particles before they cause damage
The new technique that’s being tested can capture the particles before they cause damage. It’s called “balloon occlusion distal protection.” The trial itself is called EMERALD (for Enhanced Myocardial Efficacy and Recovery by Aspiration of Liberalized Debris). 

Eligible study participants are those who have had an acute myocardial infarction, or heart attack, within the past six hours. The goal of the study is to show that the distal protection technique can

  • Help the heart attack itself end more quickly
  • Make the area of heart damage smaller
  • Improve blood flow

The distal protection technique, called the GuideWire system, was developed by Medtronic, Inc. The system has already been used successfully on patients during heart bypass surgery. When using the GuideWire system during balloon angioplasty, surgeons use not just one balloon, but two. They inflate an additional balloon downstream from the site of the blockage. When particles are showered off into the blood stream, the second balloon keeps them contained in a small area. After the blockage is cleared, the surgeon moves another catheter into the area where the particles have gathered and vacuums them away. The additional balloon is then deflated and removed.

One beneficiary of the GuideWire system was a patient named Denny Forsyth, of Elk River, Minnesota. He was working out at his gym when he suffered a heart attack. Minutes after he arrived at Mercy Hospital, he was taken to the Cardiac Cath Lab. Dr Jeffery Chambers, a cardiologist with Metropolitan Cardiology Consultants, began the experimental procedure. The technique was successful for Forsyth, and he’s doing well now.

Surgeons are constantly looking for ways to enhance the angioplasty procedure and improve outcomes for patients. The distal protection technique is just a part of this ongoing search for improved results. It adds a layer of control to the angioplasty procedure. Dr. Chambers says of the technique, “In years to come, distal protection will likely become the standard of care in interventional cardiac procedures.”

Remember to listen to your heart
Remember the signs that you may be having a heart attack—shortness of breath, arm pain, jaw pain, nausea and indigestion. The sooner you realize you may be having a heart attack, the better the chances of getting treatment that can save your life and minimize damage to your heart.

Kathy Shibrowski, Administrator, Cardiac Center at Mercy Hospital; Medtronic, Inc.
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