Renée Gutierrez’s Post

The transition from the 4th wave of cardiac care (POC Troponin and STEMI model) to the 5th wave of cardiac care (adding subtle findings of NSTEMI that are OCCLUSIVE MI) is an important step in reducing long term cardiac mortality from acute cardiac events. Traditionally we felt NSTEMI cases could wait up to 24 hours for cardiac Cath, yet overall, mortality under the 4th wave model remainder higher for the NSTEMI cases. By identifying that approximately 30% of NSTEMI cases that truly represent an occlusive pattern (Occlusive MI or OMI) and getting these patients urgently to the Cath Lab, we can further reduce cardiac mortality. I've been working closely with PMCardio/Powerful Medical out of Slovakia and their AI model that helps identify the sometimes very subtle findings of OMI. Even with intensive education on EKGs, the subtle findings can be REALLY subtle and this AI tool provides an exceptionally high quality (investigative at this time only) way of leveling the playing field. My hope is we can get this FDA approved and in production status at Multicare in the near future as I believe it will significantly improve our ability to care for ALL occlusive MI patients. https://lnkd.in/gCc6JVjg

The latest findings from the SCAI 2024 conference highlight significant advancements in interventional cardiology, particularly the growing adoption of radial access in PCI procedures. This shift, showing a 2.8-fold increase in radial access usage from 2013 to 2022, has reduced in-hospital mortality, major access site bleeding, and major vascular complications. However, it comes with a slight increase in ischemic stroke risk. At RADPAD® Radiation Protection, we are committed to advancing safety and efficacy in PCI procedures. Our RADPAD® Radiation Protection Shields are designed to minimize scatter radiation exposure, safeguarding the primary physician and supporting staff during these critical interventions. Additionally, our OPN NC Super High-Pressure PTCA Balloons are pivotal in achieving optimal stent expansion, particularly in challenging cases involving heavily calcified lesions. By integrating RADPAD shields and OPN NC balloons into PCI procedures, we can enhance safety and procedural success, ensuring the best outcomes for patients and healthcare professionals. Stay ahead in innovation and safety. Read more about the six takeaways below: https://lnkd.in/g4b7mrs2 #Cardiology #InterventionalCardiology #RadiationProtection #HealthcareInnovation #SCAI2024 #PatientSafety #RADPAD #OPNNC

False positive STEMI protocol activation can lead to significant and avoidable clinical and financial issues, both for the patient and for the healthcare system. Diagnostic ECG is an essential part of fast, appropriate care. #ECG #Cardiology #DCARInsights

False positive STEMI protocol activation can lead to significant and avoidable clinical and financial issues, both for the patient and for the healthcare system. Diagnostic ECG is an essential part of fast, appropriate care. #ECG #Cardiology #DCARInsights

False positive STEMI protocol activation can lead to significant and avoidable clinical and financial issues, both for the patient and for the healthcare system. Diagnostic ECG is an essential part of fast, appropriate care. #ECG #Cardiology #DCARInsights

False positive STEMI protocol activation can lead to significant and avoidable clinical and financial issues, both for the patient and for the healthcare system. Diagnostic ECG is an essential part of fast, appropriate care. #ECG #Cardiology #DCARInsights

Why is Failure to Rescue (FTR)—an established concept in many medical fields—not embraced in interventional cardiology? This TCTMD article explores how utilizing FTR could be key to enhancing #PCI quality and improving patient outcomes. ➡️Read now: https://lnkd.in/gm9CabUz

It's Q & A Thursday! ❓ Question: What criteria need to be met to assign code 92941 for coronary revascularization for acute MI? Answer: ➡️ Code 92941 is assigned when an intervention is performed during an acute myocardial infarction (AMI). Typically the patient is taken directly from the emergency department to the cardiac catheterization lab. This code is used for treatment of both native coronary arteries and bypass grafts. ➡️ Code 92941 includes any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed. ➡️ If a patient is admitted with an AMI on one day and the intervention is not performed until the next day, code 92941 should not be assigned. See codes 92920 – 92928, C9600-C9608. (CPT Assistant, March 2014) The phrase “during acute myocardial infarction” refers to a procedure that meets all three of the following requirements: ✅ Electrocardiography changes consistent with acute MI are recognized. ✅ Emergent coronary angiography & percutaneous coronary intervention are performed. ✅ Percutaneous coronary intervention is performed on a target lesion that is totally (100%, thrombolysis in myocardial infarction (TIMI) grade flow of zero) or subtotally occluded. 💡 A subtotal occlusion is one where there is reduced flow through the lesion. The subtotal occlusion must be present in the setting of an acute MI. A chronic subtotal occlusion in a patient who does not experience an acute MI would not meet criteria for this code. 🚫 The following scenarios do not meet criteria of “during acute myocardial infarction” even if the patient is taken emergently to the cardiac catheterization lab and should not be reported with code 92941: ⛔ Noncardiac chest pain ⛔ Unstable angina ⛔ Non-ST elevation myocardial infarction, unless there are ongoing symptoms prompting emergent activation of the cath lab with demonstration of a subtotal or total coronary occlusion of the culprit vessel ⛔ Completed MI undergoing nonemergent angiography & percutaneous coronary intervention ⛔ Percutaneous coronary intervention of thrombotic coronary lesions performed non-emergently after recent MI 💡 A “culprit” lesion is the lesion identified as causing the myocardial infarction. Code 92941 is assigned for treatment of the culprit lesion. Additional lesions treated in separate vessels are not reported with code 92941. Assign the appropriate percutaneous coronary intervention code (92920 – 92928, C9600-C9608) for each vessel. References: Cracking the IR Code: Your Comprehensive Guide to Mastering Interventional Radiology 2024 edition & CPT Assistant, January 2014 #qandathursday #radrx #crackingtheIRcode #circc #interventionalradiologycoding #ivrcoding #ircoding

Is Failure to Rescue due to a complication reported in a way that undermines the Interventionalist? Reporting the complication should be nonpunitive review with the team and a review team consisting of an interventionslist, fellow, nurse, and a registered invasive technoligist. Other contributing persons that may have contributed to an occurrence should be present for (the) or ( separate ) review. Occurrences can be addressed and documented methodically and purposefully for resolution. Recurrent occurrences that seem preventable may need further scrutiny, standards and policy review, and corrective measures depending on morbidity, mortality, or poor outcome.

Choosing to practice in rural America has its benefits and challenges. While some interventional cardiologists may be concerned that they won’t be able to meet the yearly percutaneous coronary intervention (PCI) proficiency quota necessary to maintain their credentials, many are finding more than enough volume in underserved areas. In fact, interventional cardiologists practicing rurally aren’t just surviving but thriving, applying their skills in a more meaningful way. #cardiology #cardiologist #interventionalcardiology #ruralhealthcare