Enrico Ferro, MD on healthcare’s IVC filter removal problem.

CCTA AI appears poised to transform ischemia detection, leading to far greater diagnostic efficiencies and far fewer unnecessary invasive procedures. See how ischemia’s AI transformation is unfolding in this Cardiac Wire Show interview with Cleerly’s chief medical officer James Earls, MD.

Surgeries & Interventions

Forgotten IVC Filters Aren’t SAFE

Troubling results from the SAFE-IVC study revealed that just one in six patients gets their inferior vena cava filters removed, despite clear guidelines calling for IVC filter removal as early as possible.

• An IVC filter is a small device that helps stop blood clots from going up into the lungs and is usually surgically inserted.
• IVC filters are used to prevent pulmonary embolism in patients with venous thromboembolism and can’t receive anticoagulation treatment.

Out of SAFE-IVC’s roughly 270k Medicare beneficiaries, only 15% had their IVC filters retrieved within 1.2 years of insertion.

• That number barely rose to 16.8% at the study’s maximum follow up of nine years.
• Old age, comorbidities, and race decreased the likelihood of IVC retrieval, whereas placement at a large teaching hospital increased retrieval likelihood.

Patients who didn’t have their IVC filters removed had significant rates of filter-related complications (1.4%), caval thrombosis (2.2%), DVT hospital visits (9.2%), and new deep vein thrombosis (21.2%). 

This IVC retrieval data directly contrasts FDA guidelines that call for removing IVC filters as soon as the patient’s PE risk subsides due to long-term complications such as filter fracture or device embolization.

• One potential reason for our low filter retrieval rates could be because the doctors placing IVC filters are often different from the physicians following these patients long-term.

Encouragingly, the number of annual IVC filter insertions across the study population decreased from 44,680 in 2013 to 19,501 in 2021.

• However, the U.S. still far surpasses the rest of the world in IVC filter insertions, with a staggering one in five older Americans receiving an IVC filter.

The Takeaway

The U.S. implants far more IVC filters than anywhere else, while post-operative follow-ups and removals are severely lacking, suggesting that our IVC filter situation is far from SAFE.

HeartFlow FFRCT Avoids Invasive Cath

Despite being conscious about his heart health, 60-year old Mike Gartman suddenly experienced classic symptoms of CAD. See how Mike’s HeartFlow FFRCT Analysis results allowed him to avoid the invasive procedure altogether and gain peace of mind about his disease.

Us2.ai’s Heart Failure Screening Impact

See how Us2.ai’s echo AI solution improved heart failure screening in the NHS, reducing echo waiting times from 12 months to under 6 weeks.

A New Era of Precision and Efficiency

Ready to enhance your cardiovascular imaging precision and efficiency? See how Circle Cardiovascular Imaging’s new cvi42 6.1 platform is bringing CT and MR imaging under a single platform.

The Wire

• CKM Syndrome Accelerates CVD: A simulation study found that people with CKD, type 2 diabetes, or both (cardiovascular-kidney-metabolic syndrome) face elevated CVD risks far earlier than people without those conditions. Using the AHA’s PREVENT calculator, researchers found CKD caused elevated CVD risk to begin at age 60 for women and 55 for men, while type 2 diabetes brought it to 59 and 52 years, and the combination lowered CVD risk age to just 42 and 35 years. That’s far below the 68 and 63 baseline for individuals without CKM syndrome.

• CVAUSA & ROMTech: Cardiovascular Associates of America (CVAUSA) ventured deeper into the home care arena through a new partnership with ROMTherapy. CVAUSA will implement the cardiac, physiological, and musculoskeletal treatment functions of ROMTech’s PortableConnect system, enabling its cardiologists to address the large and growing group of cardiac rehabilitation candidates (a fraction of whom actually receive rehab). The partnership is CVAUSA’s latest expansion into home cardiovascular care following its acquisition of Novolink in August.

• PMA for Endocarditis: Percutaneous mechanical aspiration (PMA) could make a significant difference for patients suffering from right-heart infective endocarditis (RSIE). Results from the CLEAR-IE study found that PMA was successful in 89.4% of patients, who saw their vegetation size (masses of fibrin, platelets, and infecting organisms) reduced by 70% or more, representing a significant reduction in infection severity. Though the study mirrored RSIE’s usual mortality rate, researchers clarified that the patients would’ve likely died without PMA.

• HCM Blood Test: Blood screening for HCM has long been unreliable due to similar conditions that cause left ventricular hypertrophy, but five newly associated proteins could help change this. Researchers isolated a five-protein model from nearly 5,000 blood proteins and found dysregulated MAPK and HIF-1 pathways led to elevated levels of biomarkers that are associated with cell proliferation, inflammation, and angiogenesis in HCM.

• CHOP Treats Fetal Heart Tumor: Children’s Hospital of Philadelphia (CHOP) successfully treated its fourth fetal pericardial teratoma patient by removing a fatal tumor from inside the sac surrounding the heart. The complex surgery involved cardiologists, fetal surgeons, maternal-fetal physicians, cardiovascular surgeons, anesthesiologists, neonatologists, psychologists and fetal nurses. CHOP has performed more than 1,629 fetal surgeries, more than any hospital in the world.

• Abbott’s Esprit for BTK PAD: Data from the LIFE-BTK trial demonstrated the long-term effectiveness of Abbott’s FDA-approved Esprit BTK everolimus eluting bioresorbable scaffold system for treating patients with severe below the knee PAD. Patients treated with Esprit had significantly greater freedom from chronic limb-threatening ischemia (CLTI) compared to balloon angioplasty (62% vs. 33%) and saw fewer repeat procedures at two years. Esprit represents a step forward compared to Abbott’s short-lived Absorb stent, which saw poor outcomes due to its thickness.

• Ligence’s Seed Funding: Echocardiography automation software startup Ligence attracted €3M in Seed funding to drive expansion efforts as it prepares for FDA clearance in early 2025. The company’s Ligence Heart technology aims to reshape echocardiography by automating measurements and reporting, driving faster and more accurate results. One study in 2020 showed that Ligence Heart’s diagnostic accuracy is non-inferior to experienced cardiologists, while a physician testing the device claimed to be “…saving 15 minutes per every patient.”

• Skin AI for BP & T2D: An AI algorithm that reviews high-speed video of skin blood flow may allow quick, no-contact screenings for high blood pressure and diabetes. Researchers tested the device and found it was 94% accurate in detecting stage 1 hypertension, 86% accurate in detecting abnormal blood pressure, and 75% accurate in identifying diabetes. However, the results come predominantly from Japanese adults and may not apply to other populations.

• Rising Rural CVD Mortality: A discouraging but unsurprising JACC report found that people who live in rural areas are dying from cardiovascular disease at a much greater rate than people in urban areas. Researchers examined CV deaths from 2010 to 2022, finding that mortality rates increased in rural areas from 431.6 to 435 per 100k residents, while mortality rates in urban areas declined from 369.3 to 345.5 per 100k.

• HDP Leads to Earlier CAD: Data analysis from the Rochester Epidemiology Project found that women who experience hypertensive disorders of pregnancy (HDP) develop CAD earlier than those who don’t. Researchers examined 506 women who gave birth and later experienced incident CAD, finding that 19% had a previous history of HDP. On average, women with HDP developed CAD seven years earlier than non-HDP women and were twice as likely to develop acute coronary syndrome and non-obstructive MI.

• AI Regulation Changes Loom?  What changes can the AI industry expect from the incoming Trump Administration? A new analysis from PricewaterhouseCoopers breaks it down, noting that one major priority will be to “shift AI oversight to focus more on self-governance,” which could affect the FDA’s developing initiative on how it regulates AI. Sure to be on the chopping block is the Biden Administration’s 2023 executive order on AI, which included a number of directives for regulating AI in healthcare.

Redefining Percutaneous Coronary Intervention

Learn about the AGENT™ Drug-Coated Balloon from Boston Scientific and how this technology is expanding the treatment options for patients with in-stent restenosis in the U.S. Rx only. (Sponsored by Boston Scientific)

Identify and Treat Cardiovascular Disease

Complex care pathways make getting patients to the next step a challenge. See how Tempus Next, an AI enabled care pathway platform, helps providers identify and reduce under treatment in cardiovascular disease by adding an intelligent layer onto their routinely generated EHR data.

Automated and Intelligent EP Reporting

EP ablation procedures are difficult, but your EP reporting process shouldn’t be. See how GE HealthCare’s Centricity EP Structured Reporting allows for quick, accurate, and complete reporting in as few steps as possible.

The Resource Wire

• A Better Way to Coordinate Post-Stroke Care: Think your EHR messaging system might be holding back your post-stroke care? See how UC San Diego Medical Center streamlined its neuro and EP teams’ post-stroke workflow with Viz Connect, and the impact it had on cardiac monitor placements in inpatient and outpatient settings.

• PIA’s Post-Processing Solution: Advanced cardiac imaging often calls for a time-consuming post-processing step, requiring costly software, hardware, and training. See how PIA provides this post-processing at lower cost, improved consistency, and greater efficiency. 

• Tracking Your Post-Treatment Plaque: Tune-in to this on-demand Cleerly webinar where preventative cardiologist John Osborne, MD, PhD, FACC, FNLA explores how to use CTA to track plaque progression and identify residual risk post-treatment.

• A Solution for Your Entire Cardiology Service Line: The pace of change in healthcare can be dizzying, creating new and more complex challenges for cardiology departments to overcome. See how Merge Cardio and Merge Hemo can turn those challenges into opportunities for greater workflow efficiency and improved care.

• Experience the future of learning: Medtronic Academy 2.0 is here! Unlock your ultimate destination for structural heart medical education with the newly redesigned Medtronic Academy 2.0. Gain access to expert-led courses, webinars, and a wealth of resources to stay ahead in cardiovascular care. Visit now!

• Advance Your TAVR Planning: Ready to advance your TAVR planning? See how you could leverage TeraRecon’s TAVR (Vessel Analysis) package to streamline and enhance your aortic valve replacement measurements.

• Automatic, Precise Analysis – From the First Beat: Monebo’s Kinetic ECG Algorithm leads with its versatility, precision, and efficiency, enabling a long list of use cases. See how it might impact your ECG monitoring clients here.

• NMMC’s Pediatric and Fetal Echo Upgrade: North Mississippi Medical Center was struggling with long report turnaround times, inefficient workflows, data and documentation challenges, and inadequate reimbursement processes. Find out how they turned their situation around after adopting Optum’s pediatric and fetal echo workflows.

The Industry Wire

1. NIH in RFK’s crosshairs for a complete overhaul.
2. How Providence “intercepts” MyChart messages.
3. DOJ sues to block UnitedHealth’s acquisition of home health firm Amedisys.
4. Why Judy Faulkner believes in “yin-yang” management.
5. Tenet CEO looks ahead to second Trump term.
6. SSM Health launches hospital at home.
7. Oracle reportedly in running to acquire Veradigm, formerly Allscripts.
8. Mass General Brigham launches challenge aimed at scaling AI evaluation.
9. KFF sues the HHS to release Medicare Advantage health plan audits.
10. Cleveland Clinic Chief on healthcare’s quantum future.