Interventional Cardiology

Interventional Cardiology

Cardiac Catheterization

Over its relatively short history, the field of Interventional Cardiology has experienced exponential growth. More than one million cardiac catheterizations are performed each year in the United States, offering safe and effective treatment for patients with coronary artery disease. With each passing year there are new innovations treating a greater variety of conditions and increasingly complex cases. For symptomatic and obstructive coronary artery disease, percutaneous coronary intervention with stenting has remained the preferred treatment. At Ascent Cardiology, we continue our relentless drive for procedural excellence, pursuing and applying the latest technical and technological advances in the field of Interventional Cardiology. We focus not only on extending life but also on restoring quality of life for our patients.

Interventional Cardiology procedures provide a nonsurgical option using small catheters to repair damaged or weakened vessels, narrowed arteries or other structures of the heart. Using minimally invasive treatments such as stent implantation, angioplasty, and transcatheter valve repair or replacement, Interventional Cardiologists help patients avoid traditional surgery.

The hallmarks of our success lie not only with the employment of cutting-edge technology and techniques but also by employing a team approach to consistently apply protocols and techniques that, when employed by skilled interventionalists, result in excellent quality and outcomes. By using a system of established standard protocols and evidence-based treatment algorithms, rigorous attention to detail, and a strong sense of teamwork we achieve stellar interventional outcomes. By taking the time to treat each patient as an individual, we hav

e created an environment where patients not only feel compelled to ask questions and participate in their care but inevitably find themselves enthusiastic advocates of the Cardiac Catheterization Laboratory.

Catheterizations have traditionally been performed by gaining arterial access through the groin. However, this approach results in greater patient discomfort and longer recovery times. More importantly, performing cardiac catheterizations through the groin carries a significantly increased risk of complications such as major bleeding. Other painful complications, such as femoral pseudoaneurysms and hematomas can infrequently occur. In the worst case, patients may develop a life-threatening complication called retroperitoneal hemorrhage. Certain patient populations, such as the elderly and obese patients, are at an increased risk of bleeding complications from femoral arterial catheterization.

Over the last few decades, a new approach to cardiac catheterization has evolved using arterial access via the arm. This technique has improved patient comfort, improved recovery times and reduced complication rates. However, despite these advantages, the adoption of this technique continues to lag. According to data from the American College of Cardiology, only 25% of interventional cardiologi

sts in the United States currently perform cardiac catheterizations and interventions through the transradial approach. Highly trained in cardiac catheterizations and interventions using the radial approach, Dr. Diwadkar is one of the 25% of cardiologists in the country performing transradial catheterizations. Furthermore, Dr. Diwadkar performs transradial catheterizations in both elective and emergency cases. Patient preference is clearly in favor of transradial catheterization.

Appropriate Use

Over the last decade, there has been a vigorous debate over the appropriateness of coronary stenting in certain clinical situations due to overutilization of coronary stenting by many interventional cardiologists. Inappropriate coronary stenting outside of established guidelines exposes patients to unnecessary risks both during and following the procedure. At Ascent Cardiology, we adhere strictly to guideline and evidence-based protocols including those established by contemporaneous clinical studies such as the COURAGE, ORBITA and ISCHEMIA trials to ensure the appropriateness of any procedures we perform. Furthermore, the employment of intraprocedural coronary physiology during cardiac catheterization guides our decision making to prevent inappropriate coronary stent implantation.