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NEW CORONARY PROBE PROCEDURE IGNITES CONTROVERSY.



Byline: Angela La Voie Knight-Ridder Tribune News Wire

Each year, more than 1 million people in the United States undergo coronary angiography coronary angiography Interventional cardiology A diagnostic technique in which a radiocontrast is injected directly into the coronary arteries, allowing visualization and quantification of stenosis and/or obstruction. , a procedure in which a tiny probe is threaded into the arteries leading to the heart in an effort to locate blocked blood vessels Blood vessels

Tubular channels for blood transport, of which there are three principal types: arteries, capillaries, and veins. Only the larger arteries and veins in the body bear distinct names.
.

But the introduction of a procedure known as electron beam computed tomography Computed tomography (CT scan)
X rays are aimed at slices of the body (by rotating equipment) and results are assembled with a computer to give a three-dimensional picture of a structure.
 (EBCT EBCT Electron Beam Computed Tomography
EBCT Empresa Brasileira de Correios e Tel├ęgrafos (Portugese: Brazilian Mail and Telegraph Company)
EBCT Empty Bed Contact Time (liquid phase carbon application design variable) 
) has ignited controversy over which procedure should be used in which patients.

EBCT allows doctors to visualize heart blockages without ever piercing the patient's skin, thus avoiding the trauma often associated with angiography angiography
 or arteriography

X-ray examination of arteries and veins with a contrast medium to differentiate them from surrounding organs. The contrast medium is introduced through a catheter to show the blood vessels and the structures they supply, including
. In just a few minutes, EBCT gives an X-ray image of calcium deposits that often clog heart arteries.

Now, a statement issued by the American Heart Association American Heart Association (AHA),
n.pr a national voluntary health agency that has the goal of increasing public and medical awareness of cardiovascular diseases and stroke, and thereby reducing the number of associated deaths and disabilities.
 seeks to define who can benefit most from the newer procedure.

Published in the Sept. 1 issue of the journal Circulation, the statement says that EBCT may be most beneficial in helping to detect artery blockages in patients who suffer the crushing chest pain known as angina. The amount of calcium detected in their arteries is related directly to the likelihood of vessel obstruction and potential for heart attack, according to the statement.

For people with chest pain and other heart-disease risk factors, EBCT could help target individuals for ``aggressive risk management, further diagnostic work-up ... and exclusion from high-risk occupations,'' the recommendations state.

Other patients, however, may not have substantial blockage but may have a type of plaque that is unstable, the guidelines say. This type of plaque can rupture, resulting in the formation of a blood clot blood clot
n.
A semisolid, gelatinous mass of coagulated blood that consists of red blood cells, white blood cells, and platelets in a fibrin network.
 that may obstruct an artery. In these patients, EBCT may not be as useful, according to the guidelines.

The American Heart Association does not recommend that EBCT be adopted as a large-scale screening tool for heart disease in people who do not have symptoms of, or risk factors for, heart disease.

Dr. Andrew Buda, chief of cardiology at Tulane University in New Orleans, said that EBCT is more useful as a research tool than a clinical tool.

``It's a promising technology with limited application,'' he said. ``There is still no immediate clinical benefit, even in detecting early coronary disease.''

But one member of the 10-person committee that prepared the new guidelines predicted widespread clinical use of EBCT in just a couple of years for people at risk of heart disease.

``I think it will be used as an early-warning system for certain groups. It's simple to do, noninvasive, takes only a few minutes, and is comparable to the cost of other tests,'' said statement co-author Dr. Bruce Brundage, chief of cardiology at Harbor-UCLA Medical Center Harbor-UCLA Medical Center is a hospital located within the city of Torrance, California, USA. The hospital was founded in 1946, and is funded by Los Angeles County

Harbor-UCLA serves as the Level I Trauma Center for the South Bay area.
 in Torrance.
COPYRIGHT 1996 Daily News
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1996, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:L.A. LIFE
Publication:Daily News (Los Angeles, CA)
Date:Sep 5, 1996
Words:434
Previous Article:WIDE-EYED CBS VAULTS TO NO. 1.
Next Article:NEWS & NOTES : WITH EYE ON REAL-LIFE TRAGEDY, `NANNY' UNDERGOING CHANGES.



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