Author + information
- Pamela S. Douglas, MD, FACC, President, American College of Cardiology⁎,
- David R. Holmes Jr, MD, FACC, Trustee, ACC Board of Trustees and
- William O’Neill, MD, FACC, Co-Chairperson, Innovation in Intervention: i2 Summit 2006
- ↵⁎Address correspondence to:
Dr. Pamela S. Douglas, American College of Cardiology, c/o Cathy Lora, 9111 Old Georgetown Road, Bethesda, Maryland 20814-1699.
Webster defines backbone as “a main support or mainstay.” Interventional cardiology has indeed become the backbone of modern cardiovascular medicine, but this was not always true. During its formative years, beginning with the initial description in September 1977, “interventional cardiology” was framed as a technique characterized by three major qualities: 1) it was initially considered in only a small number of highly selected patients and lesions, 2) failure occurred in approximately 33% of even these selected patients and was unpredictable, and 3) the failure mode often was awful, complicated by intractable ischemia, myocardial infarction, need for emergency coronary artery bypass graft surgery, and even mortality (1). Only a wildly optimistic visionary could have foretold or imagined the prominent position the technique has come to assume as the dominant revascularization strategy for the treatment of coronary artery, peripheral, and cerebrovascular disease (2).
What happened along the way to account for this revolution? There have been dramatic changes in equipment from big, bulky devices that were difficult or impossible to deliver to non-flexible delivery devices that can reach as far as our imagination can take us. Current equipment includes highly sophisticated four-component devices marrying a balloon delivery system, a metallic stent, a carrier polymer, and a drug. This creative combination has revolutionized the field.
Other key changes happened along the way, perhaps the most important of which was a modification in mindset so that physicians demonstrated that they could successfully work less invasively—percutaneously—within the vascular tree. This “light bulb moment” has led to the development of invasive electrophysiologic procedures, such as mapping and ablation, percutaneous application of technology to treat valvular heart disease, and application of percutaneous technologies to treat peripheral arterial disease and now cerebrovascular disease (2). Having broken that barrier, invasive percutaneous methods initially introduced by interventional cardiologists should become the treatment of choice for a multiplicity of cardiovascular conditions.
The wholesale acceptance that interventional cardiology now enjoys as a core practice component has taken nearly 30 years of constant innovation and daring to accomplish. There have been critical concerns to allay; among them, how to demonstrate effectiveness as well as safety and how to train cardiologists to perform these sometimes risky procedures. Interventional cardiologists again have led the way. First, we conducted arguably the most comprehensive large-scale scientific trials in the history of medicine to evaluate the evidence behind the practice (1). Second, interventional cardiologists created training and education programs so that percutaneous coronary intervention can be applied for the greatest common good (for example, Gruentzig instituted closed-circuit televised demonstration courses, the first of which was held in 1978 with 28 physicians in attendance) (1).
The American College of Cardiology (ACC) has been heavily involved in both aspects of overcoming these barriers. The ACC has showcased interventional cardiology in extramural and intramural courses and at its Annual Scientific Sessions since the early 1980s, demonstrating the scientific underpinnings of the practice. And the ACC’s efforts to develop high-quality educational and training programs—crucial missions of the ACC—have been pivotal. To this end, the College has committed significant financial, member, and staff resources to developing a new top-flight intervention meeting in co-sponsorship with the Society for Angiography and Intervention (SCAI). Now known as Innovation in Intervention: i2 Summit 2006, this three-day annual meeting will offer concentrated education, simulation, laptop learning, and networking that will run concurrently with ACC ‘06, March 11 to 14, 2006, in Atlanta, Georgia. All of its many pieces have been carefully assembled by interventionalists to meet your special needs, based on unbiased research.
Education requires multiple components—needs assessment, learner objectives, available teaching aids, curriculum development, personnel, and required resources. In 2004, the ACC engaged a consulting company to assess how the ACC could optimize the content of its interventional programs. Given the size of the ACC’s interventional constituency—nearly one-quarter of college members classify themselves as interventional cardiologists—this undertaking had great importance (3). Interventional members wanted comprehensive, detailed, but balanced offerings saturated with science, technical details, and practical tips but relatively free of commercial bias. They wanted an expert faculty who were dedicated to the art and science and who could communicate freely and fully. They wanted live cases, simulation, case-based approaches, complication management, tips and tricks, and late-breaking clinical trials. They wanted debates and controversy but also consensus and guidelines. They wanted to know where they are now and where they are going. Finally, they wanted “one-stop shopping” so they could be efficient with their learning time.
In response to this rather lengthy and robust request for a menu, what did the ACC leadership say? A resounding “Yes!” And so, Innovation in Intervention: i2 Summit 2006 was born and will bring those wishes to life through a unique combination of needs-based knowledge, practical innovation, and unparalleled networking.
Everything asked for, i2 Summit is serving. It will have live cases from hand-picked sites that will focus on how to do things and with what approach. It will provide virtual-reality simulators to teach new approaches and complication management. It will report late-breaking clinical trials—the latest and greatest. There will be core curriculum lectures on pathophysiology, adjunctive therapy, devices, and patient and lesion selection. There will be complication management, video-taped cases, team training, radiation safety, and management and treatment of acute coronary syndromes. There will be controversy and consensus. There will be state-of-the-art lectures in what we have today and what we will have tomorrow. There will be lectures on how we image and how we decide on what to treat, how to treat it, and then results of that treatment. There will be industry exhibits and expert faculty from around the world who are eager and available. All these things in one place, at one time. One-stop shopping never sounded so good. Be there. It is the start of something big.
- American College of Cardiology Foundation