Northwest Continues ?Stent? as Cardiac King

Northwest Medical Center of Washington County in mid-May introduced a new minimally invasive therapy for patients with heart disease.

The Springdale hospital is offering patients intravascular radiotherapy — a clinically proven safe and effective treatment for in-stent restenosis, or recurring blockage in the coronary artery after stent implantation.

Northwest, a subsidiary of publicly traded Triad Hospitals Inc. of Dallas, was the first hospital in the state to offer the beta-ray treatment. St. Edward Mercy Medical Center in Fort Smith since has begun offering a similar procedure using gamma rays.

Being the first to add “brachy therapy” to its cadre of services is in keeping with Northwest’s tradition of leading in cardiac care. In April 1991, it became the first local hospital to insert intracoronary stents for mainstream use.

Dr. Charles W. Inlow performed that first stent procedure at what was then Springdale Memorial Hospital.

Stents are stainless steel mesh tubes that are used like scaffolding to prop open vessels and maintain blood flow. Typically, they’re delivered on a surgical balloon during angioplasty and embedded into the vessel wall as the balloon expands.

According to a press release from Northwest, 800,000 patients in the United States receive stent implants each year. About 20 percent of those have to return to the hospital when scar tissue develops around the stent and coincidentally helps re-clog the vessel.

Rick Upshaw is a registered cardiovascular invasive specialist and Northwest’s director of cardiac catheter labs. He said intravascular radiotherapy, or “brachy therapy,” slows or eliminates restenosis by stopping the cell production that causes re-blockages.

“This gives us another method to treat resistant coronary disease in patients who probably don’t need to go through another open-heart surgery for a single blocked vessel,” Upshaw said. “If it buys them two or three years before they have to have another surgery, then it’s saved the patient money and the hospital money.”

Northwest invested $44,000 in a Galileo Intravascular Radiotherapy System, made by Guidant Corp. of Indianapolis, Ind., to acquire its brachy therapy equipment. It takes three doctors — a cardiologist, a radiation oncologist and a radiation physicist — to administer each brachy-therapy procedure.

The bulk of the Galileo hardware is the hot source for its radiation, but the equipment is easily pulled on a cart. The procedure itself uses 14/1000 guide wire, the same catheter device used in 95 percent of intracoronary cases.

Upshaw said patients can have the gamma-ray treatment only once in their life but could endure repeated beta treatments if necessary. Also, Upshaw said, more thorough shielding is needed for the gamma treatments, and doctors cannot be in the same room while its in use.

He said the addition of brachy therapy should be good news for Northwest’s corporate clients. According to the American Heart Association, the risk of cardiovascular disease more than doubles between the age of 34 and 45. The AHA also estimates that 20 percent of a company’s work force will be affected by cardiovascular disease.

The estimated cost to a company per employee CVD incident is $4,500. That means that over time, a company with 100 employees could expect to incur $450,000 in costs associated with the treatment of CVD.

Last year, 11,331 Arkansans died due to cardiovascular disease.