Tag Archives: Heart and Vascular Institute

Cross-disciplinary Collaboration, Around-the-Clock Nurse Practitioners Provide Consistent Care in ICU

As the population ages, the number of ICU beds and demand for intensivists is increasing, but these specially-trained physicians are in dramatically short supply.1 Over the last decade, the 30-bed Heart and Vascular Critical Care Unit (CCU) at Penn State Health Milton S. Hershey Medical Center has addressed this challenge with intensivist-led care teams that increasingly rely on nurse practitioners (NPs), while continuing to meet the complex needs of critically ill patients. Research suggests the model may confer a slight boost in ICU survival rates.2

The Heart and Vascular Institute plans to add one intensivist and five NPs to its current team of three intensivists and 11 NPs, according to Christoph Brehm, MD, and Angela Manoskey, CRNP. Continue reading

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Chemoembolization and Radioembolization for Difficult Liver Tumors; Choice May Depend on Blood Flow

Two-thirds of primary liver cancer patients and 90 percent of secondary liver cancer patients have inoperable tumors that are unresponsive to systemic chemotherapy and may benefit from transarterial chemoembolization or radioembolization with yttrium-90 (Y-90), both minimally-invasive, palliative procedures. Although research shows transarterial chemoembolization and Y-90 are usually equivalent treatments for most intermediate-stage hepatocellular carcinomas (HCCs)1, Heart and Vascular Institute considers tumor blood supply when deciding which therapy would be most beneficial for a specific patient.

Image on the left: Pre-chemoembolization axial, contrast-enhanced CT scan at the level of the liver. Image on the right: Post-chemoembolization axial, contrast-enhanced CT scan at the same level as the previous image.

Image on the left: Pre-chemoembolization axial, contrast-enhanced CT scan at the level of the liver. White arrow shows a hypervascular lesion (33.8 mm x 31.6 mm) in segment 7 of the liver consistent with hepatocellular carcinoma.
Image on the right: Post-chemoembolization axial, contrast-enhanced CT scan at the same level as the previous image. White arrows show the treated lesion (22.4 mm x 24.0 mm) in segment 7. The lesion is no longer enhancing and has decreased in size.

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WATCHMAN™ Device: Innovative Therapy for Stroke Prevention in Growing Atrial Fibrillation (AF) Population

By the year 2050, it is estimated that nearly 16 million people could suffer from atrial fibrillation (AF), but not all will tolerate long-term anticoagulant therapy.1 The WATCHMAN™ Left Atrial Appendage Closure (LAAC) device, the latest minimally invasive option at the Heart and Vascular Institute, can help bridge this clinical gap. In March, Penn State Health Milton S. Hershey Medical Center became the first in the region to implant the WATCHMAN device in non-valvular AF patients at increased risk for stroke and systemic embolism seeking an alternative to long-term warfarin therapy.

WATCHMAN<sup>TM</sup> device

WATCHMAN™ is delivered via a transfemoral approach and is designed to close the left atrial appendage (LAA) to prevent migration of blood clots, thus reducing the risk of stroke and systemic embolism. Images provided courtesy of Boston Scientific.© 2016 Boston Scientific Corporation or its affiliates. All rights reserved.

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