Tejas,
Thank you for the invitation. Since I have started Radial program in Rochester, NY. After I spent one week with you at Sterling Hospital, Ahmedabad in 2005 my volume for Invasive/Interventional procedures have increased tremendously. So far I have performed more than 4000 procedures through Radial approach. Your initial guidance on phone almost once or twice a month also helped lot. Radial atlas is also very important asset. As you might know most of the Radial procedures in USA performed is in Northeast area and credit should go to you and some of the Interventionalist who have migrated from Canada to USA in this region. Your course at St. Vincent Hospital with Dr. Coppola have trained many Interventional cardiologist even in USA. After I had started this program in Rochester there was some resistance at one of the institution but once they and other Interventional cardiologist realized benefit of this approach, every body is performing Radial procedures in Rochester, NY. I perform almost 80-90% of the procedures through Radial approach including most of the peripheral endovascular procedures. Conferences like TRICO is major milestone in Interventional Cardiology as live cases performed by world renowned Interventional cardiologist shows that any Coronary and Peripheral intervention including Carotid artery stenting can be performed through Radial approach. At present from the USA standpoint CMS have taken stand that any procedure related complications (i.e. bleeding that require blood transfusion or prolong hospital stay, UTI due to Foley catheter placement if patient cannot urinate as some body have performed angiogram/intervention through Femoral approach and cannot standup immediately, A-V Fistula repair related cost that was related to any invasive procedure, retroperitoneal bleeding and so on and on!) they will not reimburse cost to the institutions. Outpatient coronary and peripheral endovascular procedures being done and patients also love it if they can be with there loved one or in there familiar environment safely after the procedure. After performing this procedures almost on the daily basis I know even though my right hand is most important for what I do for living, if I need any coronary/peripheral endovascular procedure I would prefer to have it done through wrist approach. Facility, accommodation and overall experience was great during this conference. I am almost certain in future this type of conferences will be even more successful as it is in the best interest of patient. I would support TRICO, INDIA as it has changed my practice and at certain extent even patient care in my home town for now (Rochester, NY)! Thank you for your hospitality.
Tejan Patel, MD, FACC, FSCAI
Director and Chief of Interventional Cardiology, Unity Health System,
1555 Long Pond Road, Rochester, NY 14626.