Shammas Performs First-in-Iowa Procedure - Genesis Health System

Published on May 16, 2018

Shammas Performs First-in-Iowa Procedure

Genesis intervention cardiologist Nicolas Shammas, M.D., performed a first-in-Iowa procedure last week to clear a blockage from a man's leg.
Shammas was the first cardiologist in Iowa and one of the first in the country to use a dual approach to open the blockage. He approached the blockage from the patient's wrist and then the patient's foot.
"The radial (wrist) approach has not really been possible to use to treat a far blockage in the lower legs because of the wires, sheaths and balloons were not long enough,' Shammas explained.  "Now a company (Terumo) has come out with long enough wires and balloons. These products have recently received FDA approval but they have had only a limited release.

"We had the perfect patient at Genesis for this approach.  By seeing these new tools in use at Genesis, Terumo can learn the pros and cons of how these devices would respond so they can anticipate issues that may appear with a broader national release.
"From our standpoint, it gives us the opportunity to again be on the cutting edge and introduce the latest technologies to the Quad Cities.''

Shammas said representatives of Terumo observed the 41/2-hour procedure and took detailed notes on each step.
"Genesis staff also took detailed notes. We would like to have this case presented to a national audience to share our own experience,'' Shammas added.

Shammas explained that the wire was first deployed from the wrist to reach the 100 percent blocked artery in the patient's leg.  The wrist approach served two purposes:

1. Delivering dye to the area of the blockage to track progress to open the blockage;

2. To reach and penetrate the cap, or edge, of the blockage.
"This wire, along with another wire that is introduced from the foot ("Pedal approach") of the patient allow the two wires to meet in the blocked artery and successfully cross and treat the blockage,'' Shammas added.  "Then using the foot, stents are deployed to complete the procedure and widely open the artery.

"By avoiding an approach from the groin, we minimize the risks and complications and hopefully reduce recovery and hospital length of stay.  We had the right patient for this approach and it went very well.''

The Genesis Heart Institute and the skilled staff of Cardiovascular Medicine PC have participated in dozens of clinical trials and new procedures over the years to benefit patients.
Dr. Shammas has personally spent much of his career participating in research and frequently presents his experiences and findings at U.S. and global medical conferences.

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