Debulking in Cardiovascular Interventions and Revascularization Strategies: Between a Rock and the Heart aims to provide a comprehensive overview on the diagnostic and therapeutic aspects of resistant lesions as well as tailored debulking processes in revascularization strategies. Cardiovascular interventionalists and surgeons alike frequently encounter technical challenges and increased risk when attempting to diagnose and treat resistant cardiovascular lesions, bio-tissues and vessels. Calcified plaques, fibrotic or thrombotic lesions, total occlusions, degenerative plaques, complex lesions and vessels impose morphologic obstacles to the safe and effective delivery and deployment of balloons and stents. In such instances, a debulking strategy involving the actual drilling and extraction of the targeted plaque/bio-tissue constitutes a unique option that ensures safe and efficacious subsequent balloon dilatations and stenting. A range of topics is included in the book, from the characteristics and constituents of various resistant targets and bio-tissues, to the corresponding options of debulking methods, and finally the technologic and pharmacologic means available for application. The book also provides an up-to-date description of related management solutions and tools, exploring the medical issues pertaining to the patients with these targets; procedural results and clinical outcomes as related to debulking strategies and associated diagnostic and therapeutic technology and revascularization options.
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Professor Topaz’s main clinical specialty is percutaneous interventions for complex lesion subsets in challenging coronary and peripheral vascular targets. He specializes in treatment of patients with critical lesions in the presence of depressed LVEF, severe left main disease, old saphenous vein grafts, chronic total occlusions, stent thrombosis and heart transplant allograft disease. He has special interest in revascularization of severe renal artery stenosis and severe subclavian artery occlusions. Professor Topaz is the inventor of several percutaneous revascularization techniques with advanced debulking technology for plaque extraction and thrombus removal. He is also a national and international proctor of FDA approved plaque debulking and thrombectomy devices such as laser and rheolytic thrombectomy.
Professor Topaz is a world authority on cardiovascular lasers whereby he pioneered the contemporary coronary lasing techniques and introduced the utilization of laser revascularization in acute myocardial infarction. In addition, he developed laser application for treatment of congenital heart conditions such as pulmonic atresia. Professor Topaz conducts basic research on the effects of laser irradiation on cardiac and vascular bio-tissue with special focus on the interaction of laser energy with thrombus and platelets. He discovered the unique phenomena of laser- induced enhancement of thrombolytic agents activity and laser induced suppression of platelet aggregation. Clinically , he investigates the therapeutic outcomes of various cardiovascular lasers.
Professor Topaz is a recognized researcher and scholar of cardiovascular pathology and vascular anatomy. In 2010 he discovered in several patients the existence of a previously unknown, peripheral artery which constitutes origin of both inferior phrenic arteries as a vascular trunk from the right renal artery. The importance of this discovery was further emphasized as this vessel supplies unique, also newly discovered trans diaphragmatic cardiac collaterals. Recently, he and colleagues introduced an important paradigm shift in the diagnosis and management of symptomatic chronic mesenteric ischemia with emphasis on the performance of endovascular interventions in the inferior mesenteric artery.
Professor Topaz served on special study sections of the NIH and NSF and is a fellow of the American College of Cardiology, the American College of Physicians, the Society for Cardiac Angiography and Interventions, the American Society of Laser Medicine and Surgery, the Society of Vascular Medicine and a member of numerous cardiovascular societies and organizations. Professor Topaz is an invited faculty of leading international conferences in the field of interventional cardiology, whereby he participates as live case operator, lecturer, moderator, discussant and session chairperson . He has lectured, proctored and performed live coronary and peripheral interventions in many countries around the world. Between 1998 and 2005 he served as the North American Editor- in- Chief of the journal Laser in Medical Sciences, the clinical publication of the European Laser Association. He is the recipient of an NIH national research service award, the Winthrop interventional award and several teaching awards. In 2010 the McGuire Veterans Affairs medical center of Virginia Commonwealth University established the “On Topaz MD award”, presented annually to their best interventional cardiology fellow. To date, Professor Topaz has published 137 peer-reviewed articles; the textbook “Lasers in Cardiovascular interventions [Springer, UK, 2016]; the textbook "Cardiovascular Thrombus" [Elsevier, Philadelphia, USA, 2018]; 31 book chapters and a member of 18 peer-reviewed journals.23 book chapters and 56 abstracts. He is a reviewer and editorial board member of 16 peer-reviewed journals and a member of medical advisory boards.
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