Release date: 2014-07-10
The 2014 European Revascularization Conference (EuroPCR2014) conference covers transcatheter aortic valve replacement (TAVR), the first artificial mitral valve used in humans, and demineralized sympathetic nerve surgery. There are several important findings in the field of interventional heart disease that will influence future clinical practice and guidelines.
Interventional cardiologist Dr. Paul D. Williams (James Cook University Hospital, UK) said, “For me, the highlight of the conference is the field of structural heart disease, not the field of coronary artery disease... and I am also pleasantly surprised to see that After experiencing the disappointment of SYMPLICITY-HTN 3, there was no stopping for renal sympathetic surgery."
Cardiology Today summarizes some of the key elements of the 2014 EuroPCR conference, which are the highlights of interventional cardiologists attending the conference.
1. The future of TAVR: becoming the gold standard or close at hand
Williams said he was impressed by the results of the SAPIEN 3 transcatheter aortic valve study conducted by Dr. John Webb. This study demonstrates the 30-day results of transcatheter aortic valve surgery and is the best result of TAVR so far. The 30-day outcome of the femoral surgery cohort was 1.1% of all-cause deaths, 1% of strokes, and 97% of patients had mild or less aortic regurgitation, which is equivalent to surgical valve replacement surgery or better.
Williams pointed out that the results of this study will pave the way for the technology to expand the indications. TAVR is likely to prove to be a good treatment for intermediate-risk patients, and it is believed that TAVR will expand its indications in the near future.
Link reading: FDA approves a new generation of transcatheter valve device Sapien XT
2. Transcatheter mitral valve replacement: challenges and opportunities coexist
Transcatheter mitral valve replacement, although complex and challenging, is a promising intervention. The FORTIS mitral valve was first used in human intervention and was also impressive. These cases at St. Thomas Hospital in London are still in the proof of concept phase, and we look forward to seeing developments in this area.
3. Go to kidney sympathetic surgery: it is too early to say
Despite the disappointing results of the SYMPLICITY-HTN trial, three systems that evaluated different renal sympathetic nerves achieved encouraging results. The ACHIEVE trial evaluated the Paradise ultrasound to the renal sympathetic nervous system. The EnligHTN Phase III trial first evaluated the EnligHTN new-generation renal sympathetic nervous system in the human body. The REDUCE-HTN trial evaluated the Vessix renal sympathetic nervous system. These three studies have shown that These three systems can significantly lower blood pressure.
Williams said that the above research shows that the time to give up this technology is not yet mature, and there is still a lot of work to be done.
Link reading: Three de-renal nerve ablation systems show an inspiring ending
4. Bivalirudin for anticoagulation after PCI: valuable
Dr. Dominick J. Angiolillo et al. conducted a EUROMAX subgroup study (n=2198) comparing the effects of bivalirudin and heparin+GPI (optional) in patients with ST-segment elevation myocardial infarction undergoing PCI. The results showed that the 30-day mortality rate or the incidence of major bleeding in the bivalirudin group was lower. This study confirmed the value of bivalirudin after PCI.
Link reading: EUROMAX data analysis once again sparked controversy over bivalirudin and heparin
5. Patients with non-ST-segment elevation myocardial infarction: pretreatment with prasugrel or no benefit
The ACCOAST-PCI study showed that patients with non-ST-segment elevation myocardial infarction who used prasugrel pretreatment did not reduce perioperative thrombus burden, stent thrombosis, emergency revascularization, or GP IIb/IIIa exposure compared with placebo. Use of body antagonists. However, prasugrel pretreatment is associated with a significant increase in the risk of major bleeding. The study showed that prasugrel did not benefit patients with non-ST-segment elevation myocardial infarction.
Source: Medical Pulse
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