Innovation at EuroPCR

New devices and new data are constantly emerging and keeping track of these changes can be difficult. Innovation day at EuroPCR 2011 is delivered in conjunction with cvPipeline, an online database solution that keeps practitioners up-to-date with products, technologies, intellectual property, people and clinical studies. Features of cvPipeline of particular interest to EuroPCR delegates are the categories of Drug-Eluting Stents and Heart Valves but these are only part of cvPipeline.

Hollis Call, CEO and founder of MarketMonitors (producers of cvPipeline) said, “We are really proud to be sponsoring Innovation day at EuroPCR 2011. We know how important it is for delegates to be aware of innovations and new developments, which will continue to transform the practice of cardiovascular therapies. We hope these sessions will provide attendees with an awareness of the rapid pace and the specialised differentiation of new technologies in development. EuroPCR is an excellent venue to reach the leading edge of medical practitioners, and we are delighted to work with the EuroPCR team to make this event special.”

MarketMonitors Chief Operating Officer Eric Lehto says, “The format of the Innovation sessions offers the presenting companies the ability to focus on their technology’s features and benefits for both patient and physician. The presenting companies can be large or small. We provide hand-outs for the session attendees to highlight the key features of the presenting technologies and put them into context with their competition.”

Innovation Incubator

This is a „must see‟ at EuroPCR. On the third floor, just outside the innovation session rooms is a space dedicated to the very latest in technology. Having the right equipment to make the job easier or to achieve better outcomes is beneficial to both cardiologist and patient. The space is open all day. Enjoy and enlighten yourself!

ABC for inventors

Chaired by Philipp Bonhoeffer, who performed the first human transcatheter heart valve implantation in 2000, this unique session aims to give young inventors a greater understanding of what it takes to bring their innovation forward.
Innovation sessions: Wednesday 18th May, Room 341
12:30-13:30: Cardiovascular Innovation Pipeline - Peripheral vascular disease and structural heart disease
13:30-15:00: Best of Innovations in Cardiovascular Interventions (ICI) Technoparade
15:00-16:30: Cardiovascular Innovation Pipeline - Coronary artery disease
16:30-18:00: ABC for inventors

Plenary session: Wednesday 18th May, 09:00 - 11:30, Theatre Bleu

New generation DES (ESC-EACTS revascularisation guidelines) - Head-to head comparisons focusing on patient-oriented outcomes

To cruise, shift gears or take a completely new route; such is the debate surrounding stent technology. Second generation DES with durable polymers are arguably difficult to improve upon. Bioresorbable polymer DES offer the "best of both worlds" - the benefit of polymer-based drug delivery in the shorter term and the benefit of BMS in the longer term. Bioresorbable stents represent a disruptive technology and may be the only route to yet further improvement in outcomes.

Second generation DES could be considered the gold standard due to excellent biocompatibility of the permanent polymers, yet bioresorbable polymer DES do seem to reduce mortality in randomised trials compared with first generation DES. An important factor to consider, however, is stent deliverability. In vessels with tortuous anatomy or calcification, second generation DES are more deliverable and the procedure may be challenging using fully bioresorbable stents. There are also economic issues; the R&D invested in latest generation stents will need to be recouped!

Bioresorbable polymer stents are attractive because the polymer, which may predispose to late adverse effects and particularly very late stent thrombosis, disappears. Clinical data indicate they are non-inferior to durable polymer-based DES, but whether they are truly superior remains to be demonstrated.

Non polymer drug delivery is also in the pipeline and may perform better than bioresorbable polymer stents. With nanotechnology allowing drug delivery directly from a modified metal surface, there is no polymer and no inflammation.

Fully bioresorbable drug-eluting scaffolds represent a step-wise change in technology. A plaster cast for a broken arm is not kept on for life. Arguably, a vessel only needs to be scaffolded for six months. Thereafter, a stent is probably unnecessary and indeed may be detrimental. A permanent scaffold can stop a vessel from expanding and contracting, may predispose to late stent thrombosis and late loss, and may interfere with repeat treatments. Patients often prefer a temporary device, if given the choice. However, there are challenges to make it sufficiently deliverable and experience has only been gained in simple narrowings, though performance in bench models is good. Later this year, two year follow-up data will be available in a large group of patients and this may confirm that in contrast to a conventional DES which is associated with late catch-up, fully bioresorbable stents may actually deliver late improvement and plaque
disappearance. John Ormiston considers, "In 10 years we will look back and laugh at the time we left pieces of metal in people's arteries!"

Late breaking first-in-human trials preview: Wednesday 18th May, 10:30 - 12:00, Room 342AB

Alain Cribier, Raimund Erbel and John Simpson will co-chair a session describing the findings from studies just being completed. It doesn‟t get much more topical than these late-breaking results…
Michael Haude will begin by presenting the results of BIOSOLVE-I, which describes the safety and clinical performance of the world‟s first drug-eluting absorbable metal scaffold. Martial Hamon follows with a review of first-in-man experience of the Orsiro drug-eluting stent, as reported in the BIOFLOW-I study treating patients with single de novo coronary artery lesions. Joerg Kempfert then follows with first-in-man results from the TA-AVI trial, with a 3-month analysis of the Symetis Acurate transapical aortic valve research. The session finishes with Bon-Kwon Koo reporting key outcomes of the DISCOVER-FLOW prospective first-in-man study. This looked at diagnosis of ischemia-causing stenosis obtained via non-invasive fractional flow reserve measurement. With these studies featuring so many first-in-man data, the discussions are bound to be challenging and extremely interesting.

Glimpse into the future: Wednesday 18th May 08:00-12:00 Room 352AB

Future treatment decision-making based on intracoronary lesion assessment - Questions and answers on relative merits of IVUS, OCT, FFR, IVUS VH, other new technologies
Selection of a treatment strategy for people with coronary artery disease relies on the accurate assessment of intracoronary lesions. Recent advances in this field have resulted in a variety of new techniques to evaluate lesions and today‟s session provides a comprehensive overview of currently available tools.
Choosing which diagnostic tool to use for intracoronary lesion assessment is a contentious issue. One school of thought maintains that traditional, tried and tested angiography provides sufficient information to make an informed treatment decision. However, many interventionalists now entertain the use of newer methodologies. The advantages and disadvantages of individual techniques will be discussed. Two presentations focus on how optical coherence tomography can be used in the decision making process.
Two different techniques for determining stent length - virtual histology assessment and near infra-red spectroscopy - will be presented. Invasive imaging and tissue characterisation will be discussed and the final presentation will consider what the future may hold, including state-of-the-art multislice computed tomography; a technology to put the world of lesion characterisation at the fingertips of any interventional cardiologist!