EuroPCR 2016 abstracts now online: innovations in interventional cardiovascular medicine for a growing range of patients
Over 900 abstracts were presented during the PCR’s Got Talent and Abstracts sessions and in the Poster Galleries.
Paris, France: EuroPCR 2016 abstracts are now available online for the annual course of the European Association of Percutaneous Cardiovascular Interventions (EAPCI), running from 17 to 20 May at the Palais des Congrès in Paris, France. The 920 abstracts outline studies being reported at the course that have the potential to change clinical practice and advance interventional cardiovascular medicine for the future. Additionally, the launch of the new PCR app makes EuroPCR abstracts much more interactive, allowing participants to comment on abstracts in real-time, rate e-posters and bookmark abstract sessions based on their interests.
“What’s really exciting at EuroPCR 2016 is the growing range of indications where interventional techniques are being developed and used in clinical practice to benefit patients,” says EuroPCR Course Director Professor William Wijns. Hot topics at this year’s meeting include developments in mitral and tricuspid valve interventions, research with new devices for percutaneous coronary interventions (PCI) that can be used in a wider range of patients than in the past and interventional approaches to treat and prevent heart failure and stroke.
Selected highly rated abstracts illustrating new research in interventional techniques across this wide range of different indications include:
High procedural success rate with new transcatheter treatment for heart failure in patients with dilated ischaemic cardiomyopathy
High rates of procedural success and improvements in heart failure severity are reported in two European studies using the ReviventTM system in patients with heart failure with ischaemic cardiomyopathy and antero-apical left ventricular aneurysm. The anchoring system excludes scarred myocardium from the left ventricle (LV) with the aim of reconfiguring abnormal cardiac geometry that leads to dysfunction. Researchers investigated a total of 71 patients with antero-apical large post-myocardial infarction scarring, dilated left ventricle and heart failure (New York Heart Association [NYHA] class > 2). They were treated with a surgical approach using the new system (51 patients) or a hybrid transcatheter approach (20 patients). Results showed a high procedural success rate for implantation of the ReviventTM system of 97.2% and an operative and 30-day mortality of 5.6%. Patients also showed significant improvement in ejection fraction and NYHA functional class.
“This technique represents a less invasive intervention to exclude apical aneurysm instead of the usual surgical approach that requires cardiopulmonary bypass and ventriculotomy. This could open a new option to treat heart failure in a high-risk population,” says lead author Marco Hernández Enríquez, from the Hospital Clinic de Barcelona, Barcelona, Spain. “It may reduce left ventricle volumes with improvement in ejection fraction and quality of life for up to one-year follow-up.”
CONTACT: Marco Hernández Enríquez, Hospital Clinic de Barcelona, Barcelona, Spain
Date: Thursday 19 May 16.30-18.00; Novelties in interventional heart failure management; room 343
Mitral valve reconstruction system reduces mitral regurgitation and improves quality of life at one year
The Cardioband® mitral value reconstruction system reduces mitral regurgitation (MR) and improves functioning and quality of life in high-risk patients with significant secondary mitral regurgitation, show one-year follow-up results of a European study. The system enables reconstruction of the mitral valve by direct annuloplasty delivered transfemorally with no need for open-heart surgery. Researchers enrolled 49 high-risk patients with significant secondary mitral regurgitation; 82% were in NYHA heart failure class III-IV with mean left ventricular ejection fraction of 33%.
The procedure was successful, with the device implanted and mitral regurgitation reduced to grade 2 or lower, in 87% of patients (41/47). At 12-month follow-up 89% of patients (n=22) had MR of grade 2 or lower, just over two-thirds (68%) had NHYA heart failure class I-II and they showed significant improvement in quality of life and exercise tolerance.
“Transeptal mitral repair with the Cardioband® device resulted in reduction of mitral regurgitation by reconstruction of the mitral annulus,” report the researchers, led by Georg Nickenig, University of Bonn, Bonn, Germany. “The safety profile is comparable to other transcatheter mitral procedures and the reduction in severity of mitral regurgitation and clinical benefit are stable up to 12 months.”
CONTACT: Georg Nickenig, University of Bonn, Bonn, Germany
Date: Tuesday 17 May 12.00-13.30; Transcatheter mitral interventions: from sizing to clinical outcome; room 351
Similar mechanical characteristics but trend for less mechanical support with DESolve® 100 compared to DESolve® 150
The novolimus-eluting bioresorbable scaffold DESolve® with a strut profile of 150µm is approved for the treatment of coronary artery lesions but a scaffold with a strut profile of 100µm has been developed to see if this can reduce the scaffold thrombosis associated with the shear stress induced by the struts. Researchers compared the short-term performance of the two scaffolds using optical coherence tomography (OCT) to assess how well they deployed in consecutive patients undergoing percutaneous coronary intervention (PCI). They implanted a total of 62 DESolve® 150 scaffolds in 42 patients and 17 DESolve® 100 scaffolds in 15 patients, with most having stable angina as the indication for their PCI.
Results showed a trend to a higher rate of residual stenosis with DESolve® 100 than with the 150 µm strut profile (21.3% vs 15.3%, p=0.22), with a trend to a smaller lumen and stent area. The mean eccentricity index was similar with the two devices but strut fractures were seen more often in the DESolve® 100 group (30.8% vs 14.0%).
“We report the first real world in vivo comparison of novolimus-eluting scaffolds with two different strut thicknesses. Although DESolve® 150 and DESolve® 100 showed similar mechanical characteristics there is a trend for less mechanical support with the DESolve® 100. We need further outcome data to assess the relevance for daily clinical use,” suggest the researchers, led by Niklas Boeder, University of Giessen, Giessen, Germany. They caution, “The attempt to reduce the strut thickness should not result in loss of radial strength of bioresorbable stents.”
CONTACT: Niklas Boeder, University of Giessen, Giessen, Germany
Date: Thursday 19 May 16.30-18.00; BRS: evolving technologies and applications; room 351
Suboptimal fractional flow reserve in patients needing long drug-eluting stents
Patients with long, diffuse coronary artery lesions achieve suboptimal fractional flow reserve (FFR), the blood flow achieved in a diseased coronary artery compared to that expected in a healthy artery, after undergoing PCI with newer-generation drug eluting stents, demonstrates a study. Researchers studied 74 patients receiving second- or newer-generation drug eluting stents with lengths of 30mmg or longer and who had fractional flow rates of 0.8 or less. They underwent angiographic and fractional flow reserve evaluation before and after PCI and at nine-month follow-up. Results showed that an optimal post-PCI FFR of > 0.95 was achieved in only 12.2% of the patients (9/74) and was not achieved in any patients with ultra-long stents (> 50mm). Only 16.2% (16.2%) had FFR values of 0.91-0.95 and more than one in ten patients (10.8%, 8/74) remained ischaemic (FFR < 0.8). The FFR gradient across the stent was higher in patients with ultra-long stents than those with long stents (0.07 vs 0.04, p=0.001). At nine-month follow-up the angiographic restenosis rate was 4.7% and the functional restenosis rate was 15.1%.
“The study shows that in the majority of cases diffuse coronary artery disease cannot be effectively treated using long drug eluting stents because the fractional flow reserve post PCI is suboptimal,” reports Arvydas Baranauskas, from Vilnius University Hospital, Vilnius, Lithuania. “Knowing that the optimal functional result is rarely achieved after stenting long coronary lesions in patients with diffuse coronary artery disease, particularly when the total stent length exceeds 5 mm, suggests other revascularisation options should be considered.”
CONTACT: Arvydas Baranauskas, Vilnius University Hospital, Vilnius, Lithuania
Date: Wednesday 18 May 14.45-16.15; Resting vs hyperaemic indices of coronary stenosis severity; room 351
Randomised trial shows no improvement in ischaemia with stem cells for angina
Injecting bone-marrow derived CD133+ cells into non-functioning regions of the left ventricle does not significantly improve inducible ischaemia or perfusion deficit in patients with refractory angina, report results from the REGENT-VSEL study. Researchers randomised 31 patients with stable angina resistant to drug treatment and myocardial ischaemia not amenable to effective vascularisation to receive autologous CD133+ cells isolated from the patients’ own bone marrow or placebo administered into hibernating areas of the left ventricle. During follow-up, changes in myocardial perfusion four months after the procedure were assessed by single-photon emission computed tomography (SPECT). Results showed inducible ischemia was numerically less with active treatment (summed difference score [SDS] 2.60 vs 3.63), as was the total perfusion deficit (3.60 vs 5.01), but the differences did not reach statistical significance. Patients treated with stem cells showed significant reduction in left ventricular volume compared to placebo. All patients completed the procedure without any serious adverse events and there were no deaths during follow-up.
“The study suggests that we probably need standardised second-generation cell products, such as expanded, pre-differentiated or allogeneic cells, in order to obtain clinical improvement,” reports lead author Wojciech Wojakowski, from the Medical University of Silesia, Katowice, Poland. He noted that the group developed new protocols for NOGA mapping that expand understanding of myocardial function.
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CONTACT: Wojciech Wojakowski, Medical University of Silesia, Katowice, Poland
Date: Tuesday 17 May 15.30-17.00; Late-breaking trials and trial updates in coronary interventions; Theatre Bordeaux
High strut coverage of Ultimaster® drug eluting stent observed in complex patients
Strut coverage is very high within three months of implanting biodegradable Ultimaster® drug eluting stents in complex patients with multivessel disease, show final results from the DISCOVERY 1TO3 study. Researchers prospectively followed up 60 patients using optimal frequency domain (OFDI) imaging to visualise stent strut coverage at baseline, one, two and three months. Results showed strut coverage at three months of single implanted stents (n=71) was 95.2 + 5.2%, with coverage of 85.1% at one month and 88.1% at two months.
“Strut coverage evaluation has been proposed as a surrogate endpoint for safety evaluation of discontinuation of dual antiplatelet therapy. This study demonstrated a very rapid and continuous coverage using the Ultimaster® stent without compromise of anti-restenotic properties. These results pave the way to a larger trial evaluating short-term dual antiplatelet therapy,” suggests lead author Bernard Chevalier, from Institut Cardiovasculaire Paris Sud (ICPS), Massy, France.
CONTACT: Bernard Chevalier, from Institut Cardiovasculaire Paris Sud (ICPS), Massy, France
Date: Thursday 19 May 14.45-16.15: Contemporary DES: focus on bioresorbable polymers – part 1; room 343
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Abstracts are available online at: http://www.pcronline.com/eurointervention/AbstractsEuroPCR2016_issue/abstracts-europcr-2016/
Notes to Editors - What is EuroPCR?
EuroPCR, the official annual meeting of the European Association for Percutaneous Cardiovascular Interventions (EAPCI), a registered branch of the European Society of Cardiology, is the world-leading course in interventional cardiovascular medicine. PCR has established a distinctive format for educational activities in the field of cardiovascular interventions. Beyond its flagship course in Paris that gathers more than 12,000 participants every year, PCR organises annual courses in Singapore, London UK, Dubai EAU, Johannesburg RSA, Istanbul Turkey, Chengdu China and Tokyo Japan.
For further information on EuroPCR, AsiaPCR/SingLIVE, PCR London Valves, GulfPCR-GIM, AfricaPCR, PCR Istanbul Peripheral, PCR-CIT China Chengdu Valves, PCR Tokyo Valves & PCR, please contact: Anne-Sophie Lartigau at firstname.lastname@example.org.
For more information, please visit http://www.pcronline.com/Courses/EuroPCR and follow us on Twitter #EuroPCR