Live from TCT – September 18, 2022

Seth Bilazarian, MD, and Bobbi Bogaev Chapman, MD, recap highlights from day two of the 2022 Transcatheter Cardiovascular Therapeutics (TCT) conference in Boston, MA.

Late-breaking clinical trials. The UNIVERSAL trial demonstrated that the use of ultrasound in femoral access improved first attempt success and was beneficial when a closure device was used. While UNIVERSAL did not demonstrate a significant reduction in bleeding or vascular complications, when looking at meta-analyses, UNIVERSAL trial principal investigator Sanjit Jolly, MD, explains, “When you put all the data together, there’s clearly a signal of benefit that’s statistically significant: about a 40% reduction in major bleeding and vascular access site complications with the use of ultrasound.”

Catalin Toma, MD, presented an update from FLASH registry, a large study evaluating the safety and effectiveness of the FlowTriever® mechanical thrombectomy device for treatment of pulmonary embolism. This data demonstrated an excellent safety profile for FlowTriever and hemodynamic improvement on-table.

Live Cases. Jonathan Hill, MD, presented another high-risk Protected PCI patient case, generating rich conversation around hemodynamic support and best practices.

Adrian Attinger-Toller, MD, from Lucerne, Switzerland, presented an abstract of a single center experience using Impella pre-PCI in patients with large anterior MIs. “Left ventricular unloading by the Impella®  device has the potential to save lives in these patients,” he explained, describing the left ventricular recovery observed in this study.

Navin Kapur, MD, discussed his presentation of the per-protocol analysis of patients in the STEMI DTU™ pilot study, offering many insights into what he calls a “breakthrough concept of delaying reperfusion in STEMI.” He emphasized that, “The 30 minutes is a critical component that may have been missing for many decades in multiple attempts to try to achieve myocardial salvage in STEMI.” 

Symposium highlights:

• A panel moderated by Dr. Gregg Stone and Dr. Cindy Grines about high-risk PCI.
• Jonathan Hill, MD, provided updates on the spectrum of high-risk PCI over the past several decades.
• Kate Kearney, MD, presented best practices for high-risk PCI.
• Adam Salisbury, MD, MSc, and Taishi Hirai, MD, presented an update on the OPTIMUM study. 
• Navin Kapur, MD, presented lessons learned in the STEMI DTU™ pilot trial.

In a live interview, Dr. Hirai provided a deeper analysis of the preliminary results from the OPTIMUM study, examining baseline characteristics and prophylactic vs bailout use of MCS in these surgically ineligible high-risk PCI patients.