Live from TCT – September 18, 2022

Seth Bilazarian, MD, and Bobbi Bogaev Chapman, MD, recap highlights from day 2 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 explains, describing left ventricular recovery seen in this study.

Navin Kapur, MD, discusses 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 emphasizes, “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 including Greg Stone, MD, and Cindy Grines, MD, discussed 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. 

In a live interview, Dr. Hirai provides 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.