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October 15, 2005

Off To See The Wizards
I'll be traveling to Washington DC this week to attend the TCT 2005 -- can you say "Transcatheter Cardiovascular Therapeutics" three times fast? If so, you might find this annual meeting interesting.You and the estimated 10,000 other attendees who will be descending on the Convention Center for a week of live TV (angioplasty and stent procedures beamed from around the globe, ostensibly to show off a new piece of equipment, a new technique, but, as more than one cardiologist has told me, it's not unlike NASCAR -- you want to see the race, but everyone's waiting for the crash), PowerPoint lectures, simulation trailers where you can try your skill at placing a carotid stent in "Roger" (okay I made the name up -- I'll tell you the actual name later this week), PowerPoint symposia, "Sponsored Events" (breakfast or dinner meetings held outside the actual TCT, but within a couple blocks in a posh hotel, lotsa food, wine or espresso, mints, and more PowerPoint presentations, usually showing how the product of the particular sponsoring company is better than the one being shown in the hotel around the corner), highly anticipated presentations of clinical trial results (these are "blinded" -- the highly guarded results are only known to a few -- kinda like the Oscars -- did the stent work? did it meet its "end-point"? will the company get FDA approval? will the stock go up?), the Exhibit Hall with its scores of company booths, both big (giant video walls, entire cath labs, conference areas, espresso bars) and small (Joe, the Director of Marketing, will show you his latest brochure) and, did I say, PowerPoint presentations?

Curious to me is that there are 10,000 attendees but, according to the American Board of Internal Medicine, there are only 4,796 certified interventional cardiologists in the U.S. -- total. And hopefully, for angioplasty patients, a percentage of them will not be in Washington this week. (Hint: maybe you want to schedule your stent procedure for next week.)

So who else is there? Well, it's an international event, so some non-U.S. cardiologists are there. Then there are the cardiologists who don't actually do interventional procedures, and other healthcare professionals, nurses and technicians. And let's not forget the press -- you no doubt will be seeing heart-related stories in the news this week.

But more and more, there are the "related" professions: device manufacturer marketing teams, company executives, sales reps, venture capitalists, stock analysts. For them the TCT is a bit like what the patients face when they are wheeled into the cath lab -- the TCT is their cath lab: will their new device succeed? will the doctors like the way it handles? will their company be healthy or will it need a long recovery period? The business of medicine is big business, and many dollars are spent promoting various therapies and products at this meeting (and the others held around the world -- but this is the biggest in this field). Just stand in the Exhibit Hall as the TV monitors start to beam the presentation of a major clinical trial for the latest drug-eluting stent. Most of the docs are in the assembly room where the presentation is occurring, but in the Exhibit Hall, the sales reps suddenly all migrate to their home booths and, if the results are good for their company, a cheer goes up or applause...yay for us!

Monday morning some results from the Endeavor drug-eluting stent trials will be presented and these will to a great extent determine the speed with which Medtronic can get approval and market their stent in the U.S. They've been talking 2007. I've heard opinions that the results may not be that substantial and that they may be looking at 2008. But these are only opinions because no one knows until...well you get the picture.

More to follow.

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