Category Archives: Intravascular Guidance

TCT 2012 – Transcatheter Cardiovascular Therapeutics in Miami Beach

Miami Beach

The TCT will be held in Miami Beach, October 22-26, 2012

The Transcatheter Cardiovascular Therapeutics conference (TCT) is the largest U.S. meeting devoted to interventional cardiology (angioplasty, stents, and related procedures) and it starts next week. Organizers are predicting a new attendance record of over 12,000 cardiologists and associated healthcare professionals, as well as members of the device, imaging and pharmaceutical industries, venture capitalists, and press. Speaking of which, yes…I will be there and Angioplasty.Org will be reporting on late-breaking trials, new directions and innovative devices.

The annual  meeting is truly international: attendees will be traveling from 70 countries; in fact, this year more than two-thirds of the registrants hail from outside the United States. Continue reading

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Filed under Clinical Trials / Studies, Cost Effectiveness, FDA, Global Trends, Heart Attack, High Blood Pressure, Intravascular Guidance, Meetings & Conferences, Stent, Transradial Approach

Results of the ADVISE Registry Published

Artist rendition illustrating the iFR "Wave Free Period"

Artist illustration of the iFR “Wave Free Period”

As previously reported on Angioplasty.Org, a new method for the functional measurement of intracoronary pressures and the severity of blockages has been developed by researchers at Imperial College in London. One of the main advantages of this new method, called Instant Wave-Free Ratio™ (iFR), is that, unlike standard fractional flow reserve (FFR), it does not require injection of a vasodilator drug, such as adenosine, to induce stress on the heart. The result is that the procedure is more comfortable for the patient and potentially useable in clinical scenarios where vasodilation is not feasible, such as acute coronary syndromes, infarctions, unstable patients, patients with breathing problems; it may also be somewhat quicker, easier to use, and more cost-effective. Continue reading

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Filed under Appropriate Use Criteria (AUC), Cost Effectiveness, FAME I / FAME II, FFR, Interviews, Intravascular Guidance, Stent

Can Using IVUS (Intravascular Ultrasound) Prevent Stent Thrombosis?

IVUS image shows stent under-expansion (click for larger image)

IVUS image shows stent under-expansion (click for larger image)

A recent paper, published online before print in SCAI’s journal, Catheterization and Cardiovascular Interventions, yet again adds to the evidence that intravascular ultrasound (IVUS) imaging during PCI can improve stent placement and expansion in a way that may prevent stent thrombosis (ST).

Titled, “Angiographically confirmed stent thrombosis in contemporary practice: insights from intravascular ultrasound“, the study looked at five years (2005-2010) of a multicenter registry of stent thromboses and studied the IVUS images where performed. Continue reading

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Filed under Innovators, IVUS, Japan, Stent Thrombosis

FAME II: Should Fractional Flow Reserve (FFR) Be Mandatory?

Should Fractional Flow Reserve (FFR) Be Mandatory?Earlier today, the opening day of EuroPCR, Dr. Bernard De Bruyne presented preliminary results from the FAME II trial which tested the diagnostic power of Fractional Flow Reserve to guide PCI (stenting) of the coronary arteries. I wrote about FAME II back in January, when enrollment in the trial was halted for ethical reasons because the results of the ongoing FAME II trial were showing that the outcomes for stents in patients with stable angina were clearly superior to those in patients who were being treated with medications (a.k.a. Optimal Medical Therapy or OMT) alone. An independent Data Safety Monitoring Board advised that continuing the randomization would not change the findings and so, it was unethical to withhold the option of stents from this patient population. Continue reading

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Filed under Appropriate Use Criteria (AUC), COURAGE, FAME I / FAME II, FFR

Q&A with Dr. Jennifer Tremmel of Stanford

Jennifer Tremmel, MD

Jennifer Tremmel, MD

The Stanford School of Medicine blog “SCOPE” is featuring an “Ask the Doctor About Women’s Heart Health” article. The doctor is Jennifer Tremmel, MD, Clinical Director of Women’s Heart Health at Stanford Clinic, and Dr. Tremmel is no stranger to us here at Angioplasty.Org. You can read our interview with Dr. Tremmel about her experience starting the transradial approach to angioplasty at Stanford (she is also Director of Transradial Intervention there). Continue reading

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Filed under FFR, Myocardial Bridging

Stent-Trek: The Next Generation

Starship Stenterprise

Starship Stenterprise

Yeah. I went there. Since everyone from Motley Fool to MassDevice to the Wall Street Journal feels the need to use “Stent Wars” (a pun that I originated on this website a decade ago) I’ve decided to go all TV. Actually, “The Next Generation” is also a more appropriate reference than the “Wars” moniker, because the story here is no longer so much about behemoth entities and dark lords battling each other for control of the universe (not that this aspect has gone away) but a story of refinement, sleeker technology and, yes, much more Data! And this past couple of weeks has seen some important developments in the next generation of stents that are positive for both patients and physicians. Continue reading

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Filed under Antiplatelet Medications, Clinical Trials / Studies, FFR, High Blood Pressure, Innovators, Intravascular Guidance, IVUS, Meetings & Conferences, OCT

FAME II is Not the “Anti-COURAGE”: Stents and Angioplasty in the Spotlight

Cath LabThere’s been much talk this week in the interventional cardiology community (and among stock market analysts) about stents and angioplasty, given the news that the FAME II clinical trial ended enrollment early, due to ethical concerns that were generated by the fact that patients randomized to Optimal Medical Therapy (OMT) alone were returning to the hospital in significant numbers for “urgent revascularization”, i.e. stenting!

So is this, as several analysts have suggested, a reversal of the COURAGE trial results? Not according to the principal investigators of both the FAME II trial AND the COURAGE trial, whom I have spoken with in the past 48 hours. Continue reading


Filed under Clinical Trials / Studies, COURAGE, FAME I / FAME II, FFR