heartwire
Brain/Kidney/Peripheral
Promising percutaneous CoreValve data from Europe leave US trialists itching for green light from the FDA
3 COMMENTS - Oct 24, 2008 18:00 EDT
New data from 18 European countries on the fully percutaneous aortic valve speak to low 30-day mortality and improved valve function sustained over the longer term. So why the holdup in the US, where nary a feasibility study has been conducted? (TCT 2008.)
Brain/Kidney/Peripheral
COOL-RCN: Hypothermia does not prevent contrast-induced nephropathy during cath procedures
Oct 21, 2008 18:00 EDT
The COOL-RCN investigators used a catheter that essentially acts as an "intravenous refrigerator," cooling the body from the inside out, but it failed to decrease the risk of acute kidney damage caused by iodinated contrast agents. (TCT 2008.)
Interventional/Surgery
New trial results support broader role for carotid stenting, but CMS again refuses to expand Medicare coverage (updated)
Oct 21, 2008 17:15 EDT
Critics say the CMS should have waited for pending publications of the SAPPHIRE, CAPTURE 2, and EXACT data before announcing its decision, especially as new results from PROTECT, EMPIRE, and EPIC indicate that stroke, death, and MI rates are continuing to decline. (TCT 2008.)
Interventional/Surgery
PREPARE: Proximal embolic protection with aspiration improves immediate ST-segment resolution
1 COMMENT - Oct 20, 2008 17:15 EDT
An embolic-protection and aspiration device delivered proximally to the lesion in primary PCI results in better immediate microvascular flow in STEMI patients compared with primary PCI alone. Although the immediate benefits did not hold up over time, investigators believe the early reperfusion will translate into better outcomes. (TCT 2008.)
Interventional/Surgery
BBC ONE: Fewer MACE with provisional T-stenting for bifurcations
Oct 17, 2008 17:30 EDT
Provisional T-stenting using the Taxus stent, instead of the crush or culotte techniques, is associated with a lower rate of death, MI, and target vessel failure at one year, results from the BBC ONE trial show. (TCT 2008.)
Interventional/Surgery
The devil in the details: Sponsors still mulling nuts and bolts of DAPT—Updated
Oct 17, 2008 12:30 EDT
Device companies contacted by heartwire about their role in the Dual Antiplatelet Therapy Trial say nothing has yet been finalized about trial funding or "in-kind" sponsorship. Hammering out these details may yet jeopardize the $100M DES trial. (TCT 2008.)
Interventional/Surgery
European data raise safety questions about Endeavor stent—Updated
1 COMMENT - Oct 16, 2008 16:30 EDT
In a comparison with the Cypher stent, SORT-OUT III showed an increased risk of MI and stent thrombosis with the Endeavor zotarolimus-eluting stent at nine months, while two-year registry data suggest an increase risk in all-cause mortality. While everybody urged caution in interpreting the findings, experts say the results are a warning signal. (TCT 2008.)
Interventional/Surgery
HORIZONS AMI: Drug-eluting stent safe and effective in the setting of STEMI
Oct 15, 2008 18:00 EDT
In addition to reducing TLR rates at 12 months, the Taxus stent was equivalent to its bare-metal counterpart in terms of major cardiovascular adverse events, including death, MI, stroke, and stent thrombosis, report investigators. (TCT 2008.)
Interventional/Surgery
$100M DAPT supplants CODA: Massive DES/dual antiplatelet therapy trial announced at TCT
Oct 15, 2008 17:00 EDT
Eight companies have agreed to sponsor the study, selecting the Harvard Clinical Research Institute to command the 33-month, $100-million dollar study. The announcement effectively shelves CODA, the dual antiplatelet study first proposed by Duke but rejected by the necessary industry funders. (TCT 2008.)
Interventional/Surgery
Left main and three-vessel disease subsets from SYNTAX: New answers, more questions
Oct 15, 2008 12:00 EDT
The analyses can be viewed only as "hypothesis generating," since SYNTAX was negative. But the data suggest that in low- or intermediate-risk patients with left main disease, DES and CABG are both "reasonable" options, but in three-vessel disease, only the lowest-risk patients should be considered as candidates for DES instead of surgery. (TCT 2008.)
Interventional/Surgery
FAME! FFR-guided PCI significantly reduces clinical events
5 COMMENTS - Oct 14, 2008 17:45 EDT
Investigators report that fractional flow reserve-guided PCI reduced the risk of death, MI, or repeat revascularization by 30% and death or MI by 35%, when compared with the current practice of using angiography to guide stenting decisions. (TCT 2008.)
Interventional/Surgery
Cypher, Taxus equal in left main disease: ISAR LM
1 COMMENT - Oct 14, 2008 14:30 EDT
Both types of drug-eluting stents performed similarly in left main subjects, leading to two-year outcomes comparable to those from CABG registries. (TCT 2008.)
Interventional/Surgery
Low 30-day and six-month mortality for transfemoral valve implantation in PARTNERS EU and SOURCE
1 COMMENT - Oct 14, 2008 09:30 EDT
High survival following transcatheter valve placement via the transfemoral approach reflects increased operator skill and lower-risk patients than the transapical arms of the study, experts say. (TCT 2008.)
Interventional/Surgery
First-in-human data with novel polymer-coated stent: No thrombosis at 12 months
3 COMMENTS - Oct 13, 2008 17:15 EDT
Investigators reported no cases of stent thrombosis at 12 months in patients implanted with the stent, as well as no adverse clinical events, despite stopping dual antiplatelet therapy at 30 days. (TCT 2008.)
Interventional/Surgery
No increased risk, but no MI/mortality benefit with DES, experts cautiously conclude
Oct 13, 2008 11:45 EDT
Leaders of some of the more provocative DES studies in recent years seem to agree that other factors may be contributing to the apparent survival benefit with DES seen in recent registries but that it is at least safe to conclude that risk of death or MI is not increased with their use. But many also argue for a bigger role for bare-metal stents. (TCT 2008.)
Interventional/Surgery
Carotid stenting safe and effective with experienced operators, European registry suggests
Oct 13, 2008 09:15 EDT
Investigators caution that the data are preliminary, but the 30-day risk of stroke and death observed in clinical trials is lower when more experienced operators perform the procedure. (TCT 2008.)

Discussion and opinions
Blogs
Heartfelt with Dr Melissa Walton-Shirley
TCT Wrap up
Oct 31, 2008 06:40 EDT
Heartfelt with Dr Melissa Walton-Shirley
The only frustration I felt during the TCT was during the Town Hall Meeting.
Oct 27, 2008 07:37 EDT
Previews