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The most prominent faculty of the ANGIOPLASTY SUMMIT-TCTAP
2010 will share their experience and opinion in the interventional vascular
field.
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Bernard
Chevalier, MD 
Institut
cardio-vasculaire Paris-Sud, France
| Q > |
1. Cardiologists are
looking forward to seeing next generation DES with biodegradable
polymer. Would you tell us about the strength of bioresorbable
PLA and biolimus A9 polymers which have been used in Nobori
Biolimus A9-eluting stent? |
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2. NOBORI 1 follow-up data have
demonstrated that Nobori stent is not inferior to Taxus Express
and Liberte stent especially in regard to restenosis and late
stent thrombosis rate. Do you have more updated data regarding
NOBORI 1 trial? |
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3. Cardiologists have high expectations
with DES using biodegradable polymer. Do you think biodegradable
DES including NOBORI stent would succeed in the future? |
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4. Clinical trials such as BBC-ONE
and CACTUS have been presented. Based on these trials, what
do you think is the optimal treatment strategy for bifurcation
lesions? |
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Antonio
Colombo, MD
EMO
Centro Cuore Columbus, San Raffaele Hospital, Italy
| Q > |
1. Would you tell
us about your tips and tricks for side branch coronary intervention? |
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2. Simple stenting strategy showed
better results than two stent technique in CACTUS and BBC ONE
trials. When do you think we should use two stent technique
in patients with bifurcation lesion? |
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3. Side branch kissing balloon
dilatation did not improve the outcomes in one-stent approach
of NORDIC Bifurcation study III. What do you think about this
result? |
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4. Do you think using IVUS in
bifurcation stenting would improve clinical outcomes? |
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Alain
G. Cribier, MD
Hôpital
Charles Nicolle, France
| Q > |
1. Edwards SAPIEN
XT transcatheter valve obtained CE mark last month. Would you
explain about the improvement in Edwards SAPIEN XT transcatheter
valve when compared to the old version? |
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2. As delivery catheter size decreases
in trans-femoral TAVI, more cardiologists prefer trans-femoral
approach. What do you think about the role of trans-apical TAVI? |
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3. As more clinical trials progressed
from REVIVE study to SOURCE registry, success rate increased
and mortality rate decreased. Would you tell us about the PARTNER
US study and your expectations from that study? |
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4. TAVI has been performed mostly
in Europe and in the US. Since the learning period is relatively
long, many cardiologists undergo trial and error. What do you
think about making a well-organized training program to reduce
the learning curve? |
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Donald
E. Cutlip, MD
Beth
Israel Deaconess Medical Center, USA
| Q > |
1. What are your indications
for using DES instead of BMS in patients with STEMI? |
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2. From SIRIUS, TAXUS IV, and
ENDEAVOR trials, we also found patients with very late stent
thrombosis after BMS implantation. What is your long-term anti-platelet
treatment strategy for patients with BMS implantation? |
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3. Anti-platelet drug dose and
duration has been an issue after coronary stenting. What is
your dual anti-platelet treatment dose and duration for patients
after either BMS or DES implantation? |
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4. Would you tell us about the
ongoing dual-antiplatelet trial in the US? |
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Stephen
G. Ellis, MD
The
Cleveland Clinic Foundation, USA
| Q > |
1. Could you please
tell us the result and its clinical implications of FINESS trial? |
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2. Even though the FINESSE trial
has not shown any advantages of facilitated reperfusion over
PCI alone, there is some intriguing data to suggest a possible
benefit of lytic and abciximab combination therapy in the high
risk groups. Do you have any plans of study for facilitated
PCI trial again in high risk patients? |
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3. In TRANSFER-AMI trial, the result has shown
that transferring STEMI patients for PCI within 6 hours of receiving
thrombolysis is superior to standard wait-and-see strategy.
Considering the ASSENT-4 trial which was stopped early with
high mortality after treated with PCI too soon after thrombolysis,
what do you think is the ideal window time to do PCI after thrombolysis? |
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4. As much as the research for which drug regimen
is better, it would also be important to set up the efficient
system which can minimize door-to-balloon time, transferring
AMI patients to PCI hospital. Could you please introduce the
emergency system in Cleveland, Ohio where you work? |
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William
F. Fearon, MD
Stanford
University Medicine Center, USA
| Q > |
1. In the TCT 2009 meeting, you presented
2-year data on FAME trial. Could you please make a brief comment
on the result of FAME trial? |
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2. Over the past few years, FFR use has been rapidly
increasing. Based on the result of FAME trial, FFR guided PCI
showed good outcome. But still it is not clear which lesion
should we use FFR. Could you please tell us the indication of
FFR? |
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3. If there are any potential pitfalls to pay attention
in the use of FFR, please let us know about it. |
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4. There are two FDA approved FFR guide wires,
that is St.Jude and Volcano. The cost of each guide wire is
600$ which is somewhat expensive. What do you think about the
cost effectiveness of FFR? |
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William
A. Gray, MD
NewYork-Presbyterian
Hospital, CUMC, USA
| Q > |
1. Could you please tell us the result
of EVEREST II trial briefly and its clinical implication? |
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2. According to statistics of United States, only
20% of patients with significant mitral regurgitation actually
undergo surgery, with most being managed medically. Do you expect
clip device will be therapeutic option in the future which can
replace surgery in the severe MR? |
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3. Increasingly, Endovascular repair has been doing
as a treatment option for AAA in Asia, even though the cases
are relatively small compared to western countries. Could you
please give any tips of your own for successful procedure of
EVAR? |
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4. Gradually, endovascular treatment technique
and devices for the below knee lesion has been improved. Could
you please tell us several options of endovascular treatment
for the below knee lesion? And are there any current ongoing
endovascular clinical trials for this lesion? |
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Eberhard
Grube, MD
Elisabeth
Hospital Heart Center Rhein-Ruhr, France
| Q > |
1. Based on Siegburg Core Valve experience,
30-day mortality rate dropped from 40% in 2005 to 4.8% in 2008.
What is the secret behind this reduction in mortality rate? |
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2. Experience is extremely important in successful
TAVI procedures. What do you recommend to many interventional
cardiologists in order to reduce the learning curve? |
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3. Patient selection is also important in successful
TAVI procedures, and aortic valve with severe calcification
is considered unsuitable for TAVI. What do you think is the
acceptable aortic valve calcification level for TAVI? |
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4. Since the introduction of CoreValve in 2004,
many clinical trials are ongoing right now. With respect to
the PARTNER US trial with Edward valve, do you have plans for
a randomized controlled trial for CoreValve? |
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Larry
F. Hamm, MD
The
George Washington University Medical Center, USA
| Q > |
1. Many interventional cardiologists
have a great interest in the revascularization itself, but not
in the cardiac rehabilitation fields. Could you please tell
us what is your opinion on this issue? |
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2. In the real world, it is not easy to apply and
maintain rehabilitation program to the patients with the matter
of cost. Do you have a good way to overcome this problem? |
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3. What do you think is the role of rehabilitation
in the patients of peripheral artery disease? |
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Ziyad
M. Hijazi, MD
Rush
University Medical center, USA
| Q > |
1. Percutaneous pulmonary valve implantation
has not been popular until now. Could you please tell us the
indication of percutaneous pulmonary valve implantation? Most
patients needed this procedure are children, because most pulmonary
valve diseases are congenital disease. For the delivery system
of these valves, do you have any criteria in terms of body weight?
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2. Currently, MELODY and SAPIEN valves which got
CE approval are under clinical study. Could you please tell
us what are the differences between these two valves and how
many patients have got this procedure until now? |
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3. What do you think about the merits of hybrid
procedure in congenital heart disease? Could you please tell
us your experiences of hybrid procedure? What patients were
operated with this? |
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4. It seems that there would be many problems in
the case of post infarct VSD with percutaneous closure. For
successful procedure, the sufficient rim of tissue will be needed
and sometimes device could be migrated by expanding of infarction
territory. Do you have any indications for successful device
closure in the patients of post infarction VSD? |
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David
Richard Holmes, MD
Mayo
Clinic, USA
| Q > |
1. Even though PCI has been rapidly
advanced, current guideline in the treatment of multi-vessel
and LM disease is CABG, so far. Could you please give us your
opinion in which cases PCI can be replaced to CABG in multi-vessel
and LM disease? |
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2. Could you please tell us your views on optimal
timing of angioplasty in NSTEMI patients? |
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3. The number of Diabetes patients is steadily
increasing and is predicted to be double within 20 years. Could
you please tell us the result of BARI-2D trial? And what do
you think the clinical implication of this trial? |
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4. As shown in BARI 2D trial, the number
of distal anastomoses per patient in the CABG was 3 versus 1.5
in the PCI. How important is this difference and do you think
this difference might have given any influence on the result? |
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5. Please comment briefly on the ongoing FREEDOM
study. What other results can be (more) expected compared to
BARI-2D trial? |
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Adnan
Kastrati, MD
Deutsches
Herzzentrum München, Germany
| Q > |
1. After widespread use of DES in recent
years, stent thrombosis has emerged as a clinical issue. Do
you think second generation DES such as Endeavor and Xience
are safer than first generation DES such as Cypher and Taxus?
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2. ISAR-DESIRE 2 trial has been presented recently.
Would you tell us more about the results? |
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3. Clinical trials using GP IIb/IIIa inhibitors
in STEMI patients have been presented recently. Do you think
that GP IIb/IIIa inhibitors should be used in all STEMI patients?
And which GP IIb/IIIa inhibitors should be used in STEMI patients? |
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John
R. Laird, Jr., MD
UC
Davis Medical Center, USA
| Q > |
1. You will give a lecture on ¡®multi-point
lessons for successful sub-intimal angioplasty in SFA CTO¡¯.
Could you share any tips of your own for successful endovascular
treatment of SFA- CTO? |
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2. Could you please give us some tips on the treatment
of complex arch and carotid anatomies during carotid artery
stenting? |
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3. Even though EVAR has been proven as an effective
and safe treatment of option in AAA, several problems still
remain which have not been solved yet. Among them, Endoleak
after EVAR have been reported up to 10-50%. Do you have life-long
surveillance strategies to prevent and to early treat for this
problem? |
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Martin
B. Leon, MD
NewYork-Presbyterian
Hospital, CUMC, USA
| Q > |
1. Many interventional cardiologists
and surgeons are waiting for the result of PARTNER trial with
Edward Sapien valves. Could you please introduce the PARTNER,
U.S. trial to us? How do you expect the result of study would
be and when could we get the results? |
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2. According to PARTNER, EU and SOURCE registry,
trans-catheter Edward valves implantation to the patients with
high surgical risk have been shown good clinical outcomes until
now. At the CRT meeting in this year, experts agreed that this
percutaneous procedure could be eventually be used in patients
with lower surgical risk. Do you have any plan of clinical study
with lower surgical risk patients? |
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3. How do you expect that the way TAVI will evolve
into? And do you think that it will be possible in the future
that TAVI will be the first-line treatment option of aortic
replacement? |
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4. In recent years, DES has been developed very
rapidly and also, new technical trials are ongoing now. Which
way do you think the DES would grow into in the future and how
do you expect the clinical results would actually influence
the real practice? |
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Roxana
Mehran, MD
NewYork-Presbyterian
Hospital, CUMC, USA
| Q > |
1. While being concerned with the safety
of DES, the introduction of new anti-platelet agent like Prasugrel
and Ticagrelor is a very good news to cardiologist. Could you
please tell us how do you expect these drugs will change treatment
strategy of PCI with DES? |
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2. Last year, FDA raised serious concerns that
Prasugrel heightened mortality in the patients with NSTE ACS.
They reported that there were several shortcomings with TRITON
trial. What are your views on this matter? |
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3. Even though high proportions of CKD patients
have coronary disease in the real word, there had not been many
data of the renal impairment patient subset because these patients
were usually excluded in coronary artery disease clinical trials.
Could you tell us clinical studies on renal impairment patients
till now? And are there any other plans of clinical trials for
CKD subset? |
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4. Many clinical trials are now actively going
on in many Asian countries including South Korea. Is there anything
to be improved and asked about? We’d appreciate your valuable
advice or comments to improve the quality of the trials. |
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Bernhard
Meier, MD
Swiss
Cardiovascular Center Bern, Switzerland
| Q > |
1. Short-term complication rate was
higher in Watchman group than warfarin group in PROTECT-AF trial.
How can we reduce the learning curve for LAA closure procedure? |
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2. Do you think left atrial appendage closure would
be the first-line therapy in patients with no valvular atrial
fibrillation? |
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3. What are the advantages of using Amplatzer cardiac
plug when compared to Watchman system? |
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4. The results of Amplatzer cardiac plug trial
will be presented soon. Would you tell us about the trial design
and background? |
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5. Who will and who should perform LAA closure
among interventional cardiologists and electrophysiologists?
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Gary
S. Mintz, MD
Cardiovascular
Research Foundation, USA
| Q > |
1. What are the imaging tools which
have been proven to optimize PCI outcome? And please also explain
the invasive and non-invasive imaging tools which are expected
to be the next generation imaging technique. |
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2. These days left main coronary artery (LMCA)
intervention is gradually getting better evidences as a treatment
option. Please tell us what is the IVUS criteria of significant
stenosis which needs PCI in LMCA? And what is the role of IVUS
during LMCA intervention? |
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3. What do you think the role of IVUS to evaluate
the mechanism of ISR? Could you explain about the predictors
of IVUS findings which can make more ISR and please recommend
the IVUS criteria to reduce ISR? |
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4. PROSPECT study has recently published and the
result of the study is very exciting. However, it is not easy
when it comes to applying this result to a real practice. In
case we find the vulnerable plaque in non-culprit lesion, should
we treat them to prevent future cardiovascular events? Do you
have any treatment strategy on this case? |
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Marie-Claude
Morice, MD
Institut
Hospitalier Jacques Cartier, France
| Q > |
1. Would you tell us more about SYNTAX
2-year follow-up data? |
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2. In spite of SYNTAX trial, the standard treatment
of left main disease is considered to be bypass surgery. With
regard to LM disease patients, why do you think that interventional
cardiologists should discuss the treatment options with the
cardiac surgeons? |
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3. What do you expect from currently ongoing EXCEL
trial? |
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Nicolaus
J. Reifart, MD
Main
Taunus Heart Institute, Germany
| Q > |
1. Euro CTO club has presented excellent
data recently. Would you tell us about future research issues
in Euro CTO club? |
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2. Patient selection is one of the most important
factors in successful CTO intervention. Would you tell us about
favorable anatomical factors for easy collateral channel crossing
in retrograde approach? |
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3. CART (controlled anterograde and retrograde
subintimal tracking) registry has been presented recently, and
what do you think about the efficacy and safety of bilateral
approach in CTO intervention? |
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4. Would you please tell us about new techniques
and new devices for CTO intervention? |
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Dierk
Scheinert, MD
Heart
Center Leipzig, Germany
| Q > |
1. Bypass surgery has been regarded
as the standard treatment for critical limb ischemia. What are
the indications for endovascular revascularization in patients
with critical limb ischemia? |
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2. Common femoral artery (CFA) is important since
it supplies blood to entire lower extremity, and what is your
treatment strategy for patients with symptomatic common femoral
artery stenosis? |
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3. Not many clinical trials have been conducted
regarding patients with below knee diffuse stenosis. Do you
think DES or drug eluting balloon could be a treatment option
in these patients? |
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4. Do you have any experience with transpedal or
transcollateral approaches as alternative access techniques
in patients with below knee stenosis? |
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Horst
Sievert, MD
Sankt
Katharinen Hospital, Germany
| Q > |
1. In comparison to conventional PFO
closure devices, what are the advantages of using in-tunnel
PFO closure device? |
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2. Recently presented Migrane Intervention with
Starflex Trial (MIST) revealed that PFO closure has no effect
on reducing headache frequency. What do you think about this
result? |
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3. Radiofrequency application or bio-absorbable
device could be a new treatment option for PFO closure in the
future. What do you think about these new treatment options? |
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4. Since you have started percutaneous LAA occlusion
in 2001, many clinical trials such as PROTECT AF trial have
been conducted. Watchman device has been demonstrated to be
non-inferior to warfarin therapy regarding safety and efficacy.
Since there are wide variations in LAA morphology, how do you
select your patients for percutaneous LAA occlusion? |
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Gregg
W. Stone, MD
NewYork-Presbyterian
Hospital, CUMC, USA
| Q > |
1. In comparison to previous left main
clinical trials such as MAIN-COMPARE and SYNTAX, what is the
purpose of EXCEL trial? |
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2. Would you tell us about the clinical design
of EXCEL trial? |
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3. Would you tell us about the results of PROSPECT
study? And what are the IVUS findings for vulnerable plaque
which increases cardiovascular event rate? |
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4. How can we apply the results of PROSPECT trial
into real clinical practice? Do you think we need to perform
routine three-vessel invasive imaging screening? How do you
treat vulnerable plaque in non-culprit lesion? |
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David
Paul Taggart, MD
University
of Oxford, United Kingdom
| Q > |
1. Many registry data and randomized
clinical data regarding multi-vessel coronary disease have been
published. At least 15 trials showed that PCI was not inferior
to bypass surgery in patients with multi-vessel disease. In
what patient population should we recommend bypass surgery instead
of PCI? |
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2. Why do you think bypass surgery has superior
survival benefit than PCI? |
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3. Recently published BARI 2D trial revealed that
there was no mortality difference between bypass surgery and
PCI. What do you think about the result? |
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4. Please tell us about the multi-disciplinary
team approach system in your hospital for patients with multi-vessel
coronary disease or left main disease. |
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Paul
S. Teirstein, MD
Scripps
Clinic & Research Foundation, USA
| Q > |
1. Even though PCI has been rapidly
developing, current guideline in the treatment of multi-vessel
and LM disease is CABG, so far. Could you please tell us your
opinion in which cases PCI can be replaced to CABG in multi-vessel
and LM disease? |
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2. Last year the meta-analysis which compared 5-year
mortality of CABG and PCI in multi-vessel disease patients was
published in the Lancet. (by Dr. Mark Hlatky, Stanford University).
From the result, CABG showed better outcome for older patients
over 65 years-old. But we should be cautious to apply this result
to real practice because the population over 75 years old was
less than 5%. What are your treatment options for over 75 years-old
patients? |
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3. After development of DES, efficacy and safety
is getting improved very fast. But safety is emerging as a major
issue such as stent thrombosis. Could you please tell us your
perspectives how we can solve this problem in the future? |
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4. Anti-platelet treatment is another important
factor for DES safety. Currently there is ongoing large clinical
trial ¡®DAPT¡¯, do you think the result
of this study will give us the appropriate guideline for anti-platelet
treatment? |
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5. I know that you are currently carrying out the
clinical research, SEASIDE trial which evaluate DAPT for 6 months
to the patients treated with Endeavor stent. Could you please
give your views on individualized anti-platelet therapy? |
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Renu
Virmani, MD
CV
Path Institute, Inc., USA
| Q > |
1. As DES is being widely used, safety
issue is considered the most important in the field of interventional
cardiology lately. From a pathologist's perspectives , Which
point you are skeptical about? And What is your point of view
about the safety of the 2nd generation DES like Endeavor? |
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2. Please tell us in order to improve safety of
DES, in what ways should those DES factors like stent platform,
polymer, drugs be developed? |
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3. In the case of biodegradable NOBORI stent, on
which you have been researching lately, what kind of result
does it show on pathology? |
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4. Could you please tell us the merits of the platinum-Chromium
alloy, the new stent platform and the pre-clinical data up to
now? |
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Ron
Waksman, MD
Washington
Hospital Center, USA
| Q > |
1. The one of the major talking point
in interventional cardiology is to develop an ideal stent with
rapid vascular healing and low re-stenosis rate. Do you expect
Nanoparticle DES to play such a role as an ideal stent? |
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2. As you know, how to control glucose in hyperglycemic
AMI patients has always been a concern to physicians. However,
unlike to expectation, NICE-SUGAR study recently published that
there was not any benefit with intensive glucose control compared
to conventional control. Could you please share your perspectives
about how we could apply this result to a real practice? |
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3. Interventional cardiologists have been gradually
expanding their territory in the fields of structural heart
disease. Which way do you think the structural heart disease
intervention would grow into? |
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4. As a chairman of CRT which is one of the most
important interventional cardiology associations in U.S, please
give us your valuable comments or advices for TCT-AP. |
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