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TCT 2018: Reflecting on 30 Years of Innovation
The meeting features highly anticipated trials as well as new training opportunities.
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At this year’s Transcatheter Cardiovascular Therapeutics Conference, being held Sept. 21 to 25 in San Diego, attendees will hear the results of long-awaited clinical trials and have the opportunity for hands-on training that will help them translate cutting-edge science to clinical practice.
With 15 Late-Breaking Clinical Trials and 12 Late-Breaking Clinical Science studies spanning all areas of interventional cardiology, the meeting offers insight into important unanswered clinical questions in all areas of the specialty.
“Because this is the 30th anniversary of TCT, we’re also going to be looking at the past, present and future to see how TCT has reflected the evolution of this subspecialty,” Gregg W. Stone, MD, professor of medicine at Columbia University and director of cardiovascular research and education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center, said in an interview. Stone is a TCT course director and a member of the Cardiology Today’s Intervention Editorial Board.
New Research Generates Enthusiasm
The COAPT trial is expected to attract a significant amount of attention, according to Stone, who is one of the study’s primary investigators. The randomized trial evaluating the MitraClip (Abbott Vascular) in patients with secondary mitral regurgitation and HF who remain symptomatic despite maximally tolerated guideline-directed medical therapy is highly anticipated because “there is a tremendous unmet clinical need in how to improve prognosis” in these patients, he said.
Stone highlighted two other structural heart disease trials — REDUCE-FMR and SOLVE-TAVI — that are also likely to garner interest. REDUCE-FMR is a sham-controlled study of the Carillon Mitral Contour System (Cardiac Dimensions) in mitral regurgitation and SOLVE-TAVI, a 2x2 factorial, randomized trial, is looking at self-expandable vs. balloon-expandable valves as well as general anesthesia vs. local anesthesia in patients undergoing transcatheter aortic valve replacement for severe aortic stenosis.
There are also large-scale randomized studies comparing different drug-eluting stents, including ultra-thin metallic strut DES and polymer-free metallic DES. There are more studies of the Absorb Bioresorbable Vascular Scaffold System (Abbott Vascular), “which is still drawing tremendous scientific attention because many people think BVS are the future of DES technology,” Stone said.
ULTIMATE, a large-scale randomized trial of IVUS guidance in patients undergoing DES implantation, and LRP, a controlled registry focusing on whether near-infrared spectroscopy can predict and identify patients who are likely to experience future events such as cardiac death and MIs in ACS, are among the important imaging late-breaking trials being presented.
In the endovascular space, IMPERIAL, which is a randomized trial of two different DES for treatment of femoral popliteal artery disease, is also interesting because “there have been very few large-scale comparative studies in the peripheral artery disease space,” Stone said.
The three-arm, randomized RADIOSOUND-HTN trial of different renal denervation devices and techniques for resistant hypertension will also be of interest to many attendees, Stone noted.
Hands-on Learning
One major innovation is the TCT 2018 Interactive Training Workshops on-site. The “training destination” area, which will be about half the size of the exhibit hall, will contain eight separate large and comprehensive training pavilions.
“At TCT, people learn from the more than 1,000 abstracts presented and watching live cases, but they don’t have the chance for much hands-on learning,” Stone said. “This year, we’ve decided to tackle that through the creation of the Interactive Training Workshops.”
The Interactive Training Workshops will offer attendees the chance to work with simulators, cadaver samples, models or actual cath lab equipment so they can learn how to do the procedures, such as TAVR, atherectomy, advanced imaging interpretation, pedal or radial access, or other complex techniques, discussed at the meeting, he said.
Major Themes
In addition to hands-on learning, the meeting will reflect on the past, identify remaining challenges and what the future holds, according to Stone.
Furthermore, it will recognize the contributions of everyone involved in the evolution of the field, he noted.
“Interventional cardiology is such a multifaceted, varied subspecialty that requires so many different types of stakeholders, including physicians, nurses, technicians and allied health personnel. However, there is also a reliance on industry, regulators, media and more,” Stone said. “They’re all required to make things work, so there will be in-depth discussion of those issues.”
This is probably most reflected by the fact that this year’s career achievement award is being given to Bram Zuckerman, MD, director of the cardiovascular devices division of the CDRH at the FDA, Stone noted.
“It’s meant to reflect on his 30 years of service and recognize what he and the entire FDA have meant to the advancement of improved outcomes for patients with CVD,” he said. – by Melissa Foster
Disclosure: Stone reports he has financial ties with various pharmaceutical and device companies. He is co-director of medical research and education at the Cardiovascular Research Foundation.