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Cardiology Today’s Intervention Editorial Board Sounds Off on Top News of 2018
Experts discuss the most important intervention developments of the past year.
The recent furor over paclitaxel-based therapy for PAD, in which a meta-analysis showed a signal of late mortality associated with paclitaxel-coated balloons and stents, has raised concerns that will need to be addressed quickly, in order to better understand any potential downside. These devices are so prominent that this will dominate the airwaves for first half of the year.
Kenneth Rosenfield, MD, MHCDS
Massachusetts General Hospital
I believe that the top trends for 2019 will involve transcatheter therapies for valvular heart disease. I anticipate that MitraClip (Abbott) will play an increasingly important role in the treatment of patients with HF and secondary (functional) mitral regurgitation, that TAVR will show benefit in low-risk patients and its indications will expand and that the first successful transcatheter therapies for tricuspid regurgitation will be investigated.
Howard C. Herrmann, MD
Hospital of the University of Pennsylvania
With the recent publication of a meta-analysis suggesting increased mortality when drug-coated devices are used in patients with symptomatic femoropopliteal artery disease, there is a frenzy of concern about the use of these devices across the world. I anticipate a number of publications in the first quarter of 2019 that will shed more light on this subject, so that the practicing vascular specialist can make an informed decision for their patients.
Michael R. Jaff, DO
Newton-Wellesley Hospital
Harvard Medical School
The failure of non-culprit lesion PCI in cardiogenic shock to improve outcomes was the biggest surprise of the past year. It promises to significantly impact guidelines in shock, but more importantly, it colors how we view non-culprit lesion PCI in STEMI generally. If it is not effective in the sickest patients to save lives, why would it be effective in more elective circumstances?
Lloyd W. Klein, MD
Rush University Medical Center
Disclosures: Herrmann reports he received research support from Abbott Vascular, Bayer, Boston Scientific, Corvia, Edwards Lifesciences, Medtronic, and St. Jude Medical and consultant fees from Edwards Lifesciences. Jaff reports he is a consultant for Abbott Vascular, AOPA, Boston Scientific, Cordis, Medtronic, Micell, Primacea, Silk Road Medical, Vactronix, Venarum and Volcano/Philips and holds equity in Embolitech, Gemini, Janacare, MC10, Northwind Medical, PQ Bypass, Primacea, Sano V and Vascular Therapies. Klein reports no relevant financial disclosures. Rosenfield reports he has financial ties with Abbott Vascular, Access Vascular, Amgen, BIO2 Medical, Capture Vascular, Cardinal Health, Contego Medical, Cook Medical, Cordis, Cruzar Systems, Embolitech, Eximo, Endospan, Icon Interventional, InspireMD, Janacare, MD Insider, Micell Technologies, PQ Bypass, Philips, Primacea, Shockwave Medical, Silk Road Medical, SimSuite, Surmodics and Vortex Medical.