EuroPCR 2022: Late-breaking Science Video Collection

Published: 13 May 2022

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Overview

Our regular review series View from the Thoraxcenter hosted by Prof Nicolas Van Mieghem and Dr Joost Daemen (Thoraxcentre, Erasmus MC, Rotterdam, NL) provide a concise analysis of the late-breaking science trials and spotlight questions that could change treatment strategies in interventional cardiology.

Short, accessible Expert Interviews will be available with select faculty focusing on the results, applicability, and impact on future research.

More from this programme

Part 1

View from the Thoraxcenter

In this concise episode of View from the Thoraxcenter, Prof Nicolas Van Mieghem and Dr Joost Daemen (Thoraxcentre, Erasmus MC, Rotterdam, NL) offer their take on the most anticipated late-breaking science form EuroPCR 2022.
2 sessions
EuroPCR 22 Late-breaking Science Preview Watch now
EuroPCR 22 Late-breaking Science Wrap-Up Watch now

Part 2

Expert Interviews

Short, accessible Expert Interviews with select faculty focusing on the results, applicability, and impact on future research.
19 sessions
EuroPCR 22: AQVA Study Shows Superiority in QFR-Based Virtual PCI Arm Watch now
EuroPCR 22: Patient-Level Pooled Analysis of Ultrasound RDN in radiance-HTN SOLO & Trio Watch now
EuroPCR 22: Optimize PRO Interim Analysis Finds New Technique is "Best-in-Class" Watch now
EuroPCR 22: MASTER-DAPT Sub-Analysis Shows Consistent Results in Complex PCI Patients Watch now
EuroPCR 22: CRUZ-HBR Indicates Use Of Supraflux™ Cruz Stent Is Favourable Watch now
EuroPCR 22: ASTRO-TAVI Shows Improved Neurological Outcomes With Neurointervention Watch now
EuroPCR 22: Short-Term Clinical Outcomes of ACURATE neo2™ Watch now
EuroPCR 22: DECISION QFR Shows Increased Practicability and Shorter Procedure Time for Revasc. Watch now
EuroPCR 22: SYNERGY™ Non-inferior to BioMatrix NeoFlex in OCT SORT-OUT VIII Watch now
EuroPCR 22: ROLEX Study Finds Promising Results in CAD Pts With the Resolute Onyx Watch now
EuroPCR 22: Balloon Vs Self-Expanding Valves in Valve-in-Valve TAVI Watch now
EuroPCR 22: MitraClip in Atrial Functional Mitral Regurgitation Watch now
EuroPCR 22: SCB with Micro-Reservoir Technology in Coronary Lesions Watch now
EuroPCR 22: FORWARD PRO Study Shows No Durability Issues After 3 Years Watch now
EuroPCR 22: DEB & DES in the Treatment of Diffuse CAD Watch now
EuroPCR 22: EASTBOURNE Registry indicates Satefy of Sirolimus-Coated Balloon Watch now
EuroPCR 22: JenaValve TAVR System for the Treatment of Aortic Regurgitation Watch now
EuroPCR 22: Transcatheter Tricuspid Valve Repair with PASCAL System Watch now
EuroPCR 2022: ALIGN-EFS Finds 100% Procedural Success Rate Using JenaValve Trilogy in Pts With AS Watch now

Faculty Biographies

Alfonso Ielasi

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Transcript

- Good morning. My name is Alfonso Ielasi I'm an Interventional Cardiologist working at Instituto Clinico Sant'Ambrogio Gruppo Ospedaliero San Donato, Milan Italy. And today I will talk about the results of the Hyper Study.

Study Rationale

Stent length is known to independently predict Restenosis and Stent Thrombosis. Based on this, it is reasonable to consider alternative strategy to manage Diffuse Coronary Artery Disease in order to limit stent length. So the use of a hybrid approach combining DES implantation and DCB inflation in diffuse disease could be an option in this kind of patients.

Hybrid Strategy With DES/DCB

So the definition of the Hybrid Strategy used in our study was as overlapping or slightly super imposing DES, new generation DES implantation in the proximal, more larger part of the vessel or at the main branch of a bifurcation. And when I talk about more larger, I mean segments with a reference vessel diameter superior than 2.75 mm. While the DCB target segment is located in the distal part of the vessel or at the side branch of a bifurcation with an LVD between 2 and 2.75 mm.

Study Design, Selection Criteria and Outcome Measures

So Hyper was a multicenter single arm pilot study. It was conducted in five Italian centres and the primary endpoint of the study was to assess the clinical outcome at one year. Primary endpoint was a device oriented composite endpoint of Cardiac Death, Target Vessel MI and Ischemia Driven TLR in the DES or DCB treated segments.

Key Findings

The one year DOC was 3.7% only related to the occurrence of ischemia driven TLR, which was 3.7%. The events were mostly related to TLR at the DCB target segments. No thrombosis were reported in both the DES or DCB target segments. So this study demonstrated the feasibility and effectiveness of this hybrid approach for the management of diffuse coronary artery disease.

Which Patients Would Benefit from the Hybrid Strategy

Well, each patient with diffuse coronary artery disease, and when I talk about diffuse coronary artery disease, I mean long lesions with lesion length more than 28 mm and bifurcation with an extension of the disease on the side branches of more than 10 mm. As I was saying before the DES target segment is located in the proximal, more larger part of the vessel. And when I talk about more larger, I mean with an reference vessel diameter superior than 2.75 mm while the DCB target segment is located in the distal part of the vessel or at the side branch of a bifurcation with a smaller reference vessel diameter. And when I talk about smaller, I mean between 2 and 2.75 mm.

Next Steps

So the next step will be to focus the use of this strategy for the treatment of very long lesions. So the HYPER-2 Study is ongoing, this is a multicenter international prospective registries where more than 500 patients will be enrolled in order to assess the clinical results following the use of this Hybrid approach for the treatment of very long lesions. And then in case of positive results in terms of visibility and safety, we will move to a direct head to head comparison versus a full metal jacket procedure with DES only. So DES only versus a hybrid approach.