Post-PCI assessment of coronary physiology
Dr. van Mieghem will present and moderate this webinar on post-percutaneous coronary intervention (PCI) physiology assessment.
The webinar is intended to educate the viewers on the concept of assessing the (intra-) coronary physiology after a lesion has been treated with an eligible stent device. Dr. van Mieghem will review the existing clinical evidence of this treatment strategy and also present the findings from the FFR SEARCH registry which was done in the Erasmus Medical Center (EMC) Rotterdam (the data was first presented at PCR 2017).
This webinar aims to critically discuss if Post-PCI fractional flow reserve (FFR) could potentially improve outcomes.
A clinical case will be presented which will highlight the procedural aspects of the physiologic assessment pre-PCI, intra-PCI and post-PCI assessment and intravascular imaging (IVUS).
Present the findings from the FFR SEARCH registry and introduce the follow-up trial: FFR REACT
- Findings FFR SEARCH
- Discuss imaging results to answer the question, 'what causes results?'
- Identify and discuss the benefits of using a microcatheter
Nicolas M Van Mieghem
This webinar is supported by:
Key Learning Objectives
- Understand more about post-PCI physiology
- To learn about microcatheter-based post-stent FFR procedures
- To learn about post-PCI intravascular imaging in high-definition
- To learn about the clinical evidence of Post-PCI FFR
- Interventional Cardiologists
- Assistant Cathlab personnel (Nurses, Technicians, Radiographers)
Nicolas M Van Mieghem
From an early age, Professor Nicolas Maria Van Mieghem decided to pursue a career that would help others. “I enjoy the feeling of being able to help someone or do something important for them. I wanted to enter a profession that would channel my energy— I was always a busy child,” he says.
A budding athlete, he was a member of Belgium’s national swimming team but soon realized that medicine was his true calling. His father was a general cardiologist and one of his biggest influences early in his career.
Professor Van Mieghem initially intended to train as a cardiac surgeon but decided to specialise in interventional cardiology instead, following advice from a mentor. This decision was cemented when he read the first-in-human case report of transcatheter aortic valve implantation (TAVI) in Circulation by Alain Cribier in 2002.
His mantra is mens sana in corpore sano (a healthy mind in a healthy body). He remains an avid swimmer and cyclist and follows a number of professional sports. “Like all Belgians, I love to watch the big cycling events—the classic cycle races, the Tour de France, the Giro d’Italia, the Vuelta a España,” he says.
Van Mieghem believes that a great cardiologist genuinely cares for their patients. He names Gary Roubin, Dr Manu Malbrain and Professor Patrick Serruys among his mentors.
In 2007, Professor Van Mieghem obtained his medical and cardiology degrees at the Catholic University of Leuven, Belgium. He completed fellowships in interventional cardiology in Ziekenhuis Oost-Limburg Genk, Belgium, Lenox Hill Hospital, New York, US and Erasmus Medical Center, Rotterdam, the Netherlands.2 His PhD focused on transcatheter valve therapies.3
His current research focuses on cerebral embolic protection during TAVI and the search for improved large bore closure devices. He works actively in expanding TAVI indications, most notably TAVI as a means to further unload the left ventricle in heart failure patients with moderate aortic stenosis (the TAVR UNLOAD trial). Professor Van Mieghem is also involved in the development and dispersion of mechanical circulatory support (MCS) devices as well as transcatheter mitral and tricuspid repair techniques. In terms of imaging and preprocedural planning, his research has covered computed tomography (CT)-derived 3D modelling and printing.
Professor Van Mieghem has received institutional research grant support from Abbott Vascular, Boston Scientific, Edwards Lifesciences, Medtronic, Daiichi-Sankyo, PulseCath BV and Abiomed.7
After his fellowships, Professor Van Mieghem joined the department of interventional cardiology at the Thorax Centre, Erasmus Medical Center, as a senior staff member in February 2010. He is now working there as a Full Professor of Interventional Cardiology.2
As well as his involvement in the percutaneous coronary interventions and structural heart programs, he has published and co-authored over 350 scientific papers in peer-reviewed journals.4 Professor Van Mieghem is a principal investigator and steering committee member in multiple ongoing international trials, evaluating various coronary and transcatheter valve technologies.3 He is a Fellow of the European Society of Cardiology (FESC) and is currently Medical Director of the department of Interventional cardiology at the Thorax Centre.3
- 2008 - 2009: Fellow, Interventional Cardiology, Lenox Hill Hospital
- 2010: Joined the senior staff, Interventional Cardiology, Thorax Centre, Erasmus MC
- 2014: Clinical Director, Interventional Cardiology, Erasmus MC
- 2019 - Present: Full Professor, Interventional Cardiology, Erasmus MC
- Present: Medical Director, Interventional Cardiology, Thorax Centre
Areas of Speciality4
- Interventional Cardiology
- Transcatheter Heart Valve Interventions
Prof Van Mieghem is on the ICR3 Editorial Board.
Dr Joost Daemen, MD, PhD obtained his degree in medicine at the Erasmus University Medical Center, Rotterdam in 2005 and did 2 years of internal medicine training and 4 years of general cardiology training at the Thoraxcenter, Rotterdam.
Dr Daemen is actively involved in several drug-eluting stent trials and is Principal Investigator of 4 trials focusing on the safety and efficacy of renal sympathetic denervation in hypertension, heart failure, vasospastic angina and heart failure. Dr Daemen is a member of the editorial board of EuroIntervention and the Netherlands Heart Journal, member of Young ICIN, and has completed courses in biomedical statistics and device training.
1. Briguori C, Nishida T, Adamian M, et al. Assessment of the functional significance of coronary lesions using a monorail catheter. J Invasive Cardiol 2001;13:279–86. PMID: 11287712.
2. Diletti R, on behalf of the Thoraxcenter Investigators: van Bommel R, Masdjedi K, van Zandvoort L, et al. Routine fractional flow reserve measurement after percutaneous coronary intervention: the FFR-SEARCH study. Presented at: EuroPCR, May 18 2017, Paris, France.
3. Diletti R, Van Mieghem NM, Valgimigli M, et al. Rapid exchange ultra-thin microcatheter using fibre-optic sensing technology for measurement of intracoronary fractional flow reserve. EuroIntervention 2015;11:428–32. DOI: 10.4244/ eijy15m05_09; PMID: 26013582.
4. Fearon WF, Chambers JW, Seto AH, et al FFR: Trials and new techniques. Primary Results of the Assessment of Catheter based Interrogation and Standard Techniques for Fractional Flow Reserve Measurement Study: The ACIST-FFR Study. Presented at: EuroPCR, May 16-19 2017, Paris.
5. Habib Samady, MD, Michael McDaniel, MD, Emir Veledar, PHD, Bernard De Bruyne, MD, PHD, Nico H. Pijls, MD, PHD, William F. Fearon, MD, Viola Vaccarino, MD, PHD* Baseline Fractional Flow Reserve and Stent Diameter Predict Optimal Post-Stent Fractional Flow Reserve and Major Adverse Cardiac Events After Bare-Metal Stent Deployment
6. Menon M, Jaffe W, Watson T, et al. Assessment of coronary fractional flow reserve using a monorail pressure catheter: the first-in-human ACCESS-NZ trial. Euro Intervention 2015;11:257–63. DOI: 10.4244/eijv11i3a51; PMID: 26196752.
7. Nico H.J. Pijls, Volker Klauss, Uwe Siebert, et al. Coronary Pressure Measurement After Stenting Predicts Adverse Events at Follow-Up: A Multicenter Registry, Circulation 2002;105:2950-2954; originally published online May 28, 2002; https://doi.org/10.1161/01.CIR.0000020547.92091.76.
8. Wolfrum M, Fahrni G, de Maria G, et al. Impact of impaired fractional flow reserve after coronary interventions on outcomes: a systematic review and meta-analysis, BMC Cardiovascular Disorders 2016 16:177, https://doi.org/10.1186/s12872-016-0355-7
9. Piroth Z, Toth G, Tonino P, et al. Prognostic Value of Fractional Flow Reserve Measured Immediately After Drug-Eluting Stent Implantation, Circulation: Cardiovascular Interventions 2017;10:e005233, https://doi.org/10.1161/CIRCINTERVENTIONS.116.005233