Post-PCI assessment of coronary physiology

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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).

Primary Objectives:

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

Moderated By:

Nicolas M Van Mieghem

Nicolas M Van Mieghem

Joost Daemen

Joost Daemen

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

Target Audience

  • Interventional Cardiologists
  • Assistant Cathlab personnel (Nurses, Technicians, Radiographers)

Faculty Biographies

Nicolas M Van Mieghem

Nicolas M Van Mieghem

Dr Nicolas M Van Mieghem obtained his medical degree and cardiology degree at the Catholic University of Leuven, Belgium. After subsequent fellowships in interventional cardiology in Ziekenhuis Oost-Limburg Genk, Belgium, Lenox Hill Hospital, New York, US and Erasmus Medical Center, Rotterdam, the Netherlands, he joined the department of interventional cardiology at the Thoraxcenter, Erasmus Medical Center, as a senior staff member in February 2010. 

He is involved in the percutaneous coronary interventions and structural heart program. He obtained the degree of PhD based upon his research in transcatheter valve therapies. So far he has published and co-authored approximately 130 scientific papers in peer-reviewed journals. 

Dr Van Mieghem is principle investigator and steering committee member in multiple ongoing international trials evaluating various coronary and transcatheter valve technologies. He is a Fellow of the European Society of Cardiology and is currently Medical Director of the department of Interventional cardiology at the Thoraxcenter.

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Joost Daemen

Joost Daemen

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.

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Key References

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

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