TCT director: Interventional specialty expands to treat systemic vascular disease

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Gregg W. Stone, MD, co-director of the Transcatheter Cardiovascular Therapeutics (TCT). Image Source: Columbia University Medical Center  

The field of interventional cardiology has metamorphosed from the early era of balloon angioplasty through various device introductions, ultimately transitioning to the first stents, which led to the current, transformative era of drug-eluting stents. This evolution will be commemorated at this year’s Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, according to the association’s co-director, Gregg W. Stone, MD.

The 20th annual conference will open this Sunday, Oct. 12 in Washington, D.C., with a host of live demonstrations, clinical trials and presentations focused on interventional cardiology. “The real skill of interventional cardiology is to be able to understand the literature, understand the science and then, incorporate that data into the care of the individual patient,” Stone told Cardiovascular Business News. “Our specialty has the benefit of tremendous wealth of evidence-based medicine to guide our decisions.”

Stone pointed out that the most recent development in the interventional realm has moved beyond the treatment of coronary artery disease. In the last five to eight years, vascular disease has begun to be treated throughout the body with the carotid therapies, treatment for subclavian flap aortoplasty, as well as others, and recent emerging therapies for aortic stenosis and mitral regurgitation, “which may revolutionize the treatment of valvular disorders,” he added.  

This year’s TCT conference will focus on three main areas:

  • The treatment of coronary artery disease;
  • The treatment of structural heart disease; and
  • The treatment of endovascular disorders.

At the symposium, these foci will be harnessed for “the practice of medicine for physicians taking care of patients, as well as emerging and future therapies in the different areas with a strong emphasis on the dual-pathways of evidence-based medicine and the live case presentations,” Stone said.

He noted that several sub-themes have emerged from the collected abstracts and presentation topics: the treatment of multi-vessel disease in coronary disease with more data emerging from the SYNTAX trial; the treatment of acute MI with the unveiling of the HORIZONS-AMI and other late-breaking clinical trials revolving around the treatment of STEMI patients; as well as new data on valvular heart disease and vulnerable plaque.   

For cath lab directors and hospital administrators, the program offers the 10-year-running Nurse & Technologist Symposium, which “has multiple breakout workshops and presentations that discuss leadership principles and reimbursements concerns,” he noted.

And, due to the burgeoning concerns about the relationships between associations and industry, Stone said that TCT is particularly careful about ensuring that all its presenters declare any conflicts of interest.

“We continue to raise the bar for transparency,” he said. “There will be forums [during this year’s conference] where conflicts of interest will be discussed both in the Main Arena and in a lunchtime session led by Dr. Richard Popp from Stanford University, who runs the Conflicts Committee at Stanford University Medical Center. It is a topic that will be very openly addressed. Also, we think that we are the first organization to have the operators of the live cases acknowledge their conflicts.”

With a look toward the future of interventional cardiology, Stone said that the specialty is trending toward “increasing management of acute MI with an emphasis on process to speed time to reperfusion and increase access to interventional therapies in acute MI.”

He also said that following the SYNTAX trial, “more complex patients with multiple vessel disease and left main coronary disease will be treated with intervention, although SYNTAX will also provide insight into which patients should be more appropriately treated with bypass surgery.”

He added that there will be a plethora of data concerning the safety and efficacy of DES, including comparative studies.
 
“It’s a tremendously comprehensive meeting—six days of non-stop presentations,” he concluded.