1055_Secemsky.pdf

1、Eric A.Secemsky,MD,MSc,RPVI,FACC,FAHA,FSCAI,FSVM Director|Vascular Intervention|Beth Israel Deaconess Medical CenterSection Head|Interventional Cardiology and Vascular Research|Richard A.and Susan F.Smith Center for Outcomes ResearchAssociate Professor of Medicine|Harvard Medical SchoolWHATS ON THE

2、HORIZON FOR BTK INTERVENTIONS?NYEVS 20252Funding:NIH/NHLBI K23HL150290,Food&Drug AdministrationGrants to Institution:Abbott/CSI,BD,Boston Scientific,Cook,Medtronic,PhilipsSpeaking/Consulting:Abbott/CSI,BD,BMS,Boston Scientific,Cagent,Conavi,Concept Medical,Cook,Cordis,Endovascular Engineering,Gore,I

3、nfraRedx,Medtronic,Philips,RapidAI,Rampart,R3,Shockwave,Teleflex,Terumo,Thrombolex,VentureMed and ZollDisclosures3Current Endovascular Treatment Options for BTK in the USAtherectomy Device variability Embolization Lack of dataAngioplasty Elastic recoil Restenosis Dissection Primary patency 20%-50%(T

4、ASC II)BMS Restenosis Permanent implant Short lengths Surgical re-interventionDCB Elastic Recoil Residual plaque Dissection Failed RCTsDES Permanent implant Short lengths Dissection Surgical reintervention1 Mustapha JA,et al.Circ Cardiovasc Interv.2016;9:e003468.DeviceDrug(inhibit NIH)Scaffold(minim

5、ize recoil)Leave nothing behindAngioplastyAtherectomyBMSDESDCBIdeal TreatmentIdeal Treatment1Only 1 BTK RCT has been successful for these alternative therapies to date Not many solutions for US patients4IN.PACT DEEP RCT358 CLI patients randomized 2:1 to DCB or PTAPrimary safety endpoint at 6 months

6、was freedom from death/amputation/TLRZeller et al.JACC 2014.5LUTONIX BTK RCT442 patients with IP disease randomized 2:1 to DCB or PTANo difference in all-cause death or amputation-free survival at 12 monthsFreedom from major amputation,CD-TLR or target-lesion occlusionFreedom from CD-TLR6We Have 1 W