It has been an exciting — and at times tumultuous — year in interventional cardiology. There were many developments in the field of intervention, from coronary to structural to peripheral and beyond. At the end of 2017, we asked the Cardiology Today’s Intervention Editorial Board to reflect on the year and make their predictions for the top trends and areas to watch in intervention for 2018.
One area of intervention to note is the recent data that came out about bioresorbable vascular scaffolds, including concerns of stent thrombosis. While there remains promise with several different types of BVS, the initially approved first-generation BVS (Absorb and Absorb GT1, Abbott Vascular) were removed from the market in 2017 due to low commercial sales. Hopefully this rocky start to the BVS experience will not dampen enthusiasm about future potential.
In the structural area, the year was notable for future refinement in transcatheter aortic valve replacement, with outcomes improved and the eligible population continuing to expand. More data have emerged with respect to left atrial appendage closure with percutaneous devices; however, questions remain regarding the ideal potential target population for this therapy. Inroads have been made into percutaneous mitral and tricuspid valve replacement. A number of trials looking at mitral valve replacement were presented at TCT 2017 and showed positive findings. These are likely going to be future areas of growth.
Drug-coated balloons appear to be a major advancement in both peripheral and coronary intervention. In situations where stent deployment may be undesirable, such as flexion points in the leg and in coronary arteries where there is drug-eluting stent restenosis and a desire to avoid additional layers of metal, DCBs are very attractive choices. The data for DCBs are growing rather quickly and hopefully we will have many more options available in the United States relatively soon. We have also seen advances in peripheral arterial and venous techniques, with a growing appreciation of how much commonality there is among different interventional approaches.
Finally, advances in imaging continue, with particular interest in hemodynamic assessment of coronary artery lesions, which continues to amass data and gain traction in clinical practice.
This issue of Cardiology Today’s Intervention focuses on updates in a number of the areas described above. What were your highlights from 2017 and what are you looking forward to in the new year? Let us know your thoughts by emailing the Editors at firstname.lastname@example.org.
— Deepak L. Bhatt, MD, MPH
Chief Medical Editor
Cardiology Today’s Intervention