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EuroPCR 2015 news tips: Treatment delays, radial ‘paradox,’ transcatheter valves, and more

1. The “Radial Paradox”: Higher Femoral Access Site Offsets Radial Benefits

Growing acceptance of radial access during to reduce access site complications may contribute to a loss of experience with femoral access, potentially increasing when the femoral technique is used. researchers compared contemporary and historical patient cohorts (n=17,059) and found that vascular access complications today, using the approach–used typically as a back-up method–are more common than before radial access was introduced. This, in turn, offsets the benefit of radial access at a population level since patients in the contemporary cohort (radial + femoral) suffered more than those in the historical cohort. Trainees and default radial operators should acknowledge the “Campeau Radial Paradox” –named after radial pioneer Lucien Campeau–and take appropriate action, investigators say.

CONTACT: Dr. Lorenzo Azzalini, Montreal Heart Institute and , CANADA [email protected]

Abstract: EURO15A-OP203
Date: Wednesday May 20, 10:30, Room Ternes 1 AND Wednesday May 20, 11:08, Room 253*

*As one of the abstracts featured in “PCRs Got Talent,” this presentation may also make it to the second round, Thursday May 16:50-18:20 and final round, Friday 9:00-10:00, both in Room 253.

2. Most Non-Culprit Vessels with Significant Stenosis Not Functionally Important: FFR Study

Controversy exists surrounding the benefits/risks of reopening all significantly blocked (“stenotic”) vessels during primary angioplasty for heart attack, or simply reopening the “culprit” blocked artery responsible for the MI and treating the others at a later date, or leaving them be. An ongoing study, COMPARE-ACUTE, is using fractional flow reserve (FFR) technology to assess whether or not a vessel blockage seen on angiography has a functional effect on the heart (by impeding oxygen flow). Preliminary findings from the trial show that more than 50% of non-culprit arteries deemed to have significant stenosis are not functionally significant by FFR, a finding that will no doubt increase the debate as to whether and when to intervene on non-infarct-related arteries.

CONTACT: Dr. Elmir Omerovic, Sahlgrenska University Hospital, Gotheborg, SWEDEN [email protected] (First author Dr. Peter Smits, Maasstad Hosptial, Rotterdam)

Abstract: EURO15A-OP024
Date: Wednesday May 20, 11:00, Room 253 AND Friday May 22, 9:39, Room 242B*

*As one of the abstracts featured in “PCRs Got Talent,” this presentation may also make it to the second round, Thursday May 16:50-18:20 and final round, Friday 9:00-10:00, both in Room 253.