TCTMD’s Top 10 Most Popular Stories for April 2018

April 2018 brought a diverse line-up of top stories to TCTMD. Device news—both on “classic hits” like PCI and TAVR as well as more novel therapies like a coronary sinus reducer for refractory angina—dominated this month. ORBITA also continued to hold our readers’ attention, with word spreading at the Society for Cardiovascular Angiography and Interventions (SCAI) 2018 Scientific Sessions that 85% of the trial’s sham arm opted for PCI when the study ended. Stories related to physiological assessment and mechanical circulatory support round out the list, as did news that Laura Mauri, MD, is headed to Medtronic.

ORBITA Continues to Surprise: 85% of Sham Arm Opted for PCI When Trial Ended

A discussion at SCAI 2018 tackled lingering ORBITA issues, with experts finally grasping a detail the PI says she’s been emphasizing from the outset.

Positive Real-World Results for Coronary Sinus Reducer in Patients With Refractory Angina

“It’d be nice to have this as an option, because I do think there are some patients out there that probably could benefit from this,” one expert says.

Device Thrombus After LAA Closure Strongly Linked to Stroke in Real-World Registry

Patients who can tolerate it should receive DAPT or oral anticoagulation after closure, because it likely lowers thrombus risk, one expert said.

Delayed Coronary Obstruction After TAVR: Prevalence, Causes, and Solution Explored for Deadly Complication

Experts say obstructions, while rare, need to be taken seriously as TAVR moves into lower-risk patients. The BASILICA procedure may help.

Impella Use in Acute MI and Cardiogenic Shock: Clues From US Registry Data

A nonrandomized, Abiomed-sponsored study highlights higher center volume, first-line use, and invasive hemodynamic monitoring as keys to better survival.

iFR Pullback Provides Roadmap for CAD Severity, Predicts Hemodynamics Post-PCI

In lesions not typically well characterized with FFR or angiography, iFR offers clues on which to treat and how much treating them will matter.

Less Bleeding, Similar Outcomes With Dual vs Triple Therapy After PCI in Patients With A-fib

A new meta-analysis adds further support to concerns that triple therapy may not be the safest strategy in this situation and offers no added efficacy.

Prominent Investigator Takes Post at Medtronic as Pivotal Renal Denervation Trial Is Announced

Laura Mauri, MD, will be the new VP for global research at the company, which just got the FDA’s go-ahead for its pivotal test for the Symplicity Spyral catheter.

Fewer Complications, Lower Risk of Death With Conscious Sedation for TAVR

Local anesthesia during TAVR should be the default strategy for experienced heart teams, say experts, although sedation choice should be individualized.

My Takeaways From ACC 2018: Everyone Missing From Clinical Trials, Please Stand Up

Are clinical trials in cardiology doing any better at enrolling women? Minorities? Nanette Kass Wenger, MD, thinks this is an idea whose time has come.