EuroPCR Highlights: CoStar Fizzles, Xience Sizzles
With a record attendance last month in Barcelona, the annual EuroPCR meeting gathered cardiologists from around the globe for live training sessions, challenging case reviews, trial updates, and data on rapidly evolving new technologies. Drug-eluting stents were high on the agenda with interesting data, but transcatheter heart valve replacement also generated significant interest with packed sessions and busy booths.
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Although safety concerns about drug-eluting stents have been mitigated somewhat by recent reports of more positive clinical data, there is lingering unease and confusion in the cardiology community about when, how, and in whom to use these devices. There is also a growing wave of healthy skepticism about the way stent trials are designed and conducted, and whether evidence- based medicine is well served by the current process.
The drug-eluting stent is the rare cardiovascular device that has seen large companies dominate not just sales and distribution channels, but product development as well. But this big company dominance/small company exclusion in DES seems to be reversing itself, at least in part, if vibes from this year's PCR are to be trusted. Over the past half year or so, a series of newly released and much debated clinical studies, including BASKET-LATE and the Swedish DES registry SCAAR, have focused attention on DES safety issues, highlighting a small but meaningful risk of late-stent thrombosis, while the COURAGE trial has even pointed to efficacy concerns of percutaneous interventions, generally speaking. And that's opened the door to dozens of small and mid-sized companies that suddenly find themselves in the enviable position of seeing market and clinical pressures accelerating demand for quick development of their technologies.
Heart valve replacement and repair has long been the exclusive province of surgeons. The percutaneous heart valve sector, including both aortic and mitral, has been among the hottest device areas for investors and entrepreneurs over the past few years. CoreValve was founded b a surgeon who is using his understanding of valve anatomy to develop a percutaneous aortic valve replacement (PAVR) device that can be used by interventional cardiologists.