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What makes TAVI in bicuspid aortic valve disease so challenging—and how can those challenges be overcome?
In this #europcr 2025 expert discussion, Chiara De Biase, Kentaro Hayashida, and Didier Tchetche share practical insights on navigating anatomical variability, refining patient selection, and optimising valve sizing.
They also address the critical role of calcification and how it can influence procedural outcomes. Whether you're performing TAVI in complex cases or building your expertise, this conversation offers valuable takeaways you won’t want to miss!
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Listen to this #europcr 2025 interview to see Giuseppe Di Gioia and Jens Flensted Lassen as they break down the essentials of the provisional strategy for non-left main true bifurcation lesions.
This approach offers a stepwise and adaptable treatment path: start with one stent in the main vessel, with the option to implant a second if needed.
They highlight the importance of proximal optimisation, techniques to protect the side branch, and how imaging can support each step. The discussion also touches on the potential role of drug-coated balloons to limit metal use in the bifurcation segment.
Get practical tips and key considerations to make the most of this streamlined yet versatile strategy.
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Howard Herrmann and Raj Makkar discuss valve under-expansion in the ACURATE neo2 from the IDE trial sub-study.
Fluoroscopy showed about 22 % of valves were under-expanded, often linked to heavy calcium buildup. These valves had worse outcomes, including higher rates of death and stroke.
What’s behind this issue, and how can it be prevented?
Listen to their #europcr 2025 discussion to learn more!
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Robert Byrne and Bruno Scheller discuss drug-coated balloon (DCB) angioplasty at #europcr 2025. Nearly 20 years after its introduction, where does DCB angioplasty stand today? When and how should it be used in daily practice?
Discover what defines adequate lesion preparation for a DCB strategy in de novo disease, the role of intravascular imaging in deciding when to use DCB, and best practices for managing dissections.
Plus, get insights on upcoming data and the future of drug-coated balloon angioplasty.
Listen to this episode to get all the answers!
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In this #europcr 2025 interview, Tanja Rudolph, Dan Blackman, and Radoslaw Parma explore the crucial aspects of repeat transcatheter valve replacement.
They dive into the risks of coronary obstruction, the importance of preserving coronary access, and strategies to optimise hemodynamics despite higher residual gradients. The discussion also covers how the index TAVR device impacts outcomes and why CT screening is essential in planning.
Tune in to get a clear picture of the current evidence and what new data is just around the corner.
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Tiffany Patterson, Nicolas Van Mieghem, and Philippe Généreux reveal the hottest emerging TAVI indications for 2025 in this #europcr 2025 discussion.
They review key trials on asymptomatic severe aortic stenosis—RECOVERY, AVATAR, ONLY TAVR, and EVoLVeD—which show early TAVI or surgery reduces hospitalisations for heart failure and suggests lower mortality and stroke compared to clinical surveillance.
The discussion then moves to symptomatic moderate aortic stenosis, highlighting the recent TAVR UNLOAD study in heart failure patients with reduced ejection fraction.
They also touch on the PROGRESS and EXPAND II trials, and share early insights on new devices for aortic regurgitation, now entering randomised comparisons with surgery.
Listen now to stay ahead on the expanding role of TAVI.
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When should TAVI be performed—and how should coronary disease be managed in these patients?
Liesbeth Rosseel, Davide Capodanno, and Michael Joner explore two key questions shaping the future of TAVI. They highlight findings from the EARLY-TAVI trial, which shows that early intervention in asymptomatic patients with severe aortic stenosis significantly reduces rehospitalisation. Then, they turn to the NOTION-3 trial, comparing PCI vs medical therapy for CAD prior to TAVI—revealing a benefit in reducing MACE, though at the cost of increased bleeding.
The message is clear: earlier may be better, and managing CAD is increasingly important in the TAVI landscape.
Hear what could reshape tomorrow’s practice!
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Simon Redwood interviews John Forrest, principal investigator of the Evolut Low Risk Bicuspid Study, during #europcr 2025.
As TAVR moves into younger patients—many with bicuspid valves—questions remain about how well the procedure performs in this anatomy, which was excluded from earlier trials.
In this exchange, they review the study design, patient selection, and main outcomes, and compare results with the original Evolut Low Risk study.
The performance of the Evolut platform in bicuspid valves may even prove superior to tricuspid cases—though long-term follow-up is essential.
Valve thrombosis is also on the table.
Listen to this episode now to explore the current data and what’s still to come!
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In this #europcr 2025 interview, Davide Capodanno and Woong Chol Kang explore the latest insights from the 4D-ACS trial and what it could mean for antithrombotic therapy in patients with acute coronary syndrome.
They discuss who was included in the trial and walk through the two de-escalation strategies that were tested: reducing the number of the drugs, from dual antiplatelet therapy to single antiplatelet therapy, and lowering the prasugrel dose from 10 mg to 5 mg.
Finally, they highlight the key findings that could help refine clinical practice.
Listen now to get up to speed in just a few minutes.
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What’s the best approach for STEMI patients with multivessel disease? Angela Mcinerney, Natalia Pinilla, and Matthias Götberg share their perspectives on how practice has evolved, with a focus on the COMPLETE trial and its intracoronary imaging substudy.
They discuss what imaging reveals about non-culprit lesions, how it may influence treatment, and how these insights are applied in daily cathlab workflows.
The conversation also touches on expectations from the upcoming COMPLETE-2 trial.
Listen now for expert views on a common but complex cathlab scenario.
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In this #europcr 2025 video, Nicola Ryan speaks with Dejan Milasinovic about when and how to adopt an upfront two-stent strategy in bifurcation PCI.
The key is assessing the side branch: if stenosis is high-grade and disease is extensive, treatment may be needed from the start—using POBA, a DCB, or a second stent. Anatomy should guide the choice between a provisional or two-stent approach.
Intracoronary imaging is essential to detect issues like abluminal rewiring and stent distortion, especially when treating the side branch. As highlighted by the OCTOBER trial, proper rewiring and final stent architecture are crucial to reduce the risk of long-term complications.
Find out how to tailor your approach to each bifurcation scenario.
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In this #europcr 2025 discussion, Mayra Guerrero, Thomas Modine, and Philipp Lurz share their views on the evolving landscape of mitral valve treatment.
While transcatheter edge-to-edge repair (TEER) remains a safe and effective approach, it doesn’t work for every patient. That’s why alternatives like TMVR, annuloplasty, or NeoChords—all currently under investigation—are generating attention.
The field is moving toward transseptal, transcatheter options that may deliver better reduction of mitral regurgitation, along with improved symptoms and quality of life. They offer the added advantage of allowing future valve-in-valve procedures if needed.
Should a strong mitral program combine both repair and replacement? How do we decide between the two?
There are still challenges—but innovation is pushing the field forward.
Listen now and get a glimpse of what’s next for mitral therapies!
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Calcified bifurcation lesions remain one of the toughest challenges in interventional cardiology, combining two high-risk features into one complex scenario.
In this #europcr 2025 interview, Dejan Milasinovic, Miroslaw Ferenc, and Mohamed Abdel Wahab explore why this topic deserves special attention.
They break down how intra-coronary imaging can guide the approach, help tailor strategy, and ultimately improve outcomes. Discover how to move beyond anatomy alone - by factoring in the patient’s clinical profile and procedural context - to find a strategy that’s not only effective, but also simple and safe.
Listen to this eppisode now to sharpen your approach to one of the most demanding lesion subsets in daily practice.
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How effective is cerebral protection during TAVI?
Bernard Prendergast and Rajesh Kharbanda take a deep dive into this key procedural question, reviewing the latest evidence from two major randomised trials—PROTECTED TAVR and BHF PROTECT-TAVI.
Although both studies individually failed to demonstrate a clinical benefit for cerebral protection devices, a new patient-level meta-analysis presented at #EuroPCR2025 offers fresh insights.
Listen to this episode now to understand how aligning endpoints and patient profiles has helped uncover new signals that could shape future practice.
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In this exchange, Vijay Kunadian and Javier Escaned explore the real-world implementation of INOCA (Ischemia with Non-Obstructive Coronary Arteries) and ANOCA (Angina with Non-Obstructive Coronary Arteries) diagnostic pathways. Drawing on the 2024 CCS (Chronic Coronary Syndromes) guidelines, and the EAPCI consensus document, they discuss why these conditions remain underdiagnosed—and how structured invasive assessment can make a difference, even in time-constrained clinical environments.
This conversation offers practical insights for improving patient care by refining diagnosis and treatment strategies in cases where traditional imaging may fall short.
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At #EuroPCR2025, Martine Gilard, Antonio Mangieri, and Marco Barbanti share their perspectives on managing coronary artery disease in patients scheduled for TAVI.
Is coronary angiography always necessary? When should PCI be performed—before, during, or after the procedure? And how do you decide?
Tune in for a practical exchange on strategy, timing, and patient selection!
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Nicola Ryan and Flavio Ribichini discuss the challenges of treating the calcified left main stem. They break down the complexities of this high-risk condition and highlight the role of mechanical circulatory support in everyday practice. They focus on the role of intracoronary imaging as a game-changer and examine the use of one versus two stents, outlining cases where two stents may be necessary.
Key takeaways
1. Calcified left main stem disease is complex but can be simplified with the right tools.
2. Intravascular imaging is crucial for accurate assessment and treatment planning.
3. A careful, step-by-step approach leads to the best angiographic results.
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What does the PREVENT trial tell us about managing vulnerable plaques?
Recorded during #europcr 2025, this discussion features Michael Haude and Thomas Cuisset as they review key insights from this major study of over 1,600 patients with physiologically non-significant but vulnerable plaques identified by intracoronary imaging—mainly IVUS.
Patients were randomised to receive either optimal medical therapy (OMT) alone or combined with preventive PCI, and followed over several years. While the composite endpoint favored the PCI group, the benefit was driven solely by a reduction in target lesion revascularisation—without differences in death or myocardial infarction.
Should PCI be systematically performed in such cases? Tune in for a nuanced expert perspective!
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Stephan Windecker and Flavio Ribichini review the outcomes of the FAITAVI trial, presented during the #europcr 2025 LBT session.
As coronary artery disease is the most common cardiac comorbidity in patients undergoing TAVI, the trial set out to evaluate whether physiology-guided decision-making could offer better clarity.
When performing diagnostic angiography before TAVI, clinicians often find intermediate coronary lesions that don’t obviously require revascularisation — so what's the right strategy in these cases?
FAITAVI is the first randomised trial comparing angiography-guided versus FFR-guided PCI decisions in the TAVI setting. Learn more about the study design, inspired by FAME-1, and how the results support the feasibility and value of FFR measurements in patients with CAD undergoing TAVI. The data also confirm that intermediate lesions can safely be left untreated.
Listen to this episode now to understand how these findings could change practice!
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Cleverson Zukowski and Pablo Lamelas take a moment during #europcr 2025 to shed light on a major regional milestone: the first-ever guidelines for the treatment of left main disease, issued jointly by the Latin American Society of Interventional Cardiology (SOLACI) and the Interamerican Society of Cardiology (SIAC).
Why were these guidelines created specifically for Latin America? What are their key recommendations? And how can they be applied in day-to-day practice, especially when deciding between PCI and surgery?
Tune in to hear how these guidelines reflect the region’s unique healthcare challenges and may help tailor treatment to the specific needs of Latin American patients.
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