JIM Today 2018 - Thursday - page 4

4
JIM today
Issue 1 
Thursday
 22 February 2018
Orsiro bioresorbable DES
‘superior’ according to new data
R
esults from a novel bi-
oresorbable drug-eluting
stent (DES) trial will be
laid bare during this afternoon’s
dedicated DES symposium, with
Ariel Roguin (Rambam Medical
Center, Haifa, Israel) relaying
superior outcomes when com-
pared to established gold-stand-
ard therapy.
Speaking to
JIM Today
, Dr
Roguin underlined that since the
introduction of DES, physicians
have tried to find a delicate bal-
ance between achieving a highly
effective result without compro-
mising the safety of the patient.
“First-generation DES were much
better then bare metal stents
[BMS],” he said. “They were able
to reduce restenosis, but these
stents – and especially the Cypher
[Cordis/Cardinal Health, USA] –
were bulky, with less flexibility,
and were not able to easily treat
every lesion.”
He added that the polymer
used in these first-generation
devices also posed a problem,
being suspected of causing
complications such as late-stent
thrombosis, and even increased
risk of cardiovascular events: “But
our community kept using them
after extensive research found
that their safety was as good as
BMS, if not better.”
During the development
of second-generation devices,
focus was placed on improving
and/or eliminating the polymer
component. Indeed, second-gen-
eration stents have established
a much more flexible and much
more user-friendly reputation,
explained Dr Roguin, along with
major improvements in polymer
composition, stent structure and
deliverability. “The clinical results
of these stents are excellent; they
are the stents most used today,
and implanted in thousands of
patients every day,” he said.
However, Dr Roguin added
that these devices still feature a
durable polymer which remains
on the stent for the duration of
its use, introducing some risk
of polymer-induced complica-
tions. With that in mind, interest
has gathered in bioresorbable
polymer technologies, with stud-
ies such as the BIOFLOW V trial
leading the way.
1
“BIOFLOW V enrolled a
complex patient population
representative of those treated
in clinical practice,” described Dr
Roguin. “Patients were included if
they had ischaemic heart disease
and an indication for PCI of up
to three de novo target lesions in
at least two target vessels, with
a reference vessel diameter be-
tween 2.25 mm and 4.0 mm, and
a visually estimated lesion length
of <36 mm.
“Among the 1334 randomised
patients (mean age 64.5 years,
~75% male), half presented with
an acute coronary syndrome,
36% had diabetes, and more
than a quarter had experienced
a prior MI. Important exclu-
sion criteria were patients with
acute ST-segment-elevation MI,
haemodynamic instability, chronic
total occlusions (CTOs), or bypass
graft disease.”
In the trial, patients were
randomly assigned (2:1) to either
the Orsiro (Biotronik, Germany)
ultrathin-strut (60 μm) bioresorb-
able polymer sirolimus-eluting
stent, or to the Xience (Abbott
Vascular, USA) durable polymer
everolimus-eluting stent. As Dr
Roguin explained, the Orsiro stent
gets its name from “oro” (gold)
and “siro” – short-hand for siroli-
mus, which is loaded on the stent
at a concentration of 1.4 µg/mm
2
.
The device comprises a L-605
cobalt-chromium stent, with a
PRO-Kinetic Energy platform – a
double-helix stent design with
thin struts, bringing flexibility and
ease of deliverability.
DES 1 
Manzoni 
Thursday 
12:45
“This is the first trial
that has demonstrated
superior outcomes
compared with the
Xience stent, which has
served as a benchmark
for drug-eluting
stents.”
Ariel Roguin
12.45 Lunch Symposia
Room Manzoni
DES 1
Room Foscolo
TAVI 1
Room Porta
CTO
Room Parini
INTRACORONARY IMAGING
Room Club
STRUCTURAL HEART 1
DES 1 – Room Manzoni
Chairpersons: Yaron Almagor, Carlo Briguori
12.45
Overview of new generation DES
Gregg W. Stone
12.55
Up to 5-year clinical outcomes of Orsiro in
complex lesions
Ariel Roguin
13.05
COMBO+ EPC Capture DES: beyond proven
concept to hard clinical evidence
Roxana Mehran
13.15
A new generation abluminal coated
Sirolimus Eluting Stent as a treatment
option for diabetic patients
Luca Testa
13.25
How to overachieve in a Left Main
Bifurcation: imaging, stent and technique?
Alessio La Manna
13.35
Cre8™ EVO: Establishing a new DES
benchmark for diabetic patients
Gennaro Sardella
13.45
Questions & Answers
TAVI 1 – Room Foscolo
Chairpersons: Marco Barbanti, Karl Heinz Kuck
12.45
What’s new in TAVI 2018
Martin B. Leon
13.00
A tale of two valves. Acurate and Lotus:
building a new chapter in TAVI
Lars Sondergaard
13.15
What should be the standard for TAVI today
and tomorrow?
Jonathan Michel
13.30
TAVI in bicuspid aortic valve disease –
Experiences from China
Yong-Jian Wu
13.45
Evolut PRO latest innovation in TAVI. A
workhorse device to treat all patients
Anna Sonia Petronio
14.00 Questions & Answers
CTO – Room Porta
Chairpersons: Roberto Garbo, Issam Moussa
12.45
What you need to know about
new CTO wires
Sunao Nakamura
13.00
Transferring CTO knowledge to
daily practice
Gabriele Gasparini
13.15
Revascularization strategies in CTO:
a case-based discussion
Joseph Dens
13.30
Complications during CTO
procedures
Jacopo Andrea Oreglia
13.45
A novel antegrade dissection/re-entry
technique for CTO-PCI
Mauro Carlino
14.00
Questions & Answers
INTRACORONARY IMAGING – Room Parini
Chairpersons: Carlo Di Mario, Ugo Limbruno
12.45
Calcific lesions: imaging for optimal lesion
preparation
Carlo Di Mario
13.00
The vulnerable patient. How to image, how
to treat
Ron Waksman
13.15
Stent optimization: how to use OCT and
IVUS
Enrico Romagnoli
13.30
Stent optimization: be careful with
the edges
Franco Fabbiocchi
13.45
Questions & Answers
STRUCTURAL HEART 1 – Room Club
Chairpersons: Lutz Buellesfeld,
Bernard Prendergast
12.45
Is it time to expand LAA indication?
Sergio Berti
12.55
Paravalvular leaks
Horst Sievert
Continued from page 2
Continued on page 6
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