At TCT, DES Use and Safety Concerns: Irrational Exuberance or Irrational Anxiety?
Still feeling the reverberations of data released in Barcelona in September, this year's TCT meeting saw session after session on the risks of stent thrombosis from drug-eluting stents. While the data was clear--there is some risk, but not a lot--what to do about it was less clear. And the whole debate raises more questions than answers, for both interventionalists and cardiovascular device companies.
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The real story that came out of this year's Transcatheter Cardiovascular Therapeutics (TCT) meeting held in October in Washington, DC, is not the news per se regarding specific clinical trial results or new device technologies. Instead, it is the story behind the news. Interventional cardiology has been built on the back of evidence-based medicine. That methodology, however, has come under attack in the last year.
For the second year in a row, results from a clinical trial announced at the annual American College of Cardiology (ACC) conference appeared to be bad news for coronary stents. The outcomes from the COURAGE trial, announced at this year's ACC meeting in New Orleans at the end of March, found that angioplasty with stenting did not reduce the risk of major adverse cardiovascular events when added to optimal medical therapy.
Recent safety issues with drug-eluting stents may have opened the door ever so slightly for cardiac surgeons and coronary artery bypass graft (CABG) surgery to stage a small but noticeable comeback in the treatment of coronary artery disease.