Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-048

Device Success Algorithm of the European Association of Percutaneous Cardiovascular interventions (EAPCI) Prospectively Applied to the Pioneer IV Trial

By Asahi Oshima, Tsung-Ying Tsai, Joanna Wykrzykowska, Faisal Sharif, Liesbeth Rosseel, Mohammad Alkhalil, Edouard Benit, Nick Curzen, Vincent Flore, Kenneth De Wilder, Valeria Paradies, Giovanni Amoroso, Sjoerd Hofma, Adel Aminian, Clemens von Birgelen, Manel Sabate, Victor Jimenez Diaz, Ignacio Amat Santos, Jeroen Sonck, Anthony Mathur, Lionel Mangin, Mathieu Pankert, Gilles Barone-Rochette, Julien Lemoine, Michael Angioi, Raymundo Ocaranza, Julien Adjedj, Albert Chinhenzva, Shiuan-Hao Hu, Emelyne Sevestre, Pruthvi C. Revaiah, Akihiro Tobe, Patrick Serruys, Yoshinobu Onuma

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Presenter

Asahi Oshima

Authors

Asahi Oshima¹, Tsung-Ying Tsai¹, Joanna Wykrzykowska², Faisal Sharif¹, Liesbeth Rosseel³, Mohammad Alkhalil⁴, Edouard Benit⁵, Nick Curzen⁶, Vincent Flore⁷, Kenneth De Wilder⁸, Valeria Paradies⁹, Giovanni Amoroso¹⁰, Sjoerd Hofma¹¹, Adel Aminian¹², Clemens von Birgelen¹³, Manel Sabate¹⁴, Victor Jimenez Diaz¹⁵, Ignacio Amat Santos¹⁶, Jeroen Sonck¹⁷, Anthony Mathur¹⁸, Lionel Mangin¹⁹, Mathieu Pankert²⁰, Gilles Barone-Rochette²¹, Julien Lemoine²², Michael Angioi²², Raymundo Ocaranza²³, Julien Adjedj²⁴, Albert Chinhenzva¹, Shiuan-Hao Hu¹, Emelyne Sevestre¹, Pruthvi C. Revaiah¹, Akihiro Tobe¹, Patrick Serruys¹, Yoshinobu Onuma¹

Affiliation

University of Galway, Ireland¹, University Medical Center Groningen, Netherlands², Algemeen Stedelijk Ziekenhuis, Belgium³, Freeman Hospital, United Kingdom⁴, Jessa Hospital, Belgium⁵, University Hospital Southampton NHS Trust, United Kingdom⁶, Algemeen Ziekenhuis Maria Middelares, Belgium⁷, Imelda Hospital, Belgium⁸, Maasstad Hospital, Netherlands⁹, OLVG Amsterdam, Netherlands¹⁰, Medisch Centrum Leeuwarden, Netherlands¹¹, Centre Hospitalier Universitaire de Charleroi, Belgium¹², Medisch Spectrum Twente, Netherlands¹³, University of Barcelona, Spain¹⁴, Hospital Alvaro Cunqueiro, Spain¹⁵, Hospital Clinico Universitario de Valladolid, Spain¹⁶, OLV Clinic, Belgium¹⁷, Queen Mary University of London, United Kingdom¹⁸, Hospital Annecy-Genevois, France¹⁹, Centre Hospitalier Avignon, France²⁰, CHU Grenoble Alpes, France²¹, Clinique Louis Pasteur, France²², Hospital Lucus Augusti, Spain²³, Arnault Tzanck Institute, France²⁴

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TCTAP A-048

Angiography/QCA

Device Success Algorithm of the European Association of Percutaneous Cardiovascular interventions (EAPCI) Prospectively Applied to the Pioneer IV Trial

Background

Device success is a key intraprocedural endpoint and a critical performance metric for drug-eluting stents. However, definitions of device success vary across trials, resulting in a large discrepancy in success rate from 91.2-100%, making cross-comparison challenging. The European Association of Percutaneous Cardiovascular Interventions (EAPCI) has endorsed an algorithm to standardize device success, but it has not been prospectively applied with core lab quantitative coronary angiography (QCA) analysis.

Methods

We prospectively applied this algorithm (Figure 1) in the ongoing PIONEER IV trial (NCT04923191), an all-comers, multicenter randomized controlled trial comparing PCI outcomes guided by angiography-derived quantitative flow ratio (QFR) or usual care and treating both arms with Healing-Targeted Supreme sirolimus-eluting stents (HT Supreme stent). Device success was adjudicated by an independent core lab (CORRIB core lab, Ireland) and compared with a performance index derived from 45 major recent DES trials (71875 lesions).

Results

Among the first 1270 patients,1128 lesions were treated, and 724 lesions were deferred. 98.4% of the HT supreme stent was implanted in the intended lesion and demonstrated a 95.0% device success rate based on site reports (with visual/QCA residual stenosis <20%). When independent core lab QCA was applied to adjudicate residual stenosis, the device success rate was 88.6%.

Conclusion

The HT Supreme stent demonstrated a 95.0% device success rate based on operator assessment, while core lab QCA yielded more modest success rates, suggesting underestimated residual stenosis by the operator(Figure 2). Thus, in the next algorithm iteration, core lab QCA should be mandatory for unbiased device comparison, and QFR, which is now Class 1b in ESC guidelines, should be integrated. Post-PCI QFR results will be presented at CRT.

E-Abstract

TCTAP A-048