Monday, March 24, 2014


I was in Shanghai over the weekend to take part in CIT 2014. I have seen it grow from a small meeting of a few hundred attendees in 2004, to the present a few thousand attendees and a few hundred faculty.

China Intervention has come along way. I first went to help them get started in 1993, and now they are doing a few hundred thousand procedures a year, while we are left behind.

The intellectual content of this meeting was good. I too learn a lot. Nothing new, but maturity of the recent advances. One of the things that I like most at these meetings was NOT just the meeting lectures, but the informal corridor talk, oh over a cuppa talk, about how leading experts see new recent advances. Just to share a few :-.
1. Looks like the ABSORB stent has a new name, the BRS ( Bioabsorbable Resorbable Scaffolding ) is getting to find its niche, in the young with LAD disease and maybe long diffuse lesions so that we do not have to get a full metal jacket. I also learn that the experts have seen problems appearing. The 2-3 years stent thrombosis rate is about 0.5% and the restenosis rate is about 5-6%. So it is not all zero as originally announced. Patrick Serruys stills feels that the ABSORB BRS is perfect and everything is zero. Antonio Columbo is of course is using ABSORB for everything conceivable from bifurcation, to CTOs and SVG stenosis. The Singaporeans are trying out ABSORB in AMIs ( I hope they have consent from their patients ). Renu Virmani ( Vascular Pathologist ) feels that there are still issues with the ABSORB and we have to do more studies. Of course, in the real world we are more circumspect. There are issues with ABSORB and their use should be restricted.  Most agree, mid LAD n the young, or long diffuse lesions where in the past, you have to use a full metal jacket.
2. The CTO techniques are getting better. Just as we have failed antegrade re-canalisation, converting to retrograde re-canalisation, we now see failed retrograde converting successfully to antegrade re--canalisation. Meaning that  there is still a role for antegrade re-canalisation. BUT it is very important to have bilateral injection and if possible IVUS.
3. While the west fight over late stent thrombosis, the Chinese accepts it and have gone on to innovate and produce their own third generation DES, while the west still have only the second generation, cobalt chromium DES. Their FIREHAWK has abluminal grooves with PLA polymer and sirolimus on the abluminal grooves. The early results on TARGET 1 shows that it is safe and TARGET 2 to show efficacy is ongoing.
4. As for the RDN ( Renal Denervation )- well all is not lost. Looks like we are heading in the direction of RDN as a form of Sympathetic Nervous System Modulation. Its indication maybe, white collar or Office hypertension.
On the social side, they were very kind to me, giving me a room on the 21st floor of the Marriott Shanghai ChangFeng, overlooking the ChangfengPark. A very nice park with a serene lake.

                                                      ChangFeng Park - View from my room
I took a walk around the park on Thursday when I had a free afternoon. As you can see from the pic, Shanghai for the duration of my stay was pollution free and cold, ranging from 10oC to 1oC at Night.

But it was a good weekend of intellectual intercourse. We exchange a lot of ideas.
Basically, I had a good time.

Now back to work.

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