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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