NOBLE Five Year Follow Up

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain LM SESSION NOBLE Five Year Follow Up Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark BACKGROUND Initial NOBLE report (LANCET 2016) indicated that PCI was inferior to CABG for MACCE Mortality was similar No difference in stroke Higher rates of spontaneous MI and revascularization after PCI CONCLUSIONS The NOBLE trial is conclusive: PCI was inferior to CABG in treatment of LMCA stenosis at 5 years for the primary endpoint of MACCE  Mortality was similar for PCI and CABG Difference in MACCE driven by higher rates of non-procedural myocardial infarctions and repeat revascularization after PCI SYNTAX score <23 did not identify a subgroup with more balanced outcome CABG had longer index admissions, more reOP, more blood transfusions Heart Team conference AND thorough balanced discussion with the patient

Early Morning Bench News: DK Double Crush

European Bifurcation Club 2019, EBC 2019 - Barcelona, Spain NEWS 1 Early Morning Bench News: DK Double Crush Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark SUMMARY Double crush in DK crush may lower risk of sub-optimal SB rewiring Use POT balloon sized to proximal reference Intravascular imaging is still required to firmly rule out suboptimal rewiring Clincal data: OCTOBER trial

Side Branch Evaluation by OCT

European Bifurcation Club 2014, EBC 2014 - Bordeaux, France LIVE BIFURCATION STENTING GUIDANCE: OCT, IVUS, FFR & ANGIO Side Branch Evaluation by OCT Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark CONCLUSION Do not advance an imaging wire into a jailed SB Observe imaging depth evaluating SBs by MV 3D-OCT SB pullback for full evaluation of two-stent techniques Adjustable 2D measurement planes may be new standard in ostial assessment Do not advance an imaging wire into a jailed SB Observe imaging depth evaluating SBs by MV 3D-OCT SB pullback for full evaluation of two-stent techniques Adjustable 2D measurement planes may be new standard in ostial assessment

Consensus statement on use and analysis

European Bifurcation Club 2013, EBC 2013 - London, UK The EBC debate on stepwise OCT guiding for bifurcation treatment Consensus statement on use and analysis Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark

Accidental abluminal rewiring, OCT check or optimal technique?

European Bifurcation Club 2013, EBC 2013 - London, UK The EBC debate on stepwise OCT guiding for bifurcation treatment Accidental abluminal rewiring, OCT check or optimal technique? Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark

The jailed side branch and OCT guided cross over

European Bifurcation Club 2013, EBC 2013 - London, UK The EBC debate on stepwise OCT guiding for bifurcation treatment The jailed side branch and OCT guided cross over Author: Niels Ramsing Holm, MD, Aarhus University Hospital, Denmark