SlideShare ist ein Scribd-Unternehmen logo
1 von 17
EArly Discharge after Transradial
 Stenting of CoronarY Arteries:
 Bivalirudin to Reduce Bleeding-
      The EASY-B2B Trial
Olivier F. Bertrand, MD, PhD
Associate-Professor of Medicine, Laval University
Adjunct-Professor, Department of Mechanical Engineering, McGill University


Quebec Heart-Lung Institute



                                                                             TCT-2011
Disclosures

Research grants: Cordis, Eli-Lilly, Bristol-Myers-
Squibb, GE Healthcare, Sanofi-Aventis, Eurocor

Consultant: Cordis, Astra-Zeneca, Opsens

Research-Scholar from Quebec Foundation for
Health Research

Funding: QHLI Foundation, Laval University
Transradial Research & Education Fund
89%
Verheugt JACC Cardio Interv 2011;4:191-7
Verheugt JACC Cardio Interv 2011;4:191-7
EXCLUSION
- PPCI
- RECENT BLEED
- CREAT CL < 30 ML/MIN
- PLT < 70.000
- CHRONIC AC




                         G PATTI ET AL. ACC 2011
Bertrand OF 201111
Bertrand OF 201111
Bertrand OF 201111
ANTITHROMBOTIC REGIMENS AND RESIDUAL BLEEDING RISK




                              HAMON ET AL. EUROINTERVENTION, 2009
Objective

In patients at high risk of
bleeding and undergoing
transradial PCI, bivalirudin
has a better safety/efficacy
profile compared to heparin
EASY B2B-Design
Patients at high risk of non-access site bleeding:  ≥
2 risk-factors: Age > 70, female, CKD, recent GI or
organ bleeding, anemia, diabetes, prior GPI/Tnk.
         ≃ 2500 Transradial PCI

                                        BAIL-OUT GPI

     HEPARIN              BIVALIRUDIN


      1ST END-POINT: DEATH, MI, URGENT
            REVASCULARIZATION,
      BARC BLEEDING 2,3,5 AT 30 DAYS FU
Results: Population Characteristics
                Age (years)             77 ± 9

                Weight (kg)             73 ± 16
                Previous MI              29%

               Previous PCI              29%

              Previous CABG              11%

               Stable Angina             10%

             Unstable Angina             46%

                 NSTEMI                  38%

                  STEMI                  7%
       Antithrombotic Rx upon arrival
              - heparin (iv) .
               - LMWH        .           44%
               - Fondaparinux.           22%
                  - Tnk/GPI               6%
                                         5.8%
Results: Population Characteristics
Results: Population Characteristics
OF BERTRAND-QC, CANADA
 T MANN-RALEIGH, NC, US
Conclusion:
Residual bleeding risk remains a serious issue
Bleedings risks non-associated with PCI
procedures are frequent
Strategies to reduce residual bleeding risk
remains to be defined
Benefit of bivalirudin-monotherapy compared
to heparin-monotherapy in patients at high
residual bleeding risk remains to be
demonstrated

Weitere ähnliche Inhalte

Was ist angesagt?

Best practice in asymptomatic carotid stenosis
Best practice in asymptomatic carotid stenosisBest practice in asymptomatic carotid stenosis
Best practice in asymptomatic carotid stenosisPascual Lozano-Vilardell
 
excel TRIAL PTCA vs CABG biggest trial
excel TRIAL PTCA vs CABG biggest trial excel TRIAL PTCA vs CABG biggest trial
excel TRIAL PTCA vs CABG biggest trial shekharrb
 
Outcomes of Venous Interventions in C5-6 Disease
Outcomes of Venous Interventions in C5-6 DiseaseOutcomes of Venous Interventions in C5-6 Disease
Outcomes of Venous Interventions in C5-6 DiseaseVein Global
 
Making the right choice in cvd management
Making the right choice in cvd managementMaking the right choice in cvd management
Making the right choice in cvd managementuvcd
 
Left main disease pci vs cabg excel trial 2016
Left main disease   pci vs cabg excel trial 2016Left main disease   pci vs cabg excel trial 2016
Left main disease pci vs cabg excel trial 2016Kunal Mahajan
 
Carotid Artery Stenosis Treatment Options
Carotid Artery Stenosis Treatment OptionsCarotid Artery Stenosis Treatment Options
Carotid Artery Stenosis Treatment OptionsRichard Wong
 
Carotid body tumors review of 56 cases
Carotid body tumors  review of 56 casesCarotid body tumors  review of 56 cases
Carotid body tumors review of 56 casesuvcd
 
Guidelines in the management of carotid stenosis
Guidelines in the management of carotid stenosisGuidelines in the management of carotid stenosis
Guidelines in the management of carotid stenosisuvcd
 
3rd vulnerable plaque rumberger 3 16-02 3
3rd vulnerable plaque rumberger 3 16-02 33rd vulnerable plaque rumberger 3 16-02 3
3rd vulnerable plaque rumberger 3 16-02 3SHAPE Society
 
Combined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should beCombined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should beuvcd
 
Coronary Ostial stenting techniques:Current status
Coronary Ostial stenting techniques:Current statusCoronary Ostial stenting techniques:Current status
Coronary Ostial stenting techniques:Current statusPawan Ola
 

Was ist angesagt? (19)

Best practice in asymptomatic carotid stenosis
Best practice in asymptomatic carotid stenosisBest practice in asymptomatic carotid stenosis
Best practice in asymptomatic carotid stenosis
 
Lack of evidence in carotid stenosis
Lack of evidence in carotid stenosisLack of evidence in carotid stenosis
Lack of evidence in carotid stenosis
 
excel TRIAL PTCA vs CABG biggest trial
excel TRIAL PTCA vs CABG biggest trial excel TRIAL PTCA vs CABG biggest trial
excel TRIAL PTCA vs CABG biggest trial
 
Outcomes of Venous Interventions in C5-6 Disease
Outcomes of Venous Interventions in C5-6 DiseaseOutcomes of Venous Interventions in C5-6 Disease
Outcomes of Venous Interventions in C5-6 Disease
 
Making the right choice in cvd management
Making the right choice in cvd managementMaking the right choice in cvd management
Making the right choice in cvd management
 
Left main disease pci vs cabg excel trial 2016
Left main disease   pci vs cabg excel trial 2016Left main disease   pci vs cabg excel trial 2016
Left main disease pci vs cabg excel trial 2016
 
Rsna ac 2011definitiva
Rsna ac 2011definitivaRsna ac 2011definitiva
Rsna ac 2011definitiva
 
Monsegu J
Monsegu JMonsegu J
Monsegu J
 
Carotid Artery Stenosis Treatment Options
Carotid Artery Stenosis Treatment OptionsCarotid Artery Stenosis Treatment Options
Carotid Artery Stenosis Treatment Options
 
Carotid body tumors review of 56 cases
Carotid body tumors  review of 56 casesCarotid body tumors  review of 56 cases
Carotid body tumors review of 56 cases
 
Guidelines in the management of carotid stenosis
Guidelines in the management of carotid stenosisGuidelines in the management of carotid stenosis
Guidelines in the management of carotid stenosis
 
3rd vulnerable plaque rumberger 3 16-02 3
3rd vulnerable plaque rumberger 3 16-02 33rd vulnerable plaque rumberger 3 16-02 3
3rd vulnerable plaque rumberger 3 16-02 3
 
250 patients with very abnormal test results
250 patients with very abnormal test results250 patients with very abnormal test results
250 patients with very abnormal test results
 
Rumberg3
Rumberg3Rumberg3
Rumberg3
 
3rd vulnerable plaque rumberger 3 16-02 3
3rd vulnerable plaque rumberger 3 16-02 33rd vulnerable plaque rumberger 3 16-02 3
3rd vulnerable plaque rumberger 3 16-02 3
 
Mi or scd in patients with very abnormal cardiac test results
Mi or scd in patients with very abnormal cardiac test resultsMi or scd in patients with very abnormal cardiac test results
Mi or scd in patients with very abnormal cardiac test results
 
Ebt rumberger- ohio state u- part 3
Ebt    rumberger- ohio state u-  part 3Ebt    rumberger- ohio state u-  part 3
Ebt rumberger- ohio state u- part 3
 
Combined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should beCombined carotid and coronary disease the strategy should be
Combined carotid and coronary disease the strategy should be
 
Coronary Ostial stenting techniques:Current status
Coronary Ostial stenting techniques:Current statusCoronary Ostial stenting techniques:Current status
Coronary Ostial stenting techniques:Current status
 

Andere mochten auch

ELABORACIÓN DE UNA BANDERA
ELABORACIÓN DE UNA BANDERA ELABORACIÓN DE UNA BANDERA
ELABORACIÓN DE UNA BANDERA e1quimica
 
Los navegadores más usados
Los navegadores más usadosLos navegadores más usados
Los navegadores más usadosmarcejesus
 
Frodsham 4 6-14
Frodsham 4 6-14Frodsham 4 6-14
Frodsham 4 6-14CJH47
 
Articles technologies
Articles technologiesArticles technologies
Articles technologiesbarallor
 
Pybelsberg — Constraint-based Programming in Python
Pybelsberg — Constraint-based Programming in PythonPybelsberg — Constraint-based Programming in Python
Pybelsberg — Constraint-based Programming in PythonChristoph Matthies
 
¿Qué es un modelo de negocio?
¿Qué es un modelo de negocio?¿Qué es un modelo de negocio?
¿Qué es un modelo de negocio?Omar Vite
 
Seoul Radial Artery Access 2009 1
Seoul Radial Artery Access 2009 1Seoul Radial Artery Access 2009 1
Seoul Radial Artery Access 2009 1NorthPoint Domain
 

Andere mochten auch (20)

Spaulding C - AIMRADIAL 2013 - Heparin and radial
Spaulding C - AIMRADIAL 2013 - Heparin and radialSpaulding C - AIMRADIAL 2013 - Heparin and radial
Spaulding C - AIMRADIAL 2013 - Heparin and radial
 
Routledge H
Routledge HRoutledge H
Routledge H
 
You want to learn spanish
You want to learn spanishYou want to learn spanish
You want to learn spanish
 
ELABORACIÓN DE UNA BANDERA
ELABORACIÓN DE UNA BANDERA ELABORACIÓN DE UNA BANDERA
ELABORACIÓN DE UNA BANDERA
 
Los navegadores más usados
Los navegadores más usadosLos navegadores más usados
Los navegadores más usados
 
Frodsham 4 6-14
Frodsham 4 6-14Frodsham 4 6-14
Frodsham 4 6-14
 
Narrativa dic
Narrativa dicNarrativa dic
Narrativa dic
 
Creation & Nature
Creation & NatureCreation & Nature
Creation & Nature
 
Articles technologies
Articles technologiesArticles technologies
Articles technologies
 
Pybelsberg — Constraint-based Programming in Python
Pybelsberg — Constraint-based Programming in PythonPybelsberg — Constraint-based Programming in Python
Pybelsberg — Constraint-based Programming in Python
 
Gilchrist IC - AIMRADIAL 2013 - Outpatient in the US
Gilchrist IC - AIMRADIAL 2013 - Outpatient in the USGilchrist IC - AIMRADIAL 2013 - Outpatient in the US
Gilchrist IC - AIMRADIAL 2013 - Outpatient in the US
 
3.BestImplementation
3.BestImplementation3.BestImplementation
3.BestImplementation
 
Secuencia didactica
Secuencia didacticaSecuencia didactica
Secuencia didactica
 
¿Qué es un modelo de negocio?
¿Qué es un modelo de negocio?¿Qué es un modelo de negocio?
¿Qué es un modelo de negocio?
 
Bertrand OF
Bertrand OFBertrand OF
Bertrand OF
 
Applegate RJ - AIMRADIAL 2013 - Learning curve
Applegate RJ - AIMRADIAL 2013 - Learning curveApplegate RJ - AIMRADIAL 2013 - Learning curve
Applegate RJ - AIMRADIAL 2013 - Learning curve
 
Bertrand OF_2 201110
Bertrand OF_2 201110Bertrand OF_2 201110
Bertrand OF_2 201110
 
Tizon-Marcos et al
Tizon-Marcos et alTizon-Marcos et al
Tizon-Marcos et al
 
Hamon M 201111
Hamon M 201111Hamon M 201111
Hamon M 201111
 
Seoul Radial Artery Access 2009 1
Seoul Radial Artery Access 2009 1Seoul Radial Artery Access 2009 1
Seoul Radial Artery Access 2009 1
 

Ähnlich wie Bertrand OF 201111

Expanding Role of Rivaroxaban Master .pptx
Expanding Role of Rivaroxaban Master .pptxExpanding Role of Rivaroxaban Master .pptx
Expanding Role of Rivaroxaban Master .pptxAhsanRaza759717
 
Long term outcomes in patients with h fr-ef treated with cabg vs pci
Long term outcomes in patients with h fr-ef treated with cabg vs pciLong term outcomes in patients with h fr-ef treated with cabg vs pci
Long term outcomes in patients with h fr-ef treated with cabg vs pciRamachandra Barik
 
Michael Knizhnik — Endovascular treatment for patients with critical limb isc...
Michael Knizhnik — Endovascular treatment for patients with critical limb isc...Michael Knizhnik — Endovascular treatment for patients with critical limb isc...
Michael Knizhnik — Endovascular treatment for patients with critical limb isc...Pavel Fedotov
 
Stable ischemic heart disease how is it different from acs..
Stable ischemic heart disease how is it different from acs..Stable ischemic heart disease how is it different from acs..
Stable ischemic heart disease how is it different from acs..cardiositeindia
 
Ppci culprit vs mv acad card 2013 mumbai
Ppci culprit vs mv acad card 2013 mumbaiPpci culprit vs mv acad card 2013 mumbai
Ppci culprit vs mv acad card 2013 mumbaicardiositeindia
 
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...vaibhavyawalkar
 
Myocardial revascularisation using radial artery presentation
Myocardial revascularisation using radial artery presentationMyocardial revascularisation using radial artery presentation
Myocardial revascularisation using radial artery presentationescts2012
 
2014session2 1
2014session2 12014session2 1
2014session2 1acvq
 
2014session5 3
2014session5 32014session5 3
2014session5 3acvq
 
Aki in cardiac patients dr.vijayanand
Aki in cardiac patients  dr.vijayanandAki in cardiac patients  dr.vijayanand
Aki in cardiac patients dr.vijayanandVijay Anand
 

Ähnlich wie Bertrand OF 201111 (20)

Chevalier B
Chevalier BChevalier B
Chevalier B
 
Expanding Role of Rivaroxaban Master .pptx
Expanding Role of Rivaroxaban Master .pptxExpanding Role of Rivaroxaban Master .pptx
Expanding Role of Rivaroxaban Master .pptx
 
Long term outcomes in patients with h fr-ef treated with cabg vs pci
Long term outcomes in patients with h fr-ef treated with cabg vs pciLong term outcomes in patients with h fr-ef treated with cabg vs pci
Long term outcomes in patients with h fr-ef treated with cabg vs pci
 
Rao SV 201111
Rao SV 201111Rao SV 201111
Rao SV 201111
 
Michael Knizhnik — Endovascular treatment for patients with critical limb isc...
Michael Knizhnik — Endovascular treatment for patients with critical limb isc...Michael Knizhnik — Endovascular treatment for patients with critical limb isc...
Michael Knizhnik — Endovascular treatment for patients with critical limb isc...
 
Poster vienne ecr
Poster vienne ecrPoster vienne ecr
Poster vienne ecr
 
Stable ischemic heart disease how is it different from acs..
Stable ischemic heart disease how is it different from acs..Stable ischemic heart disease how is it different from acs..
Stable ischemic heart disease how is it different from acs..
 
Bertrand OF_2 201111
Bertrand OF_2 201111Bertrand OF_2 201111
Bertrand OF_2 201111
 
Braveheart. NOAC in AF patients after coronary stenting
Braveheart. NOAC in AF patients after coronary stentingBraveheart. NOAC in AF patients after coronary stenting
Braveheart. NOAC in AF patients after coronary stenting
 
19 Ruzsa aimradial20170922 Valvuloplasty BAV
19 Ruzsa aimradial20170922 Valvuloplasty BAV19 Ruzsa aimradial20170922 Valvuloplasty BAV
19 Ruzsa aimradial20170922 Valvuloplasty BAV
 
Ppci culprit vs mv acad card 2013 mumbai
Ppci culprit vs mv acad card 2013 mumbaiPpci culprit vs mv acad card 2013 mumbai
Ppci culprit vs mv acad card 2013 mumbai
 
15 aimradial2016 fri A Amin
15 aimradial2016 fri A Amin15 aimradial2016 fri A Amin
15 aimradial2016 fri A Amin
 
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...
SYNTAX Score in Patients With Diabetes Undergoing Coronary Revascularization ...
 
Myocardial revascularisation using radial artery presentation
Myocardial revascularisation using radial artery presentationMyocardial revascularisation using radial artery presentation
Myocardial revascularisation using radial artery presentation
 
2014session2 1
2014session2 12014session2 1
2014session2 1
 
2014session5 3
2014session5 32014session5 3
2014session5 3
 
Bernat I 201111
Bernat I 201111Bernat I 201111
Bernat I 201111
 
Bertrand OF 201305
Bertrand OF 201305Bertrand OF 201305
Bertrand OF 201305
 
Confirm trial
Confirm trial Confirm trial
Confirm trial
 
Aki in cardiac patients dr.vijayanand
Aki in cardiac patients  dr.vijayanandAki in cardiac patients  dr.vijayanand
Aki in cardiac patients dr.vijayanand
 

Mehr von International Chair on Interventional Cardiology and Transradial Approach

Mehr von International Chair on Interventional Cardiology and Transradial Approach (20)

PCI & AimRadial 2018 | Innovation in Cardiovascular Medicine - Tim A. Fischell
PCI & AimRadial 2018 | Innovation in Cardiovascular Medicine - Tim A. FischellPCI & AimRadial 2018 | Innovation in Cardiovascular Medicine - Tim A. Fischell
PCI & AimRadial 2018 | Innovation in Cardiovascular Medicine - Tim A. Fischell
 
PCI & AimRadial 2018 | A novel stent concept for South America - Ramses Galaz
PCI & AimRadial 2018 | A novel stent concept for South America - Ramses GalazPCI & AimRadial 2018 | A novel stent concept for South America - Ramses Galaz
PCI & AimRadial 2018 | A novel stent concept for South America - Ramses Galaz
 
PCI & AimRadial 2018 | Biomechanics of biodegradable stents: a primer for car...
PCI & AimRadial 2018 | Biomechanics of biodegradable stents: a primer for car...PCI & AimRadial 2018 | Biomechanics of biodegradable stents: a primer for car...
PCI & AimRadial 2018 | Biomechanics of biodegradable stents: a primer for car...
 
PCI & AimRadial 2018 | Radial vs Femoral: Review of the Evidence in 2018 - Ia...
PCI & AimRadial 2018 | Radial vs Femoral: Review of the Evidence in 2018 - Ia...PCI & AimRadial 2018 | Radial vs Femoral: Review of the Evidence in 2018 - Ia...
PCI & AimRadial 2018 | Radial vs Femoral: Review of the Evidence in 2018 - Ia...
 
PCI & AimRadial 2018 | Best practices in same day discharge - Ivo Bernat
PCI & AimRadial 2018 | Best practices in same day discharge - Ivo BernatPCI & AimRadial 2018 | Best practices in same day discharge - Ivo Bernat
PCI & AimRadial 2018 | Best practices in same day discharge - Ivo Bernat
 
PCI & AimRadial 2018 | Even the big boss fail - Zoltán Ruzsa
PCI & AimRadial 2018 | Even the big boss fail - Zoltán RuzsaPCI & AimRadial 2018 | Even the big boss fail - Zoltán Ruzsa
PCI & AimRadial 2018 | Even the big boss fail - Zoltán Ruzsa
 
PCI & AimRadial 2018 | Contemporary Transradial Access Practices: Results of ...
PCI & AimRadial 2018 | Contemporary Transradial Access Practices: Results of ...PCI & AimRadial 2018 | Contemporary Transradial Access Practices: Results of ...
PCI & AimRadial 2018 | Contemporary Transradial Access Practices: Results of ...
 
PCI & AimRadial 2018 | A Growing Population in the Cath Lab: Patient Identifi...
PCI & AimRadial 2018 | A Growing Population in the Cath Lab: Patient Identifi...PCI & AimRadial 2018 | A Growing Population in the Cath Lab: Patient Identifi...
PCI & AimRadial 2018 | A Growing Population in the Cath Lab: Patient Identifi...
 
PCI & AimRadial 2018 | Treating Cardiogenic Shock with Impella with Escalatio...
PCI & AimRadial 2018 | Treating Cardiogenic Shock with Impella with Escalatio...PCI & AimRadial 2018 | Treating Cardiogenic Shock with Impella with Escalatio...
PCI & AimRadial 2018 | Treating Cardiogenic Shock with Impella with Escalatio...
 
PCI & AimRadial 2018 | LEFT MAIN PCI Lessons from the BCIS registry - Jim Nolan
PCI & AimRadial 2018 | LEFT MAIN PCILessons from the BCIS registry - Jim NolanPCI & AimRadial 2018 | LEFT MAIN PCILessons from the BCIS registry - Jim Nolan
PCI & AimRadial 2018 | LEFT MAIN PCI Lessons from the BCIS registry - Jim Nolan
 
PCI & AimRadial 2018 | Left Ventricular Endomyocardial Biopsy by Transradial...
PCI & AimRadial 2018 | Left Ventricular Endomyocardial Biopsy by  Transradial...PCI & AimRadial 2018 | Left Ventricular Endomyocardial Biopsy by  Transradial...
PCI & AimRadial 2018 | Left Ventricular Endomyocardial Biopsy by Transradial...
 
PCI & AimRadial 2018 | Right Heart Access by Radial - Ian C Gilchrist
PCI & AimRadial 2018 | Right Heart Access by Radial - Ian C GilchristPCI & AimRadial 2018 | Right Heart Access by Radial - Ian C Gilchrist
PCI & AimRadial 2018 | Right Heart Access by Radial - Ian C Gilchrist
 
PCI & AimRadial 2018 | Radial Artery Puncture - Ian C Gilchrist
PCI & AimRadial 2018 | Radial Artery Puncture - Ian C GilchristPCI & AimRadial 2018 | Radial Artery Puncture - Ian C Gilchrist
PCI & AimRadial 2018 | Radial Artery Puncture - Ian C Gilchrist
 
PCI & AimRadial 2018 | Post-PCI FFR: Time is coming - Olivier F. Bertrand
PCI & AimRadial 2018 | Post-PCI FFR: Time is coming - Olivier F. BertrandPCI & AimRadial 2018 | Post-PCI FFR: Time is coming - Olivier F. Bertrand
PCI & AimRadial 2018 | Post-PCI FFR: Time is coming - Olivier F. Bertrand
 
PCI & AimRadial 2018 | Lessons from iFR-SWEDEHEART and DEFINE-FLAIR - Hitoshi...
PCI & AimRadial 2018 | Lessons from iFR-SWEDEHEART and DEFINE-FLAIR - Hitoshi...PCI & AimRadial 2018 | Lessons from iFR-SWEDEHEART and DEFINE-FLAIR - Hitoshi...
PCI & AimRadial 2018 | Lessons from iFR-SWEDEHEART and DEFINE-FLAIR - Hitoshi...
 
PCI & AimRadial 2018 | Use of physiology in ACS - Colin Berry
PCI & AimRadial 2018 | Use of physiology in ACS - Colin Berry PCI & AimRadial 2018 | Use of physiology in ACS - Colin Berry
PCI & AimRadial 2018 | Use of physiology in ACS - Colin Berry
 
PCI & AimRadial 2018 | FFR using 4Fr catheters: Can Slender Technique Work He...
PCI & AimRadial 2018 | FFR using 4Fr catheters: Can Slender Technique Work He...PCI & AimRadial 2018 | FFR using 4Fr catheters: Can Slender Technique Work He...
PCI & AimRadial 2018 | FFR using 4Fr catheters: Can Slender Technique Work He...
 
PCI & AimRadial 2018 | FFR in Left Main Disease - William F. Fearon
PCI & AimRadial 2018 | FFR in Left Main Disease - William F. FearonPCI & AimRadial 2018 | FFR in Left Main Disease - William F. Fearon
PCI & AimRadial 2018 | FFR in Left Main Disease - William F. Fearon
 
PCI & AimRadial 2018 | FFR-CT - Colin Berry
PCI & AimRadial 2018 | FFR-CT - Colin BerryPCI & AimRadial 2018 | FFR-CT - Colin Berry
PCI & AimRadial 2018 | FFR-CT - Colin Berry
 
PCI & AimRadial 2018 | Image based FFR during coronary angiography - Hitoshi...
PCI & AimRadial 2018 | Image based FFR during coronary angiography - Hitoshi...PCI & AimRadial 2018 | Image based FFR during coronary angiography - Hitoshi...
PCI & AimRadial 2018 | Image based FFR during coronary angiography - Hitoshi...
 

Kürzlich hochgeladen

ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxNaveenkumar267201
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets barmohitRahangdale
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu Medical University
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyZurück zum Ursprung
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfHongBiThi1
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfDolisha Warbi
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdfHongBiThi1
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationMedicoseAcademics
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectiondrhanifmohdali
 

Kürzlich hochgeladen (20)

ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptxBreast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
Breast cancer -ONCO IN MEDICAL AND SURGICAL NURSING.pptx
 
Role of Soap based and synthetic or syndets bar
Role of  Soap based and synthetic or syndets barRole of  Soap based and synthetic or syndets bar
Role of Soap based and synthetic or syndets bar
 
Mental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil ThirusanguMental health Team. Dr Senthil Thirusangu
Mental health Team. Dr Senthil Thirusangu
 
How to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturallyHow to cure cirrhosis and chronic hepatitis naturally
How to cure cirrhosis and chronic hepatitis naturally
 
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
How to master Steroid (glucocorticoids) prescription, different scenarios, ca...
 
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdfSGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
SGK LEUKEMIA KINH DÒNG BẠCH CÂU HẠT HAY.pdf
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdfPAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
PAIN/CLASSIFICATION AND MANAGEMENT OF PAIN.pdf
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdfSGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA    .pdf
SGK NGẠT NƯỚC ĐHYHN RẤT LÀ HAY NHA .pdf
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxationPhysiology of Smooth Muscles -Mechanics of contraction and relaxation
Physiology of Smooth Muscles -Mechanics of contraction and relaxation
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
AORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissectionAORTIC DISSECTION and management of aortic dissection
AORTIC DISSECTION and management of aortic dissection
 

Bertrand OF 201111

  • 1. EArly Discharge after Transradial Stenting of CoronarY Arteries: Bivalirudin to Reduce Bleeding- The EASY-B2B Trial Olivier F. Bertrand, MD, PhD Associate-Professor of Medicine, Laval University Adjunct-Professor, Department of Mechanical Engineering, McGill University Quebec Heart-Lung Institute TCT-2011
  • 2. Disclosures Research grants: Cordis, Eli-Lilly, Bristol-Myers- Squibb, GE Healthcare, Sanofi-Aventis, Eurocor Consultant: Cordis, Astra-Zeneca, Opsens Research-Scholar from Quebec Foundation for Health Research Funding: QHLI Foundation, Laval University Transradial Research & Education Fund
  • 3. 89%
  • 4. Verheugt JACC Cardio Interv 2011;4:191-7
  • 5. Verheugt JACC Cardio Interv 2011;4:191-7
  • 6. EXCLUSION - PPCI - RECENT BLEED - CREAT CL < 30 ML/MIN - PLT < 70.000 - CHRONIC AC G PATTI ET AL. ACC 2011
  • 10. ANTITHROMBOTIC REGIMENS AND RESIDUAL BLEEDING RISK HAMON ET AL. EUROINTERVENTION, 2009
  • 11. Objective In patients at high risk of bleeding and undergoing transradial PCI, bivalirudin has a better safety/efficacy profile compared to heparin
  • 12. EASY B2B-Design Patients at high risk of non-access site bleeding: ≥ 2 risk-factors: Age > 70, female, CKD, recent GI or organ bleeding, anemia, diabetes, prior GPI/Tnk. ≃ 2500 Transradial PCI BAIL-OUT GPI HEPARIN BIVALIRUDIN 1ST END-POINT: DEATH, MI, URGENT REVASCULARIZATION, BARC BLEEDING 2,3,5 AT 30 DAYS FU
  • 13. Results: Population Characteristics Age (years) 77 ± 9 Weight (kg) 73 ± 16 Previous MI 29% Previous PCI 29% Previous CABG 11% Stable Angina 10% Unstable Angina 46% NSTEMI 38% STEMI 7% Antithrombotic Rx upon arrival - heparin (iv) . - LMWH . 44% - Fondaparinux. 22% - Tnk/GPI 6% 5.8%
  • 16. OF BERTRAND-QC, CANADA T MANN-RALEIGH, NC, US
  • 17. Conclusion: Residual bleeding risk remains a serious issue Bleedings risks non-associated with PCI procedures are frequent Strategies to reduce residual bleeding risk remains to be defined Benefit of bivalirudin-monotherapy compared to heparin-monotherapy in patients at high residual bleeding risk remains to be demonstrated