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International Symposium On Endovascular Therapy (ISET)

This appeared to be a smaller, quieter ISET than last year. There was little controversy at ISET this year, but lots of interesting data. Among the key findings: Embolic filters are a must for carotid stenting, and there are a number that work well; the benefit of drug-coated balloons appears to fade over time; EVAR and TEVAR continue to gain popularity; there is real interest in using thrombectomy for pulmonary embolisms, but more data are needed; and while small bore vascular closure devices are underutilized, large bore VCDs are in strong demand because of the growth of procedures like TAVR.

Society Of Thoracic Surgeons (STS)

Despite all the hoopla over transcatheter procedures, cardiac surgery is alive and well. Surgeons continue to be active partners in the Heart Team, and their devices and procedures continue to improve. Among the trends: Surgeons are increasingly ablating patients with atrial fibrillation during open cardiac procedures; robotic cardiac surgery is growing, with several new robots on the horizon; for temporary hemodynamic support, Abiomed’s Impella 5.5 looks promising; use of mechanical aortic valves is decreasing; TAVR volume has surpassed SAVR; and mitral repair is preferable to replacement.

North American Neuromodulation Society (NANS)

Spinal cord stimulation (SCS)use market has been growing by double digits, and that is expected to continue in 2018. That growth is driven by new data, device improvements, and marketing more than a move away from opioids for pain, though the expectation is opioid restrictions will spur future use of SCS. All vendors are likely to benefit, and there is interest in using the devices for new indications, but not until there is FDA approval and payor reimbursement.

Digital Therapeutics

Software and mobile apps for treating diseases by monitoring and modifying patient behavior, known as digital therapeutics, are still in their infancy, but a number of companies are actively trying to develop and market products. FDA approval and oversight is evolving, and the Agency has launched a Pre-Cert pilot program.

Clinical And Cost Burdens Of CMV And Antiviral Therapies For HCT Patients

For more than 25 years, preemptive antiviral therapy has been the standard of care for cytomegalovirus (CMV) infections in hematopoietic cell transplant (HCT) patients. These drugs typically have been IV Cytovene (ganciclovir, Roche) or its oral prodrug, Valcyte (valganciclovir, Roche), or, alternatively, IV Foscavir (foscarnet sodium, Clinigen) or Vistide (cidofovir, Gilead Sciences).

North American Spine Society (NASS)

There is a slowdown in spine procedures, and it is due mostly to insurance company hurdles but also more focus on non-surgical approaches. Surgical robots are catching on in spine, but slowly because of cost, lack of a perceived need, and the limited applications in spine so far (just pedicle screws). But there is marketing appeal. Three companies have FDA-cleared spine robots – with more on the horizon – but the buzz at NASS was about Globus Medical’s ExcelsiusGPS.

North American Cystic Fibrosis Conference (NACFC)

The focus at the meeting this year was on combination therapy – doublets and triplets that are in the pipeline. While the existing drugs are a major advance, the cystic fibrosis (CF) community now wants more – treatments that are more effective, that are applicable to more patients, that treat rare mutations, etc.