Q&A
Q.
Which three cases do you consider the best among the 200?
A.
From my personal viewpoint, following are the 3 top cases of ccclive;
- Case of LM acute closure requiring ECMO and pt recovered fully; 2014.
- Case of calcified LAD/D1 bifurcation requiring Rota of both branches followed by minicrush stenting; 2016. Total 65,000+ hits for this case.
- Case of CTO RCA done via retrograde approach; 2017. Total 42000+ hits for this case.
Q.
And the best?
A.
Salvage successful PCI of acute closure of LM requiring CPR, ACLS protocol and ECMO. Great educational value of the case.
Q.
Has there been a country where CCCLiveCases have been transformative in their Interventional Cardiology development?
A.
I confidently say that outside USA, CCClive webcast has been transformative in India by educating emerging young interventional leaders. We hear these accolades frequently in the international meetings.
Q.
What remains the biggest challenge for ccclivecases?
A.
Better interactive website and targeted marketing are the biggest challenges for ccclivewebcast to further gain its reach and audience.
Q.
What major advancement do you see for ccclivecases?
A.
CME and focused presentations periodically (CTO, stenting techniques, Yellow trials) will contribute to refine the interventional field via ccclive webcast.
Q.
How much do you subscribe to the stent-free philosophy as advanced by Dr. Colombo and Dr. Waksman today?
A.
In my opinion, based heavily on the published data and somewhat on personal experience, stent-free strategy philosophy will play a major role in managing small to mid size vessels (upto 2.75mm size) particularly with diffuse long disease where current DES have restenosis rates upto 20-30% and limits the future interventional options. DCB PCI sites in these cases if restenose, then will be appropriate for stenting in the 2nd round.
Q.
Is this a radical departure from what is done at ccclivecases?
A.
That is correct that currently we have been teaching adequate plaque modification in diffuse small-medium size vessels followed by full stenting. I am sure with increasing experience and confidence, we will be advocating DCB in these appropriate settings via our ccclive webcast.
Q.
Which seems more promising: DCB or Mg based resorbable stents?
A.
DCB has very strong data as compared to Magnesium based alloy biodegradable scaffold; which I am very skeptical based on past experience and have declined to participate in the ongoing RCT.
Q.
How will these advance change the economics of a cath lab?
A.
Currently as of January 2026, newer CPT and DRG codes have been introduced for the DCB procedures, which are good for Medicare pts and as usual other insurance carriers will soon recognize this effective emerging technology for new device reimbursement. As you know key major interventional device manufacturers will have DCB in their portfolio.
Q.
100% imaging for DCB and Bioresorbable stents?
A.
Intravascular imaging (IVI) is not a must for DCB but will be preferred in complex cases after plaque preparation before DCB implantation and avoid imaging after the deployment (for fear off scrapping the recently deployed drug in the vessel wall). Yes for bioresorbable scaffold, IVI is must pre, during and post procedure deployment to get optimal results. Current bioresorbable trials making IVI mandatory for their RCT enrollment. Only one DCB trial (Solution ISR trial of Cordis) involving ISR had the initial and then follow-up IVI mandatory.
