Coronary revascularisation in TAVI: meta-analysis of 4 Trials

Major LBTs from EuroPCR 2026How should coronary artery disease (CAD) be managed in patients undergoing TAVI?At #europcr 2026, Martin Leon and Roberto Scarsini discuss the findings of a patient-level meta-analysis pooling data from four randomised trials: ACTIVATION, NOTION-3, FAITAVI, and TCW.The analysis included 1,050 patients with severe aortic stenosis and concomitant CAD, comparing medical therapy, angiography-guided PCI, and FFR-guided PCI strategies.At 1 year, PCI was associated with a lower rate of MACE compared with conservative management.Among the different strategies, FFR-guided PCI showed the greatest benefit, reinforcing the value of physiological assessment when treating these complex patients.Beyond the trial results, the conversation moves toward a practical algorithm for approaching severe AS and CAD, and raises important questions about when, how, and in whom revascularisation should really be performed.Listen to the full discussion to learn more about the implications of these findings for clinical practice. Hosted on Acast. See acast.com/privacy for more information.