Interventional cardiology showing more interest in endovascular procedures

“This is the first randomized trial of its kind,” Parikh said. “PE is the third leading cardiovascular killer. It's an enormous unmet clinical need and the devices that we've been using for treatment of this have been proliferating over the last decade or so with the advent the pulmonary embolism response team (PERT) movement."

Adding symbolic weight to this milestone, Kenneth Rosenfield, MD, founder of the PERT Consortium and a leader in advancing PE care, received the Jeffrey Hartzler Lifetime Achievement Award at TCT 2025.

Another major presentation was the LIFE-BTK three-year results, evaluating Abbott’s Esprit below-the-knee (BTK) bioresorbable drug-eluting scaffold for patients with critical limb ischemia. Parikh, a co-investigator who presented the long-term data, noted that the trial demonstrated persistent benefit, even after the scaffold had fully dissolved.

"We now have three-year data demonstrating that there's still persistent benefit of a drug-eluting resorbable scaffold for BTK intervention at three years, when the scaffold is gone," he said.

A 'back to the future' moment

Beyond the late-breaking trials, Parikh said the enthusiasm for vascular sessions at TCT 2025 has been striking.

"If you just listen to the buzz of this meeting, it's been sort of like 'Back to the Future.' We look back a decade and it kind of felt like this. There's a real excitement about all of the sessions going on, but even then, the vascular sessions, which are generally relatively undersubscribed, have been really full," Parikh explained.

He said endovascular sessions on renal denervation, PAD intervention, stroke and carotid disease were packed. TCT also featured hands-on training with different endovascular devices and a lot of small-group educational forums.

On the show floor, new technologies mirrored that excitement, ranging from next-generation carotid stents and embolic protection systems to mechanical thrombectomy devices for PE and deep vein thrombosis (DVT). Parikh likened the evolution in PE and stroke interventions to the transformation that occurred in the 1990s when interventionalists shifted from thrombolytics to primary percutaneous coronary intervention (PCI) for heart attack treatment.

“The evolution is quite similar,” he explained. “STEMI was the groundbreaking clinical program where new systems of care were developed for application with a huge implication in reduction of cardiovascular mortality. Stroke has gotten that same sort of attention this last 20 years, and now I think the same is going to be true for PE. I'm hoping this application of pulmonary embolism response teams, or PERTs, will be a more clinical approach to these patients, with team-based, multidisciplinary care."

New opportunities for cath labs to expand volumes

Procedural volumes for coronary interventions have leveled off over the past several years thanks in part to better stents and medical therapies being developed. But lower PCI volumes are making hospital systems and cath labs look for new ways to expand into new areas.

"Many of the outpatient procedures that we do now are being moved into ambulatory surgical centers and office-based laboratories. So a lot of the peripheral artery disease procedures that used to be done in the hospital are now moving to other venues of care, as are cardiac procedures, both on the electrophysiology and coronary side," he said.

For younger operators and hospital programs looking to adapt, Parikh’s advice is to learn these new procedures, because this is where there is a large amount of potential for growth.