International Circulation: Last year ESC and EACTS published joint guidelines on myocardial revascularization. Could you briefly summarize the latest progress in reperfusion strategy for STEMI?
Dr. Eeckhout: This joint effort for the first time to have surgeons to work together and write common guidelines on myocardial revascularization is a big step forward and this European initiative should be congratulated. We will have a session this afternoon at CIT dedicated to this topic and we will focus left main disease and triple vessel disease. The key is that for elective patients there must be a discussion upfront with the patient， his family， and a heart team discussion between cardiologists and surgeons. The gatekeeper function of the cardiologist as it has been traditionally seen should probably change somewhat.
In terms of STEMI patients， the mainstay of treatment still lays in the hands of the interventional cardiologist. Europe is doing a lot now in the area of STEMI intervention now. We have the Stent for Life initiative， which is an initiative cobranded by the ESC， EuroPCR， and EAPCI.
International Circulation: What is the latest status in preclinical research and clinical application of drug-eluting balloons? What kind of patients are the best candidates for drug-eluting balloons?
Dr. Eeckhout: Drug-eluting balloons have been around for a while. If you go back to the paper of Scheller in the mid 2000s where we saw in preclinical work with a balloon in animals where there was a clear reduction in neointimal proliferation. Then， there came the first trials and the NEJM paper in 2006 by Scheller on a small randomized trial demonstrating the benefit of a DEB over a conventional balloon for restenosis. Therefore， the best indication for a DEB today is clearly in-stent restenosis. It appears that， although the evidence is still not very strong， that in the field of DES in-stent restenosis， which is usually very difficult to treat， this kind of technology seems to work very well. Some people use it in small vessels and bifurcations， but for me the mainstay of therapy with DEB is in-stent restenosis， and this pathology is quite frequent.
International Circulation: When using a DEB to treat in-stent restenosis would you use just balloon dilatation or in combination with another DES?
Dr. Eeckhout: If you have in-stent restenosis I personally believe that if you can avoid a second layer of metal then you will be better off. The important thing when you use this kind of technology is to use it properly. I think there is some bias in the results because people do not use it clearly. You must avoid geographical miss， use a short non-slippery balloon， prepare the vessel very well， and then the DEB is just here to appose the drug against the vessel wall and not to dilate. This must be done prior to application of the DEB and try to avoid using a stent.
International Circulation: Can you give us a brief preview of the upcoming EuroPCR meeting?
Dr. Eeckhout: The program will be very dense as usual and will be held in Paris again this year. We have tried at AsiaPCR in Singapore a new concept for the main sessions and it worked out very well. This means that we will have case presentations in the main program. We will try to combine clinical cases and complication cases in the main session， make the lectures shorter and more focused， use more recorded cases， and there will be a lot of innovation. Finally， there will be many case review sessions and we will attempt to implement as many local societies and even those outside of Europe as possible in the program.
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