In this EuroPCR 2026 preview, Prof Nicolas Van Mieghem (Erasmus University, NL) provides an in-depth look at the most anticipated late-breaking trials, translating emerging data into actionable takeaways for interventional practice.

Focusing on the management of heavily calcified coronary disease, structural innovations, and mechanical support, he walks through the design and potential real-world impact of: FRACTURE, SHORTCUT, I-CARE, ORACLE, SMART, the Tri-Valve registry, PROTECT-EU, and a definitive meta-analysis on pulmonary embolism

The discussion centers on how these data should influence:

• Lesion Modification Strategy: Evaluating laser-based IVL versus traditional technologies and the mechanistic differences between orbital and rotational atherectomy
• TAVI Outcomes: Analyzing three-year data in small aortic anatomies and the clinical relevance of hemodynamic valve performance
• Tricuspid & RV Function: Exploring the "Anrep effect" and how the right ventricle adapts to immediate afterload changes after intervention
• Complex PCI & PE: Navigating the nuances of mechanical circulatory support and the evolving choice between thrombectomy and thrombolysis
• Whether you are an interventional cardiologist or a structural heart specialist, this preview will help you identify which trials are practice-changing and where further evidence is needed

You can watch the full version here or jump directly to individual chapters here.

Editor: Mirjam Boros, Jordan Rance 
Videographer: Oliver Miles