Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of patients with severe aortic stenosis (AS). Randomized studies have shown the benefits of TAVR for treating inoperable patients, as well as high and intermediate risk patients. The NOTION (Nordic Aortic Valve Intervention Trial) randomized patients with low risk severe AS to TAVR or SAVR (surgical…
AGENT-IDE: Drug Coated Balloons for Instent Restenosis
Drug eluting stents (DES) have improved considerably over the years, reducing the initial indices of instent restenosis (ISR) by roughly 5-10% a year in USA. However, DES failure might lead to neointimal hyperplasia and neoatherosclerosis, which increases the chance of developing chronic and acute coronary syndromes. Drug coated balloons (DCB), which administer anti-proliferative agents with…
Rehospitalization After Treatment of Left Main Coronary Artery Disease and Its Prognosis: Sub-Analysis of the EXCEL Study
Individual randomized studies have shown variable results regarding the mortality risk following treatment of left main coronary artery disease (LMCAD), either through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). However, upon assessment of the latest meta-analyses (with matched data), similar risks of all-cause and cardiovascular mortality have been reported for both groups.…
Guidewire Pacing and Pressure Assessment in TAVR: The SAFE-TAVI Study
Currently, the number of transcatheter aortic valve replacement (TAVR) procedures is increasing as it expands towards a lower-risk younger population. Therefore, continuous technological advancement is imperative to reduce post-procedural complications. The Food and Drug Administration (FDA) has approved the SavyWire, a preformed 0.035-gauge guidewire that can perform three essential functions: 1) it facilitates prosthesis transportation…
ISCHEMIA Outcomes: Does Sex Have Any Impact?
We are well aware of CAD physiopathological disparities and how it manifests differently in men and women. The ISCHEMIA study (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) has revealed that during 3.2 years no differences were seen in the incidence of ischemic events when comparing an invasive strategy (INV) vs a…
TENDER Study, Evolution at One Year
The use of transcatheter mitral valve intervention for the treatment of mitral valve regurgitation (MR) continues to evolve; at present guidelines only recommend it for inoperable or high surgical risk patients. So far, many devices have been assessed, some of which have shown promising results, but only for poor surgical candidates. Researchers looked into the…
Use of IVL in Calcified Coronary Lesions in a Real World Population
The presence of calcification in coronary arteries (CAC) remains a challenge for the percutaneous treatment of these lesions. Several studies have established the link between CAC and poor long term results. Intravascular lithotripsy (IVL) has surged as a tool to induce calcified plaque fracture. Even though studies on this strategy are not randomized, they have…
Lithotripsy in the Left Main Coronary Artery
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which…
IN.PACT Outcomes at 5 Years
Over time, percutaneous coronary intervention (PCI) with drug coated balloons (DCB) have been shown more beneficial than conventional PCI. However, in many cases, stenting is required to treat suboptimal results. Even though several studies have looked into this scenario, long term durability still calls for research. This was a 5 year thorough analysis of the…
ERCTO Registry: Current Results for Percutaneous Treatment of Chronic Total Occlusions
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access…