SOLACI | Latin American Society of Interventional Cardiology

1) Balloon Angioplasty: A Reasonable Plan B for Chronic Thromboembolic Hypertension

Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B, such as balloon pulmonary angioplasty.

2) Ischemic and Bleeding Risk After Primary Angioplasty

Patients with ST-segment elevation myocardial infarction who undergo primary angioplasty are at high risk for both ischemic and bleeding events, which affect significantly both morbidity and mortality. An optimal selection of antithrombotic therapies in terms of strength and duration must take into account the timing for the procedure, since the risk for these complications may vary over time.

3) Angioplasty Complexity May Define the Duration of Dual Antiplatelet Therapy

The DAPT study concluded that continued thienopyridine plus aspirin beyond a year after coronary angioplasty is associated with a decrease in the rate of stent thrombosis and major cardiovascular events. In contrast, there is a significant increase in moderate to severe bleeding when compared with continued aspirin alone.

4) Though on the Rise, the Transradial Approach to Primary PCI Remains Underused

There is evidence to support the use of the transradial approach to coronary angioplasty. Several randomized studies have shown reduced bleeding and vascular complications when adopted, compared against patients treated with the femoralapproach. There are also studies and meta-analysis suggesting that, in the context of primary PCI, the benefit would be even bigger, with significant events rate reduction.

5) Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting

Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable.

6) The End of Aspirin for Anticoagulated Patients Undergoing PCI

The discussion about the best anti-thrombotic strategy for patients with atrial fibrillation undergoing PCI seemed never-ending until the RE-DUAL PCI trial was published in the New England Journal of Medicine (NEJM). This study has arrived to simplify the tough choice between the risk of a thrombotic event vs. the risk of bleeding with a simpler scheme, without giving up efficacy and gaining in safety.

7) Endarterectomy vs. Stenting in Asymptomatic Carotid Artery Stenosis

The comparative efficacy and safety of carotid stenting vs. endarterectomy in asymptomatic carotid stenosis patients remains controversial and, what is worse, consensus seems unlikely in the near future. Given the lack of definite evidence, several meta-analyzis and systematic reviews have been produced in an attempt to shed some light on this matter.