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Below, we share February’s most read scientific abstracts in interventional cardiology at solaci.org.
One of the challenges of percutaneous coronary interventions (PCI) are <2.5 mm vessels, since complications and restenosis complications rate are higher than with >3.0 mm vessels.
Is Using Drug-Eluting Balloons and Single Antiplatlelet Therapy Safe for Patients at High Risk for Bleeding Who Undergo Percutaneous Coronary Intervention?
The safety and efficacy of drug-coated balloons (DCB) has been established for the treatment of in-stent restenosis of conventional bare-metal stents (BMS) and drug-eluting stents (DES).
Acute coronary syndromes (ACS) involve high mortality risk, especially ST elevation ACS. Their treatment is based on reperfusion, dual antiplatelet therapy (DAPT) and anticoagulation, with enoxaparin (1 mg/kg twice a day) as the preferred anticoagulant according to the contemporary guidelines.
Recent studies have shown that drug-eluting stents with biodegradable polymer and ultrathin struts are safe and effective, including low rates of stent thrombosis.
Recent studies have shown that a drug coated balloons (DCB) based approach resulted non inferior when compared against drug eluting stents (DES) only approach in patients with instent restenosis and de novo lesions in small vessel disease. So far, two international consensuses have reported the use of DCB is feasible and safe to treat native vessels instead of DES.
A study compared pooled data of claudication and critical ischemia patients treated with stenting vs. by-pass surgery in femoropopliteal disease.
Mortality Assessment, Interventions and Hospitalization in Patients with Uncomplicated Type B Aortic Dissection with TEVAR.
Even though prolonged dual antiplatelet therapy (DAPT) might reduce the risk of important ischemic complications, this reduction will come at the expense of a significant increase of bleeding risk, which makes us reassess the cost benefit ratio of this decision. This is also why guidelines recommend choosing a strategy on a case by case basis.
Plaque Erosion with No Stenting in Acute Coronary Syndrome: Are There Event Predictors to Avoid This Strategy?
A third of all acute coronary syndrome (ACS) cases are caused by plaque erosion. In the initial EROSION study, it was shown that patients with plaque erosion (as evidenced by OCT, with stenosis <70%, TIMI III flow, and asymptomatic) were stabilized without stent implantation (no stenting strategy), with antiplatelet therapy using aspirin and ticagrelor. In turn, the 4-year follow-up of this study showed an incidence of major adverse cardiovascular events (MACE) of 23.1%.
In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR rate significantly. According to US statistics, second generation DES restenosis 5-year rate has been 6%.
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