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...
Survey on Hemodynamics Centers in Latin America – SOLACI, Stent Save a Life! and South American Society of Cardiology Initiative
The treatment of ST-segment elevation myocardial infarction (STEMI) in Latin America is highly diverse. There are notable differences between countries and even among regions within a single country. It is clear that the treatment of STEMI is still an unmet need in our region. SOLACI and the Stent – Save a Life! Initiative in Latin...
Network Meta-Analysis of Complementary Imaging (IVUS/OCT + Conventional Angiography) for Coronary Stenting
Complementary imaging allows for the identification of numerous scenarios not visible with conventional angiography (ICA), both for the assessment of differential diagnoses and the improvement of percutaneous coronary intervention (PCI) outcomes. Advantages include assessment of plaque characteristics, vessel plaque burden, stent edge dissection, vessel diameter, and correct apposition, among others. While intravascular ultrasound (IVUS) was...
Recurrent Revascularization at 10 Years after Percutaneous Treatment of DES In-Stent Restenosis
In stent restenosis (ISR) continues to be the main limitation to the percutaneous treatment of coronary artery disease, with 5 to 10% prevalence after new generation DES stenting. Guideline recommendations for this intervention include new DES stenting and the use of drug coated balloons (DCB). Recurrent ISR stenting rate ranges between 10 and 40%, and...
ROTACUT Study: Rotational Atherectomy with Cutting Balloon for Stent Expansion Optimization
Approximately 30% of patients undergoing percutaneous coronary intervention (PCI) present moderate to severe calcified lesions, which presents a significant challenge involving a high incidence of major adverse cardiovascular events (MACE). Rotational atherectomy (RA) is used to modify these calcified lesions and facilitate balloon angioplasty followed by stent implantation. The combination of RA with other plaque...
Stentless Strategy in ACS: Perfusion and Drug Coated Balloons
The initial strategy for the treatment of patients at high risk of bleeding (HBR) after percutaneous coronary intervention (PCI) has consisted of a short dual antiaggregation therapy (DAPT). Stents continue to improve, which has allowed the reduction of DAPT schemes and therefore the incidence of bleeding. However, researchers are also looking into another strategy to...
Long-Term Results from the BEST Study: Drug-Eluting Stents vs. Bypass Surgery in Diabetic Patients with Multiple Vessel Disease
The impact of diabetes on the development of cardiovascular disease is widely known, with a strong association with extensive and diffuse coronary artery disease. Decision-making regarding how to revascularize patients with multi-vessel disease is a complex process. In this context, coronary artery bypass grafting (CABG) has been recommended over percutaneous coronary intervention (PCI) based on...
TCT 2023 | In Stent Restenosis: Sirolimus vs. Paclitaxel Coated Balloons
This was a prospective, multicenter, randomized study including 130 patients with instent restenosis treated with sirolimus coated balloons (DCB S) and 128 treated with paclitaxel coated balloons (DCB P). Primary end point was late lumen loss (LLL) at 12 months. There were no significant differences between the groups. Mean patient age was 63, 75% were...
Ultrathin Stents Shown Safe and Effective in Real World Patients
Ultrathin drug eluting stents (60 µm) had been shown beneficial vs. thin-strut stents in terms of target lesion failure (TLF) at 2, 3 and 5 years in randomized studies, but they had not been yet assessed in “real world” patients. The BIOFLOW VII is a prospective, multicenter study including 556 “real world”patients with a total...
Treatment and Gender-Based Outcomes for Coronary Bifurcation Stent Placement: Report from the e-ULTIMASTER Registry
Approximately 20% of all percutaneous coronary interventions (PCI) are performed on bifurcation lesions, which continue to pose a challenge in terms of strategy: how many stents to use, what is the most suitable strategy, and when to transition from a single stent to two during the procedure. Additionally, the use of two stents in these...