Routine manual vacuum in patients with acute coronary syndrome and ST-segment elevation improves myocardial perfusion according to non-invasive parameters. Invasive assessment of microcirculation has not been adequately studied in this group of patients. The objective of this study was to compare the effect of manual thromboaspiration in perfusion according to the microcirculation resistance index (MRI).…
Coherex Wave Crest: New device for atrial appendage closure
Appendage closure devices have emerged as an alternative to anticoagulation in fibrillated patients with a contraindication for it. The study included 63 patients with paroxysmal, persistent or permanent FA coupled with a CHADS score >1 and eligible to interrupt anticoagulation. The primary endpoint was atrial appendage occlusion evaluated by ultrasound between 45 and 180 days…
RIPCORD study: FFR changes clinical consideration of chest pain
The objective of this study was to evaluate whether routine use of FFR in all the coronary arteries could change the strategy in stable patients that underwent angiography for the investigation of a chest pain. We included 200 patients with chest pain; for 72 of them, the strategy would be to provide medical treatment by…
Clinical results of TAVI in Asia
Since all the studies available in the literature were conducted in North America or Europe, the results of percutaneous aortic valve replacement in Asia are unknown. We included 253 patients with severe aortic stenosis who received TAVI at 14 sites in Asia (Edwards Sapiens: 140 patients; Medtronic Core Valve: 113 patients). The success rate was…
Coronary obstruction registry after TAVI
There is little information in the literature about the obstruction of the coronary ostia after percutaneous aortic valve implantation. 81 TAVI sites and programs and 6688 patients in total provided information on this complication. Of all, 28 patients (0.66%) developed this complication, being more frequent for balloon-expandable prosthesis and when procedures were performed “valve in…
ELISA 3: Early vs. late invasive strategy in patients without high-risk ST elevation
The invasive strategy is preferred to treat patients with acute coronary syndromes without ST-segment elevation, but the ideal time for the procedure is controversial. This study randomized 542 patients with acute coronary syndrome without high-risk ST elevation to carry out immediate (invasive treatment within 12 hours) or late treatment (after 48 hours). The primary endpoint…
Treatment of in-stent restenosis with drug-eluting balloon
ISAR-DESIRE 3 did not show that paclitaxel-eluting balloon may be useful for treating restenosis of a sirolimus–eluting stent. This study tests the safety and efficacy of a paclitaxel-eluting balloon versus a paclitaxel-eluting stent in cases of in-stent drug-eluting restenosis. We included 220 patients with in-stent restenosis of a drug-eluting stent ball randomized at a 1:1…
IN-PACT CORO: OCT validation of drug-eluting balloons
Drug-eluting balloons could reduce intimal hyperplasia detected by OCT in intmerventions with conventional stents. 30 patients were randomized into 3 groups: 10 patients received conventional stents, 10 patients received a drug-eluting balloon prior to the conventional stent, and 10 patients receive a drug-eluting balloon after the conventional stent. We performed angiographic and OCT follow-up at…
RENAL DES: reduction of restenosis in patients with kidney failure
Coronary angioplasty in patients with kidney failure is associated with an increased occurrence of events. This study compared the efficacy of preventing clinical restenosis using an everolimus-eluting stent versus a conventional stent, both implanted in the same patient with lesions in more than one vessel and suffering from kidney failure. The primary endpoint was target…
ADVISE II: functional assessment of coronary lesions without adenosine
The pressure ratio in the resting phase of the cardiac cycle is a newly Introduced procedure for the assessment of coronary stenoses based on pressure measurement without adenosine. It generated interest with over 1500 comparisons with the FFR since its introduction at TCT 2011. The discrepancies between the two methods have been attributed to the…
Pre-dilation of side branch during percutaneous treatment of bifurcation lesions
The simple strategy with a provisional stent is now favored to treat bifurcation lesions; however, stent implantation in the main branch can compromise or even occlude the side branch. Pre-dilation of the side branch could lower the chances of this happening. We included 372 patients with bifurcation lesions (Medina 111, 011 and 101); the technique…
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