This work addressed the occurrence of complications after endovascular aortic aneurysm repair (EVAR) for the treatment of infrarenal abdominal aortic aneurysms in a cohort of 454 patients with a 5.2-year follow-up. About 25% of patients experience complications of some kind. As opposed to other studies, here, the vast majority of those complications were asymptomatic and had…
EuroPCR 2020 | Aortic Valve in Valve in the Long Term
The outcomes of this work are important to plan valve replacement with the largest possible prosthesis allowed by patient anatomy in the index procedure. As a worldwide trend, increasingly more patients are receiving bioprostheses, which have improved a lot but still tend to become deteriorated and require a valve-in-valve procedure if the patient is no…
EuroPCR 2020 | FABOLUS FASTER: In the Quest for the Fastest, Most Potent Platelet Inhibition
This small study tested the pharmacodynamic effects of several antiplatelet agents. It concluded that tirofiban (Aggrastat) provides “more potent and consistent” inhibition of platelet aggregation compared with cangrelor in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty. Thirty minutes after the initiation of treatment, there was a nearly threefold difference between tirofiban and cangrelor…
EuroPCR 2020 | Deferral Based on iFR vs. FFR: Are They Equivalent or Is There a New “Gold Standard”?
Age may impact results when making an angioplasty choice based on fractional flow reserve (FFR) vs. instantaneous wave-free ratio (iFR). After 2 years of follow-up, patients whose treatment of intermediate lesions was deferred based on functional testing had similar outcomes regardless of whether this decision was informed by FFR or iFR. However, iFR performance was constant,…
EuroPCR 2020 | CLASP: New Device for Mitral Repair with at One Year Follow Up
The CLASP looked into patients treated with the new device for transcatheter mitral repair called PASCAL and showed low complications rate, high survival rate, significant mitral regurgitation reduction and improved quality of life at one year. In July 2019 we published on our web page the 30 year outcomes of the PASCAL device () which…
EuroPCR 2020 | Revascularization vs. Initial Medical Treatment in Chronic Patients
There is no survival advantage with invasive coronary revascularization over initial medical treatment in patients with chronic coronary artery disease. However, revascularization did reduce the incidence of unstable angina and its symptoms, according to this new meta-analysis published in Circulation and presented virtually at EuroPCR 2020. There was no significant difference in spontaneous infarctions overall, but…
EuroPCR 2020 | EVOQUE: New Transcatheter Mitral Valve Replacement System, Promises at Short Term and Future Hope
Transeptal transcatheter mitral valve replacement offers a less invasive alternative vs. surgery and with fewer anatomical limitations than transcatheter repair (e.g. MitraClip) in patients with severe mitral valve failure. The first patients treated with the new system EVOQUE were included between September 2018 and October 2019 and its outcomes were presented at the virtual EuroPCR…
EuroPCR 2020 | Sudden Death Increase Two to Three Times While MI Rate Falls
The number of sudden deaths reported around the world is on the rise in Covid-19 times. These deaths are caused either by the virus and its capacity to produce lethal arrhythmias or by the fact that patients are staying away from hospitals and are not being examined. Cardiologists were the first to warn that the…
EuroPCR 2020 | Is Renal Denervation Coming Back to Life?
Additional analyses from the Global SYMPLICITY Registry and the RADIANCE-HTN SOLO trial, presented virtually at EuroPCR 2020, can contribute to the comeback of renal denervation as another alternative for patients with uncontrolled hypertension. The 3-year results from the SYMPLICITY registry showed significant and durable reductions in blood pressure regardless of how many medications patients were taking.…
Anesthetic Modes and Their Impact on Elective Endoprostheses
This work supports previous observations on the mortality benefit of regional (and even local) anesthesia in patients who undergo elective endovascular aneurysm repair for the treatment of infrarenal abdominal aortic aneurysms. These benefits also translated into a shorter hospital stay, but not into less pulmonary complications, which is what previous studies had suggested. Minimally invasive…