According to this recent Excel analysis, mortality seems to rise when the SYNTAX II score is not taken into account when defining the revascularization strategy. The difference does not reach statistical significance and further studies are required, but the message is clear: the left main coronary artery is not the only thing that matters; other…
Antianginal Medication Before and After Rechanneling
Escalation or de-escalation of antianginal medication was less common than treatment continuation without change after a chronic total occlusion rechanneling, with little variation according to the site. Further research is needed to identify patients who would benefit (or not) from these drugs and to develop strategies to adjust treatment during follow-up. This work basically tells…
The FDA Affirms Mortality Signs with Paclitaxel Based Devices
Evidently, we are still uncertain. The information goes both ways, even on our own web page, we have been coming and going just like any other publication around the world. After a 2-day debate, the Circulatory System Devices FDA panel has confirmed the tendency to higher mortality with paclitaxel-based devices and is expected to debate…
Aspirin in Primary Prevention: Another “Trendy” Topic in Publications
Aspirin is the standard treatment when it comes to optimal medical treatment in the context of secondary prevention of coronary artery disease, in patients with diagnosed, established atherosclerosis. Even though bleeding risk is rather small in the short period an acute event takes place, it increases substantially over time. However, the evidence clearly supports the…
The Most Read Articles of may in Interventional Cardiology
1- Surprising EXCEL Outcomes in Diabetics with Main Left Stenosis This study especially designed to compare PCI vs. CABG in patients with left main coronary artery disease and low to intermediate Syntax score showed that 30-day and 3 -year outcomes of PCI with everolimus eluting stents vs CABG were consistent both in diabetic and non-diabetic…
New Risk Factors: Air Pollution, Air Temperature, Pain, and Sleep Hours
Traditionally, we have used age, gender, obesity, hypertension, dyslipidemia, smoking, and diabetes as cardiovascular risk factors. However, this new era (during which the changes made to care for our shared home, the planet, will play a key role) has seen the emergence of new factors such as pollution, noise, temperature, sleep hours, and air quality.…
EuroPCR 2019 | MeRes-1: Bioresorbable Scaffolds Return with Renewed Strength
A small number of highly selected patients presents good outcomes with new bioresorbable scaffold MeRes, but much more evidence is necessary to bring back the concept. The MeRes-1 study tested the newest generation of the Meril Life Sciences bioresorbable scaffold, a device featuring thinner struts compared with Absorb (from 150 µm in Absorb to only…
EuroPCR 2019 | Stent Firehawk Continues to Show Good Results at 2 Years vs. Xience
This device, an abluminal groove-filled biodegradable-polymer sirolimus-eluting stent manufactured in China, showed very similar efficacy and safety to the “gold standard” everolimus eluting Xience at 2-year follow up, according to the TARGET outcomes, presented yesterday at the EuroPCR 2019 and simultaneously published in J Am Coll Cardiol Intv. The device, which is manufactured in China…
EuroPCR 2019 | BASKET-SMALL 2: Drug-Coated Balloons vs. DES in Small Vessels
This angiographic substudy supports the safety of drug-coated balloons in small vessels. Despite better angiographic outcomes, there were eight cases of stent thrombosis among drug-eluting stent (DES) patients, while there was none with drug-coated balloons. In patients with small vessels, using a drug-coated balloon appears safe and comparable to DES, with favorable angiographic outcomes at…
EuroPCR 2019 | Intravascular Imaging Almost Indispensable for Planning an Angioplasty
Cost and time are the two main enemies of intravascular imaging, but lack of expertise may also play a role. A new European Association of Percutaneous Cardiovascular Interventions (EAPCI) expert consensus statement released at EuroPCR 2019 argues that there is a need for more use of intracoronary imaging in settings of acute coronary syndromes and…
EuroPCR 2019 | REVELATION: Drug Coated Balloons in ST Elevation MI
Drug coated balloons in the context of ST elevation acute myocardial infarction seem safe and feasible under certain circumstances. This single center study is the kickoff to keep studying the possibility of “leaving nothing behind” after primary PCI. This small randomized study revives drug coated balloons to be used particularly instead of stents in young…