Any change towards a healthier lifestyle, even if it seems small, can have a great impact, particularly in patients with diabetes. These changes are never too late. In consequence, as physicians, we should always be attentive and never stop encouraging patients to adopt them. Patients with diabetes who make changes to their lifestyle, such as…
Real-Life Functional Assessment of Coronary Stenosis: We Are Yet to Convert to It
The use of functional assessment of coronary stenosis (following the class IA recommendation in both American and European guidelines) is below 50% in daily clinical practice. Truth be told, most operators continue having blind faith in angiography. The inclusion of coronary physiology in the decision-making process has spread widely across countries, sites, and operators. The ERIS…
Angina Is as Subjective as Any Other Pain
Almost 80% of all patients randomized in this study reported Canadian Cardiovascular Society class II or III angina, and almost all of them (97%) had more than 1 positive non-invasive ischemia test that matched the area of their single diseased coronary vessel. Beyond fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR), the study randomized patients to…
CTO Revascularization Improves Quality of Life
Courtesy of Dr. Carlos Fava. The presence of CTO hovers around 15, 20% in coronary angiographies of patients with chronic stable angina, but only 5% receive percutaneous coronary intervention (PCI). One of the obstacles to percutaneous revascularization is the lack of relevant studies justifying it, though we do have different comparative studies that improve symptoms, ventricular…
Manual vs. Mechanical Compression after Transradial Catheterization
For patients undergoing transradial catheterization, whether puncture site compression is manual or mechanical has no significant difference as regards post procedural radial artery occlusion (RAO) rate. Hemostasis is shorter with manual compression, but it seems difficult to implement in the clinical practice. We could carry out an economical sub-analyzis of this study to find out…
More Bad News on Bioresorbable Scaffolds
A year after the implantation of everolimus-eluting bioresorbable scaffold Absorb 1.1, optical coherence tomography (OCT) scans showed neointima formation covering plaque without significant luminal loss. At 5 years, the device is supposed to disappear completely, potentially thrombogenic plaque components are supposed to be covered by endothelium, and the vasomotor function is supposed to be recovered. However, there…
EuroPCR 2018 | TRANSIENT trial: What is the best timing for TRANSIENT STEMI revascularization?
The objective of this study was to determine the best time to revascularize a patient who is undergoing an acute coronary syndrome (ACS) with transient ST segment elevation. This population hovers around 15% of STEMI patients. The question is whether to reduce infarction area (or potential reinfarction) with an immediate intervention, or to delay intervention…
EuroPCR 2018 | Ultimaster Registry: Difference in Strut Thickness
This work compared the safety and efficacy of angioplasty with thin-strut (80 µm) sirolimus-eluting stents with a cobalt chromium structure (Ultimaster) vs. thick-strut (120 µm) biolimus-eluting stents with a cobalt chromium structure (Nobori). This study compared two prospective multicenter single-arm registries: e-Ultimaster and NOBORI 2. The Ultimaster Registry included over 37,000 patients in 4 continents, while the NOBORI 2 Registry included…
EuroPCR 2018 | Consistent CTO Study: Rechanneling with Current Techniques and SYNERGY Stents
This observational study included 231 patients from 6 sites who presented chronic total occlusions and underwent rechanneling procedures using currently available techniques, which were successful in 90% of all cases (210 patients). All patients who underwent successful rechanneling received a SYNERGY stent and most of them underwent intravascular ultrasound (90.5%). There was only 1 patient lost to clinical follow-up…
EuroPCR 2018 | 2nd and 3rd-Generation DES for Bifurcation Lesions: Nothing New Under the Sun
This study aimed to assess the outcome of Culotte stenting with newer-generation drug-eluting stents (DES) in Medina 1, 1, 1 bifurcation lesions. The 2nd-generation device used was permanent-polymer everolimus-eluting stent Xience, a device for which there is comparatively plenty of evidence available. Alternatively, the 3rd-generation stent used was thin-strut abluminal bioresorbable-polymer everolimus-eluting stent SYNERGY. Patients with…
EuroPCR 2018 | OxAMI-PICSO: Coronary Sinus Occlusion, Improving Microvascular Function and Reducing Infarct Size
The index of microcirculatory resistance might guide therapy and controlled intermittent coronary sinus occlusions, improve microvascular function, and reduce infarct size. This study included patients with prior ST-segment elevation myocardial infarction treated with primary angioplasty. Researchers measured the index of microcirculatory resistance before stenting and intermittent coronary sinus occlusion was used if the result was…
