Original title: Hybrid Revascularization for Multivessel Coronary Artery Disease Reference: Mariuz Gassior, et al. J Am Cardiol Intv 2014;7:1277-83 According to the international guidelines, coronary artery bypass grafting (CABG) continues to be the “Gold Standard” treatment for multiple vessels diseases. However, second generation DES and the hybrid strategy may eventually change indications. This study randomized 102…
FFR results could change over the years
Original title: The impact of age flow reserve-guided percutaneous coronary intervention: A FAME (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) trial substudy. Reference: Hong-Seok Lim et al. International Journal of Cardiology 2014; 177:66-70 The FAME study has shown the benefit of FFR guided PCI, but the question as to whether age affects lesion evaluation remains unclear. A…
Despite the evidence, visual estimation continues to dominate the decision on intermediate lesions
Original title: Revascularization Decisions in Patients With Stable Angina and Intermediate Lesions. Results of the International Survey on Interventional Strategy. Reference: Gabor G. Toth et al. CircCardiovascInterv. 2014. Epubahead of print. Measurement of fractional flow reserve (FFR) is recommended by the guidelines and supported by evidence in intermediate lesions when not any proof of ischemia is available…
Target amount for reasonable incomplete revascularization
Original title: Reasonable incomplete revascularisation after percutaneouscoronary intervention: the SYNTAX Revascularisation Index. Reference: Philippe Généreux et al. EuroIntervention 2014;10-online publish-ahead-of-print. While the absolute amount of residual disease after coronary angioplasty is associated with poor prognosis, the proportion of treated coronary disease modifying the prognosis is still to be determined. This study attempted to quantify the proportion of coronary…
PCI Superior to Optimal Medical Treatment in Patients with Ischemic Cardiomyopathy
Original title: Fractional Flow Reserve–Guided PCI for Stable Coronary Artery Disease. The FAME 2 Trial Investigators. Reference: Bernard De Bruyne et al. N Engl J Med 2014;371:1208-17. The FAME 2 and the COURAGE studies tested similar hypothesis, only in the first study PCI was guided by fractional flow reserve (FFR) in addition to an angiography. The study hypothesis…
The higher the bleeding risk, the greater the benefit of radial access in terms of mortality
Original title: Baseline bleeding risk and arterial access site practice in relation to procedural outcomes after percutaneous coronary intervention. Presenter: Mamas A. Mamas et al. J Am Coll Cardiol. 2014;64:1554-1564. The transradial approach has been associated with reduced access site related bleeding complications as well as a reduced mortality in the context of PCI. It seems…
Outcomes are still associated to operator experience and institutional volume
This study is a retrospective analysis of 2,243,209 PCI stenting procedures in the USA between 2005 and 2009. During this period, a reduction in the number of PCI procedures was observed (also observed globally) from 53 in previous years to 33 procedures per operator per year, and from 1,024 to 693 per hospital per year.…
Most of stable patients have the wrong idea about the purpose of PCI
Original title: Variation in patients’ perceptions of elective percutaneous coronary intervention in stable coronary artery disease: cross sectional study. Referencia: Kureshi F et al. BMJ. 2014;Epub ahead of print. This study included 991 consecutive patients with stable coronary disease undergoing elective PCI in 10 university and community centers between 2009 and 2011. After procedure, patients were asked a…
Minimal Lumen Area Criteria for Functionally Significant Intermediate Left Main Coronary Artery Stenosis
Original title: Intravascular Ultrasound-Derived Minimal Lumen Area Criteria for Functionally Significant Left Main Coronary Artery Stenosis. Reference: Seung-Jung Park et al. J Am Coll Cardiol Intv. 2014;7(8):868-874. Deciding on a course of action when facing intermediate main left stenosis is usually challenging. We tend to overestimate the lesion or to use additional methods, other than angiography, to tip…
Hemodialysis Associated to Higher Incidence of In Stent Thrombosis
Original title: Impact of hemodialysis on local vessel healing and thrombus formation after drug-eluting stent implantation. Reference: Akihide Konishi, et al. Journal of Cardiology 2014;64:25-31 Even though the benefit of DES implantation to the general population is undeniable, it has been proved lower in hemodialysis patients (HD); the reason behind this phenomenon remains unclear. 121 patients received…
Thrombosis with bioresorbable scaffolds: the story of DES all over again?
Original title: Percutaneous coronary intervention with everolimus-eluting bioresorbable vascular scaffolds in routine clinical practice: early and midterm outcomes from the European multicentre GHOST-EU registry. Reference: Capodanno D et al. EuroIntervention. 2014 Jul 18. Epub ahead of print The GHOST-EU registry, that included 1189 patients from 10 European centers between 2011 and 2014, is now the largest registry…