Original title: Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease: final five-year follow-up of the SYNTAX trial. Reference: Eur Heart J. 2014 May 21. pii: ehu213. (Epub ahead of print). The SYNTAX study was one of the largest randomized clinical studies comparing long-term results of angioplasty versus surgery in multivessel disease and /or…
Coronary angioplasty via radial access using 4 Fr introducer. Minimally invasive to the extreme.
Original title: Comparison of frequency of Radial Artery Oclusion Alter 4Fr Versus 6Fr Transradial Coronary intervention (from the Novel Angioplasty Using Coronary Accessor Trial). Reference: Satoshi Takesita, et al. Am J Cardiol 2014;113:1986-89) Since Andreas Gruentzig performed the first angioplasty, technological development has improved devices and radial access becomes more common. This procedure reduces complications, mainly bleeding. However,…
Orbital Atherectomy improves calcified lesions treatment outcomes
Original title: Pivotal Trial to Evaluate the Safety and Efficacy of the Orbital Atherectomy System in Treating de Novo, Severely Calcified Coronary Lesions (ORBIT II) Reference: Jeffrey Chambers, et al. JACC Intervention 2014;7:510-8 Severely calcified coronary lesions, traditionally associated to difficult or impossible stent implantation, asymmetric stent expansion, higher post procedural events rate, more restenosis, more lesion revascularization,…
Best results of angioplasty with DES guided by IVUS versus angiography only
Original title: Intravascular Ultrasound-Guided Implantation of Drug-Eluting Stents to Improve Outcome. A Meta-Analysis. Reference: Jae-Sik Jang et al. J Am Coll Cardiol Intv 2014, epub ahead of print. Several previous studies and meta-analysis showed that implantation of conventional stents (BMS) intravascular ultrasound (IVUS) guided may decrease restenosis and clinical events. This information was not yet clear to drug-eluting…
Currently a patient receiving angioplasty is more likely to die from non-cardiac causes
Original title: Trends in cause of death after percutaneous coronary intervention. Reference: Spoon DB et al. Circulation. 2014; Epub ahead of print. This retrospective study evaluated the specific cause of death in 19077patients who received angioplasty in a center between 1991 and 2008. To perform the analysis, the track was divided into three time periods: 1991-1996, 1997-2002,…
Hybrid revascularization versus conventional surgery. Advantages and disadvantages for choosing ideal patients.
Original title: Clinical Outcomes after Hybrid Coronary Revascularization versus Coronary Artery Bypass Surgery: A Meta-Analysis of 1,190 Patients. Reference: Ralf E. Harskamp et al. American Heart Journal (2014), epub ahead of print. Hybrid revascularization combines long-term patency of the mammary artery connected to the left anterior descending with minimally invasive drug-eluting stents to other injuries. This in…
The FFR changes the treatment strategy in almost half of patients
Original title: Outcome impact of coronary revascularization strategy reclassification with fractional flow reserve at time of diagnostic angiography. Reference: Van Belle E et al. Circulation. 2014 Jan 14;129(2):173-85. Any comprehensive registry has not been yet published that evaluates the impact of fractional coronary flow reserve (FFR) to change the strategy of revascularization on individual patients referred for diagnostic…
Malapposition in drug-eluting stents. Much more common and much less serious than we thought
Original title: Incidences, Predictors, and Clinical Outcomes of Acute and Late Stent Malapposition Detected by Optical Coherence Tomography After Drug-Eluting Stent Implantation Reference: Im E. et al. CircCardiovascInterv. 2014 Jan 14. [Epubahead of print] This paper analyzed the imaging of 351 patients by optical coherence tomography (OCT) who received drug-eluting stents over 356 lesions between 2009 and…
Ischemic versus anatomical risk. Is anyone better to help us decide therapeutically?
Original title: Predicting Outcome in the COURAGE Trial. Coronary Anatomy Versus Ischemia. Reference: G. B. John Mancini et al. J Am Coll Cardiol Intv 2013, Article in press. Anatomical risk, ischemic amount or a combination of both, are often factors taken into account for estimating the prognosis or choose a treatment strategy. The COURAGE study (Clinical Outcomes Utilizing…
Everolimus-eluting stent and DEB in restenosis for BMS. Good results of both with some expected differences.
Original title: A Randomized Comparison of Drug-Eluting Balloon Versus Everolimus-Eluting Stent in Patients With Bare-Metal Stent In-Stent Restenosis: The RIBS V Clinical Trial. Reference: Fernando Alfonso et al. J Am Coll Cardiol. 2014; Epub ahead of print. Drug-eluting stents (DES) have proven to be superior in terms of restenosis than bare metal stents (BMS). BMS, however due…
Longer follow-up registry of angioplasty in left main coronary artery. Significant differences according to the diseased segment.
Original title: The DELTA Registry (Drug-Eluting Stent for Left Main Coronary Artery Disease): A Multicenter registry Evaluating Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for left Main Treatment Reference: Naganuma T, et al. J Am Coll Cardiol Intv 2013;6:1242–9 Angioplasty of the unprotected left coronary trunk has increased significantly in recent years showing good results. Currently the…