Courtesy of Dr. Rodrigo Abreu. INTRODUCTION Bifurcation lesion treatment has evolved considerably in the last years: from balloon angioplasty (with high occlusion and restenosis rates) to bare metal stent angioplasty (with a procedural success around 86% and major adverse cardiac events [MACE] at 1 year around 32%). The subsequent emergence of drug-eluting stents (DES) reduced…
ABSORV at Long Term in Daily Practice Lesions
This work reports one year outcomes of the BVS Expand registry. Multiple studies have shown the safety and feasibility of the everolimus eluting bioresorbable scaffold ABSORB (Abbott Vascular, Santa Clara, California), but medium and long term data are limited and only on simple lesions. This is a prospective single-center registry assessing ABSORB performance in…
Optimal Duration of DAPT: How to Predict Long-Term Events
Courtesy of Dr. Santiago F. Coroleu. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel after percutaneous coronary intervention (PCI) reduces the risk for coronary thrombotic events (CTEs) at the expense of increasing risk for major bleeding (MB). However, the lack of information to accurately predict the occurrence of each event in out-of-hospital patients under…
DES in primary PCI: The Best Option?
Courtesy of Dr. Brian Nazareth Donato. The relative safety of drug-eluting stents (DES) and conventional bare-metal stents (BMS) in primary angioplasty (percutaneous coronary intervention, PCI) in patients with ST elevation myocardial infarction (STEMI) is still subject of debate. A search was carried out using Medline, CENTRAL, EMBASE, TCTMD and Cardiosource. There were 9673 patients included,…
BVS: Comparable to Second-Generation DES in Complex Lesions
A center carrying out a mid- to long-term follow-up of the performance of everolimus-eluting bioresorbable scaffolds (Absorb) observed that this new device has an acceptable rate of major cardiovascular events, when compared to second-generation drug-eluting stents. Furthermore, although the population was complex and non-selected, no cases of early thrombosis were reported. This study enrolled 249 patients…
DAPT after PCI with EES: 6 or 12 Months?
Original Title: 6-Month versus 12-Month Dual-Antiplatelet Therapy Following Long Everolimus-Eluting Stent Implantation. The IVUS-XPL Randomized Clinical Trial. Reference: Hong et al. JACC Cardiovasc Interv. 2016 May 11. [Epub ahead of print] Courtesy of Dr. Brian Nazareth Donato. This publication stems from the IVUS-XPL published by JAMA in November 2015. This study presents outcomes on the…
Tissue Protrusion after DES: Adverse Events at Long Term?
Original Title: Tissue Protrusion after Stent Implantation. An ADAPT-DES Intravascular Ultrasound Substudy. Reference: Fuyu Qiu et al. J Am Coll Cardiol Intv. 2016;9(14):1499-1507. After DES implantation we may observe tissue protrusion (plaque or thrombus) relatively often, especially in unstable lesions; however, its clinical impact has not been studied. The aim of this study was…
Stent Fracture: More Frequent than Expected
Original Title: Incidence and Clinical Outcome of Stent Fractures on the Basis of 6555 Patients and 16482 Drug Eluting Stents From 4 Centers. Reference: Kan J et al. JACC Cardiovasc Interv. 2016 Jun 13;9(11):1115-23. Courtesy of Dr. Guillermo Migliaro. Stent fracture (SF) has been associated with instent restenosis (ISR), stent thrombosis (ST) and repeat revascularization…
Instent restenosis: Drug eluting balloons or drug eluting stents?
Original Title: Long-Term Results of Everolimus-Eluting Stents versus Drug-Eluting Balloons in Patients with Bare-Metal In-Stent Restenosis 3-Year Follow-Up of the RIBS V Clinical Trial. Reference: Alfonso F. et al. JACC Cardiovasc Interv. 2016 Jun 27;9(12):1246-55. Courtesy of Dr. Agustín Vecchia. RIBS V 3 year follow up Stents have become the gold standard for…
Stent thrombosis: Comparative analysis between BMS, DES and BRS
Original Title: Stent Thrombosis with Drug Eluting Stents and Bioresorbable Scaffolds. Evidence from a Network Meta-Analysis of 147 trials. Reference: Kang S et al. J Am Coll Cardiol Intv 2016 doi 10.1016. Courtesy of Dr. Guillermo Migliaro. When treating heart disease, drug eluting stents (DES) have become essential for PCI. Its main advantage lies on…
Bioresorbable Scaffold Thrombosis: incidence, risk factors and possible mechanism
Original Title: Bioresorbable Vascular Scaffold Thrombosis. Multicenter Comprehensive Analysis of Clinical Presentation, Mechanisms, and Predictors. Reference: Puricel S et al. J Am Coll Cardiol 2016;67:921-31. Courtesy of Dr. Guillermo Migliaro. Bioresorbable scaffolds (BVS) were introduced in interventional cardiology to avoid late DES complications. However, recent reports suggest an elevated incidence of thrombosis with these new devices.…