Long after myocardial revascularization guidelines had established no medical reason justifies the use of bare metal stents (BMS), along comes this study to refresh the old trials comparing drug eluting vs bare metal stents in the context of primary PCI. The problem for many countries is that primary PCI obviously occurs in the context of…
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 | BIO-RESORT and SCAAR Registry: Ultrathin Struts Also in Small Vessels pequeños
Data from randomized studies are also supported by the SCAAR registry, in which ultrathin-strut stents show real-world advantages. Patients with small vessels who received ultrathin-strut stents are less likely to undergo revascularization at 3 years than those who received first-generation thin-strut devices, according to the BIO-RESORT trial, presented during the first day of the annual…
DES and DCB with Similar Results in Femoropopliteal Artery Disease
Courtesy of Dr. Carlos Fava. Nowadays, peripheral interventions are on the rise and the technological development of stents and balloons would help achieve better outcomes. Both drug-eluting stents (DES) and drug-coated balloons (DCB) have proved to be beneficial for femoropopliteal interventions, but the actual role of each of these technologies remains unclear. This prospective, randomized 1:1…
Drug eluting Stents vs. Drug Coated Balloons for In-Stent Restenosis
The rationale behind the decision to not add another layer of metal to the artery sounded attractive and this was what paved the way for drug coated balloons as an alternative strategy to treat in-stent restenosis. “We’ve already got a stent in place, we only have to dilate and leave the drug” is what we…
Outcomes of Contemporary DES in Patients with Diabetes: Do They Render Freedom Obsolete?
Despite our high hopes for new-generation drug-eluting stents (DES), patients with diabetes still have a different prognosis, both clinical and angiographic, compared with non-diabetic patients. Authors sought to investigate the impact of diabetes on patients who underwent drug-eluting stent implantation in the BIONICS (BioNIR Ridaforolimus Eluting Coronary Stent System in Coronary Stenosis) trial. This…
Everolimus-Eluting Stents Finally Have a Rival and Not Just a “Non-Inferior” Stent
In this large randomized trial, there were significant differences as regards both target-lesion failure and target-vessel-related infarction, which persisted through a 2-year follow-up and favored treatment with an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (Orsiro) compared with the gold standard, a durable-polymer everolimus-eluting stent (Xience). Moreover, there were significantly lower rates of target lesion revascularization and late/very…
Several Features Define a Hostile Neck in AAA patients, but Only One Makes the Difference
Patients with infrarenal abdominal aortic aneurysm (AAA) and ≥ 30 mm neck diameter have 3 times higher risk of type 1A endoleak and 5 times higher risk of rupture at follow up after standard endovascular aneurysm repair (EVAR), as well as lower survival rate. This could tilt the scales against EVAR, or at best call…
Early Strut Coverage and Its Implications for Dual Antiplatelet Therapy
Optical coherence tomography (OCT)-guided drug-eluting stent implantation improves early strut coverage compared with angiography-guided angioplasty. No difference was observed in terms of strut coverage between permanent-polymer everolimus-eluting stents and bioresorbable-polymer biolimus-eluting stents. Short-term dual antiplatelet therapy may be feasible in selected patients with early strut coverage. This study sought to measure early strut coverage…
AHA 2018 | New-Generation DES Are Similar to Second-Generation DES Beyond Polymer
Sirolimus-eluting stents with biodegradable polymer did not offer better outcomes compared with instant-classic (and undoubtedly valid) everolimus-eluting stents with durable polymer such as Xience. New-generation drug-eluting stents (DES) offer better outcomes than first-generation devices after a 10-year follow-up, according to the ISAR-TEST 4 trial presented at the American Heart Association (AHA) Congress Scientific Sessions and published…