It has been reported that the two stents technique is not superior to a provisional stent when treating bifurcations. However, the optimal approach to rescue a secondary branch (SB) when initially opting for provisional stenting has not been established. The aim of this study was to determine angioplasty indication using balloon or stent for…
Stent MGuard, primary angioplasty with a higher TIMI III
Original title: The MASTER Trial – Prospective, Randomized, Multicenter Evaluation of a Polyethylene Terephthalate Micronet Mesh–Covered Stent (MGuard) in ST-Segment Elevation Myocardial Infarction. Reference: Gregg W. Stone et. al. J Am Coll Cardiol 2012; 60: 1975-1984 Primary angioplasty has proven effective in restoring epicardial flow but myocardial perfusion is often suboptimal. One of the main mechanisms is distal…
The use of a paclitaxel eluting balloon in small vessels
Original title: A Randomized Multicenter Study Comparing a Paclitaxel Drug-Eluting Balloon With a Paclitaxel-Eluting Stent in Small Coronary Vessels. The BELLO (Balloon Elution and Late Loss Optimization) Study Reference: Referencia: Azeem Latib et al J Am Coll Cardiol 2012;()doi:10.1016/j.jacc.2012.09.020 The utility of paclitaxel-eluting balloons to treat in-stent restenosis is known but data for novo lesions is more limited. …
What are the chances we presently have of carrying a cardiovascular disease at some point in our lives?
Original title: Lifetime Risk and Years Lived Free of Total Cardiovascular Disease Reference: John T. Wilkins et al. JAMA. 2012; 308(17):1795-1801. This study analyzed more than 120,000 patients in the cohorts of large community studies, such as the Framingham, who did not have cardiovascular disease at the time of inclusion Considering all the age subgroups, only between 1.7%…
Bleeding risk in ACS. Do the scores we have work?
Original title: Comparing the predictive validity of three contemporary bleeding risk scores in acute coronary syndrome Reference: European Heart Journal: Acute Cardiovascular Care 2012 1: 222 DOI: 10.1177/2048872612453924 The aim of this study was to compare the validity of the three most widely used scores to predict the risk of bleeding in patients who are hospitalized for acute…
A new paradigm in the treatment of in-stent restenosis?
Original title: ISAR DESIRE 3: Drug-eluting balloon is best option for restenosis of limus-eluting stents Reference: Dr Robert Byrne. TCT 2012. Miami, Fl. The first of the ISAR DESIRE trials showed that drug-eluting stents (DES) were the best strategy for treating restenosis of a bare metal stent, the second ISAR DESIRE trial tested the hypothesis of changing or…
Diabetics with multivessel, must keep waiting.
Original title: Strategies for Multivessel Revascularization in Patients with Diabetes. The FREEDOM Trial. Reference: Michael E. Farkouh et al. N Engl J Med 2012. DOI: 10.1056/NEJMoa1211585 This study was designed to determine the best revascularization strategy in diabetic patients with multivessel using current techniques of angioplasty (PCI) and surgery (CABG). Randomized 1:1 diabetic patients with injuries > 70%…
Future second-generation stents, today.
Original title: First Serial Assessment at 6 Months and 2 Years of the Second Generation of Absorb Everolimus-Eluting Bioresorbable Vascular Scaffold A Multi-Imaging Modality Study. Reference: John Ormiston et al. Circ Cardiovasc Interv. 2012;5:620-632. The first bioabsorbable stents eluting everolimus showed a 6-month delayed recoil resulting in late lumen loss of 0.44 mm, (intermediate between a metal stent…
Predictors of invasive versus conservative treatment in elderly patients with acute coronary syndromes.
Original title: Predictors of Treatment in Acute Coronary Syndromes in the Elderly: Impact on Decision Making and Clinical Outcome After Interventional Versus Conservative Treatment. Reference: Harald Rittger et al. Catheterization and Cardiovascular Interventions 80:735–743 (2012). This study, recently published in Cath Cardiovasc Interven, was performed to determine the factors that helped physicians decide to be conservative or invasive.…
Global Risk Score for stratification of patients with multivessel coronary artery disease: A wider look
Reference: Serruys et al J Am Coll Cardiol Intv 2012;5:606–17 SYNTAX Analysis study demonstrates the utility of a new risk score for patients stratification with left main coronary artery or multivessel disease. Numerous studies have demonstrated the value of SYNTAX score to stratify risk of angioplasty and decision-making (angioplasty versus surgery) in patients with multivessel…
Drug-Eluting Stents: device without polymers overcomes limitations of first generations stents
The NEXT randomized trial showed the superiority of a polymer-free amphilimus-eluting stent compared to paclitaxel-eluting stents with permanent polymers The NEXT clinical trial (International Randomized Comparison Between DES Limus Carbostent and Taxus Drug-Eluting Stents in the Treatment of De Novo Coronary Lesions), is a multicenter randomized trial (n=296) comparing coronary amphilimus eluting stent Cre8 (CID,…