While the benefits of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor are recognized, its primary complication is the occurrence of bleeding events, which negatively impact patient morbidity and mortality. Additionally, about 10% of patients undergoing percutaneous coronary intervention (PCI) are on oral anticoagulant therapy, which significantly increases the risk of bleeding when…
Stentless Strategy in ACS: Perfusion and Drug Coated Balloons
The initial strategy for the treatment of patients at high risk of bleeding (HBR) after percutaneous coronary intervention (PCI) has consisted of a short dual antiaggregation therapy (DAPT). Stents continue to improve, which has allowed the reduction of DAPT schemes and therefore the incidence of bleeding. However, researchers are also looking into another strategy to…
AHA 2023 | MINT: Liberal vs Restrictive Transfusion in Patients with Acute Coronary Syndrome
The aim of this study was to assess hard end points such as death or MI in patients with acute coronary syndrome (ACS) presenting hemoglobin levels lower than 10 mg/dl. It was a randomized multicenter double blind trial including 3506 participants. The study looked at different transfusion strategies, comparing restrictive strategy with 7-8 g/dl hemoglobin…
AHA 2023 | ORBITA-2: PCI vs. Placebo in Stable Angina for Symptom Reduction
In patients with stable chronic angina, percutaneous coronary intervention (PCI) is often conducted to relieve symptoms. However, there is still some uncertainty regarding whether PCI provides superior symptomatic relief compared with a placebo in patients not receiving anti-anginal medication. Researchers conducted a controlled and randomized study in which patients with stable angina discontinued all anti-anginal…
Low vs High Dose Drug Coated Balloons in Femoropopliteal Territory
The use of drub coated balloons (DCB) in the treatment of femoropopliteal artery disease has grown. Studies on first generation high dose DCB (HD-DCB) have shown benefits, which has led to their recommendation by current guidelines. However, there have been reports of secondary effects caused by paclitaxel and its excipients. Second generation low dose DCB…
Coronary Calcification: More Frequent Use of Coronary Lithotripsy as a Recommendation
Coronary calcification, whether concentric or eccentric, has always posed a challenge in percutaneous coronary intervention (PCI) due to difficulties in plaque preparation, device navigability, proper stent apposition, drug release, and potential complications during the procedure. This study analyzed 262 patients who participated in the four Disrupt CAD OCT Studies and underwent PCI using coronary lithotripsy followed…
Long-Term Results from the BEST Study: Drug-Eluting Stents vs. Bypass Surgery in Diabetic Patients with Multiple Vessel Disease
The impact of diabetes on the development of cardiovascular disease is widely known, with a strong association with extensive and diffuse coronary artery disease. Decision-making regarding how to revascularize patients with multi-vessel disease is a complex process. In this context, coronary artery bypass grafting (CABG) has been recommended over percutaneous coronary intervention (PCI) based on…
TCT 2023 | ISAR-DESIRE 3: 10-Year Results
In-stent restenosis (ISR) remains the primary limitation of percutaneous treatment for coronary artery disease. The strategy to address this limitation involves the use of drug-eluting stents (DES) or drug-coated balloons (DCB), both of which have proven to be effective and safe therapeutic alternatives. Despite current recommendations, treating ISR continues to be a challenge, and clinical…
TCT 2023 | COMPARE 60/80 HBR TRIAL
This was a randomized study including patients at high risk of bleeding treated with short dual antiplatelet therapy (DAPT). A total 747 patients were recruited, 368 received PCI with the ultrathin Superflex stent with 60 µm struts (SUF), and 364 received the Terumo Tansei with 89 µm struts (SF). Primary end point was NACE at…
TCT 2023 | In Stent Restenosis: Sirolimus vs. Paclitaxel Coated Balloons
This was a prospective, multicenter, randomized study including 130 patients with instent restenosis treated with sirolimus coated balloons (DCB S) and 128 treated with paclitaxel coated balloons (DCB P). Primary end point was late lumen loss (LLL) at 12 months. There were no significant differences between the groups. Mean patient age was 63, 75% were…
TCT 2023 | T-PASS TRIAL, ASA and Ticagrelor in Acute Coronary Syndrome
This is a multicenter randomized study including 2,850 patients with acute coronary syndrome. Patients were randomized to: dual antiplatelet therapy (DAPT) with ASA and ticagrelor during one month (1,426 patients), followed by ticagrelor monotherapy for 12 months, while the other group received DAPT with ASA and ticagrelor during 12 months (1,424 patients). This study was…