After the large studies which set provisional stenting as the preferred strategy to treat bifurcations comes the double kissing crush technique (DK crush) to break the mold once again. This time, the DK crush technique is tested against provisional stenting in the left main, with a 3-year follow-up. The DKCRUSH-V, soon to be published in…
TCT 2019 | PCI in Stable CAD. Prior TAVR, with TAVR or Never?
Courtesy of SBHCI. This interesting study presented at TCT 2019 and simultaneously published in Am J Cardiol tells us PCI in stable coronary artery disease cannot lower risk in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR). Unless patients are symptomatic, most coronary artery lesions do not need revascularization according to researchers.…
TCT 2019 | IVUS-XPL: 5-Year Follow-up for Angiography-vs. IVUS-Guided Angioplasty
Courtesy of SBHCI. The aim of this work, which was presented during the TCT 2019 Scientific Session and simultaneously published in JACC Intv, was to prove the benefit of intravascular ultrasound (IVUS) in angioplasty. The IVUS-XPL trial randomized 1400 patients with long coronary lesions (≥28 mm) to IVUS-guided angioplasty (n = 700) vs. angiography-guided angioplasty (n = 700). All procedures were…
TCT 2019 | FORZA: OCT vs FFR to Define Intermediate Lesions: Anatomy or Function?
Courtesy of SBHCI. Both fractional flow reserve (FFR) and optimal coherence tomography (OCT) can be useful to help define intermediate coronary lesions and optimize PCI outcomes. The FORZA study presented at San Francisco TCT 2019 scientific sessions simultaneously published in JACC randomized patients with intermediate lesions 1:1 to FFR vs OCT. For the FFR arm,…
TCT 2019 | COMPLETE: Sub-Study to Find Out Complete Optimal Revascularization Timing in STEMI
Courtesy of SBHCI. The COMPLETE study was carried out to assess the benefit of complete revascularization vs culprit vessel revascularization in the context of ST elevation acute myocardial infarction. This COMPLETE sub-study presented at TCT 2019 scientific sessions simultaneously published in JACC assessed the optimal timing of complete revascularization. The general study had already shown…
TCT 2019 | EURO-CTO: Results at 3 Years of CTO Recanalization vs. Optimal Medical Treatment
Courtesy of SBHCI. Between 16 and 18% of coronary artery lesions in patients with chronic stable CAD are chronic total occlusions (CTO). CTO revascularization could benefit symptomatic patients, but it remains unclear whether such complex procedure is safe in the long run, given the study outcomes on PCI in CAD so far. This study presented…
TCT 2019 | EXCEL: Left Main Coronary Artery Angioplasty with Favorable Results at 5 Years
Courtesy of Dr. Carlos Fava. Unprotected left main coronary artery angioplasty with drug-eluting stents has emerged as an acceptable strategy for a select group of patients, with results comparable to those of myocardial revascularization surgery at 2 or 3 years. However, beyond such term, we had no valid information. Researchers analyzed the 5-year follow-up results for the…
TCT 2019 | MODEL U-SES: More Devices for High Risk of Bleeding and Short DAPT
Courtesy of SBHCI. This study tested the safety of dual antiplatelet therapy (DAPT) after only three months of bioresorbable polymer sirolimus DES implantation (Ultimaster). Secondary end point was following with P2Y12 inhibitor monotherapy after the first 3 months compared with aspirin. It included 1695 patients treated with sirolimus eluting Ultimaster receiving 3-month DAPT. After the…
TCT 2019 | EVOLVE Short DAPT: Only 3-month DATP in High Risk Bleeding
Courtesy of the SBHCI. This study used the thin strut everolimus eluting stent with ultrathin abluminal bioresorbable polymer coating chromium platinum stent, basically the Synergy stent. Drug release and polymer degradation within four months facilitate endothelization and would allow a shorter DAPT. Presented during the scientific sessions of TCT 2019, this study included 2009 high…
TCT 2019 | IDEAL-LM: Bioabsorbable Polymer DES vs. Permanent Polymer DES for Left Main Stenosis
Courtesy of SBHCI. This study showed that using the everolimus eluting stent with bioabsorbable polymer Synergy followed by 4 months of dual antiplatelet therapy (DAPT) to treat left main stenosis (LMS) was safe and effective, compared against using the everolimus eluting stent with permanent polymer Xience followed by the conventional 12 months DAPT. This study…
TCT 2019 | Onyx ONE: Durable Polymer vs. Polymer-Free Stent with Only One Month of Dual Antiplatelet Therapy
Courtesy of the SBHCI. This is the first randomized study comparing a durable-polymer drug-eluting stent (zotarolimus-eluting stent Onyx) and a polymer-free drug-eluting stent (biolimus-A9-coated stent BioFreedom), with only one month of dual antiplatelet therapy in patients at high risk for bleeding. Onyx ONE was a study conducted at 84 sites that randomized 1:1 2000 total patients at…