Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and…
Everolimus DES are more effective and less costly than conventional BMS
Courtesy of Dr. Guillermo Migliaro. Drug eluting stents (DES) represented the greatest technological advance in the treatment of instent restenosis from conventional metallic stents (BMS), especially cobalt chromium everolimus eluting stents (CoCr EES), which have shown an excellent profile, and are mostly safer, compared to first generation DES. Indeed, several randomized studies and meta-analyzis have…
TAVR presents less post-procedural MI than surgical aortic valve replacement
Courtesy of Dr. Carlos Fava. Surgical aortic valve replacement (SAVR) continues to be elective, but the presence of post-procedural acute myocardial infarction (AMI) has been associated to bad evolution. Despite the proven benefits of TAVR for high risk patients and the progress shown by patients of intermediate risk, the incidence of post implantation MI has…
Same-day discharge after coronary angioplasty is increasingly popular but still not the gold standard
The length of hospital stay after elective coronary angioplasty varies significantly among operators and hospitals, according to a recent survey of interventional cardiologists in the United States (US), Canada, and the United Kingdom (UK), published in Catherization and Cardiovascular Interventions. While same-day discharge is a routine proceeding in the UK, most interventional cardiologists surveyed mentioned…
Biodegradable-polymer stents are as safe as permanent-polymer stents in a 5-year follow-up
Courtesy of Dr. Carlos Fava. One of the questions around drug-eluting stents (DES) is whether the development of biodegradable polymers would derive in better outcomes than the performance of durable polymers as regards the presence of events. In consequence, the COMPARE II trial was carried out with the aim of testing them in “real-world” patients. This…
Mortality at one year in post PCI myocardial infarction
Courtesy of Dr. Brian Nazareth Donato. Multiple definitions with biomarkers and variable thresholds have been proposed to diagnose post procedural MI. The last update of the Third Universal Definition of Myocardial Infarction decided to use only troponin values with a threshold >5 over the normal value, on top of the clinical evidence by ECG, echocardiography…
Angioplasty in lesions due to radiation treatment presents similar mortality rates
Courtesy of Dr. Carlos Fava. Thoracic radiation causes cardiac lesions, and coronary arteries are among the most affected structures. Furthermore, it provokes obstructive lesions due to wall fibrosis. Generally, patients with this background are not eligible for surgery and receive angioplasty, a seemingly great alternative. However, there is no clear information on outcomes yet. This…
EuroCTO: Rechanneling vs. Optimal Medical Treatment in Total Occlusions
Courtesy of the SBHCI. Chronic total occlusions represent around 18% of all coronary lesions. However, they account for just 5% of all interventions, which means that many patients only receive medical treatment. This prospective, open, multicenter study randomized patients with multivessel lesions in whom at least one of these was a chronic total occlusion. Patients…
Nearly half of interventional cardiologists may have pre-cataract lesions
This statement is based on eye exams conducted during the last SCAI meeting (Society for Cardiovascular Angiography and Interventions), where 47% of evaluated operators had radiation related lesions in their crystalline. In time, these might turn into cataract. Studies on astronauts and Chernobyl survivors have shown a clear association between ionizing radiation and crystalline damage,…
PRISON IV: DES with resorbable polymer vs. DES with permanent polymer in total occlusions
Courtesy of SBHCI. The PRISON IV trial compared the sirolimus eluting stent with ultra-thin struts and biodegradable polymer vs. the second-generation everolimus-eluting stent with thin struts and durable polymer in successfully recanalized chronic total occlusions. This is a sub-study with optical coherence tomography (OCT). The study included 330 patients, 85% angiographically followed up at…
Leaders Free ACS: Good Results for the Polymer-Free Stent at 2 Years in ACS
Courtesy of the SBHCI. Guidelines recommend dual antiplatelet therapy for a year in patients admitted with coronary acute syndrome. However, patients at high risk for bleeding who receive coronary angioplasty have been historically excluded from studies. The new polymer-free stent BioFreedom allows for the reduction of dual antiplatelet therapy time, due to rapid drug elution…