Original Title: Utilizing Post-Intervention Fractional Flow Reserve to Optimize Acute Results and the Relationship to Long-Term Outcomes Reference: Shiv K. Agarwal, et al. JACC Cardiovascular Intervention 2016;9:1022-31 Courtesy of Dr. Carlos Fava. Fractional flow reserve has shown benefits and it is considered the gold standard to assess intermediate lesions (Class IA), but its…
Stent Fracture: More Frequent than Expected
Original Title: Incidence and Clinical Outcome of Stent Fractures on the Basis of 6555 Patients and 16482 Drug Eluting Stents From 4 Centers. Reference: Kan J et al. JACC Cardiovasc Interv. 2016 Jun 13;9(11):1115-23. Courtesy of Dr. Guillermo Migliaro. Stent fracture (SF) has been associated with instent restenosis (ISR), stent thrombosis (ST) and repeat revascularization…
Instent restenosis: Drug eluting balloons or drug eluting stents?
Original Title: Long-Term Results of Everolimus-Eluting Stents versus Drug-Eluting Balloons in Patients with Bare-Metal In-Stent Restenosis 3-Year Follow-Up of the RIBS V Clinical Trial. Reference: Alfonso F. et al. JACC Cardiovasc Interv. 2016 Jun 27;9(12):1246-55. Courtesy of Dr. Agustín Vecchia. RIBS V 3 year follow up Stents have become the gold standard for…
Metoprolol before primary PCI doesn’t reduce infarction size
Original Title: Early Intravenous Beta-Blockers in Patients with ST-Segment Elevation Myocardial Infarction before Primary Percutaneous Coronary Intervention. Reference: Roolvink V et al. J Am Coll Cardiol. 2016 Jun 14;67(23):2705-15. The impact of endovenous beta-blockers before primary PCI has not been established yet. This is the first double blind multicenter trial, controlled with placebo, to…
A new round against aspiration thrombectomy
Original Title: Aspiration thrombectomy prior to percutaneous coronary intervention in ST elevation myocardial infarction: a systematic review and meta-analysis. Reference: Regina El Dib et al. BMC Cardiovascular Disorders (2016) 16:121. Courtesy of Dr. Brian Nazareth Donato. Based on contradicting results obtained from different studies on the role of mechanical aspiration thrombectomy before PCI vs. PCI alone,…
Chronic total occlusions: Pilot experience with BVS
Original Title: Percutaneous coronary intervention for chronic total occlusion of the coronary artery with implantation of bioresorbable everolimus-eluting scaffolds. Poznan CTO-Absorb Pilot Registry. Reference: Maciej Lesiak, et al EuroIntervention 2016;12:e144-e151 Courtesy of Dr. Carlos Fava. Chronic total occlusion (CTO) is a real challenge and have a success rate of around 80% with trained…
Stent thrombosis: Comparative analysis between BMS, DES and BRS
Original Title: Stent Thrombosis with Drug Eluting Stents and Bioresorbable Scaffolds. Evidence from a Network Meta-Analysis of 147 trials. Reference: Kang S et al. J Am Coll Cardiol Intv 2016 doi 10.1016. Courtesy of Dr. Guillermo Migliaro. When treating heart disease, drug eluting stents (DES) have become essential for PCI. Its main advantage lies on…
Post PCI FFR: Outcome and Prognosis Optimization?
Original Title: Utilizing Post-Intervention Fractional Flow Reserve to Optimize Acute Results and the Relationship to Long-Term Outcomes Reference: Shiv K. Agarwal et al. J Am Coll Cardiol Intv. 2016;9(10):1022-1031. Courtesy of Dr. Agustín Vecchia. At present, fractional flow reserve (FFR) has become the gold standard to define ischemia in intermediate lesions, and to…
Left main PCI: Requiem for the Syntax score?
Original Title: Angiographic and Clinical Outcomes After Everolimus-Eluting Stenting for Unprotected Left Main Disease and High Anatomic Coronary Complexity. Reference: JACC Cardiovascular Interventions. Doi: 10.1016/j.jcin.2016.02.016. Courtesy of Dr. Agustín Vecchia. In patients with unprotected left main disease (ULMD) associated to complex coronary anatomy, choosing a revascularization strategy can be challenging. Current guidelines recommend surgery for…
LV: Everolimus Eluting Stents vs. Coronary Artery Bypass Graft
Original Title: Revascularization in Patients with Multivessel Coronary Artery Disease and Severe Left Ventricular Systolic Dysfunction: Everolimus Eluting Stents vs Coronary Artery Bypass Graft Surgery Reference: Bangalore et al. Circulation. 2016 May 5. Epub ahead of print. Courtesy of Dr. Guillermo Migliaro. Guidelines recommend coronary artery bypass graft surgery (CABG) over percutaneous coronary…
Coronary angiogram for all post cardiac arrest patients?
Courtesy of Dr. Agustín Vecchia. There is no doubt cases of post out of hospital cardiac arrest (OHCA) secondary to an ST elevation acute coronary syndrome (STEMI) should be submitted to a coronary angiogram and eventually an angioplasty (PCI). However, in patients with non ST elevation MI, the use of a similar invasive strategy is…