The fact that polymers can degrade after drug release seems interesting, more so when there appears to be evidence that they might cause inflammation (manly eosinophil infiltration) given its unwanted consequences. However, nice theories often get a reality check, and the polymer discussion is no exception. This article, soon to be published in J Am…
TAVR in Bicuspid Has the Same Results in Surgery at Hospital Level
Courtesy of Dr. Carlos Fava. Bicuspid aortic stenosis patients (bicuspid AS) represent a small group and have not been included in the larger transcatheter aortic valve replacement (TAVR) studies, since they present different morphology and asymmetric calcification, which might come along with more paravalvular leak and less accurate positioning. Between 2012 and 2016, 475,315 patients…
Revascularization in Spontaneous Coronary Artery Dissection Causing ST-Segment Elevation Myocardial Infarction
Spontaneous coronary artery dissection is an increasing cause of acute myocardial infarction, particularly in younger women. These infarctions are frequently treated conservatively given the risks entailed by revascularization, due to the possibility of causing an antegrade or retrograde expansion of the dissection. The uncertainty around treatment for these patients gave way to this study (recently…
Drug Coated Balloons vs. Drug Eluting Stents in Primary PCI
There might come the time when we are finally able to leave nothing behind, at least in the context of primary PCI. The REVELATION study, soon to be published in J Am Coll Cardiol Intv, has shown that paclitaxel coated balloons resulted non inferior to drug eluting stents (DES) in terms of FFR (fractional flow…
DK CRUSH Is Still The Best Option
Courtesy of Dr. Carlos Fava. When it comes to severe unprotected left main distal bifurcation lesions, surgery continues to be the preferred treatment option. However, due to the growing number of patients that cannot receive surgery, left main PCI has significantly advanced, and though the strategy in this scenario remains controversial, double kissing crush stenting…
Thin, Very Thin, and Ultrathin Struts, with Permanent or Biodegradable Polymer… Which Is the Best Combination?
Results from the BIO-RESORT trial at three years, soon to be published in JACC Intv., show that, despite significant differences among stents as regards strut thickness and capability to reabsorb the polymer, there are no apparent safety or efficacy differences among devices. The aim of this study was to determine the three-year safety and efficacy…
STEMI in Coronary Dissections. When Should We Do It and What Are Its Outcomes?
Courtesy of Dr. Carlos Fava. Generally, coronary artery dissection (SCAD) is not very frequent in young women and presents better evolution with medical treatment. However, it is occasionally associated with ST segment elevation. In this scenario, PCI with stent implantation is quite challenging. The study looked at 4298 STEMI patients; 53 presented SCAD (1.23%). STEMI-SCAD…
The Most Read Articles of August in solaci website
1-FDA Expands TAVR Indication to Low-Risk Patients Both the self-expandable valve Evolut R and its direct competitor, balloon-expandable valve Sapien 3, received the authorization to be indicated for low-risk patients in a long-awaited announcement made on August 16th, 2019. Read also HERE 2-Mechanisms of Post PCI Persistent Angina Angina persistence or recurrence after PCI can…
MitraClip in the Real World: Mid-Term Progress
Courtesy of Dr. Carlos Fava. The fact that the outcomes of edge-to-edge repair with MitraClip have improved, particularly in the immediate and short term, is widely known. Such improvement is basically a result of more operator experience and the arrival of 3-D echocardiography. However, there are no mid-term follow-up studies available, except for the EVEREST…
Is Complete Revascularization the Right Choice in Acute Myocardial Infarction with Multivessel Disease?
Courtesy of Dr. Carlos Fava. Primary coronary angioplasty has been the treatment of choice for acute myocardial infarction (MI) for many years, but such strategy is associated with nonculprit lesions in a large group of patients. While it has been proven that nonculprit-lesion revascularization offers better outcomes, the groups that would benefit from it are…