One in three “nondiabetic” patients who undergo angioplasty with current drug-eluting stents have an altered glucose metabolism, which is associated with a 4-fold higher risk of events, according to a study that will be published soon in JACC Intv. One in three patients is definitely one patient too many, and four times higher is definitely…
Next-Day Discharge after TAVR: Is It Viable?
Next-day discharge after transfemoral transcatheter aortic valve replacement (TAVR) might be viable, with no major complications at 30 days or one year, compared against patients with longer hospital stay. We only have to consider a few factors that will help us choose the most adequate patients for this modality without compromising safety. One of the main advantages…
Complete Revascularization Is Beneficial in Acute MI with Cardiogenic Shock
Around half of all cases of ST-segment elevation acute myocardial infarction (STEMI) come alongside lesions in another vessel, for which the current strategy is complete revascularization in one or two steps. However, there are no large-scale studies analyzing patients who also present cardiogenic shock; we only have observational studies with inconclusive results influenced by several…
Keys to Productivity Improvement in the Cath Lab
The systematic reduction of inefficiencies in the catheterization laboratory (such as the improvement of lab room start times and room turnaround times) can definitely improve the productivity of a Department of Interventional Cardiology without forcing its members to stay in the facilities longer. As a matter of fact, work can be finished even faster with…
What Is the Prognosis for Reinterventions in Critical Lower Limb Ischemia?
Infrapopliteal (below the knee, BTK) percutaneous transluminal angioplasty (PTA) has been acknowledged as a useful strategy in chronic critical limb ischemia (CLI), but artery calcification severity results in considerable restenosis. Repeat PTA and the management of trophic lesions help with wound healing. However, this conduct has not been extensively assessed. This study enrolled 152 patients (175 limbs)…
Red Light for TAVR in Low Surgical Risk Patients
A new study raises an alarm against expanding transcatheter aortic valve replacement (TAVR) procedures to low surgical risk patients, since 2 year mortality seems higher in these patients with TAVR, compared to conventional surgery. This study will soon be published in Catheter Cardiovasc Interv. Expanding TAVR to low risk patients might involve risks we have not…
Win a Grant to the C3 in Orlando, Florida
From June 27th to June 30th, Orlando, Florida will hold the Complex Cardiovascular Catheter Therapeutics (C3 Conference), an event with a steadily growing number of attendees each year. The Conference Organizing Committee grants, through SOLACI, five scholarships for professionals aiming to present their approved work or complex case. Scholarships include the following: Congress…
Lesion Targeting Seems to Be the Secret in Critical Ischemia
Ulcers that do not heal, thus threatening the integrity of a lower limb in patients with critical ischemia, is a main concern. Sometimes, despite successful revascularization, major amputation cannot be prevented. The anatomical description of angiosomes started in the 70s as a way of optimizing tissue grafts. Angiosomes are basically blocks of tissue that include…
Routine FFR/iFR Reclassifies Treatment Strategies in Half of Cases
Routine invasive physiology assessment at time of angiography reclassifies treatment strategies in a big number of patients with lesions in 2 or 3 vessels, according to the multicenter prospective study DEFINE REAL, recently published in JACC Cardiovascular Interventions. The information obtained by measuring fractional flow reserve (FFR) or instantaneous wave free ratio (iFR) made interventionists modify their original plans in…
What Is the Best Antiplatelet Therapy in Primary Angioplasty at 12 Months?
Both prasugrel and ticagrelor showed superiority in terms of efficacy, reducing the number of major cardiovascular events at the expense of increased bleeding. This is an affordable cost, and the net clinical benefit supports these new antiplatelet therapies. The one-year follow-up of the PRAGUE-18 study focused on a comparison of efficacy and safety between prasugrel…