Courtesy of Dr. Carlos Fava. Health system costs have increased significantly and there have been attempts to reduce it without compromising the quality of PCI outcomes. The benefits of the transradial approach combined with same day discharge could help reach this goal. This study included 279,987 MEDICARE PCI procedures where costs were analyzed. Cases…
Zotarolimus with Durable Polymer vs. Biolimus with Biodegradable Polymer
The present work compared the safety and efficacy of the permanent polymer zotarolimus eluting stent vs. the biodegradable polymer biolimus eluting stent in unselected coronary artery disease patients. The biodegradable polymer biolimus eluting stent resulted superior to the first generation durable polymer stent in long term randomized studies. However, little evidence supports this superiority…
RESOLUTE Global: 5 Years of Zotarolimus DES Stenting
This study assessed the cumulative incidence of cardiovascular evens after zotarolimus eluting stent implantation. Individual studies often lack enough statistical power to show differences in low frequency adverse events. The Resolute zotarolimus eluting stent was evaluated across 10 prospective clinical trials designed with identical adverse events definitions. The Global Resolute clinical trial program…
Critical Limb Ischemia: Wound Blush Is the Most Important Objective
The aim of this study was to find the optimal angiographic endpoint for infrapopliteal interventions to be able to predict wound healing. Evidence shows acceptable patency and successful limb salvage in patients with critical limb ischemia after infrapopliteal intervention. However, the optimal angiographic endpoint remains unclear. Is it enough to restore flow in one…
A new alternative for PCI of the common femoral artery
Courtesy of Dr. Carlos Fava. Not long ago, atherosclerosis of the common femoral artery used to be treated surgically and, thanks to better training and new balloon devices, we have advanced the endovascular treatment alternative. However, severe calcification continues to be a great limitation. This study aimed at evaluating the feasibility and one year…
Pacing with a 0.035” Guidewire, an Old Technique Coming Back to Simplify TAVR
This study seeks to prove the safety and efficacy of rapid left ventricular pacing through a 0.035” guidewire during aortic valvuloplasty and transcatheter aortic valve replacement (TAVR). Right ventricular temporary pacing placed through venous access during aortic valvuloplasty or during TAVR is time-consuming and, above all, associated with cardiac perforation and tamponade. Since…
Aspirin Desensitization in Patients with Coronary Artery Disease
There are limited data on aspirin desensitization in patients with coronary artery disease (CAD). The aim of this study was to test the safety and efficacy of a rapid desensitization protocol inpatients with a history of aspirin sensitivity about to receive PCI. This was a prospective multicenter observational study, carried out in seven Italian…
MitraClip: Impact of Sinus Rhythm and Heart Rate
Courtesy of Dr. Carlos Fava. Atrial fibrillation (AF) and fast heart rate (>70 lpm) have been shown to increase the risk of mitral valve repair surgery. The MitraClip has shown benefits in high risk patients, but its relation to abnormal heart rhythm has not yet been established. 760 patients were analyzed; 315 (52.4%) presented…
Cerebral Protection in TAVR: Does It Improve Cognitive Function?
Neurological complications during transcatheter aortic valve replacement (TAVR) may be reduced with cerebral protection devices; this study was designed to explore that hypothesis. The study enrolled 363 patients undergoing TAVR in 19 sites and divided them in three arms: a safety arm (n = 123), a device imaging arm (n = 121), and a non-device imaging arm (n = 119). The…
Meta-analysis on Cerebral Embolic Protection in TAVR
Cerebral embolic protection is a strategy to prevent embolization of thrombotic or calcific debris during transcatheter aortic valve replacement (TAVR). A number of randomized and controlled studies have tested the safety and efficacy of various devices, though none of them have enough statistical power to show significant differences in end points. While preliminary…