Guidelines recommend that carotid endarterectomy be performed within two weeks of stroke in patients with symptomatic carotid stenosis. Because a Swedish registry study showed patients treated within the first days after a transient ischemic attack or stroke are at increased risk of death and perioperatory stroke, this study aims at verifying this risk in…
Cerebral Protection in TAVR: Studies Presented at London Valves
SENTINEL One of the new devices assessed at London Valves was Sentinel, which is made up of two independent filters. The larger filter is deployed in the brachiocephalic trunk, and the smaller filter is deployed in the left common carotid artery. The study included 22 patients and the device was deployed successfully in 20 of them…
Residual Thrombus After Aspiration Thrombectomy: Does It Affect the Outcome of Primary Angioplasty?
The aim of this study was to evaluate if the residual thrombus burden after aspiration thrombectomy may affect the outcome of primary angioplasty in patients with acute coronary syndrome with ST-segment elevation. The most recent studies on aspiration thrombectomy failed to show clinical benefit in patients with ST-segment elevation. This study is based on…
Cardiovascular Events Reduction: Bivalirudin or Heparin?
The MATRIX study did not find a clear advantage of bivalirudin over unfractioned heparin to reduce major adverse cardiovascular events (MACE) or net cardiovascular adverse events (NCAE) in patients undergoing acute coronary syndrome receiving PCI. This new analyzis confirms there is no difference in ischemic and thrombotic events in patients with acute coronary syndrome…
How to Make Radial Access Even Safer with Minimum Effort
Courtesy of Dr. Agustín Vecchia. Since 1990, radial access has progressively gained ground, currently becoming the default technique in most endovascular intervention centers. One of its few associated complications is radial artery occlusion. While most frequently clinically silent and non-serious, this complication could hinder the performance of future procedures in the patient and, in some…
Rechanneling a CTO in a Non-Infarct-Related Artery After Primary PCI: Yes or No?
Between 10% and 15% of patients admitted with ST-segment elevation myocardial infarction present concurrent coronary chronic total occlusion (CTO) in a non-infarct-related artery, which is associated with increased morbidity and mortality. The EXPLORE (Evaluating Xience and Left Ventricular Function in Percutaneous Coronary Intervention on Occlusions After ST-Elevation Myocardial Infarction) trial evaluated whether patients admitted…
Bioresorbable Scaffolds: Promising in Peripheral Territory
Bioresorbable Vascular Scaffolds (BVS) could change the paradigm of peripheral angioplasty according to several small studies suggesting these everolimus eluting devices could significantly improve symptoms in patients with intermittent claudication. [plain] Three year outcomes of the ESPRIT I trial, presented at VIVA 2016 (held in Las Vegas) showed there were no new events between…
Paclitaxel Drug Coated Balloon in Femoral: Effective at Long Term?
In patients with symptomatic peripheral vascular disease, the paclitaxel coated balloon showed superior efficacy at 3 years compared to the conventional balloon, in addition to very good results at one year when tested in the real world outside strict trial inclusion/exclusion criteria. Both the IN.PACT SFA trial and the IN.PACT SFA global registry showed…
Percutaneous Device Closure of PVL: An Alternative to Surgery
Paravalvular Leak (PVL) occurs in 5 to 17% of patients undergoing surgical valve replacement. Percutaneous device closure of PVL represents an alternative to repeat surgery. All centers in UK and Ireland performing percutaneous PVL closure delivered their data to the UK PVL registry. Data were analyzed for factors associated with mortality and major cardiovascular…
Is It Safe to Discontinue Ticagrelor One Day Before CABG?
Courtesy of Dr. Agustín Vecchia. Nearly 10% of patients with acute coronary syndrome (ACS) require surgery. Managing periprocedural dual antiplatelet therapy (DAPT) in ACS patients is controversial and, to date, there are no randomized trials in this regard. Guidelines recommend ticagrelor discontinuation five days prior surgery and in the most emblematic work on this drug…