According to this single-site study, published in J Am Coll Cardiol Intv., interventional cardiologists can safely conduct revascularizations in a setting of acute stroke, with high clinical and technical success. Cardiologists are taking on this traditional interventional neurology field simply due to the lack of interventional neurologists, who are thus unable to provide coverage 24/7,…
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…
Should We Start Using the Retrograte Access in Critical Limb Ischemia?
Courtesy of Dr. Carlos Fava. Peripheral vascular disease in lower limbs is on the rise. Antegrade recanalization is associated with amputation and death, and therefore contraindicated. For a while we have been using the retrograde access when classic revascularization is not possible. Even though there is evidence in favor of this access, it is just…
The Real Impact of Peripheral Artery Disease in TAVR
Courtesy of Dr. Carlos Fava. The real incidence of peripheral artery (PAD) disease in TAVR remains unclear. Different reports still estimate it is between 10 and 46%, but they have shown it has a negative impact in evolution. 51,685 TAVR patients were analyzed. 12,740 of these patients presented PAD (24.6%). PAD patients tended to be…
The Most Read Articles of July in solaci website
1-Though Systolic BP Seems More Important, Diastolic BP Should Not Be Disregarded Systolic hypertension is more often associated to cardiovascular events. However, diastolic blood pressure should not be disregarded, since it can also predict even worse outcomes. Read more HERE 2-After Much Toing and Froing, Gastrointestinal Protection Is Back to the Forefront Several clinical guidelines…
Permanent Carotid Coil Filters in Patients with Atrial Fibrillation
This new strategy to reduce the risk of stroke in patients with atrial fibrillation is technically feasible and safe, even though long-term outcomes are yet to be seen and despite the evidence available, for instance, left atrial appendage closure devices. It is true that they could be used simultaneously, but its synergy and cost have…
Angioplasty vs. Surgery in Lower Limb Ischemia
This analysis of data from an already published study, “Bypass Versus Angioplasty in Severe Ischemia of the Limb (BASIL-1),” confirms the superiority of bypass over balloon angioplasty, with or without stenting, in patients with chronic lower limb ischemia who require a femoropopliteal intervention. While analyzed interventions took place between 1999 and 2003 (a fact subject…
New FDA Updates on Paclitaxel Device Outcomes
A new FDA letter confirms late mortality signal with paclitaxel eluting stents and paclitaxel coated balloons in peripheral territory. Even though this recently published letter confirms data, there are no new recommendations on the use of these devices. After careful consideration of their own analyzis outcomes and a 2-day discussion of an advisory panel especially…
Supervised Exercise and Revascularization for Intermittent Claudication
The combination of optimal medical treatment plus angioplasty plus supervised exercise seems to be the first line of treatment for patients with intermittent claudication, in terms of maximum walking distance and best quality of life. This combination requires a multidisciplinary team for the best possible results. The aim of this study was to conduct a…
Vena Cava Filter for All Patients After Severe Trauma
Until today, there was no evidence warranting the early implantation of a vena cava filter for the reduction of the risk of pulmonary embolism in patients with severe trauma and contraindication to prophylactic anticoagulation. This article, soon to be published in the New England Medical Journal (NEJM), brings us such evidence and we surrender to…
Improved Outcomes after Lower Limb Revascularization
Operator ability combined with improved and diverse devices for lower limb revascularization has clearly increased in the last decade. However, is this technical feasibility we did not use to have translating into better clinical outcomes for patients, or is it simply inflating our interventionist egos? This study aims at answering the question above by identifying…