JAMA Cardiology dedicated a special with 4 articles on different issues women continue to face when considering this area of expertise, or when they have already chosen this fascinating field but still feel undervalued or discriminated compared with their male colleagues. One of the studies showed the career preferences of med school students. What trainees…
Post Carotid Stenting Cerebral Hyperperfusion: a Preventable Complication
This syndrome, which can be reverted, is also one of the causes of preventable stroke, at least in the context of carotid endarterectomy. At present, there is little information on the incidence of this condition in the context of carotid stenting, which is the purpose of this study, in addition to providing tips to prevent it.…
Cost-Effectiveness of Frenestrated or Branched Endoprostheses vs. Open Surgery
Fenestrated of branched endoprostheses are appealing options for the repair of anatomically-complex aortic aneurysms. Their use is limited by their cost (which is high for everyone, everywhere) and also by the lack of a head-to-head study showing best results than open surgery. This work offers results at 2 years for these devices, including an economic assessment…
Endovascular Therapy in Stroke: Much Evidence and Few Trained Operators
Endovascular therapy is now considered as the standard of care for acute ischemic stroke caused by large vessel occlusion. The time between symptoms onset and reperfusion emerges as the most determinant factor for good clinical outcomes, much more strongly than even in acute myocardial infarction. The saying “time is brain” is even more relevant than…
Are Abdominal Aortic Aneurysm Screening Programs Overstated?
With the remarkable drop in tobacco use across the world, also dropped mortality associated to abdominal aorta aneurysm rupture (AAA). All AAA screening programs have been designed decades ago, when the risk was higher. This is why we might need to rethink these programs, or at least design new randomized controlled studies to pave the…
Renal Impairment: How Does It Affect Angioplasty and Surgery?
Courtesy of Dr. Carlos Fava. The incidence of kidney disease is increasing. In its final stage, this pathology is related with coronary disease and increased mortality. Furthermore, we know that, in many occasions, it is associated with diabetes. Nowadays, the evidence comparing the progress of patients with impaired kidney function who have undergone left main…
New Tools to Define Intervention in Asymptomatic Carotid Disease
This meta-analysis included 14 studies and compared the uptake of fluorodeoxyglucose (18F-FDG) according to positron emission tomography (PET)/computed tomography (CT) in symptomatic versus asymptomatic patients, demonstrating a significantly higher uptake in patients with symptomatic lesions. While PET/CT imaging of atheroma is a tool under investigation, with limited applicability in clinical practice, in a relatively close future,…
EuroPCR 2018 | RADIANCE-HTN SOLO: Renal Denervation Guided Through Intravascular Ultrasound
Patients eligible for this study suffered from hypertension, had been treated with up to 2 drugs, and presented a daytime ambulatory blood pressure ≥135/85 mmHg and <170/105 mmHg after a 4-week washout period. The study enrolled 146 patients who were randomized 1:1 to denervation treatment or a sham procedure. The reduction in daytime ambulatory systolic blood pressure was greater…
EuroPCR 2018 | SPYRAL HTN-ON MED: Renal Denervation Comes Back to Life
After several trials with neutral outcomes, renal denervation had been demoted for some time. However, this new study presented at EuroPCR 2018 and simultaneously published in the LANCET brings back the technique with improved devices that seem to yield improved outcomes. The study included patients with uncontrolled arterial hypertension under medical treatment. Eligible patients…
Antithrombotics after Venous Stenting: Rather Different from Coronary Artery Stenting
Should the Antithrombotic/antiplatelet therapy following 10.0 by 60 mm stent implantation to the subclavian vein of a chronic kidney patient be the same as one following a 3.0 by 18 mm stent implantation to the second segment of the left anterior descending artery of this same patient? The daily practice of many interventional cardiologists performing…
Post EVAR Contrast Enhanced Ultrasound Based Follow Up Reduces CT by 90%. Is It Safe Though?
This four-year retrospective analyzis has shown that contrast enhanced ultrasound based follow up protocol post endovascular aortic repair is safe and effective. Aneurysm related mortality, reintervention rate, sac retraction and endoleak detection resulted similar to that of CT based follow up protocols. In this study, doppler and enhanced contrast ultrasound were the main follow up…
