1- Surprising EXCEL Outcomes in Diabetics with Main Left Stenosis This study especially designed to compare PCI vs. CABG in patients with left main coronary artery disease and low to intermediate Syntax score showed that 30-day and 3 -year outcomes of PCI with everolimus eluting stents vs CABG were consistent both in diabetic and non-diabetic…
Mortality and Paclitaxel Devices, Data Are Aligning
5 years ago, several prospective randomized studies confirmed paclitaxel coated balloons were safe and effective in femoropopliteal territory. However, a recently published meta-analysis of heterogeneous studies including both paclitaxel coated balloons and drug eluting stents has linked these devices to mortality. In addition, higher doses were associated to higher mortality, both at 2 and 5…
New Risk Factors: Air Pollution, Air Temperature, Pain, and Sleep Hours
Traditionally, we have used age, gender, obesity, hypertension, dyslipidemia, smoking, and diabetes as cardiovascular risk factors. However, this new era (during which the changes made to care for our shared home, the planet, will play a key role) has seen the emergence of new factors such as pollution, noise, temperature, sleep hours, and air quality.…
EuroPCR 2019 | EFFPAC: New Peripheral Paclitaxel Coated Balloons, Efficacy with no Sign of Mortality
Paclitaxel coated balloons in peripheral territory have been under the spotlight for alleged increased mortality, which even though not observed in this study, experts insist, calls for new studies with enough statistical power. Compared against plain balloon angioplasty, paclitaxel coated balloons resulted in improved patency and less revascularization at 24 months in superficial or popliteal…
New Percutaneous Devices to Prevent Embolism in Atrial Fibrillation
Patients with atrial fibrillation (AF) unsuitable for anticoagulation because of bleeding risk, require other strategies to prevent stroke. For some years, there have been in the market (limited to some places; not as part of the regular agenda of cardiologists and hematologists) devices to occlude the atrium that have been proved safe and effective. These…
Patients: What They Really Want to Know about Their Disease
When we decide that 30-day mortality to repair an abdominal aortic aneurysm (AAA) is at least twice as high with conventional surgery compared against endovascular treatment, many of us think choosing a strategy is far from hard, and recent stats show exactly that. However, are we sure our patient agrees with us, or at least…
The Most Read Articles of March in Interventional Cardiology
1- What to Do with Blood Pressure Levels Between 130/80 and 139/89 mmHg The decision to be made with a treatment-free patient with systolic blood pressure over 160 mmHg or diastolic blood pressure over 100 mmHg is an easy one. All guidelines agree: treatment should be started immediately alongside lifestyle changes. Read more 2-…
New Device for More Protection in Carotid Artery Stenting
This new “Paladin” system for post-dilation during carotid artery stenting was safe and may effectively reduce the number of particles that reach the brain, with a subsequent decreased risk for peri-procedural stroke. This study evaluated the safety and efficacy of the Paladin System, a novel post-dilation balloon with an integrated distal protection filter designed to…
¿Metformin to Treat Abdominal Aortic Aneurysms?
Currently, there are no drugs to treat abdominal aortic aneurysms (AAA) outside those indicated as secondary prevention drugs. What this study shows is that diabetic patients treated with metformin had lower AAA incidence than diabetic patients treated without metformin, and even lower incidence than non- diabetic patients, as if metformin per se were a…
Drug-Eluting Stents vs. Balloons While Paclitaxel Is in the Eye of the Storm
Even after the US Food and Drug Administration (FDA) issued an alert on paclitaxel devices in patients with femoropopliteal artery disease, which caused the interruption of a few ongoing studies, reality indicates that the efficacy of these devices has been proven and that they are still used. The increased mortality observed in the meta-analysis that…
Descending Thoracic Aortic Aneurysms: Is There a New Plan A?
The last available evidence suggests that open surgery should be the preferred treatment for intact descending thoracic aortic aneurysms. However, this study recently published in J Am Coll Cardiol, seems to have steered the wheel. In this study, open surgery was associated to increased early mortality and lower late mortality. Despite this long-term benefit, mean…