In recent years, there has been a growing concern about the occupational hazard for interventional cardiologists who have high and unprecedented levels of ionizing radiation exposure. microRNAs are a class of short and highly conserved non-coding RNA molecules (about 22 nucleotides) that become altered (dysregulated) in many diseases. Read also: “Nearly half of interventional cardiologists may…
An Important Study Shows That Renal Function Must Be Cared for in TAVR
Courtesy of Dr. Carlos Fava. The presence of renal dysfunction in the “real world” is over 25% in patients who undergo transcatheter aortic valve implantation (TAVI). The evolution of this disease among patients who are subjected to a replacement is well known, but evidence for patients who undergo TAVI is still limited, particularly for those who…
Multivessel Disease and Severe Carotid Stenosis: How to Proceed
Myocardial revascularization surgery (CABG) is the most frequent of all cardiovascular surgeries and is still the gold standard to treat multivessel disease. Between 6 and 8% of these patients present concomitant carotid stenosis and it is associated with increased peri and post procedural stroke rates during and after surgery. To prevent carotid stenosis, either PCI or endarterectomy…
Endarterectomy vs. Stenting in Asymptomatic Carotid Artery Stenosis
The comparative efficacy and safety of carotid stenting vs. endarterectomy in asymptomatic carotid stenosis patients remains controversial and, what is worse, consensus seems unlikely in the near future. Given the lack of definite evidence, several meta-analyzis and systematic reviews have been produced in an attempt to shed some light on this matter. This study included all…
New Strategies for the Femoropopliteal Artery
Courtesy of Dr. Carlos Fava. The incidence of peripheral vascular disease is clearly increasing, progressing towards critical ischemic claudication and amputation. Angioplasty is currently the treatment of choice for these pathologies. Several times, an implanted stent ends up cracking due to extensive calcification, increasing the rate of restenosis and worsening critical ischemia. Technological development on drug-eluting…
A New Opportunity for Renal Denervation
Courtesy of dr. Carlos Fava. At first, renal denervation enjoyed a considerable boost because, according to early studies, it lowered blood pressure (BP). However, after the results of the SYMPLICITY HTN 3 Trial its popularity decreased. Currently, the development of new technologies and greater operator experience may facilitate a change in this scenario. This…
The need for dialysis after TAVR increases mortality
Courtesy of Dr. Carlos Fava. Stage III or higher renal impairment is frequent before TAVR, and the need for new dialysis after the procedure may reach up to 20%. Within that percentage, 5% may require permanent dialysis, which increases mortality up to 9 times at one year. In that sense, factors leading to that complication have not…
Minimum Appropriate Follow-Up Reduces Mortality After Endoprosthesis Implantation
No study has been able to prove long-term benefit of regular imaging follow-up after abdominal aortic aneurysm repair by means of endoprosthesis implantation. This is important because the costs for these studies are high, which should be added to potential radiation and contrast morbidity. This work sought to characterize the association between post-endovascular abdominal aortic aneurysm…
SPYRAL HTN-OFF MED: Renal Denervation Reloaded?
This work presented at the ESC Congress 2017 held in Barcelona, simultaneously published in The Lancet, seems to give hope to all those that still believe in renal denervation. Interim outcomes suggest that a more intensive denervation of renal arteries, carried out at the SYMPLICITY HTN-3 trial, could reduce blood pressure in patients with untreated mild to moderate hypertension.…
2 Year Outcomes of Lutonix Drug Coated Balloon in Superficial Femoral Arteries
There are plenty of clinical studies assessing the use of angioplasty for en la peripheral artery disease with restenosis rates as high as 40% and 60% at 6 and 12 months. Drug coated balloons have significantly raised primary patency, but they have mostly been tested in short lesions with mild calcification and no total occlusions. This…
Risk of Thrombosis and Bleeding with Peripheral Artery Disease and Concomitants
Peripheral artery disease (PAD) is no longer a systemic manifestation of atherosclerosis. In fact, 2 in 3 people with PAD have concomitant heart disease, and 1 in 3 people has concomitant PAD. To understand the real dimension of this problem, we should know that PAD patients have 60% more risk of acute myocardial infarction…