Original title: Reasonable incomplete revascularisation after percutaneouscoronary intervention: the SYNTAX Revascularisation Index. Reference: Philippe Généreux et al. EuroIntervention 2014;10-online publish-ahead-of-print. While the absolute amount of residual disease after coronary angioplasty is associated with poor prognosis, the proportion of treated coronary disease modifying the prognosis is still to be determined. This study attempted to quantify the proportion of coronary…
Lower Rates of In-Stent Thrombosis with the New Generation DES
Original title: New-generation drug-eluting stents reduce stent thrombosis and myocardial infarction: a propensity-score-adjusted analysis from the multicenter REAL registry. Reference: Vignali L et al. Cath Cardiovasc Interv. 2014; Epub ahead of print. Compared to the first generation of drug eluting stents (DES), the new generation has a lower long term risk of in-stent thrombosis and acute myocardial infarction…
PCI Superior to Optimal Medical Treatment in Patients with Ischemic Cardiomyopathy
Original title: Fractional Flow Reserve–Guided PCI for Stable Coronary Artery Disease. The FAME 2 Trial Investigators. Reference: Bernard De Bruyne et al. N Engl J Med 2014;371:1208-17. The FAME 2 and the COURAGE studies tested similar hypothesis, only in the first study PCI was guided by fractional flow reserve (FFR) in addition to an angiography. The study hypothesis…
Patent Foramen Ovale: when to indicate closure
References: Matthew Nayor et al. Contemporary Approach to Paradoxical Embolism. Circulation. 2014;129:1892-1897. Marco Hernandez-Enrıquez et al. Current Indications for Percutaneous Closure of Patent Foramen Ovale. Rev Esp Cardiol. 2014;67(8):603–607. The debate on patent foramen ovale behavior in different clinical contexts remains open, no pun intended. Based on numerous observational studies and expert recommendations, when facing the…
Predictors of Carotid Occlusion Intolerance during Proximal Protected Carotid Artery Stenting
Original title: Predictors of Carotid Occlusion Intolerance During Proximal Protected Carotid Artery Stenting. Reference: Giuseppe Giugliano et al. J Am Coll Cardiol Intv 2014, Epub ahead of print. Proximal endovascular occlusion devices (PEO) have been proved particularly effective and safe for proximal protected carotid stenting procedures. However, endovascular occlusion can expose the ipsilateral hemisphere to hypoperfusion and produce…
Carotid Stenting and Endarterectomy: Equal Long Term Efficacy in Symptomatic Patients
Original title: Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial. Reference: Bonati LH et al. Lancet. 2014;Epub ahead of print. Carotid stenting is an alternative to endarterectomy though long term efficacy remains unknown. This study reports the long term follow up of the International Carotid…
More evidence for unprotected left main PCI
Original title: Outcomes After Emergency Percutaneous Coronary Intervention in Patients UIT unprotected Left Main Stem Occlusion. The BCIS National Audit of Percutaneous Coronary Intervention 6-Years Experience. Reference: Niket Patel, et al. J Am Coll Cardiol Interv 2014;7:969-80 AMI involving unprotected left main is not frequent in catheterization labs since most of these cases present in shock. There is…
Greater platelet reactivity in diabetic patients receiving DES and clopidogrel
Original title: Impact of diabetes mellitus and metabolic syndrome on acute and chronic on-clopidogrel platelet reactivity in patients with stable coronary artery disease undergoing drug-eluting stent placement. Reference: Feldman L. et al. Am Heart J. 2014; Epub ahead of print. Diabetes mellitus type 2 (T2DM) or metabolic syndrome patients undergoing drug eluting stent implantation have 3 to 4…
The higher the bleeding risk, the greater the benefit of radial access in terms of mortality
Original title: Baseline bleeding risk and arterial access site practice in relation to procedural outcomes after percutaneous coronary intervention. Presenter: Mamas A. Mamas et al. J Am Coll Cardiol. 2014;64:1554-1564. The transradial approach has been associated with reduced access site related bleeding complications as well as a reduced mortality in the context of PCI. It seems…
Outcomes are still associated to operator experience and institutional volume
This study is a retrospective analysis of 2,243,209 PCI stenting procedures in the USA between 2005 and 2009. During this period, a reduction in the number of PCI procedures was observed (also observed globally) from 53 in previous years to 33 procedures per operator per year, and from 1,024 to 693 per hospital per year.…
Worse post TAVI ejection fraction recovery in coronary artery disease patients without revascularization
Original title: Impact of coronary artery disease on left ventricular ejection fraction recovery following transcatheter aortic valve implantation. Reference: Freixa X et al. Catheter Cardiovasc Interv. 2014;Epub ahead of print. This single center study analyzed data form 56 consecutive patients with severe aortic stenosis and LVEF of ≤ 50% undergoing TAVI (transcatheter aortic valve implantation) between March 2006…