The NIPPON trial (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was a randomized study comparing a short dual antiplatelet therapy scheme (6 months) vs. a prolonged scheme (18 months) in patients receiving the Nobori drug eluting stent (Terumo, Tokyo, Japan) with a biodegradable abluminal polymer. It included 3,773 patients with chronic stable angina or acute coronary...
New generation DES present better results in vein grafts than older DES and BMS
There is little information comparing contemporary drug eluting stents (DES) against bare metal stents (BMS), for PCI in saphenous vein grafts in patients receiving (CABG). This study aimed to assess clinical outcomes after PCI in saphenous vein grafts in patients receiving BMS, first generation DES, and new generation DES between 2006 and 2013. The study...
Everolimus DES are more effective and less costly than conventional BMS
Courtesy of Dr. Guillermo Migliaro. Drug eluting stents (DES) represented the greatest technological advance in the treatment of instent restenosis from conventional metallic stents (BMS), especially cobalt chromium everolimus eluting stents (CoCr EES), which have shown an excellent profile, and are mostly safer, compared to first generation DES. Indeed, several randomized studies and meta-analyzis have...
PRISON IV: DES with resorbable polymer vs. DES with permanent polymer in total occlusions
Courtesy of SBHCI. The PRISON IV trial compared the sirolimus eluting stent with ultra-thin struts and biodegradable polymer vs. the second-generation everolimus-eluting stent with thin struts and durable polymer in successfully recanalized chronic total occlusions. This is a sub-study with optical coherence tomography (OCT). The study included 330 patients, 85% angiographically followed up at...
Second-Generation DES Present Lower Mortality Rates for Vein Grafts
Courtesy of Dr. Carlos Fava. The treatment of vein graft lesions has always been difficult in relation to angioplasty, due to their characteristics. While drug-eluting stents (DES) have proven to be superior to bare-metal stents (BMS) for coronary arteries, such superiority is unclear as regards vein grafts. Several studies with first-generation DES (DES1) have even reported...
DESSOLVE III: Xience vs. MiStent
The MiStent device is made of cobalt-chromium, with struts of up to 64 µm thick. It is coated with a completely absorbable polymer that contains a microcrystalline form of sirolimus that embeds directly into the vessel wall. The drug is eluted continuously for up to 9 months. This was a multicenter noninferiority study that randomized patients...
Peripheral artery disease associated to ischemic and bleeding events after DES implantation
Patients with peripheral artery disease (PAD) have higher rates of cardiovascular events after DES implantation, which could be explained partly by higher platelet reactivity. The present work studies the relationship between platelet reactivity and clinical events after PCI in patients with and without a history of peripheral artery disease. The ADAPT-DES study (Assessment of...
Proximal anterior descending artery angioplasty: what are its long-term outcomes?
Courtesy of Dr. Javier Castro. Certain coronary lesions have been historically discouraged for endovascular treatment. Among these can be found left main coronary artery lesions, multivessel disease, and proximal anterior descending artery lesions. As a matter of fact, the latter is actually considered separately as a criterion for choosing the revascularization method. Endovascular treatment of...
RESOLUTE Global: 5 Years of Zotarolimus DES Stenting
This study assessed the cumulative incidence of cardiovascular evens after zotarolimus eluting stent implantation. Individual studies often lack enough statistical power to show differences in low frequency adverse events. The Resolute zotarolimus eluting stent was evaluated across 10 prospective clinical trials designed with identical adverse events definitions. The Global Resolute clinical trial program...
Aspirin Desensitization in Patients with Coronary Artery Disease
There are limited data on aspirin desensitization in patients with coronary artery disease (CAD). The aim of this study was to test the safety and efficacy of a rapid desensitization protocol inpatients with a history of aspirin sensitivity about to receive PCI. This was a prospective multicenter observational study, carried out in seven Italian...