Diabetic patients have twice as high a risk of developing coronary artery disease (CAD). Additionally, CAD increases mortality risk. Patients with a history of percutaneous coronary intervention (PCI) tend to need repeat revascularization, even with second generation stents. To date, there are few studies assessing the role of glycemic control in stent failure, stent thrombosis,...
Sirolimus-Eluting Balloon in Femoropopliteal Disease
Drug-eluting balloons (DEB) with paclitaxel have shown efficacy and safety in the treatment of femoropopliteal disease. Sirolimus-eluting balloons (DEB S) are currently being introduced. This new drug acts during the cellular resting phase (G0) and is considered potentially more effective than paclitaxel, which is a cytostatic drug. However, there is no conclusive evidence in this...
AGENT-IDE: Drug Coated Balloons for Instent Restenosis
Drug eluting stents (DES) have improved considerably over the years, reducing the initial indices of instent restenosis (ISR) by roughly 5-10% a year in USA. However, DES failure might lead to neointimal hyperplasia and neoatherosclerosis, which increases the chance of developing chronic and acute coronary syndromes. Drug coated balloons (DCB), which administer anti-proliferative agents with...
Network Meta-Analysis of Complementary Imaging (IVUS/OCT + Conventional Angiography) for Coronary Stenting
Complementary imaging allows for the identification of numerous scenarios not visible with conventional angiography (ICA), both for the assessment of differential diagnoses and the improvement of percutaneous coronary intervention (PCI) outcomes. Advantages include assessment of plaque characteristics, vessel plaque burden, stent edge dissection, vessel diameter, and correct apposition, among others. While intravascular ultrasound (IVUS) was...
Recurrent Revascularization at 10 Years after Percutaneous Treatment of DES In-Stent Restenosis
In stent restenosis (ISR) continues to be the main limitation to the percutaneous treatment of coronary artery disease, with 5 to 10% prevalence after new generation DES stenting. Guideline recommendations for this intervention include new DES stenting and the use of drug coated balloons (DCB). Recurrent ISR stenting rate ranges between 10 and 40%, and...
Ultrathin Stents Shown Safe and Effective in Real World Patients
Ultrathin drug eluting stents (60 µm) had been shown beneficial vs. thin-strut stents in terms of target lesion failure (TLF) at 2, 3 and 5 years in randomized studies, but they had not been yet assessed in “real world” patients. The BIOFLOW VII is a prospective, multicenter study including 556 “real world”patients with a total...
Intrastent Restenosis in Ostial Lesions in the Right Coronary Artery: Predictors of an Unfavorable Location
Predictors of intrastent restenosis in the right coronary artery ostium. The ostium of the right coronary artery (RCA) presents certain histological aspects. Atherosclerotic and fibrotic plaques in this area contain an abundance of smooth muscle, collagen, and a certain degree of calcification, along with thicker adventitia. Additionally, it has certain anatomical aspects such as poor...
EuroPCR 2023 | EBC Two – Provisional Stenting vs Culotte in Bifurcations
MD Sandeep Arunothayaraj presented the 5-year followup of EBC Two (which had not previously shown significant differences in clinical outcomes at 12 months) in patients randomized to provisional stenting vs. systematic culotte in bifurcations that were not left main. The study followed up 200 patients with true bifurcations, side branch ≥2.5mm and lesion length ≥5mm,...
Drug-Eluting Balloon in STEACS: Leaving No Trace is Beneficial?
Using drug-eluting balloons in patients with ST-segment elevation acute coronary syndrome. The benefits of early reperfusion in ST-segment elevation acute coronary syndromes (STEACS) have not been discussed; compared with fibrinolysis, primary percutaneous coronary intervention (pPCI) has shown benefits in terms of mortality. Despite the constant advancements in stent technology and design, these devices are not...
Arterial Patency in Femoropopliteal Disease with Drug-Eluting Balloons
Follow-up of drug-coated balloon angioplasty in femoropopliteal disease in a real-world population. Using drug-releasing devices has decreased the rate of restenosis in obstructive femoropopliteal lesions compared with conventional balloons or conventional stents (bare-nitinol stent, BNS). Both in the placement of BNS and of drug-eluting stents (DES) there is a mechanical risk of stent fracture or...