revascularization

Thienopyridine Pretreatment in Non ST Elevation ACS syndrome

Original title: Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. Reference: Bellemain-Appaix A. et al. BMJ. 2014;Epub ahead of print. This meta-analysis included 7 studies that included a total 32383 patients admitted with non ST elevation ACS; 17545 (54.5%) underwent PCI. These studies were published between 2001 and 2013:...

The SYNTAX Score II: a tool that should be used

Original title: Validation and Comparison of the Long-Term Prognostic Capability of SYNTAX Store-II Among 1528 Consecutive Patients Who Underwent Left Main Percutaneous Coronary Intervention. Reference: Bo Xu, et al. JACC Cardiovascular Intervention 2014;7:1128-37.   The SYNTAX angiography score is useful when deciding revascularization in multivessel, but with the addition of clinical variables in the second version, SYNTAX score...

Despite the evidence, visual estimation continues to dominate the decision on intermediate lesions

Original title: Revascularization Decisions in Patients With Stable Angina and Intermediate Lesions. Results of the International Survey on Interventional Strategy. Reference: Gabor G. Toth et al. CircCardiovascInterv. 2014. Epubahead of print.   Measurement of fractional flow reserve (FFR) is recommended by the guidelines and supported by evidence in intermediate lesions when not any proof of ischemia is available...

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...

Less Definite Thrombosis with Everolimus Eluting Stents

Original title: Three-Year Outcomes After Revascularization With Everolimus-and Sirulimus -Eluting Stents From the SORT OUT IV Trial. Reference: Lisette Okkels Jensen et al. J Am CollCardiolIntv, 2014;7: 840-8. Drug eluting stents (DES) have been shown to safely and effectively reduce restenosis compared to bare-metal stents. While the risk of thrombosis remains a matter of concern when it comes...

Direct Implantation of Drug Eluting Stents does not reduce restenosis

Original: Direct drug-eluting Stenting to reduce stent reestenosis (STRESSED). Reference: Wouter S. Remkes et al. J Am Coll Cardiol Intv, 2014;7: 751-8. Direct stenting, without predilation, has been considered a safe and effective technique that reduces procedural time, radiation exposure, contrast material and costs; however, the pertinent studies tested conventional stents only.  This study aimed at assessing whether...

Less Bleeding at the Expense of a Higher Risk of Acute Thrombosis with Bivalirudin

Original title: Bivalirudin versus heparin in patients treated with percutaneous coronary Intervention: a meta-analysis of randomised trials. Reference: Salvatore Cassese et al. EuroIntervention 2014;10-online publish-ahead-of-print August 2014. Current recommendations for the use of bivalirudin in PCI patients are mostly based on studies comparing bivalirudin vs. heparin combined with glycoprotein IIb/IIIa inhibitors. Whether bivalirudin is superior to heparin alone...

Percutaneous Coronary Intervention to Unprotected Left Main Stem In Different Coronary Syndromes

Original title: Comparative Outcomes After Unprotected Left Main Stem Percutaneous Coronary Intervention: A National Linked Cohort Study of 5,065 Acute and Elective Cases From the BCIS Registry (British Cardiovascular Intervention Society). Reference: Sami S. Almudarra, et al. JACC Cardiovasc Interv 2014;7:717-30 Although myocardial revascularization surgery has long been the gold standard treatment for left main lesions, PCI has...

Thrombosis with bioresorbable scaffolds: the story of DES all over again?

Original title: Percutaneous coronary intervention with everolimus-eluting bioresorbable vascular scaffolds in routine clinical practice: early and midterm outcomes from the European multicentre GHOST-EU registry. Reference: Capodanno D et al. EuroIntervention. 2014 Jul 18. Epub ahead of print   The GHOST-EU registry, that included 1189 patients from 10 European centers between 2011 and 2014, is now the largest registry...

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