stent

Las angioplastias exitosas en pacientes mayores con oclusiones crónicas totales disminuyen la mortalidad

Successful angioplasty in elderly patients with chronic total occlusion reduces mortality

Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75&nbsp;years old due to their frailty and<a href="https://solaci.org/en/2017/06/19/successful-angioplasty-in-elderly-patients-with-chronic-total-occlusion-reduces-mortality/" title="Read more" >...</a>

Los DES liberadores de everolimus son más eficaces y menos costosos que los stent metálicos convencionales

Everolimus DES are more effective and less costly than conventional BMS

&nbsp;Courtesy of Dr. Guillermo Migliaro. Drug eluting stents (DES) represented the greatest technological advance in the treatment of instent restenosis from conventional metallic&nbsp;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. &nbsp; Indeed, several randomized studies and meta-analyzis have<a href="https://solaci.org/en/2017/06/16/everolimus-des-are-more-effective-and-less-costly-than-conventional-bms/" title="Read more" >...</a>

Mortalidad a un año en infarto post PCI

Mortality at one year in post PCI myocardial infarction

Courtesy of Dr. Brian Nazareth Donato. Multiple definitions with biomarkers and variable thresholds have been proposed to diagnose post procedural MI. The last update of the Third Universal Definition of Myocardial Infarction decided to use only troponin values with a threshold &gt;5 over the normal value, on top of the clinical evidence by ECG, echocardiography<a href="https://solaci.org/en/2017/06/11/mortality-at-one-year-in-post-pci-myocardial-infarction/" title="Read more" >...</a>

EuroCTO: Rechanneling vs. Optimal Medical Treatment in Total Occlusions

Courtesy of the SBHCI. Chronic total occlusions represent around 18% of all coronary lesions. However, they account for just 5% of all interventions, which means that many patients only receive medical treatment. This prospective, open, multicenter study randomized patients with multivessel lesions in whom at least one of these was a chronic total occlusion. Patients<a href="https://solaci.org/en/2017/06/02/eurocto-rechanneling-vs-optimal-medical-treatment-in-total-occlusions/" title="Read more" >...</a>

AIDA: La trombosis de las plataformas bioabsorbibles sigue en la mira de los estudios

AIDA: bioresorbable scaffold thrombosis still a concern in studies

Courtesy of the SBHCI. This study presented at PCR and simultaneously published by NEJM still challenges the safety of bioresorbable scaffolds. &nbsp; This was a multicenter noninferiority work carried out in the Netherlands, comparing 1:1 everolimus-eluting bioresorbable scaffold ABSORB and permanent-polymer everolimus-eluting stent Xience. &nbsp; The primary endpoint was target-vessel failure (a composite of cardiac<a href="https://solaci.org/en/2017/06/02/aida-bioresorbable-scaffold-thrombosis-still-a-concern-in-studies/" title="Read more" >...</a>

DES_angioplastia_primaria

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). &nbsp; The study included 330 patients, 85% angiographically followed up at<a href="https://solaci.org/en/2017/05/30/prison-iv-des-with-resorbable-polymer-vs-des-with-permanent-polymer-in-total-occlusions/" title="Read more" >...</a>

Desempeño de los DES actuales ¿hay margen para mejorar?

Second-Generation DES Present Lower Mortality Rates for Vein Grafts

Courtesy of Dr. Carlos&nbsp;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<a href="https://solaci.org/en/2017/05/24/second-generation-des-present-lower-mortality-rates-for-vein-grafts/" title="Read more" >...</a>

El éxito en una CTO ¿Se relaciona con mayor sobrevida?

Successful CTO: associated to higher survival rate?

Courtesy of Dr. Carlos Fava. The presence of chronic total occlusions (CTO) in coronary angiograms varies between 5% and 30%, depending of the different analyzis. Likewise, they have been associated to higher mortality rate and the need for myocardial revascularization surgery. &nbsp; The frequency of CTO PCI is low across the different series (3.8%), though<a href="https://solaci.org/en/2017/05/16/successful-cto-associated-to-higher-survival-rate/" title="Read more" >...</a>

Seguimiento a 10 años de estrategia invasiva vs conservadora en infartos sin supradesnivel del ST

Follow-up at 10 years for invasive vs. conservative strategy for non-ST-segment elevation infarction

The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), with elevated markers such as cardiac troponin T. The absence of long-term benefit of an early invasive strategy at 1 and 5&nbsp;years had already been reported.<a href="https://solaci.org/en/2017/05/09/follow-up-at-10-years-for-invasive-vs-conservative-strategy-for-non-st-segment-elevation-infarction/" title="Read more" >...</a>

Tiempo de doble antiagregación y muerte por sangrado

Dual antiaggregation time and death by bleeding

Despite the fact that some randomized studies and meta-analyzis have suggested prolonged dual antiaggregation could be associated to increased death rate, the underlying mechanism remains unclear. It is only logical to assume that if there was an actual increase in mortality associated to prolonged antiaggregation, this should be due to bleeding; however, no studies have<a href="https://solaci.org/en/2017/05/05/dual-antiaggregation-time-and-death-by-bleeding/" title="Read more" >...</a>

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