Early Endarterectomy Seems Superior to Carotid Stenting in Symptomatic Patients

Carotid stenting or endarterectomy? considering vascular anatomy…

Complex vascular anatomy could increase the risk of periprocedural stroke during carotid artery stenting (CAS). However, no randomize study has provided evidence showing this potential difficulty should inform the choice between carotid stenting and endarterectomy.  This study included 184 patients with symptomatic lesions of the internal carotid randomized to CAS vs. endarterectomy in the context<a href="https://solaci.org/en/2017/05/28/carotid-stenting-or-endarterectomy-considering-vascular-anatomy/" title="Read more" >...</a>

Estenosis aórtica moderada y disfunción ventricular ¿debería apurarse la indicación del recambio?

Moderate Aortic Stenosis and Ventricular Dysfunction: Should Valve Replacement Come Sooner?

Ventricular dysfunction and moderate aortic stenosis are more frequent with advancing age and often coexist. Afterload reduction is one of the main pillars of pharmacological treatment of heart failure, and aortic stenosis (even that of moderate severity) increases the afterload. Nowadays, aortic valve replacement is only formally indicated for symptomatic severe aortic stenosis.   This<a href="https://solaci.org/en/2017/05/25/moderate-aortic-stenosis-and-ventricular-dysfunction-should-valve-replacement-come-sooner/" title="Read more" >...</a>

CENTERA: Results of the New Self-Expandable Valve

This new device offers the advantage of a lower frame height, which reduces the chance of coronary occlusion. The delivery system is totally motorized and the valve can be repositioned. In addition, the sheath is “14 F” for all valve sizes (23, 26 and 29mm).   203 patients were included, all with severe aortic stenosis<a href="https://solaci.org/en/2017/05/25/centera-results-of-the-new-self-expandable-valve/" title="Read more" >...</a>

ARTE: ¿AsEl fin de la aspirina para los pacientes anticoagulados que reciben angioplastiapirina o aspirina más clopidogrel post TAVI?

ARTE: Aspirin or Aspirin and Clopidogrel after TAVR?

Courtesy of SBHCI. This study presented at Euro PCR and simultaneously published by JACC Cardiovascular Interventions poses a question that has remained unanswered since the start of TAVR.   There is little information on the optimal antithrombotic therapy after transcatheter aortic valve replacement (TAVR). In general, patients receive between 1 and 6 months of dual<a href="https://solaci.org/en/2017/05/25/arte-aspirin-or-aspirin-and-clopidogrel-after-tavr/" title="Read more" >...</a>

Post DES Dual Antiplatelet Therapy Still under Debate

TOPIC: Benefits of Switching Dual Antiplatelet Therapy in Patients with ACS

Newer P2Y12 blockers are the front-line treatment and dual antiplatelet therapy is indicated for 1 year after acute coronary syndrome (ACS). Both prasugrel and ticagrelor offer more ischemic benefit than clopidogrel during the initial phase; however, bleeding complications could increase in the long term. The objective of this study was to assess the safety and efficacy<a href="https://solaci.org/en/2017/05/23/topic-benefits-of-switching-dual-antiplatelet-therapy-in-patients-with-acs/" title="Read more" >...</a>

Las CTO por reestenosis ¿tienen pronóstico diferente a las CTO de novo?

In-stent CTO: different prognosis from that of De Novo CTO?

Courtesy of Dr. Carlos Fava. Chronic Total Occlusions (CTO) are truly challenging and different technologies are being developed to treat them, but currently our most pressing questions about them are whether in-stent CTO present the same success rate as de novo CTO, and what their prognosis is.   The present trial analyzed 899 CTO: 111(12.3%)<a href="https://solaci.org/en/2017/05/14/in-stent-cto-different-prognosis-from-that-of-de-novo-cto/" title="Read more" >...</a>

TAVI: la estrategia minimalista es favorable en el EPOC severo

TAVR: minimalist strategy Is favorable in severe COPD

Courtesy of Dr. Carlos Fava. The presence of chronic obstructive pulmonary disease (COPD) is a criterion for which patients are ruled out for surgery and proposed as candidates for its current alternative, transcatheter aortic valve replacement (TAVR). A minimalist strategy could benefit this patient group, given the use of conscious sedation instead of general anesthesia.  <a href="https://solaci.org/en/2017/05/14/tavr-minimalist-strategy-is-favorable-in-severe-copd/" title="Read more" >...</a>

Incidence of ‘Slow Flow’ After Rotational Atherectomy of Calcified Arteries

Courtesy of Dr. José Álvarez ‘Slow flow’ may complicate a rotational atherectomy procedure, especially when done on severely and extensively calcified lesions and small caliber vessels. Although its incidence is between 3% and 27%, its cause remains unclear, and it is thought that platelet antiaggregation induced by burr rotation speed may be behind it.  <a href="https://solaci.org/en/2017/05/11/incidence-of-slow-flow-after-rotational-atherectomy-of-calcified-arteries/" title="Read more" >...</a>

Bivalirudin reduces bleeding rate in carotid stenting

Courtesy of Dr. Carlos Fava Bivalirudin has been shown to reduce bleeding in carotid stenting and maintain its efficacy. Even though carotid stenting has shown benefits, these remain unclear.   With this in mind, four studies were analyzed (one randomized) including 7,784 patients undergoing carotid stenting with unfractioned heparin vs. bivalirudin.   No difference was<a href="https://solaci.org/en/2017/05/08/bivalirudin-reduces-bleeding-rate-in-carotid-stenting/" title="Read more" >...</a>

Promising Outcomes of Overlapping Stents in Patients Undergoing Bioresorbable Scaffold (BRS) Implantation

Courtesy of Dr. Guillermo Migliaro. In regular clinical practice, overlapping stents are reported in up to 30% of patients undergoing coronary angioplasty, especially due to very long lesions requiring implantation of multiple stents or dissection after the implantation of a first stent.   In bare metal stent era, overlapping was associated with unfavorable clinical outcomes<a href="https://solaci.org/en/2017/05/08/promising-outcomes-of-overlapping-stents-in-patients-undergoing-bioresorbable-scaffold-brs-implantation/" title="Read more" >...</a>

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