Fractional flow reserve (FFR) proved to be very useful and safe in the FAME study, but its trade-off was using adenosine (which has a short half-life) and adverse reactions, which fortunately were rare. Subsequently, two large studies—the iFR-SWEDEHEART and DEFINE-FLAIR—demonstrated that instantaneous wave-free ratio (iFR) offered comparable results to FFR in the short term, avoiding...
Same-day discharge (SDD) has been shown to be effective in angioplasties and some peripheral procedures, but the pandemic—because of the burden it caused on the healthcare system—has forced the optimization of hospitalization times for other pathologies and procedures. This strategy is yet to be tested in transcatheter aortic valve replacement (TAVR) due to the possible...
The mortality of ST-segment elevation acute coronary syndromes (STEACS) has decreased thanks to improved reperfusion times (fibrinolysis or primary angioplasty), so that, in daily practice, there is a greater number of patients with stable acute myocardial infarction (AMI). This clinical stability and a low rate of complications raise the question of whether performing triage is...
The use of intravascular ultrasound (IVUS) has seen exponential growth across registries over the years, combined with mounting and increasingly robust evidence. The fact that it will enable us to characterize plaque morphology and extension prior the intervention, and even assess stent expansion post intervention, has turned it into a pillar of our efforts to...
Carotid endarterectomy continues to be the safest technique for emergency revascularization. However, 48 hours after index event, different strategy outcomes will become comparable. Multiple advances in device development have brought promising results for carotid revascularization patients with symptomatic stenosis. Regardless these developments, optimal revascularization timing after index event remains unclear. This study included patients with...
In patients at high risk of bleeding undergoing coronary PCI and after completing 3-month DAPT with no events, you may discontinue aspirin and follow up with ticagrelor monotherapy. This will significantly reduce bleeding without increasing ischemic events. With this strategy, the greater the risk of bleeding, the greater the absolute reduction of bleeding. Patients at...
According to this new meta-analysis (presented at AHA 2021 and published in The Lancet), mortality is similar between surgery and angioplasty to treat left main coronary artery in patients with simple or intermediate anatomy. This new study estimates that, after 5 years, mortality with surgery would be 11.2% vs. 10.2% with angioplasty, a non-significant difference. This debate...
Patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) will benefit from rivaroxaban monotherapy both in terms of safety and efficacy. The AFIRE study included 2215 patients with atrial fibrillation and stable coronary artery disease (CAD). A subgroups analysis recently published in JACC Intv evaluated patients undergoing coronary stenting. The study compared rivaroxaban + antiplatelet...
One-month dual antiplatelet therapy (DAPT) in patients undergoing acute coronary syndrome (ACS) did not reach the safety and efficacy results observed in the general population of the original trial STOPDAPT-2. The STOPDAPT-2 ACS compared one-month DAPT followed by clopidogrel monotherapy for one year vs. one-year DAPT after PCI. Initially, the study enrolled mostly stable patients...
Instituto Nacional de Angioplastia Location: E-mail: wmogrovejo@cardiovasculardelpacifico.com; cdiaz10@medco.jnj.com