Courtesy of Dr. Carlos Fava. The transradial approach has been proven beneficial for quite some time now, but certain scenarios require the use of a 7 Fr or 8 Fr introducer, which is a great limitation. This study included 60 patients who underwent complex angioplasty with the help of 7 Fr dedicated transradial (TR) introducer Glidesheath Slender (Terumo, Tokyo,...
Courtesy of Dr. Carlos Fava. It is known that patients with low gradient aortic stenosis show poor evolution with medical treatment and, in addition, present high mortality rate with surgery. As regards TAVR, a far simpler procedure compared to surgery, there is contradicting evidence; while some studies claim it holds comparable risks, others have found...
Courtesy of Dr. José Álvarez. In patients with presumed paradoxical embolism through a patent foramen ovale (PFO) who are at high risk of recurrent thromboembolic events, percutaneous PFO closure is an alternative to pharmacological treatment. This closure has been shown to be safe and feasible with different devices including various technologies based on an umbrella,...
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). The study included 330 patients, 85% angiographically followed up at...
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...
Courtesy of SBHCI Diabetic patients have worse evolution after coronary PCI. Drug eluting stents with bioresorbable polymers were designed to facilitate arterial healing, and reduce inflammation and late and very late thrombosis risk. This sub-study of diabetic EVOLVE II patients presents the 3 year outcomes of the SYNERGY stent. The EVOLVE II included...
Courtesy of Dr. Carlos Fava The EVEREST II trial showed the MitraClip had similar mortality rate to that of surgery but, even though residual mitral valve regurgitation (MR) is associated to a strong negative impact, little is known about post MitraClip increased transvalvular gradient and its implication. 268 patients undergoing MC implantation were analyzed....
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...
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...
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has proven to be beneficial for extreme- and high-risk patients. It is also increasingly used in intermediate-risk patients, and it has been hinted at for low-risk patients. However, different sectors in the medical community still challenge the existence of real TAVR benefit. This assessment consisted...