PCI is far more successful at reducing ischemia when treating focal stable coronary artery disease (CAD). However, there were no differences in symptoms between both types of CAD. Physiological assessment with pressure wire pullback can be used to distinguish focal vs diffuse CAD, even though the relevance of this distinction has not been looked at...
Ticagrelor or Prasugrel for Acute Patients Who Undergo Angioplasty
We are still asking the same question: ticagrelor or prasugrel? With narrow margins between these drugs in terms of efficacy and bleeding, it is difficult to decide which to prescribe. While it has certain methodological limitations, this research published in JAMA seems to clarify the picture at least for patients with acute coronary syndromes who...
SOLACI PERIPHERAL | 7th Clinical Case: Percutaneous Treatment for Nutcracker Syndrome
New SOLACI PERIPHERAL clinical case to keep learning among peers! Dr. Carlos Eduardo Díniz Couto shares a “Nutcracker” case from Belo Horizonte, Brazil. This is the 7th clinical case presented by SOLACI Peripheral on the SOLACI website. This space is intended to further promote and share experiences and opinions in order to continue improving our...
IVUS vs iFR for Left Main Decision Making
No decision on the coronary tree has more impact than left main intervention. This makes interventionists prone to over and underestimation of angiographic imaging. In other words, in real life we never report on angiograms showing moderate left main lesions. This reality should be looked into, since operating or intervening moderate left main lesions on...
EuroPCR 2021 | COLOR: Complex PCI via Transradial vs Transfemoral Approach
Treating total occlusions, complex bifurcations, grossly calcified lesions or left main lesions via transradial approach is associated with significant reduction in access-site bleeding or vascular complications vs transfemoral approach. This kind of procedures have been typically excluded from studies randomizing patients to transradial vs transfemoral approach. The COLOR study used the transradial bore-guiding catheter Glidesheath...
Very Short Dual Antiplatelet Therapy after Complex PCI
The 1-month outcomes of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy were comparable to 12-month DAPT in patients with both simple and complex PCI. There was no significant interaction between DAPT period and procedure difficulty. This is a post hoc study of the STOPDAPT-2 that looked at the complex PCI patient subgroup. It is...
ACC 2021 | VOYAGER PAD: Usefulness of Rivaroxaban After Peripheral Angioplasty
Patients with peripheral vascular disease who undergo angioplasty in the lower limbs find benefit from treatment with rivaroxaban, according to the VOYAGER PAD study, presented at the scientific sessions of the American College of Cardiology (ACC) 2021 Congress and simultaneously published in JACC. Patients with said disease present a higher risk of ischemic events not...
ACC 2021 | HOST-EXAM: Clopidogrel vs ASA monotherapy post DAPT in PCI patients
Clopidogrel monotherapy after dual antiplatelet therapy (DAPT) was associated with reduced mortality, MI, stroke, and other events in patients receiving PCI compared against aspirin monotherapy (ASA). This information was provided by the Korean HOST-EXAM study, presented at ACC 2021 scientific sessions, and simultaneously published in the Lancet. Researchers followed patients for 2 years and observed...
Xience Receives CE Mark for Short and Ultrashort DAPT Schemes
Dual antiplatelet therapy (DAPT) one month after angioplasty with Xience stent was approved in Europe for patients with high risk of bleeding. The CE Mark approval comes after studies Xience 28 and Xience 90 are published. Immediately after authorization, Abbot was fast to announce what they consider to be the shortest approved scheme with the most...
IVUS vs OCT to Guide PCI: Which Should We Choose?
Controlling stent expansion with optical coherence tomography (OCT) based on an external elastic membrane–based protocol for stent sizing resulted non-inferior to the control group which used intravascular ultrasound (IVUS) and superior the angiography only group. Based on these study outcomes and the prior outcomes, we should use IVUS imaging if available. There are no specific algorithms...