According to this large European registry, drug-eluting balloons (DEBs) are competing with drug-eluting stents (DES) to treat in-stent restenosis. Drug-eluting balloons seem to work equally well for the treatment of long-term in-stent restenosis compared with new stent implantation (for the thin-strut DES registry). If DEBs can compete with DES—adding to the advantage of avoiding a...
ACC 2021 | SAFE-PAD: Paclitaxel-Eluting Devices in Peripheral Disease
This work was conducted alongside the US Food and Drug Administration (FDA) to investigate the association between all-cause mortality and paclitaxel-eluting devices in peripheral vascular disease. According to data from SAFE-PAD, presented at the American College of Cardiology (ACC) 2021 Congress and simultaneously published in JAMA, there is no increase in mortality compared with conventional...
The Future of Prevention? Stenting Vulnerable Fractional FFR Negative Lesions
For many patients, the first symptom of heart disease is acute MI, or even sudden death. Changes in lifestyle and optimal medical treatment (OMT) are vital to the prevention of serious events, but we cannot help wondering whether preventive stenting might do it. Intravascular ultrasound (IVUS), optical coherence tomography (OCT), NIRS near-infrared spectroscopy (NIRS) and computed...
Last Bastion of Bare Metal Stents Finally Falls
Multiple studies have shown the safety and efficacy of drug eluting stents (DES) in patients with high risk of bleeding. Only one last bastion of bare metal stents (BMS) was left standing: vein grafts. With controversial evidence and different physiopathology, many still argued against DES in saphenous vein grafts. This multicenter study randomized patients with...
In-Stent Restenosis Treatment: Meta-Analysis of 10 Randomized Studies
The best strategy to treat in stent restenosis continues to be a dilemma. A new drug eluting stent (DES) seems to be the simplest treatment, even though it adds metal layers that will make it harder and harder to retreat. Drug coated balloons might be a viable alternative seeing as it seems to enable retreatment,...
Stenting of Lipid-Rich vs Fibrous and calcified Plaques: Different Prognosis?
Coronary PCI with contemporary drug eluting stents (DES) in lipidic-rich plaques were not associated with increased periprocedural events at long term compared against plaques with no significant lipidic composition. This study recently published in J Am Coll Cardiol looked into the association between lipidic rich plaques detected by near-infrared spectroscopy (NIRS) and clinical events in...
TCT 2019 | Onyx ONE: Durable Polymer vs. Polymer-Free Stent with Only One Month of Dual Antiplatelet Therapy
Courtesy of the SBHCI. This is the first randomized study comparing a durable-polymer drug-eluting stent (zotarolimus-eluting stent Onyx) and a polymer-free drug-eluting stent (biolimus-A9-coated stent BioFreedom), with only one month of dual antiplatelet therapy in patients at high risk for bleeding. Onyx ONE was a study conducted at 84 sites that randomized 1:1 2000 total patients at...
DES with Bioresorbable Polymer vs. Bare Metal Stents in Primary PCI
Long after myocardial revascularization guidelines had established no medical reason justifies the use of bare metal stents (BMS), along comes this study to refresh the old trials comparing drug eluting vs bare metal stents in the context of primary PCI. The problem for many countries is that primary PCI obviously occurs in the context of...
EuroPCR 2019 | Stent Firehawk Continues to Show Good Results at 2 Years vs. Xience
This device, an abluminal groove-filled biodegradable-polymer sirolimus-eluting stent manufactured in China, showed very similar efficacy and safety to the “gold standard” everolimus eluting Xience at 2-year follow up, according to the TARGET outcomes, presented yesterday at the EuroPCR 2019 and simultaneously published in J Am Coll Cardiol Intv. The device, which is manufactured in China...
FDA Alert on Drug-Coated Balloons and Stents in Femoropopliteal Artery Disease
The US Food and Drug Administration (FDA) has issued an alert on the potential long-term risk of paclitaxel-coated balloons and paclitaxel-eluting stents in patients with femoropopliteal artery disease. This agency is evaluating signals of increased long-term deaths among patients with femoral or popliteal artery disease treated with paclitaxel-coated devices in a recent study. In...