In patients with peripheral vascular disease (PVD), the presence of diabetes has been significantly associated with increased failure of critical lower limb ischemia (CLI) treatment, and higher incidence of amputation. This relationship has been attributed mainly to comorbidities and patient characteristics, concomitant peripheral neuropathy and marked microvascular alteration. Also, a high proportion of these patients...
The MASTER DAPT study analyzed the results of an abbreviated (mean 34 days) vs. conventional dual antiplatelet therapy (DAPT) in 4579 patients treated with angioplasty and a biodegradable polymer sirolimus-eluting stent. This recent publication on the same study analyzed the evolution within the same strategies of the subgroup of patients with complex angioplasty and compared...
Thrombectomy with stent retriever and direct aspiration have been considered equally effective in the treatment of anterior circulation acute ischemic stroke. But are they really? This study recently published in Stroke compares the safety and efficacy of both techniques per occlusion segment. This study analyzed data from the MR CLEAN registry at every endovascular therapy...
Courtesy of SBHCI. Patients with severe aortic stenosis and low surgical risk showed decreased mortality, stroke, and heart failure hospitalization at one year with transcatheter aortic valve replacement compared with surgery. Improved quality of life may seem an obvious consequence, but until now that was mere speculation. This work, presented at the TCT 2019 Scientific Sessions...
According to the EXCEL trial, peri-procedural infarction was more common after left main coronary artery surgery compared with angioplasty, and it was strongly associated with increased 3-year mortality after controlling all possible confounding variables. This increased mortality was only present in extensive infarctions with an increase in CK-MB ≥10×. The EXCEL trial seems to want...
The potential need for a 7-Fr guidewire, the use of several coronary guidewires and/or a kissing balloon, and the requirement of indispensable monitoring by intravascular ultrasound (IVUS) have been used by some interventional cardiologists as excuses to resist radial access. In that sense, left main coronary artery angioplasty was the last stand of femoral access....
There are plenty of clinical studies assessing the use of angioplasty for en la peripheral artery disease with restenosis rates as high as 40% and 60% at 6 and 12 months. Drug coated balloons have significantly raised primary patency, but they have mostly been tested in short lesions with mild calcification and no total occlusions. This...
Original Title: Zilver PTX Post-Market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan 12-Month Results. Reference: Hiroyoshi Yokoi et al. J Am Coll Cardiol Intv. 2016;9(3):271-277. This multicenter prospective study carried out in Japan assessed the paclitaxel eluting stent Zilver PTX in an unselected real world population very different to...
Original title: Deployment of Self-Expandable Stents for Complex Proximal Superficial Femoral Artery Lesions Involving the Femoral Bifurcation With Or Without Jailed Deep Femoral Artery. Reference: Masahiro Yamawaki et al. Catheterization and Cardiovascular Interventions 81:1031–1041 (2013). The endovascular management of chronic total occlusions of the lower extremities has seen great progress over the past years; however, specific segments require...
Original title: Staged Versus One-time Complete Revascularization With Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease Patients Without ST-Elevation Myocardial Infarction. Reference: Edward L. Hannan et al. Circ Cardiovasc Interv 2013;6;12-20. There is evidence that in patients with multi-vessel disease affected by an acute coronary syndrome (ACS) with ST segment elevation, only the cause lesion should be treated...