complete revascularization

ffr post angioplastia

Post PCI FFR: Outcome and Prognosis Optimization?

Original Title: Utilizing Post-Intervention Fractional Flow Reserve to Optimize Acute Results and the Relationship to Long-Term Outcomes Reference: Shiv K. Agarwal et al. J Am Coll Cardiol Intv. 2016;9(10):1022-1031.   Courtesy of Dr. Agustín Vecchia.   At present, fractional flow reserve (FFR) has become the gold standard to define ischemia in intermediate lesions, and to...

FAME at 5 years: FFR Should Guide All Multivessel PCIs

Though the benefit of FFR (fractional flow reserve) over angiography is statistically important only over the first 2 years, this pattern is maintained at long term according to FAME 5 year follow up, presented at the ECS and simultaneously published in The Lancet. Between the second and fifth year, the number of patients at risk...

Is the 2nd generation DES an alternative to surgery in multivessel coronary disease?

The benefits of 2nd generation drug-eluting stents (DES) are being compared with Coronary artery bypass graft surgery (CABG), looking to achieve a safe, effective, less invasive and as complete as possible revascularization. As background of SYNTAX, the stent thrombosis (ST) with Taxus, reached 25% of the events in the group of intervention (PCI), so that...

Thienopyridine Pretreatment in Non ST Elevation ACS syndrome

Original title: Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and meta-analysis. Reference: Bellemain-Appaix A. et al. BMJ. 2014;Epub ahead of print. This meta-analysis included 7 studies that included a total 32383 patients admitted with non ST elevation ACS; 17545 (54.5%) underwent PCI. These studies were published between 2001 and 2013:...

Percutaneous Closure of Postinfarction Ventricular Septal Defect, an early alternative to surgery.

Original title: Percutaneous Closure of Postinfarction Ventricular Septal Defect: In-Hospital Outcomes and Long-Term Follow-Up of UK Experience. Reference: Circulation. 2014 Jun 10;129(23):2395-402. As a mechanical post AMI complication, interventricular communication carries a grim prognosis. Surgery has achieved reasonable outcomes but only for those patients who survive the acute phase of healing. Percutaneous closure is a viable early alternative. ...

Best results of angioplasty with DES guided by IVUS versus angiography only

Original title: Intravascular Ultrasound-Guided Implantation of Drug-Eluting Stents to Improve Outcome. A Meta-Analysis. Reference: Jae-Sik Jang et al. J Am Coll Cardiol Intv 2014, epub ahead of print. Several previous studies and meta-analysis showed that implantation of conventional stents (BMS) intravascular ultrasound (IVUS) guided may decrease restenosis and clinical events. This information was not yet clear to drug-eluting...

The length of the stent is not an event predictor with the new generation of DES. It is the end of the Spot stenting?

Original title: Impact of the Stent Length on Long-Term Clinical Outcomes Following Newer-Generation Drug-Eluting Stent Implantation. Reference: Ik Jun Choi et al. Am J Cardiol 2014;113:457-464. Completely cover the lesion with a sufficiently long stent has been the preferred strategy that emerged from drug-eluting stents (DES). However, for the first-generation DES stent length has been a predictor of...

Self-expandable stenting with jailed deep femoral artery (DFA) for proximal superficial femoral artery (SFA) lesions is safe

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...

First results of bioabsorbable metal scaffolds DREAMS

Original title: Safety and performance of the drug-eluting absorbable metal scaffold (DREAMS) in patients with de-novo coronary lesions: 12 month results of the prospective, multicentre, first-in-man BIOSOLVE-I trial. Reference: Michael Haude et al. Lancet 2013; 381: 836–44. Bioabsorbable scaffolds could improve vasomotion, remodelling and facilitate new interventions, both percutaneous and surgical. This new bioabsorbable scaffold, different from the...

The largest series of femoropopliteal in-stent restenosis to date 

Original title: Treatment of Femoropopliteal In-Stent Restenosis With Paclitaxel-Eluting Stents. Zilver PTX Global Registry. ZILVER-PTX. Reference: Thomas Zeller et al. J Am Coll Cardiol Intv 2013;6:274–81. Femoropopliteal in-stent restenosis (ISR) is reported in between 19% and 37% of lesions a year and this incidence increases with lesion length.  The ZILVER-PTX study tested the self-expanding paclitaxel-eluting nitinol stent (Cook...

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