Transulnar access can be as safe and effective as transradial access, and it is a particularly good alternative for the preservation of radial artery patency or when such vessel presents a difficult anatomy. This new meta-analysis that will be published soon in Catheter Cardiovasc Interv showed a relatively high failure rate for that access, but...
Next-day discharge after transfemoral transcatheter aortic valve replacement (TAVR) might be viable, with no major complications at 30 days or one year, compared against patients with longer hospital stay. We only have to consider a few factors that will help us choose the most adequate patients for this modality without compromising safety. One of the main advantages...
The authors have given an entertaining account of the most relevant points and differences between the new STEMI guidelines and the prior ones, from 2014. The article features 10 points resembling the ten commandments, which makes it easy to read, compared to the tedious task of reading the complete guidelines. 1) The emergency systems should help...
Whether a second arterial conduit improves outcomes in patients undergoing myocardial revascularization surgery is and will remain unclear until the 10-year results of the ART (Arterial Revascularization Trial) are published. Consequently, arterial conduits other than the left internal thoracic artery are seldom used in daily practice. Using a database including 126 non-federal hospitals in California, researchers...
Courtesy of Dr. Pablo Baglioni. This is a prospective observational study with a 1-year follow-up analyzing 2062 patients with acute coronary syndrome (ACS) who have been treated with coronary angioplasty using new-generation drug-eluting stents (DES). Patients were included between December 21, 2012 and August 25, 2015. On May, 2014, due to changes in international guidelines, clopidogrel...
The occurrence of renal failure after any endovascular intervention is associated with increased morbility and mortality. After a coronary intervention (whether it be angioplasty or surgery), renal failure increases mortality 20-fold. Relatedly, surgical repair of an abdominal aortic aneurysm with renal failure is also associated with a significant increase in the number of events. Read...
In the subgroup of patients with ST-segment elevation myocardial infarction who fail thrombolysis, transradial access reduces both bleeding and mortality, according to the results of this new study recently published in JACC Cardiovascular Interventions. Overall, transradial access following failed thrombolysis was associated with a 70% reduction in vascular complications, a 28% reduction in combined in-hospital...
According to previous studies, patients receiving bilateral internal mammary artery conduits during coronary artery bypass grafting have better survival than those receiving a single internal mammary artery. The reason behind this remains unclear, let alone whether there really is lower repeat revascularization rate. This analysis compared timing, frequency, and type of repeat coronary revascularization among patients...
1) Balloon Angioplasty: A Reasonable Plan B for Chronic Thromboembolic Hypertension Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B,...
A large study conducted in 19 countries has found that a policy of restrictive red-cell transfusion during cardiac surgery is just as safe and effective as more liberal policies. TRICS III enrolled 5243 patients and was presented at the American Heart Association (AHA) Scientific Sessions and published simultaneously in the New England Journal of Medicine (NEJM). Patients were...