Read the most outstanding articles from the third day of the SOLACI-SOCIME 2022 Congress. In this case, consult the presentation by Dr. Alejandro Goldsmit, entitled “Rotablation in Superficial Femoral Angioplasty”.
Angioplasty in Nonagenarians Is Increasingly Frequent: How Does It Evolve?
Currently, the number of nonagenarian patients undergoing angioplasty (whether elective, urgent or emergency) has increased. This population is linked to more comorbidities and has barely been included in most randomized studies or registries. As such, we do not have robust evidence on this group. Researchers conducted an analysis of the J-PCI OUTCOME Registry, in which<a href="https://solaci.org/en/2022/07/19/angioplasty-in-nonagenarians-is-increasingly-frequent-how-does-it-evolve/" title="Read more" >...</a>
An Abbreviated Dual Antiplatelet Regimen Is Also Safe in Patients at High Risk for Bleeding Undergoing Complex Angioplasty
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<a href="https://solaci.org/en/2022/07/06/an-abbreviated-dual-antiplatelet-regimen-is-also-safe-in-patients-at-high-risk-for-bleeding-undergoing-complex-angioplasty/" title="Read more" >...</a>
Coronary Flow Reserve in Patients with Intermediate FFR: Should We Use This Tool to Define When to Perform Coronary Angioplasty?
Current guidelines recommend using fractional flow reserve (FFR) to guide coronary angioplasty. However, intermediate FFR values (0.75-0.80) generate uncertainty about the prognostic value of performing coronary angioplasty over optimal medical treatment. The use of coronary flow reserve (CFR) together with FFR provides further insight into coronary circulation because CFR is an index that also includes<a href="https://solaci.org/en/2022/05/11/coronary-flow-reserve-in-patients-with-intermediate-ffr-should-we-use-this-tool-to-define-when-to-perform-coronary-angioplasty/" title="Read more" >...</a>
Coronary Angioplasty Evolution According to Syntax II: 5-Year Followup
It has been long since the SYNTAX (NEJM 2009) came out comparing percutaneous coronary intervention (PCI) against coronary artery bypass grafting (CABG). That emblematic study associated PCI with first generation drug eluting stents (Taxus) with increased major cardiac and cerebrovascular events (all-cause mortality, AMI, stroke, or any revascularization – MACCE) vs. CABG, at 5 years,<a href="https://solaci.org/en/2022/05/05/coronary-angioplasty-evolution-according-to-syntax-ii-5-year-followup/" title="Read more" >...</a>
IVUS-Guided Coronary Angioplasty: Promising Results at 3-Year Follow-Up
Intravascular ultrasound (IVUS) to guide drug-eluting stent (DES) implantation has been evaluated in several studies. Two randomized studies, IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) and ULTIMATE (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in All-Comers Coronary Lesions), have shown fewer repeat revascularizations compared with angiography-guided<a href="https://solaci.org/en/2022/05/02/ivus-guided-coronary-angioplasty-promising-results-at-3-year-follow-up/" title="Read more" >...</a>
AHA 2021 | Meta-Analysis of Surgery vs. Angioplasty in Left Main Coronary Artery Disease
According to this new meta-analysis (presented at AHA 2021 and published in The Lancet), mortality is similar between surgery and angioplasty to treat left main coronary artery in patients with simple or intermediate anatomy. This new study estimates that, after 5 years, mortality with surgery would be 11.2% vs. 10.2% with angioplasty, a non-significant difference. This debate<a href="https://solaci.org/en/2021/11/25/aha-2021-meta-analysis-of-surgery-vs-angioplasty-in-left-main-coronary-artery-disease/" title="Read more" >...</a>
Non-Culprit Vessel Angioplasty in the Elderly: Choosing the Right Cases Is Important
This large analysis found no benefit at a 1-year follow-up to angioplasty of non-culprit vessels in elderly patients admitted with ST-segment elevation myocardial infarction. The COMPLETE study was presented at the European Society of Cardiology 2019 Congress (and simultaneously published in NEJM) with evidence that seemed to leave no doubt regarding this issue. However, new<a href="https://solaci.org/en/2021/09/09/non-culprit-vessel-angioplasty-in-the-elderly-choosing-the-right-cases-is-important/" title="Read more" >...</a>
ESC 2021 | MASTER DAPT: Dual Antiplatelet Therapy After Coronary Angioplasty in Patients at High Bleeding Risk
Courtesy of Dr. José Álvarez. In patients at high bleeding risk with drug-eluting stents, the duration of dual antiplatelet therapy has been subjected to ongoing review. Guidelines from the European Society of Cardiology (ESC) and the American College of Cardiology (ACC) suggest shortening this treatment to a maximum of three to six months (Class IIb).<a href="https://solaci.org/en/2021/08/31/esc-2021-master-dapt-dual-antiplatelet-therapy-after-coronary-angioplasty-in-patients-at-high-bleeding-risk/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2021/07/16/ticagrelor-or-prasugrel-for-acute-patients-who-undergo-angioplasty/" title="Read more" >...</a>