The proportion of patients treated with coronary angioplasty who are at a high risk for bleeding is increasing. In this population, extended dual antithrombotic therapy increases the risk of bleeding. The 1-year randomized Onyx one study has demonstrated the non-inferiority of zotarolimus-eluting stents (ZES) vs. biolimus-coated polymer-free stent BioFreedom (DCS). Patients received dual-antiplatelet therapy (DAPT)...
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...
EuroPCR 2018 | LEADERS FREE: Complex Angioplasty in Patients with High Risk for Bleeding
The LEADERS FREE study showed that a biolimus A9-coated polymer-free stent was superior to a conventional stent in terms of safety and efficacy in patients who received dual antiplatelet therapy for only a month due to their high risk for bleeding. In this substudy, researchers analyzed 667 patients enrolled in the original LEADERS FREE trial who met certain requirements...
Striking Finding on Diabetes and Bypass Graft Patency
The higher rate of restenosis in the diabetic population is historic and has been reproduced in all studies and with all kinds of stents, but it was only after the FREEDOM trial when we found out about the higher infarction rate with PCI compared to surgery. This is why 50% of patients undergoing CABG are diabetic. Apart from the above...
Additional Benefit from Radial Artery Graft in Myocardial Revascularization Surgery
Used to different extents according to institution, surgeon, and historical time, the radial artery graft is yet to prove whether it can improve the outcomes of myocardial revascularization surgery when added to a single or bilateral internal thoracic artery graft. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral vs. single left internal...
Usefulness of FFR in coronary bypass intermediate lesions
Original title: Long-term clinical outcome after fractional flow reserve– versus angio-guided percutaneous coronary intervention in patients with intermediate stenosis of coronary artery bypass grafts. Reference: Luigi Di Serafino et al. Am Heart J 2013;166:110-8. Bypass coronary angioplasty is often preferred strategy versus re-operation , however it is associated with a greater number of events, both short and long...
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