01- ESC 2021 | Updated European Society of Cardiology Guidelines for the Management of Valvular Heart Disease Early intervention in asymptomatic valvular heart disease, age recommendations to decide between TAVR and surgery for aortic stenosis, and a push in favor of transcatheter repair in secondary mitral regurgitation are some of the new modifications to the European<a href="https://solaci.org/en/2021/10/01/the-most-read-scientific-papers-of-september-in-interventional-cardiology/" title="Read more" >...</a>
HOST-EXAM: The Study that Challenges Aspirin as Long-Term Antiplatelet Therapy
The HOST-EXAM study (which was prospective, randomized, and open-label, with the participation of 37 Korean sites) was specifically designed to determine the role of aspirin as the long-term antiplatelet therapy of choice after angioplasty with current drug-eluting stents. To this end, the study compared aspirin head-to-head with clopidogrel. Over the course of four years, 5438 patients (mean<a href="https://solaci.org/en/2021/09/10/host-exam-the-study-that-challenges-aspirin-as-long-term-antiplatelet-therapy/" 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>
ELUVIA: DES in Complex Femoropopliteal Lesions
Paclitaxel-eluting stent Eluvia showed promising results after two years with a revascularization freedom rate of 80% despite the fact that these were complex femoropopliteal lesions. As the safety of paclitaxel-eluting devices becomes more consistent, more studies on its efficacy are being published. Back in 2018, the safety of paclitaxel-eluting balloons and stents was under scrutiny<a href="https://solaci.org/en/2021/06/12/eluvia-des-in-complex-femoropopliteal-lesions/" title="Read more" >...</a>
EuroPCR 2021 | Ultrathin Struts Consolidate as Next DES Development
According to this recent meta-analysis of randomized studies, ultrathin strut devices are associated with lower rates of target vessel failure vs. 2nd generation drug eluting stents (DES). This advantage was driven by fewer clinically justified reinterventions. This study was published in the European Heart Journal and simultaneously presented at EuroPCR 2021 Scientific Sessions. Ultrathin struts<a href="https://solaci.org/en/2021/05/26/europcr-2021-ultrathin-struts-consolidate-as-next-des-development/" title="Read more" >...</a>
Very Short Dual Antiplatelet Therapy after Complex PCI
The 1-month outcomes of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy were comparable to 12-month DAPT in patients with both simple and complex PCI. There was no significant interaction between DAPT period and procedure difficulty. This is a post hoc study of the STOPDAPT-2 that looked at the complex PCI patient subgroup. It is<a href="https://solaci.org/en/2021/05/24/very-short-dual-antiplatelet-therapy-after-complex-pci/" title="Read more" >...</a>
How to Discontinue Antiplatelet Therapy Prior Non-Cardiac Surgery
Both the indication and discontinuation of antiplatelet therapy to balance ischemic-bleeding risks has been left to physician criterion. However, leaving the decision to one single specialist might not be the best. This is when the team’s role becomes essential. This study looked at the advantages consensus decision-making amongst clinicians, surgeons and anesthesiologists to continue or<a href="https://solaci.org/en/2021/05/03/how-to-discontinue-antiplatelet-therapy-prior-non-cardiac-surgery/" title="Read more" >...</a>
Short Therapy and Monotherapy, Plenty of Evidence
A short dual antiplatelet therapy (DAPT) of 1 to 3 months followed by P2Y12 inhibitor monotherapy after second generation drug eluting stent (DES) implantation is safer and as effective as the traditional scheme. The idea is clear, but why hasn’t aspirin monotherapy been tested as follow up? Is aspirin old fashioned? Are there physiopathological reasons<a href="https://solaci.org/en/2021/04/12/short-therapy-and-monotherapy-plenty-of-evidence/" title="Read more" >...</a>
In-Stent Restenosis Treatment: Meta-Analysis of 10 Randomized Studies
The best strategy to treat in stent restenosis continues to be a dilemma. A new drug eluting stent (DES) seems to be the simplest treatment, even though it adds metal layers that will make it harder and harder to retreat. Drug coated balloons might be a viable alternative seeing as it seems to enable retreatment,<a href="https://solaci.org/en/2020/11/18/in-stent-restenosis-treatment-meta-analysis-of-10-randomized-studies/" title="Read more" >...</a>
IVUS in Left Main Coronary Artery Angioplasty: Luxury or Necessity?
Technique advancements in left main coronary artery angioplasty have turned this procedure into a reasonable alternative to surgery, particularly in patients with a low or intermediate Syntax score and, obviously, those in whom surgery was contraindicated. Results can be credited to a refinement in technique, better drug-eluting stents, better patient selection, and frequent use of<a href="https://solaci.org/en/2020/04/15/ivus-in-left-main-coronary-artery-angioplasty-luxury-or-necessity/" title="Read more" >...</a>