The results of the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial have shown a lower rate of events in patients with diabetes and stable multivessel disease who were randomized to undergo myocardial revascularization surgery, compared to those who underwent angioplasty. Surgery even showed a mortality reduction that<a href="https://solaci.org/en/2018/01/22/does-a-combination-of-diabetes-and-acute-coronary-syndrome-change-the-revascularization-strategy/" title="Read more" >...</a>
Patients and Healthcare Providers Benefit from Less Symptoms and Lower Costs with FFR
Previous studies in which revascularization was guided by angiography alone found that coronary angioplasty does not improve outcomes compared with optimal medical treatment in patients with chronic stable angina. The FAME 2 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared angioplasty guided by fractional flow reserve (FFR) with optimal medical treatment, arriving to<a href="https://solaci.org/en/2017/12/05/patients-and-healthcare-providers-benefit-from-less-symptoms-and-lower-costs-with-ffr/" title="Read more" >...</a>
Latest articles about peripheral vascular diseases
1) Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable. Read more 2) Multivessel Disease and Severe Carotid Stenosis: How to Proceed Myocardial revascularization surgery (CABG) is<a href="https://solaci.org/en/2017/11/22/latest-articles-about-peripheral-vascular-diseases/" title="Read more" >...</a>
CULPRIT-SHOCK Results Will Transform Guidelines and Clinical Practice
Courtesy of the SBHCI. After treating the culprit lesion in patients with acute myocardial infarction complicated by cardiogenic shock, continuing revascularization of all other lesions worsens outcomes. This finding of the CULPRIT-SHOCK trial has changed entirely the way we treated this patient group and will surely modify guidelines. Culprit-lesion treatment with the option to perform<a href="https://solaci.org/en/2017/11/01/culprit-shock-results-will-transform-guidelines-and-clinical-practice/" title="Read more" >...</a>
Impella Improves Safety in High Risk Unprotected Left Main PCI
Courtesy of Dr. Carlos Fava. The incidence of unprotected left main severe stenosis ranges between 4 and 8%, and it’s mostly associated with multivessel disease. The use of left ventricular support devices in high risk unprotected left main PCI is on the rise, but not much information available in this regard. Read also: “Prior assistance<a href="https://solaci.org/en/2017/10/18/impella-improves-safety-in-high-risk-unprotected-left-main-pci/" title="Read more" >...</a>
Tricuspid and Bicuspid Valves Present More Coincidences Than Expected
There is more and more positive evidence that new-generation transcatheter valves, originally designed to treat tricuspid aortic valves, work perfectly fine on bicuspid aortic valves. A comparison of computerized tomography (CT) scans obtained before and after the procedure showed that the most commonly used devices appear to reshape the aortic annulus to the same degree<a href="https://solaci.org/en/2017/10/13/tricuspid-and-bicuspid-valves-present-more-coincidences-than-expected/" title="Read more" >...</a>
Transcatheter Reduction or Surgery for Paravalvular Leak Repair?
Paravalvular leak is complication derived from incomplete sealing between the implanted prosthesis and the native annulus, which occurs in 5% of all patients who undergo mitral valve replacement and 10% of those who undergo transcatheter aortic valve replacement. This is the most frequent non-structural valve dysfunction. While mild leaks can be asymptomatic, moderate to severe<a href="https://solaci.org/en/2017/10/12/transcatheter-reduction-or-surgery-for-paravalvular-leak-repair/" title="Read more" >...</a>
Introducing the number one enemy of PCI: diabetes
About 25% of patients with multivessel disease undergoing myocardial revascularization surgery or PCI have diabetes. In this subgroup, the benefit of surgery in terms of mortality has long been shown: in the BARI study (Bypass Angioplasty Revascularization Investigation) patients undergoing PCI had close to double the mortality rate at 5 years compared to those<a href="https://solaci.org/en/2017/09/22/introducing-the-number-one-enemy-of-pci-diabetes/" title="Read more" >...</a>
SYNTAX II: Better Stents, IVUS, FFR, or a Combination of All of Them to Catch Up with Surgery
In patients with 3-vessel disease, surgery obtained better outcomes than angioplasty, according to results from the SYNTAX and FREEDOM trials, which used first-generation drug-eluting stents. Even in the BEST trial, which used new-generation stents, surgery still offered far better outcomes. Nobody is surprised by the fact that, whenever angioplasty evolves due to a new device<a href="https://solaci.org/en/2017/09/13/syntax-ii-better-stents-ivus-ffr-or-a-combination-of-all-of-them-to-catch-up-with-surgery/" title="Read more" >...</a>
DETO2X-AMI: Supplemental O2 Provides No Benefit for Patients with Suspected Infarction
According to this study simultaneously presented at the European Society of Cardiology Congress 2017 and published in the New England Journal of Medicine, routinely providing supplemental oxygen therapy to patients without hypoxemia with suspected acute myocardial infarction did not result in a reduction in the 1-year risk of all-cause mortality when compared with patients receiving<a href="https://solaci.org/en/2017/09/13/deto2x-ami-supplemental-o2-provides-no-benefit-for-patients-with-suspected-infarction/" title="Read more" >...</a>