Abbreviated dual antiplatelet therapy in patients at high risk for bleeding and acute myocardial infarction. Patients with acute coronary syndrome (ACS) who undergo stent placement (percutaneous coronary intervention, PCI) conventionally require at least 12 months of dual antiplatelet therapy (DAPT) to reduce ischemic events. Patients with ACS who are also at high risk for bleeding...
The optimal treatment of true bifurcation lesions not affecting the left main coronary artery is widely debated. Results from randomized studies have shown neutral or worse outcomes with the two-stent technique. Regarding these studies, researchers used first-generation stents and the secondary branches were small. The EBC TWO study compared the provisional stenting strategy against the...
The EBC MAIN LM study randomized 467 patients with severe left main coronary artery (LCA) lesions to receive provisional stenting or a two-sent strategy (Resolute or Onix stent). The two-stent strategy was decided by the operator (culotte, DK-minicrush, T/TAP). The crossover rate from those randomized to provisional stenting was 22%. After a 3-year follow-up, the composite...
MD Sandeep Arunothayaraj presented the 5-year followup of EBC Two (which had not previously shown significant differences in clinical outcomes at 12 months) in patients randomized to provisional stenting vs. systematic culotte in bifurcations that were not left main. The study followed up 200 patients with true bifurcations, side branch ≥2.5mm and lesion length ≥5mm,...
Use of drug-coated balloons vs. drug-eluting stents in small caliber vessels. The constant advancements in coronary device technology have significantly reduced complication rates (such as that of restenosis). However, there are gaps where a high number of undesirable events prevail, such as small vessel disease (SVD), for which, in previous studies up, the rate of...
Sex-related MINOCA and MIOCA differences. Several international guidelines recommend invasive treatment after diagnosing an acute coronary syndrome (ACS). The first studies that described acute myocardial infarction (AMI) without obstructive epicardial coronary disease reported a 10% incidence rate. Based on this significant prevalence, it was recommended that this diagnosis be classified as MINOCA for patients who...
Coronary artery disease (CAD) coexists with aortic stenosis in about half the patients who suffer the latter. These patients receiving antiplatelet therapy are at a higher risk of periprocedural bleeding—one of the most frequent complications in patients who undergo transcatheter aortic valve replacement (TAVR). One way of limiting the risk for bleeding is choosing the...
Several studies have used physiological assessment after a percutaneous coronary intervention (PCI) to improve clinical outcomes. However, results are not entirely conclusive. The limitations of using these physiological assessment methods are the need for extra measurements with increased procedure time, more radiation, and more contrast, which in turn leads to higher costs. To counteract these...
New unibody endologix endografts for the endovascular repair of abdominal aortic aneurysm 3-4-year safety followup At present, we have seen endovascular intervention of abdominal aortic aneurysm (EVAR) increase over surgical repair. However, the procedure is not free from complications, endoleak being the most frequent. Indeed, according to different series, it has a 20-25% incidence in AAA. Most...
Over the years, early diagnosis of myocardial ischemia has ranged from 0-to-3-h protocols to abbreviated guidelines with point-of-care cardiac marker dosing. However, specific devices for this have not yet been validated. The Sengupta P. et al. research group evaluated the feasibility of using an infrared measuring device—placed on the wrist of patients—compared with blood sampling...