Since the last version of the European guidelines on the diagnosis and treatment of peripheral arterial disease in 2011, there have been many trials and registries that warrant guideline adjustments in many aspects. The first novelty is the teamwork that gave way to these guidelines, which were written in collaboration with the European Society of<a href="https://solaci.org/en/2018/04/04/whats-new-in-the-european-guidelines-on-peripheral-arterial-disease/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Currently, some small observational studies and a meta-analysis suggest that women experience more short-term complications after TAVR (due to higher rates of bleeding, vascular complications, and stroke), as well as less 1-year mortality. However, results are still conflicting. This work analyzed 17 studies including 8 different registries, with a total 23,303 women and 23,885 men.<a href="https://solaci.org/en/2018/02/14/who-lives-longer-after-tavr-men-or-women/" title="Read more" >...</a>
The current guidelines point out a class I recommendation to the use of distal embolic protection devices for angioplasty in venous bridges, in fact, the evidence is controversial to support this recommendation. The goal of this meta-analysis was to compare mortality from any cause, major cardiovascular events, acute myocardial infarction, and target vessel revascularization of<a href="https://solaci.org/en/2018/02/07/it-is-justified-to-use-distal-protection-filter-in-venous-bridges/" title="Read more" >...</a>
1) Radiation Exposure in Chronic Total Occlusions Even in the hands of experienced operators, rechanneling and angioplasty of a chronic total occlusion (CTO) results in patients and the whole cath lab team receiving high doses of radiation, according to this registry presented at the American Heart Association 2017 Scientific Sessions. Read more 2) Should We Begin to Use IVUS in CTO?<a href="https://solaci.org/en/2017/12/12/6-articles-on-total-chronic-occlusions-that-you-can-not-stop-reading/" title="Read more" >...</a>
Even in the hands of experienced operators, rechanneling and angioplasty of a chronic total occlusion (CTO) results in patients and the whole cath lab team receiving high doses of radiation, according to this registry presented at the American Heart Association 2017 Scientific Sessions. Up to 23% of patients who undergo rechanneling of a CTO receive<a href="https://solaci.org/en/2017/12/01/radiation-exposure-in-chronic-total-occlusions/" title="Read more" >...</a>
Patients with ST-segment elevation myocardial infarction who undergo primary angioplasty are at high risk for both ischemic and bleeding events, which affect significantly both morbidity and mortality. An optimal selection of antithrombotic therapies in terms of strength and duration must take into account the timing for the procedure, since the risk for these complications may<a href="https://solaci.org/en/2017/11/22/ischemic-and-bleeding-risk-after-primary-angioplasty/" title="Read more" >...</a>
Courtesy of SBHCI. According to a new quality of life sub-study, the “EXCEL”, both coronary artery bypass graft and left main PCI are associated with significant clinical improvement in terms of angina frequency, tolerance to exertion and treatment satisfaction. At 12 and 36 months, there were no significant differences between PCI and surgery after several quality of<a href="https://solaci.org/en/2017/11/01/excel-qol-substudy-similar-quality-of-life-both-with-cabg-and-left-main-pci/" title="Read more" >...</a>
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>
The presence of a metallic device interrupts normal laminar flow and creates an artery environment that favors thrombosis, leaving the vessel vulnerable to very late thrombosis. Dual antiplatelet therapy, a better implantation technique, and several improvements in new drug-eluting stents (DES) (thinner struts, and higher polymer stability and biocompatibility) have lowered significantly the incidence of<a href="https://solaci.org/en/2017/09/26/very-late-thrombosis-in-bioresorbable-scaffolds/" title="Read more" >...</a>
The fundamental advantage offered by transcatheter aortic valve replacement (TAVR) has always been the fact that it is less invasive than surgical valve replacement. So far, most improvements for these devices have derived in less invasiveness (e.g., by improving the profile of the eluting system). However, there are also cases of “deployment” reduction during the<a href="https://solaci.org/en/2017/09/25/conscious-sedation-in-tavr-is-it-advisable/" title="Read more" >...</a>