The use of intravascular imaging such as intravascular ultrasound or optical coherence tomography (OCT) both for decision making optimization and percutaneous intervention planning have introduced changes in some scenarios, such as the left main, improving trial end points. There are ongoing studies set to deliver more evidence on its long term safety and efficacy (especially<a href="https://solaci.org/en/2022/11/28/changes-in-decision-making-based-on-oct/" title="Read more" >...</a>
Stent thrombosis (ST) is a serious complication of coronary PCI. However, its incidence across registries is low. It has been classified according to onset into acute (less than 24 hrs.), subacute (between 24 and 30 days), late (between 30 and 365 days) and very late (later than 365 days). The estimated incidence of ST is<a href="https://solaci.org/en/2022/10/27/stent-thrombosis-clinical-characteristics-and-event-predictors-in-a-contemporary-cohort/" title="Read more" >...</a>
Endovascular therapy in femoropopliteal territory has become the standard, mainly with self-expanding stents, aimed at preventing early vascular recoil and late constrictive remodeling. Randomized studies have shown that the use of Paclitaxel drug eluting stents (DES) reduces the number of new revascularizations (even though these studies compared mostly against conventional balloons, which is why we<a href="https://solaci.org/en/2022/10/26/eminent-trial-stent-eluvia-vs-bms-in-femoropopliteal-territory/" title="Read more" >...</a>
The technological development of drug eluting stents has allowed us to treat increasingly complex patients, with around 10% stenosis and using more, and longer stents. This situation generates a great challenge: keep using stents or use paclitaxel coated balloons (PCB). At present, there are sirolimus drug coated balloons (SCB), but we do not have enough<a href="https://solaci.org/en/2022/10/11/the-new-sirolimus-eluting-balloons-are-also-effective/" title="Read more" >...</a>
Severely calcified coronary lesions are found in 25% of patients undergoing PCI, and their presence has a negative impact in long term outcomes. These lesions difficult stent expansion and increase device failure rate, even when using the latest generation of drug eluting stents (DES). This is why there is an interest in lesion preparation strategies<a href="https://solaci.org/en/2022/09/28/devices-to-prepare-severely-calcified-lesions-is-there-a-difference-when-assessed-by-intravascular-imaging/" title="Read more" >...</a>
The benefits of DES are well known, as well as the benefits of more recent polymer-based DES versions (even those with no polymers). However, strut size is no small matter, and might even make the difference, seeing as thinner struts are associated to better deliverability, simpler crossing profile in bifurcations, better endothelization and healing. Besides,<a href="https://solaci.org/en/2022/09/28/should-we-start-using-ultra-thin-struts/" title="Read more" >...</a>
Vascular calcification is a predictor of difficult stent positioning and expansion, which increases the chance of device failure (even with last generation stents). Calcium modifying strategies are being developed to reduce these difficulties. Two recent randomized studies compare different calcium preparation devices. The PREPARE-CALC compares rotational atherectomy (RA) against plaque modifying balloons (PMB = cutting<a href="https://solaci.org/en/2022/09/26/calcified-lesions-cto-strategies-for-plaque-preparation/" title="Read more" >...</a>
The BEST study was a prospective, randomized study to compare percutaneous coronary intervention (PCI) with everolimus-eluting stents vs. myocardial revascularization surgery (MRS) in patients with multivessel disease. The analysis was interrupted early due to slow patient inclusion. The study included 880 patients, who were randomized 438 to the PCI arm and 442 to the MRS arm.<a href="https://solaci.org/en/2022/09/26/tct-2022-angioplasty-vs-surgery-the-best-study-long-term-results/" title="Read more" >...</a>
✔️ PCI-Advances in DIABETIC PATIENTES – MIL & WIN SESSION ✔️ SOLACI-SOCIME 2022 Scientific Session 👨‍🏫 Contents: 00:10 – Welcoming words – Dra. Emma Miranda (MEX) 01:35 – Diabetes mellitus and coronary artery disease – Dra. Patricia Aubanel (MEX) 20:30 – Advances in the design of stents in PCI: Diabetes mellitus – Dra. Roxana Mehran<a href="https://solaci.org/en/2022/09/15/pci-advances-in-diabetic-patients-mil-win-session-solaci-socime-2022%ef%bf%bc%ef%bf%bc-2/" title="Read more" >...</a>
While the need for repeat cinecoronary angiography after transluminal coronary angioplasty (TCA) has decreased with the use of drug-eluting stents and improved medical treatment, patients still present ischemic recurrence or cardiovascular events at follow-up. Using a functional test at follow-up after TCA or myocardial revascularization (CMR) is a frequent practice in our context. This is<a href="https://solaci.org/en/2022/09/05/esc-2022-should-we-follow-up-with-functional-testing-in-high-risk-patients-after-cta/" title="Read more" >...</a>