Original title: Long-term clinical outcome after fractional flow reserve– versus angio-guided percutaneous coronary intervention in patients with intermediate stenosis of coronary artery bypass grafts. Reference: Luigi Di Serafino et al. Am Heart J 2013;166:110-8. Bypass coronary angioplasty is often preferred strategy versus re-operation , however it is associated with a greater number of events, both short and long...
Everolimus Eluting Stent in multiple vessels with short SYNTAX score
Original title: A Clinical and Angiographic Study of the XIENCE V Everolimus-Eluting Coronary Stent System in the Treatment of Patients With Multivessel Coronary Artery Disease. The EXECUTIVE (EXecutive RCT: Evaluating XIENCE V in a Multi Vessel Disease) Trial. Reference: Flavio Ribichini et al. J Am Coll Cardiol Intv 2013. Article in press. Drug-eluting stents (DES ) have emerged...
Full conversion from transfemoral to transradial: similar success rate and far less complications.
Original title: Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. Reference: Vincent Dangoisse et al. EuroIntervention 2013;9:345-352. Although the transfemoral approach has clear disadvantages when it comes to bleeding complications, it continues to be the preferred approach...
Carotid angioplasty prior to central venous catheter. The best option to solve combined problems.
Original title: A Direct Comparison of Early and Late Outcomes with Three Approaches to Carotid Revascularization and Open Heart Surgery. Reference: Mehdi H. Shishehbor et al. J Am Coll Cardiol, article in press. The prevalence of severe carotid stenosis (> 80%) in patients planning to have a Central Venous Catheter (CVC) is estimated at between 6 and...
A worse prognosis for incomplete revascularization in both angioplasty and surgery.
Original title: The Negative Impact of Incomplete Angiographic Revascularization on Clinical Outcomes and Its Association With Total Occlusions. The SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Trial. Reference: Vasim Farooq et al. J Am Coll Cardiol 2013;61:282–94 In patients with complex coronary artery disease who underwent coronary artery bypass surgery, (CABG), or percutaneous transluminal...
Spontaneous coronary artery dissection (SCAD) is associated with fibro-muscular dysplasia in other territories
Original title: Spontaneous Coronary Artery Dissection. Prevalence of Predisposing Conditions Including Fibromuscular Dysplasia in a Tertiary Center Cohort Reference: Jacqueline Saw, et al. J Am Coll Cardiol Intv 2013;6:44 –52 Non atherosclerotic spontaneous coronary artery dissection (Non atherosclerotic SCAD) is a rare disease that is associated with acute myocardial infarction and sudden death. This condition is more common...
Strategies for treating left coronary trunk restenosis.
Original title: Clinical and Procedural Predictors of Suboptimal Outcome After the Treatment of Drug-Eluting Stent Restenosis in the Unprotected Distal Left Main Stem The Milan and New-Tokyo (MITO) Registry. Reference: Circ Cardiovasc Interv. 2012;5: 491-498 We have very little data on the percutaneous treatment of restenosis of an unprotected LMCA. The aim of this study was to evaluate...
Is a counter-pulsation balloon useful in myocardial infarction?
Original title: Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock (for the IABP-Shock II Trial Investigator) Reference: Holger T, et al. NEJM 367;14:1287 The rate of mortality in cardiogenic shock secondary to acute myocardial infarction (AMI) is high even in patients receiving early revascularization. The use of an intra-aortic balloon counter-pulsation pump (IABP) according to the...
Diabetics with multivessel, must keep waiting.
Original title: Strategies for Multivessel Revascularization in Patients with Diabetes. The FREEDOM Trial. Reference: Michael E. Farkouh et al. N Engl J Med 2012. DOI: 10.1056/NEJMoa1211585 This study was designed to determine the best revascularization strategy in diabetic patients with multivessel using current techniques of angioplasty (PCI) and surgery (CABG). Randomized 1:1 diabetic patients with injuries > 70%...
Coronary CTA Use in Emergency Department saves time and money
Reference: Goldstein JA, Chinnaiyan KM, Abidov A, et al. The CT-STAT (coronary computed tomographic angiography for systemic triage of acute chest pain patients to treatment) trial. J Am Coll Cardiol 2011; 58: 1414-22. Using coronary computed tomographic angiography (CTA) as a screening tool for low-risk patients with chest pain in the emergency department achieves lower costs...