Currently, the number of nonagenarian patients undergoing angioplasty (whether elective, urgent or emergency) has increased. This population is linked to more comorbidities and has barely been included in most randomized studies or registries. As such, we do not have robust evidence on this group. Researchers conducted an analysis of the J-PCI OUTCOME Registry, in which...
Drug-eluting balloons have demonstrated safety and effectiveness in the treatment of small-vessel coronary artery disease and in-stent restenosis. However, randomized studies were performed using paclitaxel. Several studies have shown that using biolimus, a semisynthetic analog of sirolimus, optimizes drug delivery in both stents and balloons. The aim of this randomized, multicenter study was to evaluate...
Intravascular ultrasound (IVUS) to guide drug-eluting stent (DES) implantation has been evaluated in several studies. Two randomized studies, IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) and ULTIMATE (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in All-Comers Coronary Lesions), have shown fewer repeat revascularizations compared with angiography-guided...
Optimizing an antiplatelet therapy after an acute coronary syndrome (ACS) aims at reducing the major adverse cardiac events (MACE) caused by atherosclerotic disease. Ticagrelor is a potent P2Y12 inhibitor that directly prevents platelet activation. It is characterized by a rapid and consistent onset of action throughout its administration (twice daily) and its proven pleiotropic effects,...
Paclitaxel-eluting stent Eluvia showed promising results after two years with a revascularization freedom rate of 80% despite the fact that these were complex femoropopliteal lesions. As the safety of paclitaxel-eluting devices becomes more consistent, more studies on its efficacy are being published. Back in 2018, the safety of paclitaxel-eluting balloons and stents was under scrutiny...
The 1-month outcomes of dual antiplatelet therapy (DAPT) followed by clopidogrel monotherapy were comparable to 12-month DAPT in patients with both simple and complex PCI. There was no significant interaction between DAPT period and procedure difficulty. This is a post hoc study of the STOPDAPT-2 that looked at the complex PCI patient subgroup. It is...
The best strategy to treat in stent restenosis continues to be a dilemma. A new drug eluting stent (DES) seems to be the simplest treatment, even though it adds metal layers that will make it harder and harder to retreat. Drug coated balloons might be a viable alternative seeing as it seems to enable retreatment,...
1- ESC 2019 | New European Guidelines on “Chronic Coronary Syndromes” In Paris, during the European Society of Cardiology (ESC) Congress 2019 Scientific Sessions, new guidelines for the diagnosis and treatment of chronic coronary syndromes were presented. This document, simultaneously published in Euro Heart J, updates the 2013 guidelines on stable ischemic heart disease and...
Myocardial revascularization surgery is still one of the most effective treatment strategies against coronary disease. One of the most important advantages of surgery over angioplasty is the chance to reach complete revascularization. This has proven to improve the survival of patients and to reduce the number of cardiovascular events. The choice of conduit for the...
Spontaneous coronary artery dissection is an increasing cause of acute myocardial infarction, particularly in younger women. These infarctions are frequently treated conservatively given the risks entailed by revascularization, due to the possibility of causing an antegrade or retrograde expansion of the dissection. The uncertainty around treatment for these patients gave way to this study (recently...