acute myocardial infarction

DES de 2.0 mm para vasos muy pequeños: ¿Es viable?

2.0-mm DES for Very Small Vessels: Are They Viable?

The reference vessel diameter is a fundamental factor for restenosis after coronary angioplasty even with drug-eluting stents. The smallest sized stents available are 2.25&nbsp;mm in diameter, but even smaller vessels can be symptomatic. This was a prospective multicenter trial of the Resolute Onyx 2.0-mm zotarolimus-eluting stent.&nbsp;The primary endpoint was target lesion failure. Read also: &#8220;Effects<a href="https://solaci.org/en/2017/10/25/2-0-mm-des-for-very-small-vessels-are-they-viable/" title="Read more" >...</a>

Frecuencia y evolución de la perforación cardíaca en CRM previa

Frequency and Evolution of Cardiac Perforation in Patients with a History of MRS

Courtesy of Dr. Carlos&nbsp;Fava. Coronary perforation (CP) is a very uncommon event (≈0.4%), associated with severe complications that entail risk of death. It has usually been related to patients with a history of myocardial revascularization surgery (MRS). However, this group usually presents lower rates of cardiac tamponade due to pericardial fibrosis caused by surgery. This<a href="https://solaci.org/en/2017/10/05/frequency-and-evolution-of-cardiac-perforation-in-patients-with-a-history-of-mrs/" title="Read more" >...</a>

Introducing the number one enemy of PCI: diabetes

About 25% of patients with multivessel disease undergoing myocardial revascularization surgery or PCI have diabetes. &nbsp; In this subgroup, the benefit of surgery in terms of mortality has long been shown: in the BARI study (Bypass Angioplasty Revascularization Investigation) patients undergoing PCI had close to double the mortality rate at 5 years compared to those<a href="https://solaci.org/en/2017/09/22/introducing-the-number-one-enemy-of-pci-diabetes/" title="Read more" >...</a>

VALIDATE-SWEDEHEART: la bivalirudina pierde cada vez más terreno

VALIDATE-SWEDEHEART: bivalirudin seems to be losing ground

Another important work that does not see the benefits of bivalirudin over heparin&nbsp;as monotherapy as regards both efficacy (death and MI) and safety end points (bleeding) in patients undergoing acute myocardial infarction with and without &nbsp;ST elevation. The study VALIDATE-SWEDEHEART, presented at ESC, simultaneously published in the New England Journal of Medicine, randomized 6000 patients<a href="https://solaci.org/en/2017/09/04/validate-swedeheart-bivalirudin-seems-to-be-losing-ground/" title="Read more" >...</a>

La estrategia invasiva precoz beneficia a los pacientes de alto riesgo

Early Invasive Strategy Benefits High-Risk Patients

Early angiography is not associated with a reduction in mortality compared with a more delayed invasive strategy in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). However, a new meta-analysis published by The&nbsp;Lancet supports the idea that certain high-risk patients would benefit from it. Patients with elevated cardiac biomarkers, a high GRACE score, diabetes, or advanced<a href="https://solaci.org/en/2017/09/01/early-invasive-strategy-benefits-high-risk-patients/" title="Read more" >...</a>

¿Debemos comenzar a utilizar IVUS en las CTO?

Should We Begin to Use IVUS in CTO?

Courtesy of Dr. Carlos&nbsp;Fava. Currently,&nbsp;chronic total occlusions&nbsp;(CTO)&nbsp;are one of the obstacles that&nbsp;coronary angioplasties must overcome, particularly with the development of&nbsp;drug-eluting stents (DES)&nbsp;and new devices and strategies for these challenging lesions. However, there is little information on the safety, efficacy, and real clinical benefit of implanting stents of over 60&nbsp;mm (known as full metal jackets, FMJ).<a href="https://solaci.org/en/2017/08/28/should-we-begin-to-use-ivus-in-cto/" title="Read more" >...</a>

Trombosis y riesgo de sangrado

Risk of Thrombosis and Bleeding with Peripheral Artery Disease and Concomitants

Peripheral artery disease (PAD) is no longer a systemic manifestation of atherosclerosis. In fact, 2 in 3 people with PAD have concomitant heart disease, and 1 in 3 people has concomitant PAD. &nbsp; To understand the real dimension of this problem, we should know that PAD patients have 60% more risk of acute myocardial infarction<a href="https://solaci.org/en/2017/08/22/risk-of-thrombosis-and-bleeding-with-peripheral-artery-disease-and-concomitants/" title="Read more" >...</a>

Clinical Significance of Collaterals in Chronic Total Occlusions

Collateral circulation develops during the gradual progression of coronary occlusions in order to replace the original artery and supply blood to areas jeopardized by ischemia. However, the relevance of collaterals has remained controversial for many years. Several works have suggested a rapid regression of collaterals after rechanneling of chronic total coronary occlusions, which could render<a href="https://solaci.org/en/2017/08/08/clinical-significance-of-collaterals-in-chronic-total-occlusions/" title="Read more" >...</a>

¿En qué pacientes intentar la recanalización de una oclusión crónica total?

In which patients should we attempt chronic total occlusion rechanneling?

Although&nbsp;chronic total occlusion (CTO)&nbsp;is a common finding, there is little consensus as to when such lesions should be treated routinely with&nbsp;angioplasty. Benefits of successful rechanneling include relief of symptoms, resolution of ischemia, improvement in ventricular function, and avoidance of myocardial revascularization surgery. &nbsp; Unsuccessful rechanneling is common and may be associated with several adverse events,<a href="https://solaci.org/en/2017/07/19/in-which-patients-should-we-attempt-chronic-total-occlusion-rechanneling/" title="Read more" >...</a>

NOTION: TAVI with Low Risk at 4 Year Follow Up

Post-dilation in TAVI associated to more stroke and more paravalvular regurgitation

Courtesy of Dr. Carlos&nbsp;Fava. Moderate/severe paravalvular regurgitation (PVR) after&nbsp;TAVR&nbsp;is present in 10%-14% of all cases, according to different series. The treatment of choice is post-dilation, generally effective in most cases. However, this strategy carries a risk of&nbsp;stroke.&nbsp;The true impact of this conduct is still unclear. &nbsp; This review analyzed 6&nbsp;studies that included 5007&nbsp;patients; 889 of<a href="https://solaci.org/en/2017/07/10/post-dilation-in-tavi-associated-to-more-stroke-and-more-paravalvular-regurgitation/" title="Read more" >...</a>

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