Newer P2Y12 blockers are the front-line treatment and dual antiplatelet therapy is indicated for 1 year after acute coronary syndrome (ACS). Both prasugrel and ticagrelor offer more ischemic benefit than clopidogrel during the initial phase; however, bleeding complications could increase in the long term. The objective of this study was to assess the safety and efficacy...
Courtesy of Dr. Carlos Fava. Carotid artery stenting (CAS) has proven to be effective in high-risk patients. Nowadays, when performed by trained operators, its results are similar to those of surgery. This study seeks to clarify the incidence and prognosis of plaque protrusion through the stent (as observed in both control angiography and intravascular ultrasound [IVUS])...
There have been several studies offering contradictory data on the relative effectiveness of carotid artery stenting and carotid artery endarterectomy for the prevention of stroke due to carotid artery stenosis. The authors of this study performed a meta-analysis assessing the efficacy of these techniques, given recently published clinical trial data. They selected randomized...
The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), with elevated markers such as cardiac troponin T. The absence of long-term benefit of an early invasive strategy at 1 and 5 years had already been reported....
Courtesy of Dr. Carlos Fava. Provitional ventricular assist devices are increasingly used in high-risk angioplasties, particularly those involving unprotected left main coronary artery (LMCA) with defective ventricular functioning. However, so far its true role has not been well-studied. This study analyzed 127 consecutive patients in the USpella registry from 2008 to 2015. These subjects underwent high-risk...
Courtesy of Dr. Javier Castro. Certain coronary lesions have been historically discouraged for endovascular treatment. Among these can be found left main coronary artery lesions, multivessel disease, and proximal anterior descending artery lesions. As a matter of fact, the latter is actually considered separately as a criterion for choosing the revascularization method. Endovascular treatment of...
Courtesy of Dr. Carlos Fava. Carotid artery disease is an important cause of stroke and is associated to coronary artery disease. When patients need myocardial revascularization surgery (Carotid Artery Bypass Graft) and cannot wait one month or more for carotid revascularization, the optimal management strategy is still controversial. The aim of this study was...
Courtesy of Dr. Carlos Fava. Health system costs have increased significantly and there have been attempts to reduce it without compromising the quality of PCI outcomes. The benefits of the transradial approach combined with same day discharge could help reach this goal. This study included 279,987 MEDICARE PCI procedures where costs were analyzed. Cases...
Remote ischemic preconditioning (RIPC) can prevent recurrent ischemic events in patients with acute or chronic cerebral ischemia. However, is remains unclear whether RIPC could prevent an ischemic event in the context of carotid PCI in patients with severe carotid artery stenosis. The study included patients with severe carotid artery stenosis randomized to RIPC, vs....
Contrast induced kidney injury incidence is in direct correlation to the administered contrast. The aim of this study was to assess the safety and efficacy of sinus aspiration immediately after PCI as a measure to reduce the volume of contrast arriving in the kidneys. The study included 43 patients with diabetes and renal impairment...