Although there are 4 approved bioresorbable scaffolds (BRS) in Europe, experts suggest that current drug-eluting stents (DES) are the best option for coronary angioplasty. These new guidelines jointly published by the European Society of Cardiology (ESC) and the Association of Percutaneous Cardiovascular Interventions (EAPCI) are an update on the use of BRS in clinical practice...
Coronary angiography is essential for patients admitted with non-ST-elevation acute coronary syndrome, since it allows physicians to confirm the diagnosis, stratify the risk, and define the revascularization and antithrombotic management strategies. There is no doubt that these patients should be studied invasively, but the timing for that is still uncertain. Coronary catheterization within...
J Am Coll Cardiol Intv has recently published a special issue on bioresorbable scaffolds. Abbott’s decision to pull Absorb off the market probably prompted the fast publishing of all related articles sent to the journal. Bioresorbable scaffolds were developed in hopes that they would reduce the rates of events per year 1 year post-implantation by 1.5%-3%...
The presence of a metallic device interrupts normal laminar flow and creates an artery environment that favors thrombosis, leaving the vessel vulnerable to very late thrombosis. Dual antiplatelet therapy, a better implantation technique, and several improvements in new drug-eluting stents (DES) (thinner struts, and higher polymer stability and biocompatibility) have lowered significantly the incidence of...
Several cases have shown an association between patent foramen ovale and cryptogenic shock, particularly in patients under 55 and in those with atrial septal aneurysm or a significant right-to-left shunt. Using PFO closure for stroke prevention has been controversial and, so far, no randomized studies have shown the superiority of this strategy compared to anti-thrombotic...
Courtesy of Dr. José Álvarez. This is a multicenter randomized study on patients with patent foramen ovale (PFO) and a first episode of cryptogenic stroke. It only included patients with moderate to large shunt based on the number of bubbles observed in the left atrium within the first three beats after being noticed in the...
Patients who receive chronic anticoagulation therapy and then undergo angioplasty are frequently discharged on a triple anti-thrombotic scheme that usually includes aspirin, clopidogrel, and warfarin. The optimal duration of this indication remains unclear, particularly for patients at high bleeding risk. According to expert consensus, patients receiving chronic anticoagulation may receive from 1 to 12 months of dual...
According to a recent study published in Circulation Cardiovascular Interventions, screening for coronary artery disease (CAD) with an invasive coronary angiography (as part of the protocol prior TAVR) and performing PCI and TAVR in the same session, has no impact on periprocedural safety or on long term outcomes. Study outcomes offer new hope, especially as regards using TAVR...
Courtesy of Dr. Carlos Fava. Severe atherosclerotic disease in iliac arteries is experienced by 15% of all men and 5% of all women. TAC II recommends angioplasty for type-A, -B, and -C lesions. As regards stent type, self-expanding stent (SE, more elasticity) vs. balloon-expandable stent (SB, more radial strength), Reekers indicates superior target lesion revascularization (TLR) with SE. However, there...
RE-DUAL PCI outcomes have been published by the New England Journal of Medicine along with their presentation at ESC 2017. The traditional triple anti-thrombotic scheme with dual antiplatelet therapy and warfarin for patients with atrial fibrillation undergoing coronary angioplasty seems to have been left behind. This new study showed that the combination of dabigatran with a P2Y12...