The prevalence of pre-procedural kidney failure in patients undergoing transcatheter aortic valve replacement (TAVR) can be as high as 50 – 60% (stage 3 kidney failure or worse); it has been strongly associated with acute kidney deterioration and, ultimately, an increase of post TAVR mortality. A recent meta-analyzis of several small studies carried out in a single...
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. To understand the real dimension of this problem, we should know that PAD patients have 60% more risk of acute myocardial infarction...
See All ProEducar “José Gabay” Course (Eighth Edition) Presentations
We are deeply thankful to all interventional physicians who, motivated by their great scientific and educational vocation, presented their works at the “José Gabay” Course and actively collaborated in training and providing updated concepts for the next generations of interventional cardiologists. Read and/or download the presentations below: Module I: Fundamentals and Basic Elements. Álvarez, José....
Incomplete Revascularization Is Associated with Mortality in TAVR
Courtesy of Dr. Carlos Fava. TAVR has proven to be beneficial for inoperable and high-risk patients, as well as for intermediate-risk patients. However, while many comorbidities have been analyzed, the presence, severity, and impact of coronary disease has not been well studied yet. This study analyzed 1270 patients who underwent TAVR. They presented >50% lesions in a major epicardial...
Valve Deterioration after TAVI Is Rare and Should Not Prevent Advancement to Younger Populations
Durability ─or better yet, lack of deterioration─ is still a matter of debate when considering transcatheter aortic valve intervention (TAVI), especially now that it is being explored as a real alternative for younger patients. A recently published meta-analysis offers more evidence and suggests TAVI deterioration is mostly rare within the first 5 years. According to...
Statin Pre-Treatment for the Prevention of Peri-Procedural Events in Carotid Artery Stenting
Recent randomized studies have shown that the rates of combined peri-procedural events for carotid artery stenting and carotid endarterectomy are similar. While the final numbers are similar, the actual events are different: more infarction events for endarterectomy and more stroke (particularly minor stroke) events for carotid artery stenting. The reduction of these rates of stroke has been the aim of...
Protection Systems Reduce Stroke and Mortality in Carotid Artery Stenting
So far, the main controlled randomized studies have almost exclusively been aimed at comparing the efficacy and safety of carotid artery stenting vs. endarterectomy. Almost all of them have left at operator discretion the choice of the devices to be used during the procedure, which is why there is few direct information to help us...
BVS: Controvertial Scaffold
Courtesy of Dr. Agustín Vecchia. The advent of resorbable vascular scaffolds (BVS) generated high expectations among interventionists because of its potential advantages over bare metal stents. However, when comparing BVS against the Xience stent, we observed an increased rate of events associated to the first device, to their detriment. Among the reasons behind this poor...
Incidence, characteristics, and treatment of valve thrombosis after TAVR
Certain studies have carried out a tomographic follow-up of patients who underwent transcatheter aortic valve replacement (TAVR) and described the frequency of leaflet thrombosis; however, in most cases, it is unclear whether this finding requires some sort of intervention. The difference between this work and those previously published is that this study is not focused on imaging, it...
Leaders Free ACS: Good Results for the Polymer-Free Stent at 2 Years in ACS
Courtesy of the SBHCI. Guidelines recommend dual antiplatelet therapy for a year in patients admitted with coronary acute syndrome. However, patients at high risk for bleeding who receive coronary angioplasty have been historically excluded from studies. The new polymer-free stent BioFreedom allows for the reduction of dual antiplatelet therapy time, due to rapid drug elution...