01- Alternatives for Patients Allergic to Aspirin The new guidelines of chronic coronary syndromes make class IIb recommendations to use prasugrel or ticagrelor in aspirin-intolerant patients. This is not meant to replace dual antiaggregation therapy in aspirin intolerant patients, when needed; it is just a recommendation to use monotherapy with the most potent antiaggregant we<a href="https://solaci.org/en/2020/03/11/the-most-read-scientific-articles-of-february/" title="Read more" >...</a>
As a “friendly,” easy-to-read document, the new European guidelines on pulmonary embolism (PE) include an excellent summary chart with new and modified items (compared with the 2014 guidelines), and also some sort of final conclusion composed of crucial tips and contraindications that come in handy in case of emergency. Diagnosis stage In suspected high-risk PE,<a href="https://solaci.org/en/2020/03/04/what-to-do-and-what-not-to-do-in-case-of-pe-according-to-the-new-european-guidelines/" title="Read more" >...</a>
Intolerance to aspirin is relatively frequent and there is no other non-steroid anti-inflammatory medication to replace it. The new guidelines of chronic coronary syndromes make class IIb recommendations to use prasugrel or ticagrelor in aspirin-intolerant patients. This is not meant to replace dual antiaggregation therapy in aspirin intolerant patients, when needed; it is just a<a href="https://solaci.org/en/2020/03/02/alternatives-for-patients-allergic-to-aspirin/" title="Read more" >...</a>
Multiple drugs and treatment strategies have emerged in recent years to change significantly the prognosis of patients who suffer from stable chronic angina or, in terms of the latest guidelines, “chronic coronary syndromes.” This semantic change may seem of little importance, but it is intended to remind us that these are not stable patients, but<a href="https://solaci.org/en/2020/02/28/chronic-coronary-syndromes-nowadays/" title="Read more" >...</a>
Since November 2015, when the LEADERS FREE was published in NEJM, polymer-free drug coated stents had undoubtedly been the best treatment for patients at high risk of bleeding. The benefit was owed to the safety and efficacy of the polymer-free biolimus coated stent (also called umirolimus) vs. bare metal stents in the context of just<a href="https://solaci.org/en/2020/02/27/onyx-one-more-options-for-patients-at-high-risk-for-bleeding/" title="Read more" >...</a>
This big analysis shows rapid absorption of paclitaxel coated devices for PCI in femoropopliteal territory, which reassures us about its alleged association to increased mortality. In fact, survival, amputation-free survival and cardiovascular events rate resulted better with paclitaxel coated devices in the treatment of chronic limb ischemia. This study emphasizes the difference that might exist<a href="https://solaci.org/en/2020/02/04/felling-reassured-with-paclitaxel-coated-devices-in-peripheral-artery-disease/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. In modern studies, carotid artery stenting (CAS) has been shown equal to surgery in terms of the composite end point of periprocedural stroke, death, acute myocardial infarction and late ipsilateral stroke. This was tested in different groups and by trained operators. In the CREST-2 Registry (C2R) 2141 patients were included,<a href="https://solaci.org/en/2020/01/27/crest-2-registry-carotid-pci-presents-low-rates-of-death-and-stroke/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Around half the treated lesions in peripheral disease are femoropopliteal lesions. Long lesions are among the challenges faced: they are associated with higher mortality and morbidity, and revascularization in that setting always entails some degree of difficulty. Nowadays, with the development of nitinol stents and more operator experience, angioplasty is becoming<a href="https://solaci.org/en/2020/01/22/angioplasty-in-long-femoropopliteal-lesions-offers-reasonable-results/" title="Read more" >...</a>
The GLOBAL LEADERS study includes a pre-specified sub-study, GLASSY, that showed that ticagrelor monotherapy after one month of dual antiplatelet therapy is non-inferior (but not superior) to conventional treatment in terms of ischemic events. As regards safety, ticagrelor monotherapy did not decrease major bleeding compared with conventional therapy. The GLOBAL LEADERS randomized 15,991 patients who required<a href="https://solaci.org/en/2020/01/13/ticagrelor-monotherapy-one-month-after-des-implantation/" title="Read more" >...</a>
1- AHA 2019 | ISCHEMIA: The Invasive Approach (PCI or Surgery) Results Similar to Optimal Medical Treatment After a several year follow up, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) has shown that an invasive approach in addition to optimal medical treatment (OMT) does not offer benefits when it<a href="https://solaci.org/en/2019/12/02/the-most-read-articles-of-november-at-solaci-org/" title="Read more" >...</a>