Several randomized studies have shown that dual antiplatelet therapy (DAPT) is as effective to prevent thrombotic events in the segment treated with PCI, as it is with the rest of the coronary segments. This is very clear. The problem is there are a series of adverse events following P2Y12 inhibitor discontinuation. This phenomenon called rebound effect, happens<a href="https://solaci.org/en/2017/09/01/dual-antiplatelet-therapy-discontinuation-causes-more-thrombotic-events-at-12-months/" title="Read more" >...</a>
Should We Begin to Use IVUS in CTO?
Courtesy of Dr. Carlos Fava. Currently, chronic total occlusions (CTO) are one of the obstacles that coronary angioplasties must overcome, particularly with the development of drug-eluting stents (DES) 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 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>
Are Bioresorbable-Polymer Stents More Thrombogenic than Durable-Polymer Second-Generation Stents?
Courtesy of Dr. Cristian Jesús Rodríguez. Most stents currently used in percutaneous coronary intervention (PCI) are durable-polymer second-generation drug-eluting stents (DP-DES, with everolimus or zotarolimus). However, it has been argued that the persistence of such a polymer after complete drug elution is one of the main factors for a dangerous complication: stent thrombosis (ST). After<a href="https://solaci.org/en/2017/08/23/are-bioresorbable-polymer-stents-more-thrombogenic-than-durable-polymer-second-generation-stents/" title="Read more" >...</a>
Bleeding and Mortality in Transcatheter Aortic Valve Replacement
Transcatheter aortic valve replacement (TAVR) is much less invasive than surgical replacement. This is associated with a substantial reduction in bleeding events (up to 60% less). However, clinically relevant bleeding is still present in one every four patients who undergo TAVR, which is associated with morbidity and mortality. Cases of bleeding are not uniform: they may<a href="https://solaci.org/en/2017/08/22/bleeding-and-mortality-in-transcatheter-aortic-valve-replacement/" title="Read more" >...</a>
Common Femoral PCI Becomes a Valid Alternative
Gentileza del Dr. Carlos Fava. The common femoral artery has always been treated with surgery. Thanks to the development of new generation stents and the advancement of percutaneous intervention, common femoral lesions are currently being treated with PCI. However, data on the safety of PCI vs. surgery, remain unavailable. The TECCO is multicenter study, randomized<a href="https://solaci.org/en/2017/08/17/common-femoral-pci-becomes-a-valid-alternative/" title="Read more" >...</a>
Different Techniques for the Improvement of Outcomes in Intermittent Claudication
Peripheral vascular diseases affect over 20% of the population and can affect up to 30% of people with cardiovascular risk factors. The most important treatment points include modification of risk factors, exercise, optimal medical treatment, and timely revascularization. Given its lower risk of peri-procedural complications (when compared to surgery), endovascular therapy is generally the first<a href="https://solaci.org/en/2017/08/14/different-techniques-for-the-improvement-of-outcomes-in-intermittent-claudication/" 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>
Increasing operator experience improves TAVR outcomes
The introduction of transcatheter aortic valve replacement (TAVR) into clinical practice in the United States has been a tightly controlled process aimed at optimizing patient outcomes and minimizing the learning curve. Many strategies have been used to reach a rational dispersion for this new technology, including choosing sites with enough volume, and adequate operator training<a href="https://solaci.org/en/2017/07/26/increasing-operator-experience-improves-tavr-outcomes/" title="Read more" >...</a>
MRS vs. DES: Which one is associated with better long-term quality of life?
The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, which included patients with 3-vessel or left main coronary artery lesions, showed that myocardial revascularization surgery (MRS) turned out to be superior to angioplasty with drug-eluting stents (DES), mainly due to differences in acute myocardial infarction and repeat revascularization. Up to this work, patient sensations (which can be<a href="https://solaci.org/en/2017/07/21/mrs-vs-des-which-one-is-associated-with-better-long-term-quality-of-life/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2017/07/07/bvs-controvertial-scaffold/" title="Read more" >...</a>