While the benefits of dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor are recognized, its primary complication is the occurrence of bleeding events, which negatively impact patient morbidity and mortality. Additionally, about 10% of patients undergoing percutaneous coronary intervention (PCI) are on oral anticoagulant therapy, which significantly increases the risk of bleeding when...
The initial strategy for the treatment of patients at high risk of bleeding (HBR) after percutaneous coronary intervention (PCI) has consisted of a short dual antiaggregation therapy (DAPT). Stents continue to improve, which has allowed the reduction of DAPT schemes and therefore the incidence of bleeding. However, researchers are also looking into another strategy to...
The progression of aortic stenosis has been extensively studied and is well-known. As observed, in its advanced stages, this condition entails high morbidity and a marked decrease in survival. Both North American and European guidelines recommend treatment when faced with severe valve disease. However, true severity can be difficult to determine due to discordant data,...
During SOLACI-SBHCI 2023, our traditional education program for young interventionists ProEducar Fellows Course was held. Discover the presentations of the prestigious interventionists that made part of this 13th edition here below. Dr. Gustavo Vignolo (UY) – “Trigger: STEMI learning clinical case” PRESENTATION Dr. Roger Renault Godinho (BRA) – “Why and how should I use Radial access? Step by Step” PRESENTATION...
The impact of diabetes on the development of cardiovascular disease is widely known, with a strong association with extensive and diffuse coronary artery disease. Decision-making regarding how to revascularize patients with multi-vessel disease is a complex process. In this context, coronary artery bypass grafting (CABG) has been recommended over percutaneous coronary intervention (PCI) based on...
In-stent restenosis (ISR) remains the primary limitation of percutaneous treatment for coronary artery disease. The strategy to address this limitation involves the use of drug-eluting stents (DES) or drug-coated balloons (DCB), both of which have proven to be effective and safe therapeutic alternatives. Despite current recommendations, treating ISR continues to be a challenge, and clinical...
TCT has presented the 5-year clinical and echocardiographic outcomes of low-risk patients with severe aortic stenosis treated with transcatheter aortic valve replacement (TAVR) using balloon-expandable Sapien valves vs. surgical aortic valve replacement (SAVR). The first primary end point was a non-hierarchical composite of all-cause mortality stroke or rehospitalization. The second was a hierarchical composite including...
In recent years, there has been a steady increase in the use of transcatheter aortic valve replacement (TAVR) in younger patients, with an average age of 74 years, as observed in US medical records. This trend goes alongside encouraging durability results, as demonstrated in the 10-year NOTION study, where structural valve degeneration (SVD) with first-generation...
It has been observed that the persistence of an opening in the left atrial appendage after percutaneous closure (LAAC) is associated with a higher risk of embolic events. Among the most commonly used devices for left atrial appendage closure are the Watchman FLX and Amulet devices. This study, known as SwissApero, represents the first randomized...
High-risk pulmonary embolism (HR-PE) is characterized by hemodynamic instability and marked deformation of the right ventricular (RV) fiber, which can lead to acute RV failure and hemodynamic collapse, with in-hospital mortality close to 25%. While guidelines recommend anticoagulant treatment followed by thrombolytics, these strategy carries a high risk of bleeding and is not suitable for...