diabetes

Unprotected trunk in diabetics: angioplasty with good long-term results but more revascularization

Original title: Coronary artery bypass graft versus percutaneous coronary intervention with drug-eluting stent implantation for diabetic patients with unprotected left main coronary artery disease: D-DELTA registry. Reference: Meliga Emanuele, et al. EuroIntervention 2013; 9:803-808 Diabetes increases cardiovascular risk events because of their involvement in diffuse form of the vessels, thereby generating more events and changes in revascularization strategy...

Infrapatellar balloon angioplasty, the easiest option and with better results in critical ischemia with tissue loss

Original title: Longitudinal outcomes After Tibioperoneal Angioplasty Alone Compared to Tibial Stenting and Atherectomy for Critical Limb ischemia. Reference: Shaun Reynolds et al. Vascular and and Endovascular Surgery 2013 47(7):507-512 The Infrapatellar peripheral vascular disease has increased in recent years, relating to tissue loss and amputation. The therapeutic strategy is not clear, let alone the use of stents...

Clinical factors to help decide between angioplasty and carotid endarterectomy

Original title: A clinical rule (sex, contralateral occlusion, age, and restenosis) to select patients for stenting versus carotid endarterectomy: Systematic review of observational studies with validation in randomized trials. Reference: Touzé E et al. Stroke. 2013;Epub ahead of print Compared with carotid endarterectomy, angioplasty with stent is associated with an increased risk of pre- procedural stroke especially for...

Bivalirudin, effective in the pre-hospitalization phase of infarction

Original title: Bivalirudin Started during Emergency Transport for Primary PCI. Reference: Philippe G. Steg, et;al. NEJM 2013; Octubre 30:1-11 Primary PCI is the preferred treatment for AMI within the first 12 hours of symptom onset and outcomes have been improving with the incorporation of new strategies and technology. This study randomized 2218 STEMI patients started with bivalirudin during...

Cilostazol reduces restenosis of DES in lesions larger than 40 mm.

Original title: Comparison of Dual Versus Triple Antiplatelet Therapy After Drug-Eluting Stent According to Stent Length (from the Pooled Analysis of DECLARE Trials). Reference: Seung-Whan Lee et al. Am J Cardiol 2013, article in press. Cilostazol, an inhibitor of phosphodiesterase III , associated with aspirin and clopidogrel showed decrease angiographic restenosis both in conventional stents as well as...

Ticagrelor effective in venous bridges

Original title: Effect of ticagrelor on the outcomes of patients with prior coronary artery bypass grafo surgery: Inssights from th PLATelet inhibition and patients outcomes (PLATO) trial. Reference: Emmanouil S. Brilakis, et al. Am Heart J 2013;166:474-80   The bridge venous occlusion is a common finding in patients with previous CABG presenting with acute coronary syndrome without ST...

Difference in mortality with surgery versus angioplasty in diabetic multivessel patients

Original title: Comparison of coronary artery bypass surgery and percutaneous coronary intervention in patients with diabetes: A meta-analysis of randomized controlled trials. Reference: Verma S. et al. Lancet Diabetes Endocrinol. 2013;Epub ahead of print. The FREEDOM study was the last of the randomized studies that compared the results of surgery versus coronary angioplasty in diabetic multivessel patients showing a...

Primary angioplasty , a race against time

Original title: Door-to-Balloon Time and Mortality among Patients Undergoing Primary PCI. Reference: Daniel S. Menees et al. N Engl J Med 2013;369:901-9. For more than a decade has been ranked , like a race, to the delay times that occur in hospitals until angioplasty is performed in the context of an infarct with ST segment elevation . Several...

Ticagrelor reduces in-stent thrombosis in patients with acute coronary syndromes

Original title: Stent thrombosis with ticagrelor versus clopidogrel in patients with acute coronary syndromes: An analysis from the prospective randomized PLATO trial. Reference: Steg PG et al. Circulation. 2013; Epub ahead of print The PLATO study randomized 18624 patients with acute coronary syndrome to receive ticagrelor   (180 mg loading dose followed by 90 mg twice daily )...

Low flow impact on outcomes following TAVI should be taken into account

Original title: Impact of Low Flow on the Outcome of High-Risk Patients Undergoing Transcatheter Aortic Valve Replacement. Reference: Florent Le Ven, et al. J Am Coll Cardiol 62;9:792-788 A study of low flow (SVi <35ml/m2) in the context of severe aortic stenosis has shown it is a predictor of worse outcomes after surgery, even though evolution with medical...

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