Fractional flow reserve (FFR) proved to be very useful and safe in the FAME study, but its trade-off was using adenosine (which has a short half-life) and adverse reactions, which fortunately were rare. Subsequently, two large studies—the iFR-SWEDEHEART and DEFINE-FLAIR—demonstrated that instantaneous wave-free ratio (iFR) offered comparable results to FFR in the short term, avoiding<a href="https://solaci.org/en/2022/04/19/is-ifr-reliable-after-5-years-analyzing-the-ifr-swedeheart-at-5-years/" title="Read more" >...</a>
ACC 2022 | SPYRAL HTN-ON: Is It Time to Start Using Renal Denervation?
Thirty-eight patients were enrolled in the renal denervation (RDN) group, and 42 in the control group. The mean ambulatory systolic blood pressure and the mean ambulatory diastolic blood pressure were significantly lower at 24 and 36 months for patients in the RDN group compared with the control group, despite similar medical treatment with antihypertensive drugs.<a href="https://solaci.org/en/2022/04/13/acc-2022-spyral-htn-on-is-it-time-to-start-using-renal-denervation/" title="Read more" >...</a>
ACC 2022 | FLAVOUR Study: FFR and IVUS in Intermediate Coronary Lesions
FLAVOUR was a prospective randomized non-inferiority study in patients with intermediate coronary lesions (40%-70%) that compared two imaging modalities: IVUS (intravascular imaging) and FFR (fractional flow reserve). According to this research—presented at ACC 2022—, FFR-guided angioplasty was non-inferior to IVUS-guided angioplasty at 2 years of follow-up. Furthermore, using FFR-based imaging led to fewer stent implantations.<a href="https://solaci.org/en/2022/04/13/acc-2022-flavour-study-ffr-and-ivus-in-intermediate-coronary-lesions/" title="Read more" >...</a>
ACC 2022 | CLASP TR Study: Tricuspid Valve Repair with the PASCAL Device
The study included 65 patients who received endovascular treatment of the tricuspid valve with the PASCAL device. Forty-six completed the 12-month follow-up. At 1-year follow-up, the major events endpoint was 16.9%; the most frequent event was bleeding (9.2%). In addition, there were three cases of stroke, one reintervention, two vascular access complications, and five cardiovascular-related<a href="https://solaci.org/en/2022/04/13/acc-2022-clasp-tr-study-tricuspid-valve-repair-with-the-pascal-device/" title="Read more" >...</a>
ACC 2022 | ADAPT-TAVR: Endoxaban Is Not Superior to DAPT After TAVR
DAPT-TAVR is a randomized trial that tested endoxaban in patients with no indication for anticoagulation who underwent successful transcatheter aortic valve replacement (TAVR) for symptomatic severe aortic stenosis. This study included 229 patients whose mean age was 80 years; 42% of them were male. Patients were randomized to either endoxaban 60 mg or 30 mg every 24 h or<a href="https://solaci.org/en/2022/04/13/acc-2022-adapt-tavr-endoxaban-is-not-superior-to-dapt-after-tavr/" title="Read more" >...</a>
Same-Day Discharger After TAVR: Are We There Yet?
Same-day discharge (SDD) has been shown to be effective in angioplasties and some peripheral procedures, but the pandemic—because of the burden it caused on the healthcare system—has forced the optimization of hospitalization times for other pathologies and procedures. This strategy is yet to be tested in transcatheter aortic valve replacement (TAVR) due to the possible<a href="https://solaci.org/en/2022/04/01/same-day-discharger-after-tavr-are-we-there-yet/" title="Read more" >...</a>
IVUS in Femoropopliteal PCI: Should We Start Using It?
For approximately two decades now, PCI has been the treatment of choice in femoropopliteal territory, and even though technological developments and increasing operator experience have indeed improved outcomes, IVUS (which has showed great benefits in PCI, even reducing left main mortality) is hardly used in this territory. This was a prospective randomized controlled study including<a href="https://solaci.org/en/2022/03/29/ivus-in-femoropopliteal-pci-should-we-start-using-it/" title="Read more" >...</a>
TRICENTO: Promising Results for Severe Tricuspid Valve Regurgitation
Difficult to treat, tricuspid valve failure poses great medical challenge. In addition, the mortality rate of surgical treatment these days is not exactly low, involving high risk, which often takes this alternative off the table. Several percutaneous devices have been developed to treat this disease, the most popular being edge-to-edge devices. The TRICENTO has an<a href="https://solaci.org/en/2022/03/25/tricento-promising-results-for-severe-tricuspid-valve-regurgitation/" title="Read more" >...</a>
Drug Eluting Stents: Does Strut Size Matter?
The benefit of first-generation Drug-Eluting Stents (DES) over Bare Metal Stents (BMS) is largely known. Moreover, technological developments have led to reduced strut size, biodegradable polymers, and new scaffolds, which in turn have led to improved outcomes. These are known as ultrathin stents, and its struts measure between 70 and 100 microns, which contributes to<a href="https://solaci.org/en/2022/03/23/drug-eluting-stents-does-strut-size-matter/" title="Read more" >...</a>
Ticagrelor Monotherapy after 3 Months: Is the Current Strategy Worth Changing?
Dual antiplatelet therapy (DAPT) after PCI with DES has shown noticeable reduction of thrombotic events, especially in acute coronary syndromes (ACS). However, this therapy encompasses increased bleeding, especially in elderly patients increasingly undergoing percutaneous intervention. Even though most bleeding events might not be fatal (many of them are mostly digestive) they do involve higher hospitalization<a href="https://solaci.org/en/2022/03/21/ticagrelor-monotherapy-after-3-months-is-the-current-strategy-worth-changing/" title="Read more" >...</a>