drug elutin baloon_reestenosis_instrastent

Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting

Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable. Many technical advancements, including new stent designs and different cerebral protection mechanisms, have improved the outcomes of angioplasty in clinical<a href="https://solaci.org/en/2017/11/10/efficacy-of-micromesh-covered-stents-in-carotid-artery-stenting/" title="Read more" >...</a>

El estudio SOURCE 3 confirma los buenos resultados de la válvula SAPIEN 3 a un año de seguimiento

The SOURCE 3 Confirms the Good Outcomes of the SAPIEN 3 at One Year Followup

Transcatheter aortic valve replacement (TAVR) was developed as a strategy to treat non-surgical aortic stenosis, and was later expanded to elderly patients at intermediate risk, because of increased operator experience (overcoming the learning curve) and improved devices. The present study presents the one year outcomes of the SOURCE 3 trial, the multicenter European registry of the<a href="https://solaci.org/en/2017/10/27/the-source-3-confirms-the-good-outcomes-of-the-sapien-3-at-one-year-followup/" title="Read more" >...</a>

Anillo pequeño, ¿debemos comenzar a elegir la válvula?

Small Annulus: Should We Start Choosing the Valve?

Courtesy of Dr. Carlos Fava. A small annulus in patients with Severe Aortic Stenosis is a real challenge, since it is associated with post-surgical prosthesis patient mismatch (PPM), which negatively affects prosthesis duration and evolution. TAVR has become a good alternative strategy, with better hemodynamic profile and lower PPM incidence in this group. The present study included 246<a href="https://solaci.org/en/2017/10/17/small-annulus-should-we-start-choosing-the-valve/" title="Read more" >...</a>

¿Cateterismo o cirugía para el cierre del leak paravalvular?

Transcatheter Reduction or Surgery for Paravalvular Leak Repair?

Paravalvular leak is complication derived from incomplete sealing between the implanted prosthesis and the native annulus, which occurs in 5% of all patients who undergo mitral valve replacement and 10% of those who undergo transcatheter aortic valve replacement. This is the most frequent non-structural valve dysfunction. While mild leaks can be asymptomatic, moderate to severe<a href="https://solaci.org/en/2017/10/12/transcatheter-reduction-or-surgery-for-paravalvular-leak-repair/" title="Read more" >...</a>

La angioplastia “ad hoc” durante el TAVI no impacta en su seguridad ni en resultados a largo plazo

“Ad Hoc” PCI during TAVR: No Impact on Safety or Long Term Outcomes

According to a recent study published in Circulation Cardiovascular Interventions, screening for coronary artery disease (CAD) with an invasive coronary angiography  (as part of the protocol prior TAVR)  and performing PCI and TAVR in the same session, has no impact on periprocedural safety or on long term outcomes. Study outcomes offer new hope, especially as regards using TAVR<a href="https://solaci.org/en/2017/09/06/ad-hoc-pci-during-tavr-no-impact-on-safety-or-long-term-outcomes/" title="Read more" >...</a>

Sorpresivo hallazgo en diabetes y permeabilidad de los bypass

Striking Finding on Diabetes and Bypass Graft Patency

The higher rate of restenosis in the diabetic population is historic and has been reproduced in all studies and with all kinds of stents, but it was only after the FREEDOM trial when we found out about the higher infarction rate with PCI compared to surgery. This is why 50% of patients undergoing CABG are diabetic. Apart from the above<a href="https://solaci.org/en/2017/09/01/striking-finding-on-diabetes-and-bypass-graft-patency/" title="Read more" >...</a>

Early Endarterectomy Seems Superior to Carotid Stenting in Symptomatic Patients

Carotid stenting or endarterectomy? considering vascular anatomy…

Complex vascular anatomy could increase the risk of periprocedural stroke during carotid artery stenting (CAS). However, no randomize study has provided evidence showing this potential difficulty should inform the choice between carotid stenting and endarterectomy.  This study included 184 patients with symptomatic lesions of the internal carotid randomized to CAS vs. endarterectomy in the context<a href="https://solaci.org/en/2017/05/28/carotid-stenting-or-endarterectomy-considering-vascular-anatomy/" title="Read more" >...</a>

REPRISE III: Lotus and CoreValve Compared in High-Risk or Inoperable Patients

The efficacy of transcatheter aortic valve replacement (TAVR) has been well-established. However, its limitations include suboptimal deployment and paravalvular leak. The Lotus system is a fully repositionable and retrievable device with controlled mechanical expansion. It features an adaptive seal to minimize paravalvular leak, it does not require early pacing during deployment, and, given its early<a href="https://solaci.org/en/2017/05/23/reprise-iii-lotus-and-corevalve-compared-in-high-risk-or-inoperable-patients/" title="Read more" >...</a>

Trombólisis local en tromboembolismo pulmonar

Diastolic Dysfunction: Shall We Begin to Assess It?

Courtesy of Dr. Carlos Fava. The association between diastolic dysfunction (DD) and aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR) has not been studied yet, but the presence of aortic regurgitation has proved to be associated with worse outcomes.   A total of 144 out of 195 patients who underwent TAVR with balloon-expandable SAPIENS or SAPIENS XT<a href="https://solaci.org/en/2017/04/19/diastolic-dysfunction-shall-we-begin-to-assess-it/" title="Read more" >...</a>

Técnica Doble Crush Doble Kissing vs. stent provisional

Double Kissing Crush vs. Provisional Stenting at 5 Years

Courtesy of Dr. Guillermo Migliaro. The Provisional Stenting technique (PS) consists of sequentially placing a stent in the main branch of the bifurcation and, only when faced with a suboptimal outcome (such as < 3 TIMI flow, flow limiting dissection or high residual stenosis), a second stent in the side branch.  Several studies have shown<a href="https://solaci.org/en/2017/02/21/double-kissing-crush-vs-provisional-stenting-at-5-years/" title="Read more" >...</a>