Original Title: Effect of intravascular ultrasound-guided vs angiography-guided everolimus-eluting stent implantation: the IVUS-XPL randomized clinical trial. Presenter: Hong S-J. Patients with long coronary lesions have better clinical results after a year of second generation DES implantation when interventions are guided by IVUS, instead of angiography. The benefit was attributed to a lower revascularization rate of ischemia...
Fundamentos e Objetivo: A persistência do polímero nos DES de primeira e segunda gerações após a liberação completa do fármaco tem sido apontado como um desencadeador da resposta inflamatória crônica. Os DES de terceira geração com hastes ultra-finas e com polímeros biodegradáveis tem sido desenvolvidos para aumentar a segurança e eficácia destes dispositivos. O objetivo...
This observational registry compared the results of myocardial revascularization with angioplasty performed using everolimus-eluting stents in patients with multivessel. The primary endpoint of the study was mortality from any cause. Side end points were infarction, stroke, and revascularization. Propensity score was used to compare populations. Between 34819 patients were eligible 9223 patients in each group...
The aim of this study was to compare the usefulness of primary angioplasty only to culprit vessel versus complete revascularization guided by fractional flow reserve (FFR) in patients admitted pursuing an acute myocardial infarction with ST-segment elevation and have multiple injuries vessels. After a successful primary angioplasty to culprit artery, patients were randomized 1:1 to...
Current guidelines suggest treating only the culprit artery of myocardial infarction with ST-segment elevation. This prospective and randomized work included 296 patients in 7 centers suffering ST-segment elevation acute myocardial infarction referred for primary angioplasty randomized to treat only the culprit artery (n = 146) versus complete revascularization (n = 150). In the culprit artery...
This multicenter noninferiority design work included 1399 patients randomized to receive 6 months (n = 682) versus 1 year (n = 717) dual anti-aggregation after implantation of 2nd generation drug-eluting stent. The primary end point was a composite of cardiac death, myocardial infarction, stroke, definite or probable thrombosis, and major bleeding. At 12 months follow-up...
While the use of intravascular ultrasound (IVUS) during coronary intervention proved useful in multiple studies, there is limited evidence in the literature regarding its use in specifically in chronic total occlusions. The IVUS may help guide in recognizing the true lumen and better distal positioning, better coverage of stent, an optimal apposition and expansion, diagnose...
This paper included 5 studies that randomized patients to conventional stent versus chromium cobalt everolimus eluting stent; at 2 years, a significantly lower risk of cardiac death (2.7% for the everolimus eluting stent versus 4% for conventional stent, p = 0013) was observed. Myocardial infarction was reduced by over 80% with drug-eluting stent (0.08% versus...
This study was designed to compare the apposition and neointimal coverage of struts by optical coherence tomography (OCT) of the new self-expanding sirolimus eluting stent (STENTYS SES) at 4 and 9 months in patients with STE-ACS. 152 patients randomized to STENTYS SES (n = 90) versus zotarolimus-eluting balloon-expandable stent (n = 62) were included. The...
This work aimed to evaluate the use of optical coherence tomography (OCT) to guide the drug-eluting stent implantation during primary angioplasty. 201 patients experiencing STEMI to use or not OCT during primary angioplasty were randomized. The clinical and angiographic characteristics were well balanced, and no differences in MACE, cardiac death, TLR, or stent thrombosis at...