stents

Diferentes técnicas para mejorar los resultados en claudicación intermitente

Different Techniques for the Improvement of Outcomes in Intermittent Claudication

Peripheral vascular diseases&nbsp;affect over 20% of the population and can affect up to 30% of people with cardiovascular risk factors. The most important treatment points include modification of risk factors, exercise, optimal medical treatment, and timely revascularization. &nbsp; Given its lower risk of peri-procedural complications (when compared to surgery), endovascular therapy is generally the first<a href="https://solaci.org/en/2017/08/14/different-techniques-for-the-improvement-of-outcomes-in-intermittent-claudication/" title="Read more" >...</a>

Doble antiagregación en TAVI, simple es mejor?

Dual Antiplatelet in TAVR: Is Single Better?

Courtesy of Dr. Agustín Vecchia. As TAVR&nbsp;is expanded to lower risk patients, complications become more relevant. As regards stroke, the PARTNER 2 and SURTAVI one year outcomes are 8.0% and 8.2% respectively. The mechanisms behind this complication have not yet been clarified and, therefore, neither have guideline recommendations in this regard (as we can tell<a href="https://solaci.org/en/2017/08/02/dual-antiplatelet-in-tavr-is-single-better/" title="Read more" >...</a>

Protección cerebral

Protection Systems Reduce Stroke and Mortality in Carotid Artery Stenting

So far, the main controlled randomized studies have almost exclusively been aimed at comparing the efficacy and safety of carotid artery stenting vs. endarterectomy. Almost all of them have left at operator discretion the choice of the devices to be used during the procedure, which is why there is few direct information to help us<a href="https://solaci.org/en/2017/07/21/protection-systems-reduce-stroke-and-mortality-in-carotid-artery-stenting/" title="Read more" >...</a>

CRM vs DES: ¿Cuál se asocia mejor calidad de vida a largo plazo?

MRS vs. DES: Which one is associated with better long-term quality of life?

The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, which included patients with 3-vessel or left main coronary artery lesions, showed that&nbsp;myocardial revascularization surgery (MRS) turned out to be superior to&nbsp;angioplasty&nbsp;with&nbsp;drug-eluting stents (DES), mainly due to differences in&nbsp;acute myocardial infarction&nbsp;and repeat revascularization. Up to this work, patient sensations (which can be<a href="https://solaci.org/en/2017/07/21/mrs-vs-des-which-one-is-associated-with-better-long-term-quality-of-life/" title="Read more" >...</a>

El éxito en las CTO reduce la isquemia residual local y a distancia

Successful CTO reduces local and remote residual ischemia

Courtesy of Dr. Carlos Fava. The presence of&nbsp;Chronic Total Occlusion (CTO)&nbsp;is about 30%, with an ischemic threshold between 10% and 12.5% to justify rechannelization. Using the new devices, the new guidelines and with more experience operators, these procedures are successful in 10% to 30% of cases. More often than not these patients are not treated<a href="https://solaci.org/en/2017/07/19/successful-cto-reduces-local-and-remote-residual-ischemia/" title="Read more" >...</a>

Post DES Dual Antiplatelet Therapy Still under Debate

The NIPPON trial (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was a randomized study comparing a short&nbsp;dual antiplatelet therapy scheme (6 months) vs. a prolonged scheme (18 months) in patients receiving the Nobori drug eluting stent (Terumo, Tokyo, Japan) with a biodegradable abluminal polymer. It included 3,773 patients with chronic stable angina or acute coronary<a href="https://solaci.org/en/2017/07/18/post-des-dual-antiplatelet-therapy-still-under-debate/" title="Read more" >...</a>

Glycemic control and risk of repeat revascularization

The association between glycemic control after coronary angioplasty and outcomes of the latter is controversial in many studies. We have come to think that the risk lies in suffering from diabetes, as if it was an unmodifiable factor. We have also come to believe that glycemic control can impact microvascular complications while it cannot do<a href="https://solaci.org/en/2017/07/12/glycemic-control-and-risk-of-repeat-revascularization/" title="Read more" >...</a>

Los DES de última generación presentan mejores resultados en puentes venosos que los DES antiguos y BMS

New generation DES present better results in vein grafts than older DES and BMS

There is little information comparing&nbsp;contemporary drug eluting stents (DES)&nbsp; against bare metal stents (BMS), for PCI in saphenous vein grafts in patients receiving (CABG). &nbsp; This study aimed to assess clinical outcomes after PCI in saphenous vein grafts in patients receiving BMS, first generation DES, and new generation DES between 2006 and 2013. The study<a href="https://solaci.org/en/2017/07/07/new-generation-des-present-better-results-in-vein-grafts-than-older-des-and-bms/" title="Read more" >...</a>

BVS, la plataforma de la discordia

BVS: Controvertial Scaffold

Courtesy of Dr. Agustín Vecchia. The advent of resorbable vascular scaffolds (BVS) generated high expectations among interventionists because of its potential advantages over bare metal stents. However, when comparing BVS against the Xience stent, we observed an increased rate of events associated to the first device, to their detriment. Among the reasons behind this poor<a href="https://solaci.org/en/2017/07/07/bvs-controvertial-scaffold/" title="Read more" >...</a>

Menos volumen, más mortalidad, ¿debemos preocuparnos?

Less volume, more mortality: should we be concerned?

Courtesy of&nbsp;Dr. Agustín Vecchia. In general, guidelines recommend a number of procedures a year for operators to maintain a reasonably safe level of proficiency. Even though this number is arbitrary and operators’ aptitude varies considerable, more than one publication has found an inverse correlation between procedure volume and outcomes. &nbsp; This study incorporated 10,496 operators<a href="https://solaci.org/en/2017/06/30/less-volume-more-mortality-should-we-be-concerned/" title="Read more" >...</a>

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