DES de 2° vs 3° generación en bifurcaciones: nada nuevo bajo el sol

EuroPCR 2018 | 2nd and 3rd-Generation DES for Bifurcation Lesions: Nothing New Under the Sun

This study aimed to assess the outcome of Culotte stenting with newer-generation drug-eluting stents (DES) in Medina 1, 1, 1 bifurcation lesions. The 2nd-generation device used was permanent-polymer everolimus-eluting stent Xience, a device for which there is comparatively plenty of evidence available. Alternatively, the 3rd-generation stent used was thin-strut abluminal bioresorbable-polymer everolimus-eluting stent SYNERGY. Patients with<a href="https://solaci.org/en/2018/05/31/europcr-2018-2nd-and-3rd-generation-des-for-bifurcation-lesions-nothing-new-under-the-sun/" title="Read more" >...</a>

EuroPCR 2018 | SYNTAX II: resultados a 2 años de la mejor angioplastia vs cirugía en múltiples vasos

EuroPCR 2018 | SYNTAX II: Results at 2 Years for Best Angioplasty vs. Surgery in Multivessel Disease

Since the publication of the original SYNTAX trial, there have been great technical advancements that have influenced the results of angioplasty: New tools for risk stratification using the SYNTAX II score which integrate clinical and anatomical variables to the team’s decision-making process. Functional revascularization (hybrid use of fractional flow reserve or instantaneous wave-free ratio). Optimization of<a href="https://solaci.org/en/2018/05/31/europcr-2018-syntax-ii-results-at-2-years-for-best-angioplasty-vs-surgery-in-multivessel-disease/" title="Read more" >...</a>

EuroPCR 2018 | DESSOLV III: polímero bioabsorbible vs durable a 2 años

EuroPCR 2018 | DESSOLV III: Bioabsorbable vs. Durable Polymer at 2 Years

Most drug-eluting stents are coated by a polymer that is used to contain the antiproliferative drug. Once the drug is released, the polymer remains in place and its presence has been associated with inflammation, restenosis, and neoatherosclerosis. The MiStent device features a polymer that becomes bioabsorbable once the drug has been released, which could, theoretically,<a href="https://solaci.org/en/2018/05/31/europcr-2018-dessolv-iii-bioabsorbable-vs-durable-polymer-at-2-years/" title="Read more" >...</a>

Registro Sueco con stent SYNERGY: por primera vez stent probado en angioplastia primaria

EuroPCR 2018 | Swedish Registry on the SYNERGY DES: tested in primary PCI for the first time

The study included 36292 consecutive patients undergoing acute myocardial infarction receiving PCI with the new generation stent SYNERGY (thin struts, bioresorbable polymer and everolimus eluting); 39.7% presented ST elevation MI. Kaplan-Meier curves at 2 years of patients receiving the SYNERGY vs patients receiving other drug eluting stents resulted very similar for thrombosis (0,69% vs 0,81%,<a href="https://solaci.org/en/2018/05/31/europcr-2018-swedish-registry-on-the-synergy-des-tested-in-primary-pci-for-the-first-time/" title="Read more" >...</a>

FAME 2: el FFR muestra su beneficio a 5 años en puntos duros

EuroPCR 2018 | FAME 2: FFR Shows 5-Year Benefit for Hard Endpoints

After a 5-year follow-up, and for the first time, functional assessment with fractional flow reserve (FFR) showed clear benefit for a hard endpoint: acute myocardial infarction. Use of FFR in patients with stable coronary artery disease so as to identify hemodynamically significant lesions in order to restrict angioplasty treatment to them has long-term benefits compared<a href="https://solaci.org/en/2018/05/28/europcr-2018-fame-2-ffr-shows-5-year-benefit-for-hard-endpoints/" title="Read more" >...</a>

Tavi en pacientes com bajo flujo, bajo gradiente clásico

TAVR in Patients with Classical Low Flow, Low Gradient

Classical symptomatic low-flow, low-gradient (LFLG) severe aortic stenosis is associated with low survival rates at 3 years (<50%). However, in the medium term and with surgery, those rates improve (although mortality rates are 6%-30%, depending on the series). In patients without contractile reserve, surgical mortality is higher. Patient evolution in TAVR is still mostly unclear.  <a href="https://solaci.org/en/2018/04/12/tavr-in-patients-with-classical-low-flow-low-gradient/" title="Read more" >...</a>

Transcatheter Valve Replacement in the Bicuspid Valve Is Increasingly Performed, but Challenges Remain

Delayed Coronary Obstruction After TAVR: A Complication We Had Not Considered

Delayed coronary obstruction (after TAVR, outside the cath lab) is a rare complication with high mortality rates, not unlike acute obstruction. Cardiologists should be expectant and, upon the slightest suspicion of this complication, patients should be brought back to the cath lab for a coronary angiography. Occlusion immediately after implant release has been well-studied and<a href="https://solaci.org/en/2018/04/11/delayed-coronary-obstruction-after-tavr-a-complication-we-had-not-considered/" title="Read more" >...</a>

NOTION: 5-Year Outcomes of TAVR vs. Surgery in Low-Risk Patients are Promising

At 5 years, there were no differences in all-cause death, stroke, acute myocardial infarction, or all of these combined between low-risk, elderly patients who underwent transcatheter aortic valve replacement (TAVR) or conventional surgery. Taking into account reports from previous years, these results are not at all surprising. NOTION enrolled an all-comers population that was 70 years old<a href="https://solaci.org/en/2018/04/04/notion-5-year-outcomes-of-tavr-vs-surgery-in-low-risk-patients-are-promising/" title="Read more" >...</a>

Silent Diabetes Is the New Stealthy Enemy

One in three “nondiabetic” patients who undergo angioplasty with current drug-eluting stents have an altered glucose metabolism, which is associated with a 4-fold higher risk of events, according to a study that will be published soon in JACC Intv. One in three patients is definitely one patient too many, and four times higher is definitely<a href="https://solaci.org/en/2018/03/20/silent-diabetes-is-the-new-stealthy-enemy/" title="Read more" >...</a>

¿Quién vive más luego del TAVI: hombres o mujeres?

Who Lives Longer After TAVR, Men or Women?

Courtesy of Dr. Carlos Fava. Currently, some small observational studies and a meta-analysis suggest that women experience more short-term complications after TAVR (due to higher rates of bleeding, vascular complications, and stroke), as well as less 1-year mortality. However, results are still conflicting. This work analyzed 17 studies including 8 different registries, with a total 23,303 women and 23,885 men.<a href="https://solaci.org/en/2018/02/14/who-lives-longer-after-tavr-men-or-women/" title="Read more" >...</a>