Courtesy of Dr. Cristian Jesús Rodríguez. Most stents currently used in percutaneous coronary intervention (PCI) are durable-polymer second-generation drug-eluting stents (DP-DES, with everolimus or zotarolimus). However, it has been argued that the persistence of such a polymer after complete drug elution is one of the main factors for a dangerous complication: stent thrombosis (ST). After<a href="https://solaci.org/en/2017/08/23/are-bioresorbable-polymer-stents-more-thrombogenic-than-durable-polymer-second-generation-stents/" title="Read more" >...</a>
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 myocardial revascularization surgery (MRS) turned out to be superior to angioplasty with drug-eluting stents (DES), mainly due to differences in acute myocardial infarction 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>
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 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>
Successful angioplasty in elderly patients with chronic total occlusion reduces mortality
Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and<a href="https://solaci.org/en/2017/06/19/successful-angioplasty-in-elderly-patients-with-chronic-total-occlusion-reduces-mortality/" title="Read more" >...</a>
AIDA: bioresorbable scaffold thrombosis still a concern in studies
Courtesy of the SBHCI. This study presented at PCR and simultaneously published by NEJM still challenges the safety of bioresorbable scaffolds. This was a multicenter noninferiority work carried out in the Netherlands, comparing 1:1 everolimus-eluting bioresorbable scaffold ABSORB and permanent-polymer everolimus-eluting stent Xience. The primary endpoint was target-vessel failure (a composite of cardiac<a href="https://solaci.org/en/2017/06/02/aida-bioresorbable-scaffold-thrombosis-still-a-concern-in-studies/" title="Read more" >...</a>
TOPIC: Benefits of Switching Dual Antiplatelet Therapy in Patients with ACS
Newer P2Y12 blockers are the front-line treatment and dual antiplatelet therapy is indicated for 1 year after acute coronary syndrome (ACS). Both prasugrel and ticagrelor offer more ischemic benefit than clopidogrel during the initial phase; however, bleeding complications could increase in the long term. The objective of this study was to assess the safety and efficacy<a href="https://solaci.org/en/2017/05/23/topic-benefits-of-switching-dual-antiplatelet-therapy-in-patients-with-acs/" title="Read more" >...</a>
TAVR in Intermediate-Risk Patients: Is It as Effective as Surgical Aortic Valve Replacement?
Courtesy of Dr. Carlos Fava. Transcatheter aortic valve replacement (TAVR) has proven to be beneficial for extreme- and high-risk patients. It is also increasingly used in intermediate-risk patients, and it has been hinted at for low-risk patients. However, different sectors in the medical community still challenge the existence of real TAVR benefit. This assessment consisted<a href="https://solaci.org/en/2017/05/03/tavr-in-intermediate-risk-patients-is-it-as-effective-as-surgical-aortic-valve-replacement/" title="Read more" >...</a>
Is Impella an option in high-risk angioplasty?
Courtesy of Dr. Carlos Fava. Provitional ventricular assist devices are increasingly used in high-risk angioplasties, particularly those involving unprotected left main coronary artery (LMCA) with defective ventricular functioning. However, so far its true role has not been well-studied. This study analyzed 127 consecutive patients in the USpella registry from 2008 to 2015. These subjects underwent high-risk<a href="https://solaci.org/en/2017/05/03/is-impella-an-option-in-high-risk-angioplasty/" title="Read more" >...</a>
Tricuspid valve repair with the MitraClip technique
Current surgical and medical treatment options for severe tricuspid regurgitation are extremely limited. However, this historically forgotten valve seems to have the option of transcatheter repair, nowadays. This observational study assessed the safety and feasibility of the MitraClip system for patients with severe chronic tricuspid regurgitation. All patients presented severe tricuspid regurgitation and<a href="https://solaci.org/en/2017/04/27/tricuspid-valve-repair-with-the-mitraclip-technique/" title="Read more" >...</a>