The main studies carried out on patients with chronic coronary syndromes (CCS), such as the MASS II, COURAGE, BARI 2D and FAME-2, failed to show benefits in terms of mortality with the invasive approach. The ISCHEMIA, a large randomized study including patients with moderate to severe ischemia, with without left main disease and with acceptable<a href="https://solaci.org/en/2024/01/31/events-according-to-revascularization-modality-in-the-ischemia-trial/" title="Read more" >...</a>
Chronic total occlusions (CTOs) account for approximately 15-20% of patients with stable coronary artery disease. This field has seen various advances regarding treatment, leading to an improvement in the success rate of procedures. According to registries and randomized studies, the main indication for percutaneous coronary intervention (PCI) of CTO should be based more on clinical<a href="https://solaci.org/en/2023/07/24/eurocto-safety-and-benefit-at-3-years/" title="Read more" >...</a>
Long 48mm Stent XIENCE Skypoint in the treatment of diffuse CAD Long coronary artery lesions often involve complex decision making since they can be treated either with a long stent or with shorter overlapping stents. Both in registries and meta-analysis, the overlapping technique has been associated to increased target vessel revascularization and increased radioscopy time,<a href="https://solaci.org/en/2023/06/08/diffuse-coronary-artery-disease-one-year-48mm-xience-skypoint-outcomes/" title="Read more" >...</a>
Use of drug-coated balloons vs. drug-eluting stents in small caliber vessels. The constant advancements in coronary device technology have significantly reduced complication rates (such as that of restenosis). However, there are gaps where a high number of undesirable events prevail, such as small vessel disease (SVD), for which, in previous studies up, the rate of<a href="https://solaci.org/en/2023/04/28/piccoleto-ii-drug-coated-balloons-in-small-vessels/" title="Read more" >...</a>
Coronary microvascular dysfunction (CMD) is emerging as an important cause of myocardial ischemia, and its role in the pathogenesis of cardiovascular disease—including angina patients with nonobstructive coronary lesions—is well known. Currently, there are several definitions of CMD and several invasive and noninvasive diagnostic tests. Using invasive tests, heterogeneous patterns of microvascular dysfunction, such as coronary<a href="https://solaci.org/en/2023/03/06/microvascular-dysfunction-in-symptomatic-patients-with-intermediate-coronary-lesions-prognostic-impact-according-to-different-patterns/" title="Read more" >...</a>
3 Year Clinical Outcome Analysis and Failure Predictors in the Use of Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR<a href="https://solaci.org/en/2023/02/14/intracoronary-brachytherapy-for-drug-eluting-stent-restenosis/" title="Read more" >...</a>
The ISAR-REACT 5 showed a significant reduction in the composite outcome of death, acute myocardial infarction (AMI), or stroke when using prasugrel vs. ticagrelor in patients with acute coronary syndrome (ACS), mainly at the expense of an AMI reduction. While this study changed clinical practice, it has stirred some criticism regarding certain methodological aspects, such<a href="https://solaci.org/en/2022/12/19/ticagrelor-or-prasugrel-post-pci-in-daily-practice-patients/" title="Read more" >...</a>
Fractional flow reserve (FFR) proved to be very useful and safe in the FAME study, but its trade-off was using adenosine (which has a short half-life) and adverse reactions, which fortunately were rare. Subsequently, two large studies—the iFR-SWEDEHEART and DEFINE-FLAIR—demonstrated that instantaneous wave-free ratio (iFR) offered comparable results to FFR in the short term, avoiding<a href="https://solaci.org/en/2022/04/19/is-ifr-reliable-after-5-years-analyzing-the-ifr-swedeheart-at-5-years/" title="Read more" >...</a>
Fractional flow reserve (FFR) has been shown effective and safe by different studies, yet not at 5 years. The aim of this multicenter registry was to assess the impact of thrombotic risk (as per CREDO-Kyoto score) as a predictor of cardiovascular events at 5 years in patients with deferred revascularization after FFR measurement. The score<a href="https://solaci.org/en/2022/04/13/5-year-tvf-and-macce-in-patients-with-deferred-of-revascularization-after-ffr-is-ffr-enough/" title="Read more" >...</a>
Compared with patients with chronic coronary syndromes, patients with acute coronary syndromes (ACS) are more likely to suffer from long term major adverse cardiac events (MACE). To prevent this, both the American and the European guidelines recommend prolonging dual antiplatelet therapy (DAPT) in this population for at least 12 months. However, in patients with certain clinical<a href="https://solaci.org/en/2022/03/21/abbreviated-dapt-in-acs-the-end-of-clopidogrel-monotherapy/" title="Read more" >...</a>