01- Virtual ACC 2020 | Controversial Trial ISCHEMIA Finally in NEJM In November 2019, during the American Heart Association (AHA) 2019 Scientific Sessions, researchers presented this revolutionary trial that called the attention of all cardiologists. We had to wait until March to read the fine print; back then, a global pandemic such as the current one seemed...
This is the largest and newest study to compare drug eluting stents with durable polymers vs. biodegradable or bioresorbable polymers. As is usually the case, the theory clashes with reality. The study has shown that the polymer does not seem to play an important role in the performance of drug eluting stents, or at least...
The TARGET FFR and DEFINE-FLOW studies were presented at TCT 2020 which have offer a deeper perspective on the value of FFR, not only before but also after PCI. TARGET FFR The TARGET FFR included 260 patients randomized after angiographically successful PCI to an FFR guided optimization vs. blinded FFR assessment strategies. In the guided...
After the “EXCEL scandal” at the end of last year, study investigators have been publishing explanations and sub-studies that were planned from the beginning, but which can still be interpreted as explanations. This sub-study states that revascularization was more common in the angioplasty arm, but only revascularizations performed on the target lesion, regardless of the...
Courtesy of Dr. Carlos Fava. Unprotected left main coronary artery angioplasty with drug-eluting stents has emerged as an acceptable strategy for a select group of patients, with results comparable to those of myocardial revascularization surgery at 2 or 3 years. However, beyond such term, we had no valid information. Researchers analyzed the 5-year follow-up results for the...
Courtesy of SBHCI. This study showed that using the everolimus eluting stent with bioabsorbable polymer Synergy followed by 4 months of dual antiplatelet therapy (DAPT) to treat left main stenosis (LMS) was safe and effective, compared against using the everolimus eluting stent with permanent polymer Xience followed by the conventional 12 months DAPT. This study...
The fact that polymers can degrade after drug release seems interesting, more so when there appears to be evidence that they might cause inflammation (manly eosinophil infiltration) given its unwanted consequences. However, nice theories often get a reality check, and the polymer discussion is no exception. This article, soon to be published in J Am...
Paclitaxel coated balloons in peripheral territory have been under the spotlight for alleged increased mortality, which even though not observed in this study, experts insist, calls for new studies with enough statistical power. Compared against plain balloon angioplasty, paclitaxel coated balloons resulted in improved patency and less revascularization at 24 months in superficial or popliteal...
It has been 3 years since EuroPCR 2016 and the presentation of the first data on possible transcatheter valve degeneration, which sparked fear regarding the possibility that transcatherter aortic valve replacement (TAVR) devices might degrade earlier than expected due to the pressure put on them to introduce them into the delivery catheter. At EuroPCR 2019,...
This angiographic substudy supports the safety of drug-coated balloons in small vessels. Despite better angiographic outcomes, there were eight cases of stent thrombosis among drug-eluting stent (DES) patients, while there was none with drug-coated balloons. In patients with small vessels, using a drug-coated balloon appears safe and comparable to DES, with favorable angiographic outcomes at...