Multiple studies have shown the safety and efficacy of drug eluting stents (DES) in patients with high risk of bleeding. Only one last bastion of bare metal stents (BMS) was left standing: vein grafts. With controversial evidence and different physiopathology, many still argued against DES in saphenous vein grafts. This multicenter study randomized patients with...
Head-to-head comparison of current drug-eluting stents (DES) showed contradictory results that led us to believe, for years, that we had reached a plateau. This feeling was also fostered by the disappointment caused by Absorb and bioresorbable-polymer stents. However, this recent article featured in JACC Interventions shows a light at the end of the tunnel with...
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...
Patients with vulnerable plaque identified by means of intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) are at a significantly increased risk of adverse cardiovascular events. Revascularization of these vulnerable lesions could prevent clinical events. That is the theory behind prophylactic angioplasty, which still needs to be proven in clinical practice. The PROSPECT ABSORB study, nested...
After 10 years, unstable or chronic coronary patients revascularized with drug-eluting stents (DES) had similar, very good outcomes regardless of whether the DES did or did not have a polymer, according to the ISAR-TEST-5 study, recently published in J Am Coll Cardiol. The 10-year device-oriented endpoints occurred in 43.8% of patients treated with a polymer-free sirolimus-eluting...
Courtesy of SBHCI. This study tested the safety of dual antiplatelet therapy (DAPT) after only three months of bioresorbable polymer sirolimus DES implantation (Ultimaster). Secondary end point was following with P2Y12 inhibitor monotherapy after the first 3 months compared with aspirin. It included 1695 patients treated with sirolimus eluting Ultimaster receiving 3-month DAPT. After the...
Courtesy of the SBHCI. This study used the thin strut everolimus eluting stent with ultrathin abluminal bioresorbable polymer coating chromium platinum stent, basically the Synergy stent. Drug release and polymer degradation within four months facilitate endothelization and would allow a shorter DAPT. Presented during the scientific sessions of TCT 2019, this study included 2009 high...
Courtesy of SBHCI. The safety and efficacy of antithrombotic and antiplatelet treatments in patients with atrial fibrillation admitted with acute coronary syndrome (who receive medical treatment or angioplasty) may vary from that in patients undergoing elective treatment. At 14 days from elective angioplasty or hospitalization due to acute coronary syndrome, patients were randomized in a 2×2...
Results from the BIO-RESORT trial at three years, soon to be published in JACC Intv., show that, despite significant differences among stents as regards strut thickness and capability to reabsorb the polymer, there are no apparent safety or efficacy differences among devices. The aim of this study was to determine the three-year safety and efficacy...
Long after myocardial revascularization guidelines had established no medical reason justifies the use of bare metal stents (BMS), along comes this study to refresh the old trials comparing drug eluting vs bare metal stents in the context of primary PCI. The problem for many countries is that primary PCI obviously occurs in the context of...