This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials. The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization...
Patients with documented spasm to the coronary arteries present increased risk of myocardial infarction (MI) and repeat angiography, while patients with microvascular spasm are associated to recurrent angina. Globally, the prognosis of all these patients continues to be favourable, even though acetylcholine testing might help distinguish one-another. Coronary spasm shows in up to 60% of...
The risk of contrast induced kidney injury is significantly lower in patients receiving transcatheter aortic valve replacement (TAVR) compared against patients getting a coronary angiography or angioplasty. This is true even for valvular heart disease patients with higher risk profiles. Differences in contrast-induced acute kidney injury between TAVR or coronary patients had not been previously...
This pre-specified protocol originally included 777 patients with chronic kidney failure. These patients are a special population of higher risk where we might be able to see the advantage of a more aggressive initial strategy. Death or MI rate (combined primary end point) resulted 36.4% for the invasive strategy vs. 36.7% for the initially conservative...
The results of this great multicenter “real-life” registry are similar to those of randomized clinical trials that studied fractional flow reserve (FFR). Lesion deferral based on FFR is a very safe strategy, even for lesions located in the proximal anterior descending artery. Randomized controlled studies FAME and DEFER convincingly showed the safety of lesion revascularization...
Among patients in the main ISCHEMIA trial, those with chronic kidney disease are a particularly high-risk subgroup. However, an invasive strategy with coronary angiography and revascularization did not improve the rate of events, similarly to what happened in the general population for the aforementioned trial. The rate of death or acute myocardial infarction was 36.4%...
Contemporary data of a recently published large registry show that mechanical complications after infarction are not frequent but maintain a very high mortality rate that does not seem to improve over time. Our information on mechanical complications was outdated and we did not have current data on their incidence and prognosis. Such is precisely the...
Courtesy of SBHCI. This work, presented at the TCT 2019 Scientific Sessions, showed the 30-day safety and 1-year efficacy of self-expanding prosthesis Portico compared with all valves approved by the US Food and Drug Administration (FDA) for the treatment of patients with severe aortic stenosis and high surgical risk. Between 2014 and 2019, researchers enrolled 750 patients...
Courtesy of Dr. Carlos Fava. Peripheral vascular disease in lower limbs is on the rise. Antegrade recanalization is associated with amputation and death, and therefore contraindicated. For a while we have been using the retrograde access when classic revascularization is not possible. Even though there is evidence in favor of this access, it is just...
Courtesy of Dr. Carlos Fava. Tricuspid regurgitation (TR) is more common than we thought. Around 1.6 million people in the US and over 3 million in Europe experience significant TR. It usually has a functional cause and its negative impact on patient prognosis is strong. Its surgical treatment is challenging, and it is important that its resolution...