New clinical case from SOLACI PERIPHERAL! This time, we present a case featuring an abdominal aortic aneurysm with hostile neck. With this, we wrap up an intense year during which we published 5 clinical cases to deepen and stimulate the exchange between Latin American interventionist colleagues. Tell us what you think about this case using...
Global FFR as Prognosis in CAD Patients without Ischemia
Global fractional flow reserve (FFR) results from adding up FFR values of the three major coronary arteries. This figure represents the physiological atherosclerosis burden and can predict events at long term in patients without stenosis leading to ischemia. This recent study published in JAHA looked at major cardiovascular events (death, infarction and revascularization) at 5...
The Ten Commandments in Adult Congenital Heart Disease
Adult congenital heart disease is a life-long condition that requires appropriate follow-up by experts. Said follow-up is paramount to diagnosing specific and highly variable complications in a timely manner. The recently published European Society of Cardiology guidelines for the management of congenital heart disease calls for a summary of its most important aspects as “ten...
Aortic Aneurysms Treated with Endologix AFX Require Special Followup
An FDA document recently published reminds doctors and patients of the need of annual follow up of abdominal aortic aneurysm patients receiving Endologix AFX endoprostheses, with imaging, and for life. The reason behind this recommendation is the risk of type III leaks. In 2019, the FDA had alerted us against this issue after finding a...
Plaque Volume Over Stenosis Degree
Paradigms are bound to eventually change. After years blinded by stenosis degree, plaque volume has proven to be a better predictor of cardiovascular events and death. Thus, patients with similar degrees of atherosclerosis burden have a similar prognosis, regardless of their lesions being obstructive or not. The aim of this work was to assess whether...
The Transradial Approach Continues to Be the Best for Primary PCI
The transradial approach has been associated to lower mortality and bleeding rates in patients receiving primary PCI for ST elevation MI. This had been called into question by the recent SAFARI-STEMI, but after including its outcomes in a new meta-analysis, the scales tilted slightly in favor of the transradial approach vs. the transfemoral. The transradial...
Low-Carb Diet and Coronary Artery Calcium Progression
People on low carb diets since a young age present increased risk of coronary artery calcium progression, particularly when carbs are replaced by animal protein and fat. This study included CARDIA participants (Coronary Artery Risk Development in Young Adults) receiving a CT scan between the years 2000 and 2001 for calcium scoring, who also completed...
AHA 2020 | Post-TAVR Anticoagulation in Patients with Atrial Fibrillation
Direct anticoagulant agents were associated with lower long-term mortality in patients with atrial fibrillation discharged after successful transcatheter aortic valve replacement (TAVR) compared with classic vitamin K inhibitors. Optimal anticoagulation in patients with atrial fibrillation (AF) undergoing TAVR is unclear. We are actually just starting to know what the ideal antiplatelet therapy is for patients undergoing...
AHA 2020 | Effect of Evolocumab in Complex Coronary Revascularization
Evolocumab, a PCSK9 inhibitor, has shown significant reduction of complex coronary disease requiring revascularization (be it PCI or CABG). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors induce plaque regression and could eventually reduce the risk of coronary revascularization, especially complex revascularization. The FOURIER study randomized 27564 patients with stable CAD already on statins to evolocumab...
AHA 2020 | The More Operators “Listen” to FFR, the Lower the Risk
When operators decide to proceed with PCI despite a negative FFR (fairly frequent in the daily practice) outcomes at 5 years are far worse. This information comes from a large Canadian register presented at AHA 2020 Scientific Sessions, simultaneously published in JAMA. PCI to a non-ischemic lesion results in increased events risk at long term,...