Potent P2Y12 receptor inhibitors, such as prasugrel and ticagrelor, have been tested mainly in a setting of acute coronary syndromes. There is little evidence on stable patients, particularly for prasugrel. Designing a study with that purpose seemed challenging enough, but adding aspirin discontinuation in patients without a particularly high bleeding risk took this research to...
In 2020, the European Society of Cardiology guidelines for the management of patients with acute coronary syndromes without ST-segment elevation (Non-ST-Segment Elevation Myocardial Infarction, NSTEMI) were presented. This document went somewhat unnoticed in the context of the COVID-19 pandemic, so this seems a good time to review it and set out some practical “commandments” (something...
At present, there is more than one dual layered stent in the market offering additional protection in carotid PCI. Therefore we saw fit to look at these devices to compare class benefits and find any specific differences. This study assessed the safety and efficacy of two dual layered mesh covered stents especially designed for carotid...
Pretreating non-ST elevation acute myocardial infarction (NSTEMI) patients with P2Y12 receptor inhibitors is not associated with improved clinical outcomes as it is to increased bleeding. NSTEMI patients are often treated with platelet antiaggregants in the daily clinical practice despite the lack of evidence for its benefits. This Swedish registry prospectively included 64857 patients undergoing NSTEMI...
Watch again our Webinar on Intervention in Congenital Heart Disease on our Youtube channel. What things will I learn if I watch this video? 03:28 – Stenting in pulmonary branches: an overview – Fabiola Quispe Peña (Peru) 23:04 – Closure of Interatrial Communication (CIA) – Marcela Almeida Dos Santos (Brazil) 35:35 – Repair of aortic...
The benefits of intravascular ultrasound (IVUS) guidance in all angioplasties with second-generation drug-eluting stents (DES) persist through 3 years of follow-up. These data derive from the extended follow-up of the ULTIMATE study, presented virtually at TCT 2020 and published simultaneously in JACC Intv. At 3 years, target-vessel failure remained lower in patients whose angioplasty was guided by...
Ticagrelor monotherapy after 3 months of dual antiplatelet therapy in patients who experienced ST-segment elevation infarction significantly reduces major bleeding without increasing ischemic risk. This pre-specified analysis of the TICO study shows that ticagrelor monotherapy is safe even in patients with higher ischemic risk. Interrupting aspirin use after 3 months of dual antiplatelet therapy and continuing treatment...
Intravascular coronary lithotripsy shows promise for the improvement of angioplasty in severely calcified lesions, according to data from the DISRUPT CAD III study, published in JACC and simultaneously presented at the TCT 2020 Congress. Calcification in all patients enrolled was highly severe, with an average length of 48 mm, and side-branch involvement in 30% of cases. Lithotripsy,...
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...