Technique advancements in left main coronary artery angioplasty have turned this procedure into a reasonable alternative to surgery, particularly in patients with a low or intermediate Syntax score and, obviously, those in whom surgery was contraindicated. Results can be credited to a refinement in technique, better drug-eluting stents, better patient selection, and frequent use of...
A new charitable case was featured at the Ecuador XL SOLACI Sessions 2020. At the CardioCentro Manta / Angiomanabí Clinic in Manta, Ecuador, physicians performed a successful closure of ductus arteriosus type A1 with an Amplatzer ADO I device (antegrade access). The patient was a 1-year old child admitted with a diagnosis of persistent ductus arteriosus. The case was sponsored by C.G MED....
Switching to ticagrelor monotherapy after 3 months of dual antiplatelet therapy reduces major bleeding without paying a price in terms of ischemic events, compared with dual antiplatelet therapy for a year, in patients who had acute coronary syndrome and underwent angioplasty with a second-generation drug-eluting stent. Interrupting aspirin at 3 months and switching it for ticagrelor reduces...
After 10 years of follow-up, there were no significant differences in the rates of major adverse cardiovascular or cerebrovascular events among patients with left main coronary artery disease randomized to angioplasty or surgery. Since this was the first study to randomize patients with left main coronary artery disease to angioplasty or surgery, it enrolled very few...
The original TWILIGHT findings in more than 9000 patients who underwent angioplasty were presented last year at TCT and showed a 3.1% absolute risk reduction in BARC 2, 3, or 5 bleeding with no increase in death, infarction, or stroke in patients who received ticagrelor and placebo compared with patients who received ticagrelor and aspirin. All patients...
This very interesting work leaves us with a sour taste in our mouth, as it failed to meet its primary endpoint. Using genotype to individualize treatment with a P2Y12 inhibitor in patients with acute coronary syndrome or stable patients after a scheduled angioplasty compared with conventional treatment with clopidogrel does not reduce the risk of...
Transcatheter aortic valve replacement with the self-expandable valves has shown optimal clinical and electrocardiographic results in patients with small annuli. These supra-annular prosthetic valves seem somewhat better than the intra-annular balloon expandable. TAVR in general has better functional results in terms of patient/prosthesis mismatch. This seems especially true for patients with a small annulus. The...
The transfemoral access is clearly the preferred approach to transcatheter aortic valve replacement (TAVR), followed by the trans-axillary or trans-subclavian. Despite the alternatives, some patients are still ineligible. This study recently published in EuroIntervention reports initial experiences in Europe with the transfemoral transcaval approach. It included 50 patients from 5 centers assessed according to the...
The revascularization of tibial arteries in patients with critical lower limb ischemia using drug-coated balloons vs. conventional angioplasty resulted in comparable long-term outcomes in terms of both safety and efficacy. Paclitaxel exposure was not related to a higher risk of amputation or all-cause mortality at 5 years (which is the good news for much questioned drug-coated...
01- Alternatives for Patients Allergic to Aspirin The new guidelines of chronic coronary syndromes make class IIb recommendations to use prasugrel or ticagrelor in aspirin-intolerant patients. This is not meant to replace dual antiaggregation therapy in aspirin intolerant patients, when needed; it is just a recommendation to use monotherapy with the most potent antiaggregant we...