Angioplasty

Hybrid revascularization versus conventional surgery. Advantages and disadvantages for choosing ideal patients.

Original title:&nbsp;Clinical Outcomes after Hybrid Coronary Revascularization versus Coronary Artery Bypass Surgery: A Meta-Analysis of 1,190 Patients.&nbsp;Reference:&nbsp;Ralf E. Harskamp et al. American Heart Journal (2014), epub ahead of print. &nbsp; Hybrid revascularization combines long-term patency of the mammary artery connected to the left anterior descending with minimally invasive drug-eluting stents to other injuries. This in<a href="https://solaci.org/en/2014/02/18/hybrid-revascularization-versus-conventional-surgery-advantages-and-disadvantages-for-choosing-ideal-patients/" title="Read more" >...</a>

Endovascular treatment in critical limb ischemia, better permeability with similar mortality and amputation than surgery.

Original title: Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia.&nbsp;Reference:&nbsp;W. Schuyler Jones et al. American Heart Journal 2014. Epub ahead of print. &nbsp; Critical limb ischemia is the most severe condition affecting patients with peripheral vascular disease. Mortality, morbidity, and costs associated with this condition are<a href="https://solaci.org/en/2014/02/14/endovascular-treatment-in-critical-limb-ischemia-better-permeability-with-similar-mortality-and-amputation-than-surgery/" title="Read more" >...</a>

Almost 40 % of those who initially receive clopidogrel then switch to prasugrel or ticagrelor in clinical practice.

Original title:&nbsp;In-hospital switching of oral P2Y12 inhibitor treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention: Prevalence, predictors and short-term outcome.&nbsp;Reference:&nbsp;Dimitrios Alexopoulos et al. Am Heart J 2014;167:68-76.e2. Given the availability of 3 Oral P2Y12 receptor inhibitors (clopidogrel, prasugrel, and ticagrelor) with different safety and efficacy profiles, the change from one to another<a href="https://solaci.org/en/2014/02/07/almost-40-of-those-who-initially-receive-clopidogrel-then-switch-to-prasugrel-or-ticagrelor-in-clinical-practice/" title="Read more" >...</a>

The ball drug is effective in the femoropopliteal area

Original title:&nbsp;Drug-Eluting Balloon in Peripheral Intervention for the Superficial Femoral Artery. The DEBATE-SFA Randomized Trial (Drug Eluting Balloon in Peripheral Intervention for Superficial Femoral Artery).&nbsp;Reference:&nbsp;Liistro, F, el tal. J Am Coll Cardiol Intv 2013;6(12):1295-1302 &nbsp; The current treatment of choice in the femoropopliteal area is angioplasty, however, this procedure has a high rate of restenosis<a href="https://solaci.org/en/2014/02/03/the-ball-drug-is-effective-in-the-femoropopliteal-area/" title="Read more" >...</a>

Decreased bleeding with radial access leaves little to bivalirudin for additional benefit

Original title:&nbsp;Bivalirudin or heparin in primary angioplasty performed through the transradial approach: results from a multicentre registry.&nbsp;Reference:&nbsp;Sciahbasi A et al. Eur Heart J: Acute Cardiovasc Care. Epub ahead of print. Bivalirudin benefit has been demonstrated in terms of bleeding; however when primary angioplasty is performed by radial access this information is not clear. To get<a href="https://solaci.org/en/2014/01/31/decreased-bleeding-with-radial-access-leaves-little-to-bivalirudin-for-additional-benefit/" title="Read more" >...</a>

The FFR changes the treatment strategy in almost half of patients

Original title:&nbsp;Outcome impact of coronary revascularization strategy reclassification with fractional flow reserve at time of diagnostic angiography.&nbsp;Reference:&nbsp;Van Belle E et al. Circulation. 2014 Jan 14;129(2):173-85. Any comprehensive registry has not been yet published that evaluates the impact of fractional coronary flow reserve (FFR) to change the strategy of revascularization on individual patients referred for diagnostic<a href="https://solaci.org/en/2014/01/29/the-ffr-changes-the-treatment-strategy-in-almost-half-of-patients/" title="Read more" >...</a>

Ischemic versus anatomical risk. Is anyone better to help us decide therapeutically?

Original title:&nbsp;Predicting Outcome in the COURAGE Trial. Coronary Anatomy Versus Ischemia.&nbsp;Reference:&nbsp;G. B. John Mancini et al. J Am Coll Cardiol Intv 2013,&nbsp;Article in press. &nbsp; Anatomical risk, ischemic amount or a combination of both, are often factors taken into account for estimating the prognosis or choose a treatment strategy. The COURAGE study (Clinical Outcomes Utilizing<a href="https://solaci.org/en/2014/01/24/ischemic-versus-anatomical-risk-is-anyone-better-to-help-us-decide-therapeutically/" title="Read more" >...</a>

Stent reestenosis, the only subgroup that benefits from longer double antiaggregation

Original title:&nbsp;Short vs. Long Term Duration of Dual Antiplatelet Therapy in Patients treated for InstentRestenosis. A PRODIGY Trial substudy.&nbsp;Reference:&nbsp;Gianluca Campo el al. J Am CollCardiol, article in press. &nbsp; In the study PRODIGY (Prolonging Dual Antiplatelet Treatment After Grading Stent- Induced Intimal Hyperplasia) we found that the 24 months ratio of dual antiaggregation was not<a href="https://solaci.org/en/2013/12/13/stent-reestenosis-the-only-subgroup-that-benefits-from-longer-double-antiaggregation/" title="Read more" >...</a>

Amputation, one of worse prognostic variables

Original title:&nbsp;Lower Extremity Amputation: Factors Associated With Mortality or Contralateral Amputation&nbsp;Reference:&nbsp;Samir K. Shah, et; al. Vascular and Endovascular Surgery 2013:47 (8):608-613. Peripheral vascular disease is associated with trophic injuries with tissue lose, often leading to amputation, of which about 50 % were major amputations. 454 amputations in 391 patients were analyzed, 63 were contralateral. Most<a href="https://solaci.org/en/2013/11/29/amputation-one-of-worse-prognostic-variables/" title="Read more" >...</a>

Culprit artery only versus revascularization with ST segment elevation myocardial infarction. The discussion continues

Original title:&nbsp;Complete Versus Culprit-Only Revascularization for Patients with Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-analysis.&nbsp;Reference:&nbsp;Kevin R et al. American Heart Journal, article in press. Primary angioplasty is the preferred reperfusion strategy in patients experiencing a STEMI as it has proven superior to fibrinolysis in reducing<a href="https://solaci.org/en/2013/11/06/culprit-artery-only-versus-revascularization-with-st-segment-elevation-myocardial-infarction-the-discussion-continues/" title="Read more" >...</a>

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