Head-to-head comparison of current drug-eluting stents (DES) showed contradictory results that led us to believe, for years, that we had reached a plateau. This feeling was also fostered by the disappointment caused by Absorb and bioresorbable-polymer stents. However, this recent article featured in JACC Interventions shows a light at the end of the tunnel with<a href="https://solaci.org/en/2021/02/02/current-des-performance-is-there-room-for-improvement/" title="Read more" >...</a>
01- Virtual ACC 2020 | Controversial Trial ISCHEMIA Finally in NEJM In November 2019, during the American Heart Association (AHA) 2019 Scientific Sessions, researchers presented this revolutionary trial that called the attention of all cardiologists. We had to wait until March to read the fine print; back then, a global pandemic such as the current one seemed<a href="https://solaci.org/en/2020/12/17/the-most-relevant-articles-in-coronary-disease-in-2020/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2020/10/22/tct-2020-our-next-goal-should-be-using-ivus-guidance-in-every-angioplasty/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2020/10/21/tct-2020-the-myth-of-biodegradable-polymers-seems-to-have-come-to-an-end/" title="Read more" >...</a>
Complex angioplasties require not only experience and patience but also technology. Imaging–guided pre-dilation, stent sizing, and post-dilation reduced the cardiovascular events after a 3-year follow-up in patients who received drug-eluting stents in complex angioplasties. This paper, recently published in JACC Interventions, compared the 3-year outcome of the complex angioplasty optimization technique with intravascular imaging to<a href="https://solaci.org/en/2020/08/20/ivus-in-every-step-of-complex-angioplasty/" title="Read more" >...</a>
After 10 years, unstable or chronic coronary patients revascularized with drug-eluting stents (DES) had similar, very good outcomes regardless of whether the DES did or did not have a polymer, according to the ISAR-TEST-5 study, recently published in J Am Coll Cardiol. The 10-year device-oriented endpoints occurred in 43.8% of patients treated with a polymer-free sirolimus-eluting<a href="https://solaci.org/en/2020/07/30/isar-test-5-10-anos-de-los-des-con-polimero-vs-sin-polimero-2/" title="Read more" >...</a>
Courtesy of Dr. Carlos Fava. Bifurcation lesions account for about 25% of all angioplasties and it is a challenge for which there is no single treatment strategy. Intravascular ultrasound (IVUS) has proven its usefulness, improving outcomes by reducing mortality in unprotected left main coronary artery (LMCA) angioplasty. A new strategy consists in conducting an IVUS after<a href="https://solaci.org/en/2020/07/14/ivus-in-unprotected-lmca-angioplasty-should-we-change-the-way-we-use-it/" title="Read more" >...</a>
There is no survival advantage with invasive coronary revascularization over initial medical treatment in patients with chronic coronary artery disease. However, revascularization did reduce the incidence of unstable angina and its symptoms, according to this new meta-analysis published in Circulation and presented virtually at EuroPCR 2020. There was no significant difference in spontaneous infarctions overall, but<a href="https://solaci.org/en/2020/07/08/europcr-2020-revascularization-vs-initial-medical-treatment-in-chronic-patients/" title="Read more" >...</a>
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<a href="https://solaci.org/en/2020/04/02/virtual-acc-2020-precombat-10-years-for-surgery-vs-angioplasty-in-left-main-coronary-artery-disease/" title="Read more" >...</a>
The GLOBAL LEADERS study includes a pre-specified sub-study, GLASSY, that showed that ticagrelor monotherapy after one month of dual antiplatelet therapy is non-inferior (but not superior) to conventional treatment in terms of ischemic events. As regards safety, ticagrelor monotherapy did not decrease major bleeding compared with conventional therapy. The GLOBAL LEADERS randomized 15,991 patients who required<a href="https://solaci.org/en/2020/01/13/ticagrelor-monotherapy-one-month-after-des-implantation/" title="Read more" >...</a>