The study included 36292 consecutive patients undergoing acute myocardial infarction receiving PCI with the new generation stent SYNERGY (thin struts, bioresorbable polymer and everolimus eluting); 39.7% presented ST elevation MI. Kaplan-Meier curves at 2 years of patients receiving the SYNERGY vs patients receiving other drug eluting stents resulted very similar for thrombosis (0,69% vs 0,81%,...
Critical ischemia is the most advanced form of peripheral arterial disease, and it is characterized by ischemic rest pain and ulcers or gangrene. Revascularization is obviously positioned as the first-line treatment, and guidelines recommend both possible strategies (surgery or angioplasty) largely based on the findings of the BASIL trial (British Angioplasty versus Surgery in Ischemic...
1) Balloon Angioplasty: A Reasonable Plan B for Chronic Thromboembolic Hypertension Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B,...
Thromboembolic pulmonary hypertension is caused by pulmonary artery stenosis caused by organized thrombi. The only treatment potentially healing for this disease is surgical thrombectomy. However, patients with lesions in very peripheral branches or high surgical risk patients with comorbidities might benefit from a plan B, such as balloon pulmonary angioplasty. The percentage of patients with chronic...
There is evidence to support the use of the transradial approach to coronary angioplasty. Several randomized studies have shown reduced bleeding and vascular complications when adopted, compared against patients treated with the femoral approach. There are also studies and meta-analysis suggesting that, in the context of primary PCI, the benefit would be even bigger, with significant events...
Courtesy of SBHCI. Angioplasty in patients with chronic stable angina and functionally significant lesions improves clinical outcomes and quality of life over the long term, as compared with optimal medical therapy alone. Furthermore, the invasive approach becomes more cost-effective as the years go by. Previously, FAME 2 had shown that angioplasty was initially more expensive, but...
Overnight observation after coronary angioplasty has been the standard of care in the United States. The foundations for this practice go back to the early days of balloon angioplasty, when acute occlusion and access-site complications were frequent. There are several registries and randomized studies showing the clear safety of same-day discharge after coronary angioplasty. This practice...
Courtesy of Dr. Carlos Fava. Thoracic radiation causes cardiac lesions, and coronary arteries are among the most affected structures. Furthermore, it provokes obstructive lesions due to wall fibrosis. Generally, patients with this background are not eligible for surgery and receive angioplasty, a seemingly great alternative. However, there is no clear information on outcomes yet. This...
Courtesy of Dr. Carlos Fava. Around 5% of patients undergoing coronary angiography present severe left main coronary artery (LMCA) lesions. Myocardial revascularization surgery (MRS) is the preferred method for this group, although there is evidence from different randomized trials demonstrating the safety and efficacy of unprotected LMCA angioplasty, with results similar to those obtained through the traditional strategy....
In patients with atrial fibrillation undergoing coronary angioplasty with stents, standard anticoagulation with vitamin K antagonists plus dual antiplatelet therapy with a P2Y12 inhibitor and aspirin reduces the risk of stent thrombosis and stroke, but increases the risk of bleeding. The effectiveness and safety of anticoagulation with rivaroxaban plus one or two antiplatelet agents...