Does a Combination of Diabetes and Acute Coronary Syndrome Change the Revascularization Strategy?

The results of the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial have shown a lower rate of events in patients with diabetes and stable multivessel disease who were randomized to undergo myocardial revascularization surgery, compared to those who underwent angioplasty. Surgery even showed a mortality reduction that<a href="https://solaci.org/en/2018/01/22/does-a-combination-of-diabetes-and-acute-coronary-syndrome-change-the-revascularization-strategy/" title="Read more" >...</a>

Doble puente mamario para reducir la chance de nuevas revascularizaciones

Bilateral Mammary Artery Graft to Reduce the Chance of Repeat Revascularization

According to previous studies, patients receiving bilateral internal mammary artery conduits during coronary artery bypass grafting have better survival than those receiving a single internal mammary artery. The reason behind this remains unclear, let alone whether there really is lower repeat revascularization rate. This analysis compared timing, frequency, and type of repeat coronary revascularization among patients<a href="https://solaci.org/en/2017/11/29/bilateral-mammary-artery-graft-to-reduce-the-chance-of-repeat-revascularization/" title="Read more" >...</a>

HREVS: la revascularización híbrida no ofrece ventajas en la enfermedad de múltiples vasos

HREVS: Hybrid Revascularization Offers No Advantage in Multivessel Disease

Courtesy of SBHCI. Hybrid revascularization, which combines CABG with PCI, failed to reduce myocardial ischemia and major cardiac and cerebrovascular events, compared to cardiac artery bypass graft  or PCI separately. However, this small study does not provide conclusive evidence, which calls for further randomized studies with enough statistical power to answer this question. Fortunately, we won’t have<a href="https://solaci.org/en/2017/11/01/hrevs-hybrid-revascularization-offers-no-advantage-in-multivessel-disease/" title="Read more" >...</a>

¿Beneficio adicional del bypass radial en la cirugía de revascularización miocárdica?

Additional Benefit from Radial Artery Graft in Myocardial Revascularization Surgery

Used to different extents according to institution, surgeon, and historical time, the radial artery graft is yet to prove whether it can improve the outcomes of myocardial revascularization surgery when added to a single or bilateral internal thoracic artery graft. The ART (Arterial Revascularization Trial) was designed to compare survival after bilateral vs. single left internal<a href="https://solaci.org/en/2017/09/21/additional-benefit-from-radial-artery-graft-in-myocardial-revascularization-surgery/" title="Read more" >...</a>

La revascularización incompleta se asocia a mortalidad en el TAVI

Incomplete Revascularization Is Associated with Mortality in TAVR

Courtesy of Dr. Carlos Fava. TAVR has proven to be beneficial for inoperable and high-risk patients, as well as for intermediate-risk patients. However, while many comorbidities have been analyzed, the presence, severity, and impact of coronary disease has not been well studied yet. This study analyzed 1270 patients who underwent TAVR. They presented >50% lesions in a major epicardial<a href="https://solaci.org/en/2017/08/15/incomplete-revascularization-is-associated-with-mortality-in-tavr/" title="Read more" >...</a>

Glycemic control and risk of repeat revascularization

The association between glycemic control after coronary angioplasty and outcomes of the latter is controversial in many studies. We have come to think that the risk lies in suffering from diabetes, as if it was an unmodifiable factor. We have also come to believe that glycemic control can impact microvascular complications while it cannot do<a href="https://solaci.org/en/2017/07/12/glycemic-control-and-risk-of-repeat-revascularization/" title="Read more" >...</a>

COMPARE-ACUTE: FFR para guiar la revascularización de vasos no culpables en la angioplastia primaria

COMPARE-ACUTE: FFR-Guided Non-Culprit Vessel Revascularization in Primary Angioplasty

Courtesy of the SBHCI. About 50% of patients admitted with acute ST-segment elevation myocardial infarction also present lesions in another vessel. Whether to treat these or not, and the optimal moment to treat non-culprit infarction-related vessels are still controversial issues.   The COMPARE-ACUTE study was recently published and showed that fractional flow reserve (FFR)-guided complete<a href="https://solaci.org/en/2017/06/02/compare-acute-ffr-guided-non-culprit-vessel-revascularization-in-primary-angioplasty/" title="Read more" >...</a>

DEFINE FLAIR and IFR SWEDEHEART: Safety in Revascularization Based on FFR and iFR in Both Stable and ACS Patients

The safety of physiology-based coronary revascularisation has been supported by evidence for years now. DEFER (1998-2001) was one of the first related studies. However, major changes in device and medical treatment safety and efficacy have taken place since then. This could affect clinical results, particularly as regards acute coronary syndromes (ACS). Several studies have cast<a href="https://solaci.org/en/2017/05/23/define-flair-and-ifr-swedeheart-safety-in-revascularization-based-on-ffr-and-ifr-in-both-stable-and-acs-patients/" title="Read more" >...</a>

FFR-Guided ACS Revascularization Apparently Superior to Culprit Vessel Treatment

Using fractional flow reserve (FFR) to guide revascularization of all functionally significant lesions in the setting of acute coronary syndrome appears to improve outcomes over treating only the culprit artery, according to the Compare-Acute trial.   This study, conducted at 24 centers in Europe and Asia, enrolled 885 patients who were stable following successful primary angioplasty and<a href="https://solaci.org/en/2017/04/11/ffr-guided-acs-revascularization-apparently-superior-to-culprit-vessel-treatment/" title="Read more" >...</a>

Revascularización en lesiones de tronco de coronaria izquierda

Left Main Target Lesion Revascularization: When is it Necessary?

Courtesy of Dr. Agustín Vecchia. Incidence, predictors and impact of target lesion revascularization (TLR) on unprotected left main stenosis initially treated with second generation DES have not yet been clearly defined and this is the main goal of the present study.   This is a multicenter observational retrospective study of patients with unprotected left main<a href="https://solaci.org/en/2017/03/27/left-main-target-lesion-revascularization-when-is-it-necessary/" title="Read more" >...</a>