Courtesy of Dr. Carlos Fava. Currently, chronic total occlusions (CTO) are one of the obstacles that coronary angioplasties must overcome, particularly with the development of drug-eluting stents (DES) and new devices and strategies for these challenging lesions. However, there is little information on the safety, efficacy, and real clinical benefit of implanting stents of over 60 mm (known as full metal jackets, FMJ)....
Courtesy of Dr. Cristian Jesús Rodríguez. Most stents currently used in percutaneous coronary intervention (PCI) are durable-polymer second-generation drug-eluting stents (DP-DES, with everolimus or zotarolimus). However, it has been argued that the persistence of such a polymer after complete drug elution is one of the main factors for a dangerous complication: stent thrombosis (ST). After...
Peripheral artery disease (PAD) is no longer a systemic manifestation of atherosclerosis. In fact, 2 in 3 people with PAD have concomitant heart disease, and 1 in 3 people has concomitant PAD. To understand the real dimension of this problem, we should know that PAD patients have 60% more risk of acute myocardial infarction...
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...
The eight month of this year saw a scientific event of utmost importance to the community of young interventional cardiologists in Latin America: the José Gabay course. The meeting, which took place at Buenos Aires Hilton Hotel, gathered more than 140 fellows eager to update their medical knowledge on this area of expertise. The event...
Although chronic total occlusion (CTO) is a common finding, there is little consensus as to when such lesions should be treated routinely with angioplasty. Benefits of successful rechanneling include relief of symptoms, resolution of ischemia, improvement in ventricular function, and avoidance of myocardial revascularization surgery. Unsuccessful rechanneling is common and may be associated with several adverse events,...
Courtesy of Dr. Carlos Fava. The presence of Chronic Total Occlusion (CTO) is about 30%, with an ischemic threshold between 10% and 12.5% to justify rechannelization. Using the new devices, the new guidelines and with more experience operators, these procedures are successful in 10% to 30% of cases. More often than not these patients are not treated...
The NIPPON trial (Nobori Dual Antiplatelet Therapy as Appropriate Duration) was a randomized study comparing a short dual antiplatelet therapy scheme (6 months) vs. a prolonged scheme (18 months) in patients receiving the Nobori drug eluting stent (Terumo, Tokyo, Japan) with a biodegradable abluminal polymer. It included 3,773 patients with chronic stable angina or acute coronary...
There is little information comparing contemporary drug eluting stents (DES) against bare metal stents (BMS), for PCI in saphenous vein grafts in patients receiving (CABG). This study aimed to assess clinical outcomes after PCI in saphenous vein grafts in patients receiving BMS, first generation DES, and new generation DES between 2006 and 2013. The study...
Courtesy of Dr. Agustín Vecchia. The advent of resorbable vascular scaffolds (BVS) generated high expectations among interventionists because of its potential advantages over bare metal stents. However, when comparing BVS against the Xience stent, we observed an increased rate of events associated to the first device, to their detriment. Among the reasons behind this poor...