Courtesy of Dr. Carlos Fava Bivalirudin has been shown to reduce bleeding in carotid stenting and maintain its efficacy. Even though carotid stenting has shown benefits, these remain unclear. With this in mind, four studies were analyzed (one randomized) including 7,784 patients undergoing carotid stenting with unfractioned heparin vs. bivalirudin. No difference was...
Courtesy of Dr Carlos Fava. The association of primary angioplasty with multivessel lesions is not infrequent and has been analyzed in various studies and meta-analyses. However, the proper course of action remains unclear. According to this study, fractional flow reserve (FFR) could better define the ischemic impact of lesions and help with the identification of...
Patients with peripheral artery disease (PAD) have higher rates of cardiovascular events after DES implantation, which could be explained partly by higher platelet reactivity. The present work studies the relationship between platelet reactivity and clinical events after PCI in patients with and without a history of peripheral artery disease. The ADAPT-DES study (Assessment of...
Courtesy of Dr. Leiva. Bioresorbable scaffolds with drug-eluting stents (bioresorbable vascular scaffolds, BVS) have been added to the list of endovascular treatment options for coronary disease. The ABSORB III trial showed the non-inferiority of this stent type to everolimus-eluting metallic stents as regards target-lesion revascularization (TLR) at one year. However, reports have suggested a higher...
This small study suggests the early use of Impella ventricular support device in patients undergoing AMI complicated by cardiogenic shock could help lower mortality rate in this population. However, study design should moderate our enthusiasm, mainly because of the cost of this device. Detroit Cardiogenic Shock Initiative has stressed early identification of cardiogenic...
Both physicians and patients are exposed to higher radiation doses during radial access PCI compared to femoral, according to this large contemporary study on high volume PCI operators of ACS patients. Even though the difference in radiation exposure was relatively small for patients (approximately 10% higher for radial PCI) this translated into double the...
Courtesy of Dr. Pablo Baglioni. Between the years 2000 and 2015, the authors of this article searched for reports on spontaneous coronary artery dissection (SCAD) in pregnant or immediate post-partum women aiming at defining the clinical characteristics of this pathology and offering management recommendations. Information on 120 women was analyzed; 116 were between 22...
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...
The transradial approach is being increasingly adopted as preferred access site, since it is more comfortable for patients, reduces vascular and bleeding complications, is cost effective and reduces mortality in high risk patients. This has created concern about the fact that operators and institutions could become unfamiliar with the transfemoral approach. The aim of...
Courtesy of Dr. Carlos Fava. Carotid artery disease is an important cause of stroke and is associated to coronary artery disease. When patients need myocardial revascularization surgery (Carotid Artery Bypass Graft) and cannot wait one month or more for carotid revascularization, the optimal management strategy is still controversial. The aim of this study was...