Courtesy of Dr. Santiago F. Coroleu. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel after percutaneous coronary intervention (PCI) reduces the risk for coronary thrombotic events (CTEs) at the expense of increasing risk for major bleeding (MB). However, the lack of information to accurately predict the occurrence of each event in out-of-hospital patients under...
DES in primary PCI: The Best Option?
Courtesy of Dr. Brian Nazareth Donato. The relative safety of drug-eluting stents (DES) and conventional bare-metal stents (BMS) in primary angioplasty (percutaneous coronary intervention, PCI) in patients with ST elevation myocardial infarction (STEMI) is still subject of debate. A search was carried out using Medline, CENTRAL, EMBASE, TCTMD and Cardiosource. There were 9673 patients included,...
BVS: Comparable to Second-Generation DES in Complex Lesions
A center carrying out a mid- to long-term follow-up of the performance of everolimus-eluting bioresorbable scaffolds (Absorb) observed that this new device has an acceptable rate of major cardiovascular events, when compared to second-generation drug-eluting stents. Furthermore, although the population was complex and non-selected, no cases of early thrombosis were reported. This study enrolled 249 patients...
Non-Compliant Balloons Improve Bifurcation Outcomes
Courtesy of Dr. Carlos Fava. The provisional approach is the standard strategy to treat bifurcations, but it might cause dissection of the ostium, a serious complication of the side branch. The use of non-compliant balloons (NCB) ensures uniform, constant, and controlled expansion along balloon length, reducing the risk of dissection. The COBIS II registry enrolled...
Visual Assessment and Misinterpretation of Coronary Lesion Severity
Courtesy of Dr. Pablo Baglioni. The visual interpretation of coronary angiographies is still used to decide for or against revascularization of ambiguous coronary lesions. Multiple factors other than stenosis degree, have been associated with the functional significance of lesions. The aim of this study was to analyze the ability of interventionists to visually assess...
Tissue Protrusion after DES: Adverse Events at Long Term?
Original Title: Tissue Protrusion after Stent Implantation. An ADAPT-DES Intravascular Ultrasound Substudy. Reference: Fuyu Qiu et al. J Am Coll Cardiol Intv. 2016;9(14):1499-1507. After DES implantation we may observe tissue protrusion (plaque or thrombus) relatively often, especially in unstable lesions; however, its clinical impact has not been studied. The aim of this study was...
Retrograde Technique: High Success Rate in CTO
Original Title: Outcomes With the Use of the Retrograde Approach for Coronary Chronic Total Occlusion Interventions in a Contemporary Multicenter US Registry. Reference: Dimitri Karmpaliotis et al. Circ Cardiovasc Interv. 2016 Jun;9(6). This study evaluated the safety and efficacy of the retrograde technique for chronic total occlusions. Researchers compared retrograde vs. anterograde technique outcomes...
DEB, the Best Option to Treat Superficial Femoral ISR
Original Title: Paclitaxel-eluting balloon versus standard balloon angioplasty in in-stent restenosis of the superficial femoral and proximal popliteal artery: 1-year results of the PACUBA trial. Reference: Kinstner CM et al. J Am Coll Cardiol Intv. 2016;9:1386-1392. Patients with symptomatic femoropopliteal in-stent restenosis (ISR) have better patency at one year if treated with drug eluting...
Does Ticagrelor Reduce Events in Peripheral Artery Disease?
Original Title: Ticagrelor for Prevention of Ischemic Events after Myocardial Infarction in Patients with Peripheral Artery Disease. Reference: Marc P. Bonaca et al. J Am Coll Cardiol. 2016 Jun 14;67(23):2719-28. Peripheral artery disease is associated with high rates of ischemic and bleeding events in patients with prior myocardial infarction. This study evaluates the safety...
Radiotherapy: Post PCI Cardiovascular Death Predictor
Original Title: Long-Term Mortality in Patients With Radiation-Associated Coronary Artery Disease Treated with Percutaneous Coronary Intervention. Reference: Reed GW et al. Circ Cardiovasc Interv. 2016 Jun;9(6). Courtesy of Dr. Brian Nazareth Donato. Radiotherapy is often used to treat malignant tumors; however, it is associated with adverse cardiovascular effects such as constrictive pericarditis, valve deterioration...