01- Surgeons’ Claim on Low-Risk Patients with Aortic Stenosis Recent randomized trials including low-risk patients showed positive results for transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement. Read more HERE 02- Major Cause of Myocardial Injury by COVID-19 The most common cause of myocardial necrosis in patient undergoing COVID-19 infection is microthrombi. These...
During TCT 2020 a preview of the results of the comparison of drug-eluting stents (DES) with biodegradable-polymer vs. durable-polymer in patients with acute coronary syndrome (ACS) was presented. The fine print and the final paper for HOST-REDUCE-POLYTECH-ACS are now published, and they lower the expectations set on biodegradable polymers. In patients with ACS undergoing angioplasty, biodegradable-polymer...
Head-to-head comparison of current drug-eluting stents (DES) showed contradictory results that led us to believe, for years, that we had reached a plateau. This feeling was also fostered by the disappointment caused by Absorb and bioresorbable-polymer stents. However, this recent article featured in JACC Interventions shows a light at the end of the tunnel with...
01- Virtual ACC 2020 | Controversial Trial ISCHEMIA Finally in NEJM In November 2019, during the American Heart Association (AHA) 2019 Scientific Sessions, researchers presented this revolutionary trial that called the attention of all cardiologists. We had to wait until March to read the fine print; back then, a global pandemic such as the current one seemed...
The benefits of intravascular ultrasound (IVUS) guidance in all angioplasties with second-generation drug-eluting stents (DES) persist through 3 years of follow-up. These data derive from the extended follow-up of the ULTIMATE study, presented virtually at TCT 2020 and published simultaneously in JACC Intv. At 3 years, target-vessel failure remained lower in patients whose angioplasty was guided by...
This is the largest and newest study to compare drug eluting stents with durable polymers vs. biodegradable or bioresorbable polymers. As is usually the case, the theory clashes with reality. The study has shown that the polymer does not seem to play an important role in the performance of drug eluting stents, or at least...
Complex angioplasties require not only experience and patience but also technology. Imaging–guided pre-dilation, stent sizing, and post-dilation reduced the cardiovascular events after a 3-year follow-up in patients who received drug-eluting stents in complex angioplasties. This paper, recently published in JACC Interventions, compared the 3-year outcome of the complex angioplasty optimization technique with intravascular imaging to...
After 10 years, unstable or chronic coronary patients revascularized with drug-eluting stents (DES) had similar, very good outcomes regardless of whether the DES did or did not have a polymer, according to the ISAR-TEST-5 study, recently published in J Am Coll Cardiol. The 10-year device-oriented endpoints occurred in 43.8% of patients treated with a polymer-free sirolimus-eluting...
Courtesy of Dr. Carlos Fava. Bifurcation lesions account for about 25% of all angioplasties and it is a challenge for which there is no single treatment strategy. Intravascular ultrasound (IVUS) has proven its usefulness, improving outcomes by reducing mortality in unprotected left main coronary artery (LMCA) angioplasty. A new strategy consists in conducting an IVUS after...
There is no survival advantage with invasive coronary revascularization over initial medical treatment in patients with chronic coronary artery disease. However, revascularization did reduce the incidence of unstable angina and its symptoms, according to this new meta-analysis published in Circulation and presented virtually at EuroPCR 2020. There was no significant difference in spontaneous infarctions overall, but...