Performing coronary angioplasties at hospitals without surgical backup seems to be safe for a wide variety of patients, from those presenting ST-segment elevation myocardial infarction to those undergoing elective procedures. This work responds to a long-running debate over whether centers without on-site surgery capabilities in case of complications can be considered as referral centers...
Courtesy of Dr. Carlos Fava. Left main coronary artery (LMCA) lesions have always been defined as high-risk, with surgery as treatment of choice. Drug-eluting stents (DES) have slowly changed that, but their use still lacks strong supporting evidence. The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) study...
Between 10% and 15% of patients admitted with ST-segment elevation myocardial infarction present concurrent coronary chronic total occlusion (CTO) in a non-infarct-related artery, which is associated with increased morbidity and mortality. The EXPLORE (Evaluating Xience and Left Ventricular Function in Percutaneous Coronary Intervention on Occlusions After ST-Elevation Myocardial Infarction) trial evaluated whether patients admitted...
The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute Myocardial Infarction 2015 suggest that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PCI). This study compared the impact of pharmacoinvasive strategy with the impact of primary angioplasty in real-world patients admitted with acute coronary syndrome with ST-segment elevation. The...
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,...
Both ischemic postconditioning and deferred stenting showed no benefit in randomized studies conducted as part of the DANAMI 3 program. Both the DANAMI 3-DEFER and the DANAMI 3-iPOSTshowed slight improvements in ventricular function after intervention, but clinical end points saw no change. This does not mean that outcomes should be considered negative, only that the...
This observational registry compared the results of myocardial revascularization with angioplasty performed using everolimus-eluting stents in patients with multivessel. The primary endpoint of the study was mortality from any cause. Side end points were infarction, stroke, and revascularization. Propensity score was used to compare populations. Between 34819 patients were eligible 9223 patients in each group...
Atherosclerotic stenosis of the renal artery is common in the elderly population. Previous clinical trials showed no benefit with angioplasty in relation to renal function but their use for preventing cardiovascular events was still uncertain. A total of 947 patients with atherosclerotic renal artery and systolic hypertension (need two or more drugs) or renal dysfunction...
ROMA II RELOAD multicenter study (General Hospital Umberto I, University of Rome, Rome, Italy) assessed the impact of an additional charge of statin in patients undergoing elective angioplasty. All patients received a rosuvastatin dose of 40 mg (GR) or atorvastatin 80 mg (GA) within 24 hours of the procedure. The primary endpoint of the study...
CLI-randomized study CLI-OPCI (n = 670, 1:1) evaluated the impact of stent implantation guided by angiography and optical coherence tomography (OCT), versus angioplasty guided alone by angiography. All patients who had been subjected to stent placement were then evaluated by angiography. Arm OCT, after an optimal angiographic result, an intracoronary OCT evaluation was performed. In...