A recent meta-analysis that will be published soon in JACC Intv offers evidence of benefit derived from short-term dual antiplatelet therapy for elderly patients. This is a patient group that has always been excluded from the major trials, while remaining one of the most challenging subgroups in which to balance bleeding and ischemic risks. The<a href="https://solaci.org/en/2018/03/27/dual-antiplatelet-therapy-less-is-more-for-elderly-patients/" title="Read more" >...</a>
Long-term follow-up of patients under 50 with multivessel coronary artery disease suggests surgery outcomes are significantly better than angioplasty outcomes. This study, presented at the Society of Thoracic Surgeons’ (STS) Annual Meeting, concludes that surgery should continue as plan A when it comes to young patients with three-vessel disease. Surgeons complain that many patients never actually<a href="https://solaci.org/en/2018/03/22/surgery-seems-superior-to-angioplasty-in-young-patients/" title="Read more" >...</a>
Just when we were starting to understand how long dual antiplatelet therapy should be for our patients, JACC publishes this study where ticagrelor combined with aspirin significantly reduces relative and absolute events rate at long term, especially in patients with multivessel disease. The PEGASUS-TIMI 54 assessed the long-term benefits of two different doses of ticagrelor (60 mg or<a href="https://solaci.org/en/2018/03/21/new-study-shows-ticagrelor-aspirin-reduce-events-rate/" title="Read more" >...</a>
One in three “nondiabetic” patients who undergo angioplasty with current drug-eluting stents have an altered glucose metabolism, which is associated with a 4-fold higher risk of events, according to a study that will be published soon in JACC Intv. One in three patients is definitely one patient too many, and four times higher is definitely<a href="https://solaci.org/en/2018/03/20/silent-diabetes-is-the-new-stealthy-enemy/" title="Read more" >...</a>
Around half of all cases of ST-segment elevation acute myocardial infarction (STEMI) come alongside lesions in another vessel, for which the current strategy is complete revascularization in one or two steps. However, there are no large-scale studies analyzing patients who also present cardiogenic shock; we only have observational studies with inconclusive results influenced by several<a href="https://solaci.org/en/2018/03/16/complete-revascularization-is-beneficial-in-acute-mi-with-cardiogenic-shock/" title="Read more" >...</a>
Routine invasive physiology assessment at time of angiography reclassifies treatment strategies in a big number of patients with lesions in 2 or 3 vessels, according to the multicenter prospective study DEFINE REAL, recently published in JACC Cardiovascular Interventions. The information obtained by measuring fractional flow reserve (FFR) or instantaneous wave free ratio (iFR) made interventionists modify their original plans in<a href="https://solaci.org/en/2018/03/07/routine-ffr-ifr-reclassifies-treatment-strategies-in-half-of-cases/" title="Read more" >...</a>
Both prasugrel and ticagrelor showed superiority in terms of efficacy, reducing the number of major cardiovascular events at the expense of increased bleeding. This is an affordable cost, and the net clinical benefit supports these new antiplatelet therapies. The one-year follow-up of the PRAGUE-18 study focused on a comparison of efficacy and safety between prasugrel<a href="https://solaci.org/en/2018/03/07/what-is-the-best-antiplatelet-therapy-in-primary-angioplasty-at-12-months/" title="Read more" >...</a>
Endovascular revascularization has become the main strategy for symptomatic patients with peripheral arterial disease in femoropopliteal territory. Conventional balloon angioplasty is effective in gaining lumen but has a restenosis rate to up 60% at 12 months. Implantation of conventional stents reduced restenosis to almost half, but presented problems such as thrombosis, stent fracture and difficulty<a href="https://solaci.org/en/2018/02/27/pharmacological-balloons-in-femoropopliteal-territory-passed-time-testing/" title="Read more" >...</a>
The prevalence of peripheral arterial disease is between 15% and 20% of patients older than 65 years and its severity is greatly underestimated. In fact, annual mortality is higher in patients with peripheral arterial disease (8.2%) than in those after acute myocardial infarction (6.3%). Despite the above, medical advice and efforts to modify risk factors<a href="https://solaci.org/en/2018/02/26/what-is-the-effect-of-statins-on-amputations-and-survival-in-peripheral-vascular-disease/" title="Read more" >...</a>
While the endovascular repair of aortic aneurysms has steadily become the number one option for aneurysms in which necks are adequate and which meet the specifications of device manufacturers. New technologies have arisen. These advancements allowed the expansion of this indication to more complex anatomies, such as those involving a short neck, no neck, or<a href="https://solaci.org/en/2018/02/23/cost-effectiveness-of-endovascular-and-surgical-repair-of-complex-aneurysms/" title="Read more" >...</a>