3 Year Clinical Outcome Analysis and Failure Predictors in the Use of Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR…
What Is the Best Strategy for Moderately Complex Femoropopliteal Lesions?
At present, PCI is the preferred treatment for femoropopliteal lesions and drug coated balloons (DCB) have shown good performance. However, they have not yet been shown superior to bare-metal stents (BMS). This study compared randomized trials IN.PACT SFA I/II and IN.PACT JAPAN including 288 patients vs. the prospective Complete SE and DURABILITY II with 483…
P2Y12 Inhibitor Monotherapy vs Aspirin: Results of a Network Meta-Analysis
Revascularization and antiaggregation guidelines have typically recommended aspirin (AAS) as first choice for secondary prevention of cardiovascular events after DES stenting. However, these past few years this strategy has been called into question, seeing as studies have shown the superiority of P2Y12 inhibitor monotherapy (IP2Y12) with clopidogrel or ticagrelor. There is little data comparing both…
Clinical Results of IVUS-Guided Drug-Eluting Stent Implantation in Femoropopliteal Disease
Endovascular treatment of femoropopliteal lesions has become the first-line treatment due to the development of devices that decrease the restenosis rate. Recently, the IMPERIAL study showed greater patency at 1 year and greater freedom from clinically guided revascularization at 2 years in favor of the ELUVIA stent (paclitaxel-eluting fluoropolymer, FP-DES) compared with the ZILVER PTX…
Excellent Outcomes for the First Sirolimus Eluting Balloon Tested on Instent Restesosis
Much has been done since studies on conventional balloon angioplasty for BMS instent restenosis showed over 40% new revascularization. Drug eluting stents, aimed at improving this problem, have never achieved 0% restenosis, which is why technologies such as paclitaxel coated balloons have been developed, with reasonable efficacy (8% to 10% reinterventions rate for BMS restenosis and 17% to 23%…
MRS vs. DES: Which one is associated with better long-term quality of life?
The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, which included patients with 3-vessel or left main coronary artery lesions, showed that myocardial revascularization surgery (MRS) turned out to be superior to angioplasty with drug-eluting stents (DES), mainly due to differences in acute myocardial infarction and repeat revascularization. Up to this work, patient sensations (which can be…
Why We Should Use IVUS in Complex Coronary Lesions
Courtesy of Dr. Carlos Fava. Drug eluting stents (DES) have shown benefits in terms of restenosis vs. conventional bare metal stents (BMS). Many of the advantages of DES depend on correct implantation, especially in complex lesions. In complex lesions, the use of intravascular ultrasound (IVUS) provides important information on lesion length, vessel diameter, calcification…
Zotarolimus with Durable Polymer vs. Biolimus with Biodegradable Polymer
The present work compared the safety and efficacy of the permanent polymer zotarolimus eluting stent vs. the biodegradable polymer biolimus eluting stent in unselected coronary artery disease patients. The biodegradable polymer biolimus eluting stent resulted superior to the first generation durable polymer stent in long term randomized studies. However, little evidence supports this superiority…
RESOLUTE Global: 5 Years of Zotarolimus DES Stenting
This study assessed the cumulative incidence of cardiovascular evens after zotarolimus eluting stent implantation. Individual studies often lack enough statistical power to show differences in low frequency adverse events. The Resolute zotarolimus eluting stent was evaluated across 10 prospective clinical trials designed with identical adverse events definitions. The Global Resolute clinical trial program…
New Generation of DES already being tested, so far safe
This study evaluated the safety and efficacy of the new drug eluting stents (Medtronic, Santa Rosa, California) to treat de novo coronary lesions. These new polymer free drug filled stents have the potential to improve clinical outcomes and allow a shorter dual antiplatelet therapy. In addition, they have been made with three layers of continuous…