The rationale behind the decision to not add another layer of metal to the artery sounded attractive and this was what paved the way for drug coated balloons as an alternative strategy to treat in-stent restenosis. “We’ve already got a stent in place, we only have to dilate and leave the drug” is what we…
Abluminal Sirolimus and luminal CD34 antibody layer: Is COMBO the Future of Stents?
This large cohort of patients treated with the dual therapy COMBO stent has showed excellent outcomes after one year (MASCOT Post Marketing Registry). Long term follow up is still ongoing. The COMBO stent is a new device with an abluminal sirolimus biodegradable polymer and a luminal layer of antibodies that promotes endothelial healing (anti CD34+)…
Are Bioresorbable-Polymer Stents More Thrombogenic than Durable-Polymer Second-Generation Stents?
Courtesy of Dr. Cristian Jesús Rodríguez. Most stents currently used in percutaneous coronary intervention (PCI) are durable-polymer second-generation drug-eluting stents (DP-DES, with everolimus or zotarolimus). However, it has been argued that the persistence of such a polymer after complete drug elution is one of the main factors for a dangerous complication: stent thrombosis (ST). After…
New generation DES present better results in vein grafts than older DES and BMS
There is little information comparing contemporary drug eluting stents (DES) against bare metal stents (BMS), for PCI in saphenous vein grafts in patients receiving (CABG). This study aimed to assess clinical outcomes after PCI in saphenous vein grafts in patients receiving BMS, first generation DES, and new generation DES between 2006 and 2013. The study…
Everolimus DES are more effective and less costly than conventional BMS
Courtesy of Dr. Guillermo Migliaro. Drug eluting stents (DES) represented the greatest technological advance in the treatment of instent restenosis from conventional metallic stents (BMS), especially cobalt chromium everolimus eluting stents (CoCr EES), which have shown an excellent profile, and are mostly safer, compared to first generation DES. Indeed, several randomized studies and meta-analyzis have…
DAPT after PCI with EES: 6 or 12 Months?
Original Title: 6-Month versus 12-Month Dual-Antiplatelet Therapy Following Long Everolimus-Eluting Stent Implantation. The IVUS-XPL Randomized Clinical Trial. Reference: Hong et al. JACC Cardiovasc Interv. 2016 May 11. [Epub ahead of print] Courtesy of Dr. Brian Nazareth Donato. This publication stems from the IVUS-XPL published by JAMA in November 2015. This study presents outcomes on the…
Stent thrombosis: Comparative analysis between BMS, DES and BRS
Original Title: Stent Thrombosis with Drug Eluting Stents and Bioresorbable Scaffolds. Evidence from a Network Meta-Analysis of 147 trials. Reference: Kang S et al. J Am Coll Cardiol Intv 2016 doi 10.1016. Courtesy of Dr. Guillermo Migliaro. When treating heart disease, drug eluting stents (DES) have become essential for PCI. Its main advantage lies on…
Meta-Analysis of Bioresorbable Vascular Scaffolds vs. Everolimus Eluting Stents
Courtesy of Dr. Agustín Vecchia. The aim of this study was to compare the safety and efficacy of bioresorbable everolimus eluting scaffolds (BVS) vs. everolimus eluting stents (EES) in patients with ischemic heart disease. Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), was searched for scientific sessions, abstracts, and relevant websites for…