Category Archives: Stent

Interventional Cardiology Late-Breakers at ACC.17

Washington Convention Center

Over the next three days, a voluminous amount of data will be presented, shared, and debated among an estimated 18,000 attendees of the annual meeting of the American College of Cardiology, this year held in Washington, DC.

While the meeting covers the whole spectrum of cardiology and heart-related issues, there are a number of studies and late breaking clinical trials specific to the subspecialty of interventional cardiology. Continue reading

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Filed under ACC, Bioresorbable Stents/Scaffolds, Clinical Trials / Studies, FAME I / FAME II, FFR, Heart Attack, iFR, Intravascular Guidance, Meetings & Conferences

NORSTENT: Drug-Eluting Stents – Doing What They’re Supposed To

Coronary StentsAt this week’s annual European Society of Cardiology Congress in Rome, an important randomized clinical trial on stents was presented by Professor Kaare H. Bønaa, MD, PhD of the Clinic for Heart Disease, St. Olav’s University Hospital in Trondheim, Norway. Called NORSTENT, short for the “Norwegian Coronary Stent Trial,” this was the largest stent trial ever conducted, with 9,013 patients followed for six years. That’s serious! Continue reading

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Filed under Antiplatelet Medications, Back to the Future, Bare Metal Stents, Clinical Trials / Studies, Cost Effectiveness, Diabetes, Drug-Eluting Stents, Europe, Global Trends, Media Coverage, Meetings & Conferences, Patient Experience, Patients, Stent, Stent Thrombosis

COURAGE: Does 15-Year Data Have Any Clinical Relevance?

pills_vs_stent_140sqThis past week saw publication of an update to the 2007 COURAGE trial which compared optimal medical therapy (OMT) to stenting (PCI) as the initial management strategy for stable coronary artery disease. (Please note the phrase “initial management strategy.” This will not be the last time you see it in this post.)

Appearing in the New England Journal of Medicine and titled “Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease,” this study, performed by Dr. Steven P. Sedlis and other COURAGE trial investigators, is described as “an extended survival analysis to examine the potential long-term survival benefit from initial PCI among the patients with stable ischemic heart disease who were followed for up to 15 years after initial enrollment in the COURAGE trial.”

This new analysis concluded: “…we did not find a difference in survival between an initial strategy of PCI plus medical therapy and medical therapy alone in patients with stable ischemic heart disease.” This also was the finding of the original COURAGE trial at five years. Continue reading

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Filed under Appropriate Use Criteria (AUC), Bare Metal Stents, Clinical Trials / Studies, COURAGE, Drug-Eluting Stents, FAME I / FAME II, FFR, Intravascular Guidance, IVUS, OCT, Optimal Medical Therapy, Stent

iFR and iFR Scout to be Featured in Live Case from Hammersmith

Dr. Justin Davies discusses value of using physiology-guided PCI

Dr. Justin Davies discusses value of using physiology-guided PCI

If you’ve been wondering what iFR (Instant wave-Free Ratio) is, how it works, how it compares to FFR (Fractional Flow Reserve) and, most importantly, how it affects clinical outcomes, then click here to register for a free, online, interactive live case being done on Monday, April 13, 2:30pm-3:30pm London Time, 9:30am-10:30am New York Time).

Interactive: that means you can ask questions!

Dr. Justin E Davies, interventional cardiologist at Imperial College NHS Trust, and developer of iFR, will be performing and guiding the worldwide audience through a live complex PCI multivessel case, using physiology to guide his procedure. Continue reading

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Filed under FAME I / FAME II, FFR, Global Trends, iFR, Imaging, Intravascular Guidance, Medical Education, Meetings & Conferences, Stent

From Bench to Bedside to Bench Revisited: Supreme Court Justice Ginsburg Back in Action

  Almost two decades ago, interventional cardiology pioneer Dr. Spencer B. King III penned an article for Circulation titled, “Angioplasty From Bench to Bedside to Bench.” Dr. King’s article was a recounting of the history of the development of the angioplasty balloon catheter by his colleague at Emory University, Andreas Gruentzig.

This morning, the title of his article took on new meaning, as Supreme Court Justice Ruth Bader Ginsburg entered the courtroom and took her seat, engaging in several complex legal arguments concerning mortgage loan officers, Facebook threats, and more. Continue reading

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Filed under Celebrity Patients, History, Media Coverage, Stent

Plavix and Aspirin After Stent: 8 Years Later – Is Longer Better?

plavix_and_stentNo one thought it would take quite so long to get this information, but in just a couple hours results from the Dual Antiplatelet Therapy (DAPT) Study will be presented at the American Heart Association Scientific Sessions 2014. The question to be answered: Is there a benefit to extending dual antiplatelet therapy (aspirin plus a thienopyridine, such as clopidogrel/Plavix, prasugrel/Effient, etc.) beyond one year after stenting?

This is a question asked back in 2006, during a special two-day FDA hearing, convened to discuss all known issues with drug-eluting stents and prompted by the “ESC firestorm” over the problems of increased incidence of late stent thrombosis in drug-eluting stents. (See “Problems Resurface with Drug-Eluting Stents” – September 9, 2006.) Continue reading

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Filed under Antiplatelet Medications, Bare Metal Stents, Clinical Trials / Studies, Drug-Eluting Stents, Global Trends, Meetings & Conferences, Optimal Medical Therapy, Stent Thrombosis

Fractional Flow Reserve: Measuring Pressures in the Marketplace

Dr. Andreas Gruentzig

I don’t know how anyone can do these procedures without measuring pressures!

That’s what Andreas Gruentzig, the father of coronary angioplasty, said to me back in 1985. He knew that looking at the angiogram alone was not sufficient for judging the blockage in an artery. Integral to the design of his technological breakthrough, the double-lumen angioplasty balloon, was a feature which allowed him to measure the blood pressure at either end of the arterial blockage. At the start of the procedure, he could quantify how significant the blockage was; when he was done inflating the balloon, he could see the benefit of the dilatation. The post-angiogram might look good, but the pressures sometimes signaled that blood flow through the area was not. So, inflate again. And maybe again. OK, pressure now looks good, we’re done! Pretty simple. Not brain surgery. Continue reading

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Filed under Business & Industry, Cost Effectiveness, FAME I / FAME II, FFR, History, Stent