Cardiology Today's Intervention highlights 7 articles on advancements in PCI

Recent weeks have produced a steady influx of headlines regarding PCI technology, ranging from American Heart Association Scientific Sessions headlines to FDA approvals.

Cardiology Today’s Intervention has listed 7 articles discussing advancements, new technologies and future studies related to PCI.

Impact of PCI vs. CABG on outcomes varies by acuity of presentation in diabetes

The mode of revascularization and acuity of presentation appear to affect short-term outcomes among patients with diabetes and multivessel disease, leading researchers for a new study to call for further investigation into the optimal revascularization strategy for patients with diabetes and ACS.

Krishnan Ramanathan, MB, ChB, clinical assistant professor at University of British Columbia, Vancouver, and colleagues analyzed real-world data from a population-based database from British Columbia that included 4,661 patients with diabetes and multivessel disease who underwent CABG or PCI with first- or second-generation stents. Of those, 2,947 patients had ACS. PCI was the preferred revascularization strategy in 60% of the overall cohort.

PCI with new-generation DES yields positive results for obstructive left main CAD

Patients with unprotected left main coronary artery stenosis who underwent PCI with new-generation drug-eluting stents showed acceptable rates of the composite endpoint of death, MI or cerebrovascular accident over a median follow-up of 17 months, according to the results of the DELTA 2 registry, recently published in JACC: Cardiovascular Interventions.

“Percutaneous treatment of unprotected left main coronary artery disease evolved over time and currently is accepted as an alternative to CABG in selected patients,” Alaide Chieffo, MD, from the interventional cardiology unit at the San Raffaele Scientific Institute in Milan, and colleagues wrote. “In this challenging subset of patients, PCI with DES has been demonstrated to be feasible and safe at midterm clinical follow-up.”

FDA approves DES system for narrowing, blocked coronary arteries

Cordis and Medinol have announced the FDA approval of a DES system for the treatment of patients with narrowing or blockages in coronary arteries.

According to a press release, the EluNIR stent system is designed with a novel metallic spring tip and has the narrowest strut width of any stent currently available in the U.S. market, assisting physicians to more effectively deliver the DES in this patient group.

Acute iFR may help rule out nonculprit stenoses

New data suggest that instantaneous wave-free ratio may be a valid tool to rule out nonculprit stenosis in patients presenting with STEMI.

“Our data provide a basis for prospective randomized studies comparing acute full revascularization with functional evaluation of nonculprit stenoses vs. staged full revascularization with functional (invasive or non-invasive) evaluation of nonculprit stenoses,” Troels Thim, MD, PhD, from the department of cardiology at Aarhus University Hospital, Denmark, and colleagues wrote in JACC: Cardiovascular Interventions.

Platinum-chromium EES safe, effective at 5 years

Long-term safety and efficacy of platinum-chromium everolimus-eluting stents were comparable to those of cobalt-chromium EES and showed low rates of stent thrombosis in both devices, according to the 5-year results of the PLATINUM trial.

“It is important to describe the final long-term outcomes from these trials because the favorable early safety and effectiveness profile of some coronary stents was not durable at late follow-up,” Christopher R. Kelly, MD, from the Columbia University Medical Center and New York-Presbyterian Hospital and the Cardiovascular Research Foundation in New York, and colleagues wrote. “The current report provides the final, 5-year follow-up results from the randomized PLATINUM trial and the single-arm SV and LL substudies.”

Expert panel: Clinical need for bioresorbable technology remains

Although disappointing data and safety issues hampered the introduction of bioresorbable vascular scaffolds, improvements in technology and implantation techniques as well as optimized patient selection and postprocedural management may help forge a place for these devices in PCI procedures, according to a consensus statement published in JACC: Cardiovascular Interventions.

“Because of the considerable amount of information, variability in practice and the number of statements being made regarding BVS, we convened a panel of experts to draft a consensus statement on the current strengths and limitations of BVS and what the future may hold,” lead consensus statement author Sripal Bangalore, MD, MHA, director of research, cardiac catheterization laboratory; director of the Cardiovascular Outcomes Group in the Leon H. Charney Division of Cardiology; and associate professor of medicine at New York University School of Medicine, and a Cardiology Today Editorial Board Member, told Cardiology Today’s Intervention.

PCI for CTO becoming more common in high-risk patient population

ANAHEIM, Calif. — There has been an increased rate of PCI for chronic total occlusion among sicker patients at high risk for comorbidities, according to an abstract presented at the American Heart Association Scientific Sessions.

According to the abstract from Sopan Lahewala, MD, from Jersey City Medical Center, and colleagues, PCI for CTO remains challenging and is less successful than PCI in patients without total occlusions.