Drug-Coated Balloons for Unselected Real World Patients: Are We There Yet?
Despite the high level of recommendation for drug-eluting stents (DES) in patients with coronary artery disease, there is still a persisting risk of DES-related adverse events during long-term follow-up. In contrast, there is growing evidence for the effectiveness of drug-coated balloons (DCB) in treating in-stent restenosis (ISR) in both bare-metal stent (BMS) and DES patients. However, the use of DCB in patients with de novo lesions or other high-risk factors is not widely accepted and more research is needed in this area. Therefore, this study aims to further explore the potential role of DCB in unselected patients with coronary artery disease.
To Debate. Drug-eluting balloons for de novo coronary lesions. Available evidence and possible superiority in certain contexts
The use of drug-eluting balloons (DELB) in the context of de novo lesions has been a topic of significant interest in the medical community. Some argue that the use of DELBs is the most compelling argument for this technology, which has seen significant progress in the last 5 years.
However, despite this progress, it is important to consider if there is enough evidence to recommend the use of DELBs in clinical practice for de novo lesions. Furthermore, it is worth investigating if there are any differences in the results and level of evidence depending on the size of the vessel being treated. This paper aims to address these questions and provide a comprehensive understanding of the use of DELBs in the treatment of de novo lesions.
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“Spontaneous” Coronary Artery Dissection After SARS-CoV-2 Messenger RNA Vaccination
The recent development and distribution of mRNA vaccines for SARS-CoV-2 have raised concerns about potential side effects, including cardiovascular complications. Some studies have suggested a possible link between SARS-CoV-2 vaccination and the occurrence of spontaneous coronary artery dissection (SCAD), a rare but serious condition that can lead to heart attack. This paper aims to investigate and discuss reported cases of SCAD following mRNA vaccination for SARS-CoV-2, in order to better understand the potential correlation between the two.
Pregnancy and Spontaneous Coronary Artery Dissection: Lessons From Survivors and Nonsurvivors
La dissezione spontanea dell’arteria coronaria (SCAD) è una condizione rara ma grave che può verificarsi durante la gravidanza e può portare a un infarto. Questa condizione è nota come SCAD associata alla gravidanza (P-SCAD). Lo scopo di questo studio è stato quello di analizzare la presentazione clinica e il trattamento della P-SCAD nelle donne sopravvissute e in quelle che non lo hanno fatto, e di esaminare gli esiti delle gravidanze successive nelle donne che avevano precedentemente sperimentato la SCAD.
Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction associated with pregnancy (P-SCAD).1–3 It is also an understudied cause of maternal death.
Spontaneous coronary artery dissection (SCAD) is a rare but serious condition that can occur during pregnancy and can lead to a heart attack. This condition is known as pregnancy-associated SCAD (P-SCAD). The purpose of this study was to analyze the clinical presentation and treatment of P-SCAD in women who survived and those who did not, and to examine the outcomes of subsequent pregnancies in women who had previously experienced SCAD.
Small Vessel Coronary Artery Disease: Rationale for Standardized Definition and Critical Appraisal of the Literature
Small vessel coronary artery disease (CAD) is a common issue faced by patients undergoing percutaneous coronary intervention, with a prevalence ranging from 30% to 67% according to different studies. However, there is a lack of consensus on the definition of small vessel CAD, making it difficult to accurately assess and treat. This inconsistency has also led to varying results and recommendations for revascularization options. As a solution, this article suggests a reference vessel diameter of less than 2.5 mm to define small vessel CAD and provide a guideline for future clinical trials and medical decisions.
Sirolimus‐coated balloon versus everolimus‐eluting stent in de novo coronary artery disease: Rationale and design of the TRANSFORM II randomized clinical trial
The TRANSFORM II trial (clinicaltrials.gov: identification number NCT04893291) is an investigator-driven, multicenter, international, randomized clinical trial that aims to compare the effectiveness of a novel sirolimus drug coated balloon to a current everolimus-eluting stent in treating de novo lesions in coronary vessels with a diameter between 2 and 3 mm. This trial will provide valuable information on the potential of the sirolimus drug coated balloon in improving outcomes for patients with coronary artery disease. Through this trial, researchers hope to determine if the novel treatment option is noninferior to the current standard treatment, and ultimately, improve patient care.