The 5 year results of the SYNTAX (SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery) trial are now published. SYNTAX assessed the optimal revascularization strategy for patients with left main and/or 3-vessel disease by randomly assigning such patients to CABG or PCI (with a first-generation paclitaxel-eluting stent) and then determining the rate of…
No Aspirin After DES? Is This The Wild, Wild WOEST? (14 Feb 2013)Richard A. Lange, MD, MBA and L. David Hillis, MD
According to the recently published results of the WOEST trial, patients receiving anticoagulation thereapy who undergo stenting have better outcomes with clopidogrel only than with clopidogrel plus aspirin. Rick Lange and David Hillis ask: Are you ready to stop prescribing aspirin to these patients?
FFR vs. iFR: All That Glitters Is Not Gold (6 Feb 2013)Richard A. Lange, MD, MBA and L. David Hillis, MD
David Hillis and Rick Lange consider new evidence that iFR is not an acceptable substitute for FFR. Does the need for adenosine administration hinder the use of FFR to guide management decisions?
Could You Be Accused of Doing Unnecessary PCI? (8 Jan 2013)Richard A. Lange, MD, MBA and L. David Hillis, MD
A recent rash of lawsuits and physician suspensions for “unnecessary PCI” have given many interventionalists pause. Rick Lange and David Hillis ponder the implications of these incidents on clinical practice.
Is “Zapping the Kidneys” Miraculous? (20 Dec 2012)Richard A. Lange, MD, MBA and L. David Hillis, MD
Renal denervation for resistant hypertension is generating a lot of excitement. In this blog, Rick Lange and David Hillis take stock of the evidence and the efforts underway to explore the potential scope of indications for the procedure.
PFO Occluder Devices Don’t Get No RESPECT (20 Nov 2012)L. David Hillis, MD
David Hillis invokes Rodney Dangerfield in considering the findings of a recent trial of a PFO closure device.
‘Rather Than … FAME, Give Me Truth’ (28 Aug 2012)Richard A. Lange, MD, MBA and L. David Hillis, MD
The FAME 2 trial adds fuel to the debate regarding what measurements should guide decisions about revascularization.
New DES Get COMFORTABLE with AMI (23 Aug 2012)Richard A. Lange, MD, MBA and L. David Hillis, MD
The use of drug-eluting stents (DES) in patients with acute myocardial infarction (AMI) has recently generated concern. In two meta-analyses (De Luca et al and Kaleson et al) , the use of early-generation DES resulted in a lower risk of repeat revascularization compared with bare-metal stents (BMS) in patients with AMI, but the DES group had a 2-fold increased…
Is there a plausible explanation for why the radial approach to PCI would yield better survival than the femoral approach in patients with ST-segment ACS?
In a recent article in Archives of Internal Medicine, researchers performed an analysis of current use of drug-eluting stents (DES) in patients at various levels of risk for target-vessel revascularization (TVR), and estimated the cost and clinical outcomes of using BMS rather than DES in patients at low risk (see News). To gauge reaction to…