Efficacy and safety of a double-coated paclitaxel-eluting coronary stent: The EUCATAX trial

Objectives: The aim of this study was the comparison of a new double-coated paclitaxel-eluting coronary stent with bare-metal stent (BMS) in patients undergoing percutaneous coronary intervention. Background: Stent coating with biodegradable polymers as a platform for elution of drugs has the potential for complete elution of drugs and for decreasing the risk of late complications. Methods: Multicenter randomized trial comparing a paclitaxel-eluting stent (PES) coated with a biodegradable polymer and glycocalyx with the equivalent BMS. We randomly assigned 422 patients with de novo coronary lesions to PES (211 patients) or to BMS (211 patients). Primary end point was target vessel failure (TVF) defined as cardiac death, myocardial infarction, and target vessel revascularization. Clinical secondary end points were target vessel revascularization, target lesion revascularization, stent thrombosis (ST), and major adverse cardiovascular events (MACE). Angiographic secondary end points were late loss and binary restenosis. Results: At 1 year of follow-up, TVF rate was 9.5% in the PES group and 17.1% in the BMS group (P = 0.02), and MACE rate was 10% in PES and 19% in BMS arm (P = 0.009). All other secondary end points were reached but ST. ST rate was low and similar in both study arms. Conclusions: The study shows that patients treated with PES with dual coating technology had significantly lower incidence of TVF and MACE than those treated with BMS design; however, longer follow-up should be necessary to assess true advantages of this technology compared with the previous one.Fil: Rodriguez, Alfredo E.. Sanatorio "Otamendi y Miroli S. A."; ArgentinaFil: Vigo, Cesar F.. Sanatorio del Salvador S. A.; ArgentinaFil: Delacasa, Alejandro. Sanatorio Belgrano; ArgentinaFil: Mieres, Juan. Sanatorio "Otamendi y Miroli S. A."; ArgentinaFil: Fernandez Pereira, Carlos. Sanatorio "Otamendi y Miroli S. A."; ArgentinaFil: Bernardi, Victor. Clinica del Sol;Fil: Bettinoti, Marcelo. Sanatorio Guemes Sociedad Anonima.; ArgentinaFil: Rodriguez Granillo, Gaston Alfredo. Sanatorio "Otamendi y Miroli S.A.". Servicio de Diagnóstico por Imágenes. Departamento de Imágenes en Cardiología. Centro de Investigaciones Cardiovasculares; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Curotto, Valeria. Sanatorio "Otamendi y Miroli S. A."; ArgentinaFil: Rubilar, Bibiana. Sanatorio "Otamendi y Miroli S. A."; ArgentinaFil: Tronge, Jorge. No especifíca;Fil: Palacios, Igor F.. Massachusetts General Hospital; Estados UnidosFil: Antoniucci, David. Careggi Hospital; Itali

Percutaneous Rheolytic Embolectomy for Massive Pulmonary Embolism

Recently, percutaneous thrombectomy therapies have begun to be used. These ones open a new therapeutic option that should be considered if necessary resources are available.Two cases of massive pulmonary embolism treated with rheolytic thrombectomy are described in this work.R EV ARGENT CARDIOL 2010;78:442-444  Pulmonary embolism (PE) is a frequent cardiovascular disease with an incidence of 1/1000 in the United States and a mortality rate of 15% within three months after its diagnosis. This mortality increases five times in patients that develop shock. Despite its high incidence and morbimortality, the regular treatment has not substantially varied in the last years, and although the advances in therapies with thrombolytic agents or surgical endarterectomy, the mortality rate remains high in patients with massive pulmonary embolism.La tromboembolia de pulmón es una patología cardiovascular frecuente, con una incidencia de 1/1.000 en los Estados Unidos y una mortalidad que alcanza el 15% en los tres meses siguientes a su diagnóstico. Esta mortalidad aumenta cinco veces en los pacientes que desarrollan shock. A pesar de su incidencia y morbimortalidad elevadas, el tratamiento habitual no ha variado sustancialmente en los últimos años y aun a pesar de los avances en las terapias con trombolíticos o la endarterectomía quirúrgica, la tasa de mortalidad se mantiene muy elevada en los pacientes con tromboembolia pulmonar masiva