CardioExchange Archive

May 18th, 2012

FAME II: Another Study Abides in Infamy

Richard A. Lange, MD, MBA and L. David Hillis, MD

In FAME II, a prospective study conducted at 28 centers in Europe and the United States, >1200 patients with ischemia (as determined by fractional flow reserve [FFR]) were randomly assigned to receive (a) PCI (with a DES) and optimal medical therapy (OMT) or (b) OMT alone. The primary endpoint was a composite of death, myocardial infarction […]

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May 2nd, 2012

Real-World Experience with TAVI: Vive la France!

Richard A. Lange, MD, MBA and L. David Hillis, MD

A study of data from FRANCE 2, a prospectively maintained, multicenter registry of the French national experience with transcatheter aortic valve implantation (TAVI), has now been published in the New England Journal of Medicine. The registry captured every TAVI performed at all 34 active centers in France and Monaco; it therefore reflects “real-life” experience with TAVI in patients with […]

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April 19th, 2012

Should We Pull the Trigger on Platelet Reactivity Testing (and Put It out of Its Misery)?

Richard A. Lange, MD, MBA and L. David Hillis, MD

“We said it before, and we’ll say it again: an assessment of platelet reactivity by this method doesn’t effectively identify individuals at high risk for a cardiovascular event following PCI.”

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April 17th, 2012

Why Make A Stent Out of Cornstarch?

Richard A. Lange, MD, MBA and L. David Hillis, MD

Biodegradable stents: here to stay… or will they disappear? A newly-released study reports the long-term results of the first-in-man fully biodegradable coronary stent.

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March 14th, 2012

The $800 Million Gamble: Jumping Aboard or Jumping the Gun?

Richard A. Lange, MD, MBA and L. David Hillis, MD

In the CLOSURE I trial (Evaluation of the STARFlex Septal Closure System in Patients with a Stroke and/or Transient Ischemic Attack Due to a Presumed Paradoxical Embolism through a Patent Foramen Ovale), 909 patients with a PFO who had a stroke or a transient ischemic attack (TIA) of unclear etiology were randomly assigned to device […]

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February 8th, 2012

(In)Appropriate PCI: An (In)Appropriate Critique?

Richard A. Lange, MD, MBA and L. David Hillis, MD

According to a recently published study by Chan and colleagues, only 50% of the PCIs performed for nonacute indications were classified as appropriate, according to appropriate use criteria (AUC); 38% were “uncertain,” and 12% were inappropriate. In a new expedited publication, Marso and colleagues  retort by expressing concerns with the “current” PCI AUC (see also our CardioExchange news coverage here). […]

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February 8th, 2012

Two Different Perspectives on the CABG Versus PCI Message in ASCERT

Fred H Edwards, MD, MS, Richard A. Lange, MD, MBA and L. David Hillis, MD

At the recent meeting of the Society of Thoracic Surgeons (STS), Fred Edwards presented the high-risk subset of ASCERT (ACCF-STS Database Collaboration on the Comparative Effectiveness of Revascularization Strategies). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to Edwards and Christopher White, the president of the Society for Cardiovascular Angiography and Interventions (SCAI). Rick Lange and David […]

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January 31st, 2012

Guiding TAVR into Clinical Practice

Steven Bailey, MD, Richard A. Lange, MD, MBA and L. David Hillis, MD

The ACC, AATS, SCAI, and STS have issued a critical consensus document to guide the use of transcatheter aortic valve replacement (TAVR) as it enters clinical practice in the U.S. (see also our CardioExchange news coverage here). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to writing committee member Steven R Bailey, the Janey Briscoe Distinguished Professor of […]

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January 25th, 2012

Heads Up (Lesions Down) on a New Embolic Protection Device for Carotid Arterial Stenting

Richard A. Lange, MD, MBA and L. David Hillis, MD

The current standard of care for individuals undergoing carotid arterial stenting (CAS) entails the use of an embolic protection device (EPD) to minimize the risk for embolic stroke. At present, the only FDA-approved EPD is a filter that is placed distal to the stenosis (i.e., it is advanced across the lesion) before stenting. In a recently completed randomized trial, a proximal balloon occlusion device provided […]

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January 18th, 2012

Cangrelor and Alaska’s “Bridge to Nowhere”

Richard A. Lange, MD, MBA and L. David Hillis, MD

The Gravina Island Bridge (also known as The Bridge to Nowhere) was a proposed bridge to replace the ferry that currently connects Ketchikan, Alaska (population, 14,000) to the Ketchikan International Airport on Gravina Island (population, 50) at a projected cost of $398 million. The bridge was to have been nearly as long as the Golden Gate […]

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