Planned PCI in high bleeding risk patient: Three forbidden options

Though two stents Onyx one (Medtronic) and Biofreedom(Biosensors) appear promising with rapid endothelisation and hence short DAPT. There are three more options. available in this situation. Option 1 Avoid the endothelium unfriendly DES and use BMS* and use MAPT (Mono or minimal antiplatelet therapy). For the sake of the young generation cardiologists, let me expand BMS,ie Bare metal stents. BMS in 2020 ! What nonsense are you talking about? (For those who ask this question, please try to go through the following study with a conscience) (NORSTENT 2016 -One of the most underrated, deliberately concealed landmark paper in cardiology. We understand, even papers from NEJM don’t get noticed, if it confronts commerce. As expected, none of the cardiology bodies considered it worthy to use this study data in CAD management guidelines) Want more evidence? One more study, BASKET -PROVE explicitly showed in large-caliber vessel (Stent >3mm) BMS vs DES doesn’t make any difference.(Christoph Kaiser 2010 NEJM) What is the second or third option? Did you guess it ? Yes, correct, avoid the stent altogether. Do a POBA* if feasible, or just continue with the self humiliating medical management and be happy to prevent a potential stroke.Mind you, most lesions are amenable for medical management unless it is critical, proximal and symptomatic. (POBA-Plain old balloon angioplasty) *If you think doing POBA downgrades your Interventional worthiness, may add a DEB to it,to pacify ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized biofreedom vs onyxone bms for high bleeding risk BMS VS DES IN 2020 NORSTENT BASKET PROVE NEJM POBA DEB to reduce bleeding risk Source Type: blogs