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血管内超声指导

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Consensus from the 5th European Bifurcation Club meeting Intravascular ultrasound-guided vs angiography-guided drug-eluting stent implantation in complex coronary lesions: Meta-analysis of randomized trials Comparison of intravascular ultrasound versus angiography-guided drug-eluting stent implantation: a meta-analysis of one randomised trial and ten observational studies involving 19,619 patients Optical Frequency Domain Imaging Versus Intravascular Ultrasound in Percutaneous Coronary Intervention (OPINION Trial) Results From the OPINION Imaging Study Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis A three-vessel virtual histology intravascular ultrasound analysis of frequency and distribution of thin-cap fibroatheromas in patients with acute coronary syndrome or stable angina pectoris Clinical impact of intravascular ultrasound guidance in drug-eluting stent implantation for unprotected left main coronary disease: pooled analysis at the patient-level of 4 registries Attenuated plaque detected by intravascular ultrasound: clinical, angiographic, and morphologic features and post-percutaneous coronary intervention complications in patients with acute coronary syndromes Impact of the Use of Intravascular Imaging on Patients Who Underwent Orbital Atherectomy Imaging- and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure: a feasibility, safety, and outcome study
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Editorial2019;321(24):2409-2411.

JOURNAL：JAMA. Article Link

Dual Antiplatelet TherapyIs It Time to Cut the Cord With Aspirin?

KM Ziada; DJ Moliterno et al. Keywords: DAPT; 1-month clopidogrel vs. 12 month aspirin and clopidogrel; clinical outcomes; 3 years

ABSTRACT

Since evidence of increased risk of stent thrombosis with first-generation drug-eluting stents surfaced in 20051,2 and the US Food and Drug Administration advised interventional cardiologists to use dual antiplatelet therapy (DAPT) for 12 months following implantation of drug-eluting stents, the appropriate duration of DAPT has been widely studied and hotly debated. Dual antiplatelet therapy consists of concurrent administration of aspirin and a P2Y12 inhibitor. Determining the duration of DAPT requires a balance between 2 objectives: lowering the risk of ischemic events with more intense and longer antiplatelet therapy vs lowering the risk of bleeding events with less intense and shorter antiplatelet therapy. Because second-generation drug-eluting stents are associated with lower rates of stent thrombosis,3 the argument against longer DAPT was revisited. The updated guidelines incorporated such considerations by recommending a shorter duration of DAPT for selected patients, namely those with stable clinical status in whom risk of ischemic events is low.4,5

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