Complementary imaging allows for the identification of numerous scenarios not visible with conventional angiography (ICA), both for the assessment of differential diagnoses and the improvement of percutaneous coronary intervention (PCI) outcomes. Advantages include assessment of plaque characteristics, vessel plaque burden, stent edge dissection, vessel diameter, and correct apposition, among others. While intravascular ultrasound (IVUS) was...
When scheduling a coronary angiography, patients are usually instructed to fast for at least 8 hours (no oral intake after dinner). However, this strategy can lead to negative effects such as discomfort, irritability, dehydration, and even hypoglycemia in some cases. Previous studies have not shown significant differences in gastric complications between patients fasting only 2 hours before...
Cardiac revascularization surgery (CABG) has shown positive results at long term in CAD patients with multivessel or left main disease. However, we are well aware that, after CABG, there might be native disease progression over time. Also, at followup, we often see high incidence of venous graft failure. According to registry data, approximately 1 in...
Several studies have used physiological assessment after a percutaneous coronary intervention (PCI) to improve clinical outcomes. However, results are not entirely conclusive. The limitations of using these physiological assessment methods are the need for extra measurements with increased procedure time, more radiation, and more contrast, which in turn leads to higher costs. To counteract these...
Patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) have worse clinical outcomes tan patients with non-complex CAD. Several studies have shown that the use of intravascular imaging (IVUS, OCT) have reduced major adverse events vs. angiography guided PCI. However, these studies present limitations both of size, studied population, short term followup...
Por Dr. Ricardo Cavalcante e Silva.
This study compared fractional flow reserve (FFR) vs. angiography to guide the angioplasty of non-culprit vessels in patients with acute coronary syndrome (ACS) and multivessel disease. Landmark studies such as COMPLETE, COMPARE-ACUTE and DANAMI-3-PRIMULTI have demonstrated the prognostic value of revascularization (after treatment of the artery responsible for the ACS) of non-culprit arteries with respect...
This summary discusses the early invasive strategy and the risk of mortality in non-ST-elevation AMI. Over the past 2 decades, mortality and complications rates have seen a significant reduction thanks to technological and pharmaceutical development, and the increasing experience of health teams. This is especially true when we look at the use of coronary angiography...
Compared with visual estimation of lesions, using quantitative angiography-derived fractional flow reserve (quantitative flow ration, QFR) provides better clinical outcomes at one year for angioplasty. These results emerge from the Chinese FAVOR III study, presented at the 2021 TCT scientific sessions and simultaneously published in The Lancet. The simplicity and safety offered by QRF—since there is...
The predecessor of this research—RIPCORD, published in 2014—showed that using fractional flow reserve (FFR) changes the treatment strategy in about 25% of patients. That marked the rise of FFR. In fact, the DEFER, FAME, and FAME 2 studies offered results consistent with the original RIPCORD. In this research, authors tested the hypothesis of systematic use of...