New revascularization after coronary artery bypass graft (CABG) is often needed, be it because of severe bridge lesion, intimal hyperplasia, thrombosis, atherosclerosis, or native vessel lesion progression. We therefore need to determine the best revascularization strategy, namely native or graft percutaneous intervention, venous or arterial, or repeat surgery, with the risk it entails. There is...
These results confirm that, despite being used less and less worldwide, DES (drug eluting stents) are the best option in saphenous vein grafts. Saphenous vein graft atherosclerosis has a different pathophysiology to that of native arteries, and PCI in this context is less effective because of high risk of friable thromboembolic material, faster plaque...
Courtesy of Dr. Carlos Fava. PCI to saphenous vein grafts is one the greatest challenges these days because, as opposed to native arteries, they present important thrombolytic material, diffuse and long lesions, and abundant macrophage and inflammatory cells, which makes the procedure more complex. At present, we have not yet agreed on the best antiplatelet...
There is little information comparing contemporary drug eluting stents (DES) against bare metal stents (BMS), for PCI in saphenous vein grafts in patients receiving (CABG). This study aimed to assess clinical outcomes after PCI in saphenous vein grafts in patients receiving BMS, first generation DES, and new generation DES between 2006 and 2013. The study...
Courtesy of Dr. Carlos Fava. The treatment of vein graft lesions has always been difficult in relation to angioplasty, due to their characteristics. While drug-eluting stents (DES) have proven to be superior to bare-metal stents (BMS) for coronary arteries, such superiority is unclear as regards vein grafts. Several studies with first-generation DES (DES1) have even reported...
Long-Term Outcomes with First vs. Second-Generation Drug-Eluting Stents in Saphenous Vein Graft Lesions. Nagendra R. Pokala. Catheterization and cardiovascular Intervention 2016;87:34-40 Courtesy of del Dr. Carlos Fava. Second generation DES have been proved superior to first generation DES in native arteries, but there is limited information on DES in saphenous vein grafts (SVG), from a...
Advanced stages of peripheral artery disease cause significant limitations in patients, such as critical limb ischemia (CLI), which manifests with resting pain and gangrene or ulcers of difficult resolution. Uncontrolled progression of this pathology might lead to major amputation, reduced life expectancy and increased healthcare costs. Prior research on infrapopliteal territory have shown contradicting results....
The retrograde approach for recanalizing chronic total occlusions (CTO) has undergone significant evolution since its introduction in 1990, improving both in terms of techniques and specialized materials. The increased skill applied to this strategy has resulted in increased success rates for the treatment of CTO in sites with an adequate volume of procedures. Given the...
Cardiovascular disease is the leading cause of death in elderly adults (individuals aged 75 years or older). In turn, coronary heart disease is one of the main causes of morbidity in this population. In addition to anatomical complexities, there are other factors that may complicate its management, such as polypharmacy, frailty, and procedure-related risks. All of...
Takotsubo Syndrome (STT) is characterized by acute cardiac failure which can be reversed in many occasions, but is associated with morbidity and mortality at short and long term. It is most frequent among women, especially after menopause. However, gender differences have not been looked into when analyzing the evolution of this cardiomyopathy. This was an...