Predictors of post PCI angina Among the complications of ischemic cardiomyopathy stenting, those called chronic, with significant functional and mental compromise, might affect patient quality of life. This can be observed in different scenarios, such as instent restenosis and post PCI angina. This kind of complications is associated with anxiety and depression at long term. …
Clinical Impact of Coronary Artery Disease on Results After TAVR
Coronary artery disease (CAD) coexists with aortic stenosis in about half the patients who suffer the latter. These patients receiving antiplatelet therapy are at a higher risk of periprocedural bleeding—one of the most frequent complications in patients who undergo transcatheter aortic valve replacement (TAVR). One way of limiting the risk for bleeding is choosing the…
AQCA Study: Pre-PCI Virtual QFR for Planning PCI vs. Conventional Angiography
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…
ACC 2023 | YELLOW III Study. Effect of Evolocumab on Coronary Plaque Characteristics in Stable Coronary Artery Disease
Dr. Kini presented the results of the YELLOW III Study where she analyzed the effect of evolocumab on coronary plaque in patients with stable coronary artery disease. The study included 137 patients who underwent coronary angioplasty to the culprit vessel and endovascular imaging (OCT, NIRS/IVUS) to non-obstructive lesions (30%-50%). If their plaque was lipid-rich (defined…
ACC 2023 | RENOVATE-COMPLEX-PCI: Intravascular Imaging-Guided vs. Angiography-Guided Complex PCI
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…
Microvascular Dysfunction in Symptomatic Patients with Intermediate Coronary Lesions Prognostic impact according to different patterns
Coronary microvascular dysfunction (CMD) is emerging as an important cause of myocardial ischemia, and its role in the pathogenesis of cardiovascular disease—including angina patients with nonobstructive coronary lesions—is well known. Currently, there are several definitions of CMD and several invasive and noninvasive diagnostic tests. Using invasive tests, heterogeneous patterns of microvascular dysfunction, such as coronary…
Left Main Revascularization: 12 Year Registry in Canada
The current indication for severe left main lesion continues to be coronary artery bypass graft surgery (CABG) but percutaneous coronary intervention (PCI) has come far in this territory thanks to increasing operator experienced and the use of IVUS during procedures. At present, left main disease have a Class IIa indication in the American guidelines when…
Coronary Physiology after Aortic Valve Intervention
Impact of Aortic Valve Intervention on Coronary Flow Reserve Myocardial flow might be compromised in patients with severe aortic stenosis, which might be driven by CAD and concomitant atherosclerosis or a compromised capillary bed. Capillary circulation might be compromised by increased left ventricular mass (LVM) which in turn might alter coronary flow reserve (CFR). Multiple…
Can Drug Coated Balloon Be a Valid Option for Small Vessels?
One of the challenges of percutaneous coronary interventions (PCI) are <2.5 mm vessels, since complications and restenosis complications rate are higher than with >3.0 mm vessels. Drug Coated Balloons (DCB) can be a useful tool, but their efficacy and safety [vs. plain old balloon angioplasty] remains unclear. PEPCAD China SVD is a prospective and multicenter…
Left Main Coronary Artery Percutaneous Coronary Intervention: Evolution and Results over Time
Left main coronary artery percutaneous coronary intervention (LMCA PCI) is a treatment option that is increasingly used in our setting. One of the reasons for choosing this therapeutic strategy is the improvements in devices and techniques. However, the long-term results of LMCA PCI are not well established. The aim of this retrospective study was to…
Long-Term Evolution of Hybrid Coronary Revascularization
Currently, myocardial revascularization surgery (MRS) and percutaneous coronary intervention (PCI) are the available strategies for multivessel coronary artery disease. However, an alternative strategy has long been developed, called hybrid coronary revascularization (HCR), where the anterior descending artery is bypassed with a graft from the mammary artery and the rest of the lesions are treated by…