Structural Heart Disease articles

TCT 2020 | Our Next Goal Should Be Using IVUS Guidance in Every Angioplasty

TCT 2020 | Our Next Goal Should Be Using IVUS Guidance in Every Angioplasty

The benefits of intravascular ultrasound (IVUS) guidance in all angioplasties with second-generation drug-eluting stents (DES) persist through 3 years of follow-up. These data derive from the extended follow-up of the ULTIMATE study, presented virtually at TCT 2020 and published simultaneously in JACC Intv. At 3 years, target-vessel failure remained lower in patients whose angioplasty was guided by

TCT 2020 | Ticagrelor Monotherapy After ST-Segment Elevation Infarction

Ticagrelor monotherapy after 3 months of dual antiplatelet therapy in patients who experienced ST-segment elevation infarction significantly reduces major bleeding without increasing ischemic risk. This pre-specified analysis of the TICO study shows that ticagrelor monotherapy is safe even in patients with higher ischemic risk. Interrupting aspirin use after 3 months of dual antiplatelet therapy and continuing treatment

TCT 2020 | Initial Studies Show Incredible Results with Lithotripsy in Calcified Lesions

Intravascular coronary lithotripsy shows promise for the improvement of angioplasty in severely calcified lesions, according to data from the DISRUPT CAD III study, published in JACC and simultaneously presented at the TCT 2020 Congress. Calcification in all patients enrolled was highly severe, with an average length of 48 mm, and side-branch involvement in 30% of cases. Lithotripsy,

TCT 2020 | Nueva información sobre el valor del FFR antes y después de la angioplastia

TCT 2020 | Fewer Symptoms and Events when Optimizing with iFR

Symptomatic patients undergoing PCI with no residual ischemia confirmed by iFR have superior symptom improvement at one year vs. patients who did not receive the optimization.  In addition to symptoms, patients receiving iFR optimization (final value ≥ 0.95) presented lower cardiac mortality, spontaneous MI or clinically justified revascularization vs. patients with <0.95 final value.  

TCT 2020 | Nueva información sobre el valor del FFR antes y después de la angioplastia

TCT 2020 | The Myth of Biodegradable Polymers Seems to Have Come to an End

This is the largest and newest study to compare drug eluting stents with durable polymers vs. biodegradable or bioresorbable polymers. As is usually the case, the theory clashes with reality.  The study has shown that the polymer does not seem to play an important role in the performance of drug eluting stents, or at least

TCT 2020 | Nueva información sobre el valor del FFR antes y después de la angioplastia

TCT 2020 | New Information about Pre and Post PCI FFR Value

The TARGET FFR and DEFINE-FLOW studies were presented at TCT 2020 which have offer a deeper perspective on the value of FFR, not only before but also after PCI. TARGET FFR The TARGET FFR included 260 patients randomized after angiographically successful PCI to an FFR guided optimization vs. blinded FFR assessment strategies.  In the guided

TCT 2020 | Administrar el comprimido de prasugrel molido previo a la angioplastia

TCT 2020 | Crushed Prasugrel Administration prior PCI

Prehospital administration of crushed tablets of prasugrel loading dose in the ambulance while patient is on his way to primary PCI does not improve reperfusion markers compared against uncrushed tablet administration according to the COMPARE CRUSH, presented at the virtual TCT 2020 and simultaneously published in Circulation. There were no differences in TIMI flow of

TCT 2020 | Prophylactic Angioplasty for Vulnerable Plaques

Patients with vulnerable plaque identified by means of intravascular ultrasound (IVUS) and near-infrared spectroscopy (NIRS) are at a significantly increased risk of adverse cardiovascular events. Revascularization of these vulnerable lesions could prevent clinical events. That is the theory behind prophylactic angioplasty, which still needs to be proven in clinical practice. The PROSPECT ABSORB study, nested

TCT 2020 | Using OCT to Detect Vulnerable Plaque even with Negative FFR

Optical coherence tomography (OCT) has proven useful in diabetic patients, even those with negative FFR.  These findings make us rethink the ischemia and functional revascularization paradigm vs. the anatomical findings of vulnerable plaque.  Diabetic patients with lesions that might be deferred base don FFR might benefit from OCT to find in these plaques certain risk