The use of transcatheter mitral valve intervention for the treatment of mitral valve regurgitation (MR) continues to evolve; at present guidelines only recommend it for inoperable or high surgical risk patients. So far, many devices have been assessed, some of which have shown promising results, but only for poor surgical candidates. Researchers looked into the…
Use of IVL in Calcified Coronary Lesions in a Real World Population
The presence of calcification in coronary arteries (CAC) remains a challenge for the percutaneous treatment of these lesions. Several studies have established the link between CAC and poor long term results. Intravascular lithotripsy (IVL) has surged as a tool to induce calcified plaque fracture. Even though studies on this strategy are not randomized, they have…
Lithotripsy in the Left Main Coronary Artery
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which…
IN.PACT Outcomes at 5 Years
Over time, percutaneous coronary intervention (PCI) with drug coated balloons (DCB) have been shown more beneficial than conventional PCI. However, in many cases, stenting is required to treat suboptimal results. Even though several studies have looked into this scenario, long term durability still calls for research. This was a 5 year thorough analysis of the…
ERCTO Registry: Current Results for Percutaneous Treatment of Chronic Total Occlusions
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access…
Tricuspid Valve Transcatheter Edge-to-Edge Repair in the “Real World”
Tricuspid valve transcatheter edge-to-edge repair (T-TEER) is currently under development, with an increasing number of conducted procedures. While the TRILUMINATE Study did not reveal benefit regarding major events, it did show improvements in quality of life. In the real world, we encounter numerous patients who do not meet the study criteria but still experience symptoms…
Proximal Optimization Technique in Unprotected LMCA
Proximal optimization technique (POT) has been recommended as a standard strategy in bifurcation lesions because it facilitates proper stent implantation and apposition in the proximal main vessel, according to the European Bifurcation Club. Percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) has specific characteristics, and the long-term impact of this strategy…
Use of Transjugular Echocardiography in TAVR
TAVR is a well-established course of treatment, increasingly indicated in lower risk populations. However, one of the challenges associated with self-expanding TAVR, compared against balloon expandable TAVR and SAVR, is the frequent need for definite permanent pacemaker implantation (PPI). High implantation, also known as cusp overlapping (COT), has been shown to reduce the need for…
Post TAVR Long Term Outcomes in Patients with Chronic Inflammatory Disease
Patients suffering from immune-mediated chronic inflammatory disease (CID) face a high risk of developing heart disease, including aortic valve disease. Inflammatory vascular disease when triggered by an autoimmune condition, can prompt a harmful response leading to valve degeneration, with increased calcification and fibrosis, and the associated progression of stenosis, failure or both. Prior research has…
Treatment of Femoropopliteal Lesions with Low-Dose vs. High-Dose Drug-Coated Balloons
The use of drug-covered balloons (DCBs) has increased significantly for the endovascular treatment of femoropopliteal arterial disease. Previous studies on first-generation high-dose DCB (HD-DCB) have validated its benefits, thus supporting its recommendation in current clinical guidelines. However, there have been reports of adverse effects associated with paclitaxel and its excipients. Second-generation, lower-dose DCBs (LD-DCB) have…