Coronary disease articles

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

Devices to Prepare Severely Calcified Lesions: Is There a Difference When Assessed by Intravascular Imaging?

Devices to Prepare Severely Calcified Lesions: Is There a Difference When Assessed by Intravascular Imaging?

Severely calcified coronary lesions are found in 25% of patients undergoing PCI, and their presence has a negative impact in long term outcomes. These lesions difficult stent expansion and increase device failure rate, even when using the latest generation of drug eluting stents (DES). This is why there is an interest in lesion preparation strategies

struts ultrafinos

Should We Start Using Ultra-Thin Struts?

The benefits of DES are well known, as well as the benefits of more recent polymer-based DES versions (even those with no polymers). However, strut size is no small matter, and might even make the difference, seeing as thinner struts are associated to better deliverability, simpler crossing profile in bifurcations, better endothelization and healing. Besides,

Dietas bajas en carbohidratos y progresión de la calcificación coronaria

Calcified Lesions: CTO Strategies for Plaque Preparation

Vascular calcification is a predictor of difficult stent positioning and expansion, which increases the chance of device failure (even with last generation stents). Calcium modifying strategies are being developed to reduce these difficulties.  Two recent randomized studies compare different calcium preparation devices. The PREPARE-CALC compares rotational atherectomy (RA) against plaque modifying balloons (PMB = cutting

TCT 2022

TCT 2022 | Angioplasty vs. Surgery: The BEST Study Long-Term Results

The BEST study was a prospective, randomized study to compare percutaneous coronary intervention (PCI) with everolimus-eluting stents vs. myocardial revascularization surgery (MRS) in patients with multivessel disease. The analysis was interrupted early due to slow patient inclusion. The study included 880 patients, who were randomized 438 to the PCI arm and 442 to the MRS arm.

TCT 2022

TCT 2022 | FAME-3 Trial: post PCI FFR And IVUS in Patients with Three-Vessel Disease

We are well aware of the benefits of Fractional Flow Reserve (FFR) to assess coronary artery stenosis. FFR after PCI (post-PCI FFR) has been shown to have prognostic value; however, few studies have included patients with complex three-vessel disease. The impact of intravascular ultrasound (IVUS) or optical computer tomography (OCT) in this field has been

TCT 2022

TCT 2022 | BYPASS CTCA

Studies have shown that the use of computed tomography cardiac angiography (CTCA) prior invasive coronary angiography (ICA) in patients with prior cardiac artery bypass graft (CABG) might reduce procedural time and post procedure kidney injury. 1 out of 5 patients with ischemic cardiomyopathy and prior CABG need to be assessed with ICA within 3 years

técnica retrógrada para oclusiones crónicas

Primary vs Secondary Retrograde Approach in CTO: Differences

Successful chronic total occlusion procedures are on the rise, especially in high volume centers, seeing as they count on more sophisticated materials and different techniques, such the retrograde approach. However, the significant increase of success rate with this technique has also brought along an increase in associated complications.  The aim of this study was to

¿Se justifica utilizar filtro de protección distal en los puentes venosos?

Mortality and Bleeding in Access Site Choice: Systematic Review

In 1992, Kiemeneij performed the first transradial coronary procedure, following Campeau’s description of that access in 1989. It’s been 30 years since that milestone in interventional cardiology. Over time, the number of procedures conducted with this approach has increased exponentially, and it is the main approach in most centers in different clinical scenarios. Historically, the

Nueva y discrepante información sobre los vasos no culpables en el infarto

Heparin Pretreatment in STEACS Treatment: A New Old Ally?

The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim

enfermedad de múltiples vasos síndrome coronario agudo

RIPCORD 2 Study: Routine Assessment Using Pressure Wires in Acute Coronary Syndrome

The inclusion of fractional flow reserve (FFR) has changed how coronary interventions are treated. Current guidelines endorse its use in intermediate lesions with no evidence of ischemia in non-invasive studies in patients with multivessel disease. The original RIPCORD (Routine Pressure Wire Assessment Influence Management Strategy at Coronary Angiography for Diagnosis of Chest Pain) study proposed

IVUS en las lesiones coronarias complejas

Are FFR and IVUS Similar to Assess Intermediate Lesions?

In coronary artery disease (CAD), lumen area and plaque burden, characteristics and physiological impact are what define prognosis.  At present, coronary angiography continues to be the gold standard for CAD assessment.  When considering PCI to treat intermediate lesions, FFR has been shown beneficial and safe. Not yet IVUS. 1682 patients with intermediate lesions (40 –

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