Coronary disease articles

Acceso femoral vs Acceso radial en el tratamiento percutáneo de CTO.

Transfemoral vs Transradial Approach in the Percutaneous Treatment of CTO

Transfemoral vs Transradial Approach in the Percutaneous Treatment of CTO

Percutaneous treatment of chronic total occlusion (CTO) has traditionally been via the transfemoral approach (TFA). The use of the transradial approach (TRA) in complex coronary interventions has been increasing. A randomized study assessed the use of TRA vs TFA in complex PCI (58% CTO) and TRA saw favorable outcomes. The aim of this prospective, randomized,

Estenosis aórtica moderada y disfunción ventricular ¿debería apurarse la indicación del recambio?

Improved Ventricular Function Post Revascularization: Fewer Events across Subgroups?

According to the STITCH and STITCHES trials, in patients with coronary artery disease and deteriorated left ventricular ejection fraction (EF), revascularization of a viable heart might reverse left ventricular systolic dysfunction.  In these patients, improved EF after coronary revascularization appears to increase long term survival, particularly after cardiac artery bypass grafting (CABG), compared against medical

reserva fraccional de flujo sindrome coronario agudo

Coronary Flow Reserve in Patients with Intermediate FFR: Should We Use This Tool to Define When to Perform Coronary Angioplasty?

Current guidelines recommend using fractional flow reserve (FFR) to guide coronary angioplasty. However, intermediate FFR values (0.75-0.80) generate uncertainty about the prognostic value of performing coronary angioplasty over optimal medical treatment. The use of coronary flow reserve (CFR) together with FFR provides further insight into coronary circulation because CFR is an index that also includes

Should We Start Using OCT in Myocardial Infarction with Non-Obstructive Lesions?

In ST elevation MI, the common assessment methodology continues to the angiography; however, we all know it has certain limitations, especially when it comes to intermediate lesions or coronary dissections.   Using imaging, especially high resolution such as OCT, has been looked into by some studies, but never randomized studies.  The EROSION III is a randomized

Un truco sencillo para mejorar nuestras punciones radiales

Can the Use of Intra Arterial Vasodilators Prevent Radial Artery Occlusion?

The incidence of post procedure radial occlusion (RAO) ranges from 1% to 12 % according to some studies. Different strategies to reduce RAO include the use of small caliber catheters, adequate anticoagulation and punction site care after procedure.  Vasodilators are used to prevent radial spasm during procedure. However, using it after procedure should increase flow,

Coronary Angioplasty Evolution According to Syntax II: 5-Year Followup

It has been long since the SYNTAX (NEJM 2009) came out comparing percutaneous coronary intervention (PCI) against coronary artery bypass grafting (CABG). That emblematic study associated PCI with first generation drug eluting stents (Taxus) with increased major cardiac and cerebrovascular events (all-cause mortality, AMI, stroke, or any revascularization – MACCE) vs. CABG, at 5 years,

El ticagrelor muestra beneficios en la función microvascular coronaria luego de un IAMSEST

Prophylactic Rivaroxaban Therapy for Left Ventricular Thrombus after ST-Segment Elevation Acute Coronary Syndrome

The incidence of left ventricular thrombosis (LVT) after anterior ST-segment elevation myocardial infarction (STEMI) ranges from 4% to 26%. This is associated with bad long-term evolution. In the past, triple-scheme therapy (vitamin K antagonist plus dual antiplatelet therapy) was recommended to prevent LVT, despite the lack of high-quality scientific evidence and an increase in the

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

IVUS-Guided Coronary Angioplasty: Promising Results at 3-Year Follow-Up

Intravascular ultrasound (IVUS) to guide drug-eluting stent (DES) implantation has been evaluated in several studies. Two randomized studies, IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) and ULTIMATE (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in All-Comers Coronary Lesions), have shown fewer repeat revascularizations compared with angiography-guided


Passive Leg Raise: An Indispensable Maneuver in the Study of Heart Failure with Preserved Ejection Fraction

Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for at least 50% of the HF population, with an increasing prevalence. Its diagnosis is based on the presence of typical symptoms and increased filling pressures, with an ejection fraction greater than 50%. In some cases—especially in the earlier stages of the disease—, laboratory and echocardiographic

Una nueva molécula para evitar la nefropatía por contraste

In Multivessel Disease, When Should Renal Impairment Be Considered?

Cardiovascular disease is one of the main causes of morbidity and mortality in patients with advanced chronic kidney disease (CKD), and vice-versa. Both diseases share risk factors, including, but not limited to, diabetes, high blood pressure, smoking, dyslipidemia, and old age. As kidney disease develops, its severity grade has been linked to more thrombotic events