Chronic Ischemic cardiopathy articles

FFR and iFR Discordance in up to 20% of Cases: Which One Should Inform Our Decisions?

FFR and iFR Discordance in up to 20% of Cases: Which One Should Inform Our Decisions?

Invasive functional measurement of intermediate lesions has become the gold standard to define revascularization. Due to its favorable long-term prognostic value, fractional flow reserve (FFR) is the reference used to compare all others. Recently, new nonhyperemic indexes, measured in a specific diastolic period, have emerged. Among them, the one with the most accumulated evidence is

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 | 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 | 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 | Xience se suma a la evidencia de doble antiagregación corta en alto riesgo de sangrado

TCT 2020 | Xience in Favor of Short Dual Antiaggregation Therapy with High Bleeding Risk

Following with aspirin alone after a short period of dual antiaggregation therapy (DAPT), 1 to 3 months, did not increase ischemic events in patients receiving a Xience stent while significantly reducing bleeding.  This study endorses the safety of short DAPT with contemporary drug eluting stents (DES) in patients presenting high bleeding risk.  The XIENCE Short

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

Further Evidence in Favor of Non-Invasive Vasospasm Diagnosis

Non-invasive coronary vasospasm diagnosis by means of echocardiography with the administration of ergonovine can be performed safely; even without prior angiography to rule out fixed lesions. These data are encouraging and move patients with vessel spasm but without significant lesions away from multiple angiographies and from the uncertainty of a diagnosis “by exclusion.” This work

perforación coronaria en angioplastia

Complex PCI: Complex Characteristics Impact Results

Patients with a bigger number of complex anatomical characteristics that increase PCI complexity have worse results at one-year followup. These data come from a large multicenter study (e-Ultimaster) recently published in EuroIntervention. The more complex the characteristics, the greater the increase in events.  It is important to see past the obvious anatomical challenges (bifurcations, calcification,

¿FFR de rutina en pacientes con síndrome coronario agudo?

Not All Coronary Spasms Are the Same: Benefits of Acetylcholine

Patients with documented spasm to the coronary arteries present increased risk of myocardial infarction (MI) and repeat angiography, while patients with microvascular spasm are associated to recurrent angina.  Globally, the prognosis of all these patients continues to be favourable, even though acetylcholine testing might help distinguish one-another.  Coronary spasm shows in up to 60% of