Lesion type articles

Suboptimal Recanalization Results Worse than Procedural Failure

Suboptimal Recanalization Results Worse than Procedural Failure

This large cohort of patients undergoing PCI for chronic total occlusion has shown suboptimal recanalization is associated with cardiac death and myocardial infarction at long term compared against procedural failure.  The link between acute outcomes and long-term events in recanalizations has been overlooked. Mainly when it comes to suboptimal results, is doing something more trouble

La era del stent provisional para las bifurcaciones parece llegar a su fin

Is the Paradigm for Bifurcation Lesions Changing Once More?

Four years ago, we published a summary of the SMART-STRATEGY Study saying that, with bifurcation lesions, “less is more.” Last month, the DEFINITION Study published in the European Heart Journal suggested that things were about to change. Today, the DK-crush technique seems to have rendered both title and article obsolete. According to this recent analysis

balon_farmacologico_reestenosis_instrastent

Two-Stent Strategy is Safer in True Bifurcation Lesions

Courtesy of Dr. Carlos Fava.  DES have improved PCI outcomes, but one of its biggest challenges continues to be bifurcations (especially when we have to use two stents, since it’s been associated to higher restenosis and stent thrombosis rates).  Left main coronary artery true bifurcation lesions are the ones that generate the greatest challenge and

angioplastia primaria estrategia farmacoinvasiva

Ideal Area for Unprotected Left Main PCI

Courtesy of Dr. Carlos Fava.  Unprotected left main PCI (PCI-UPLMS) is an acceptable and comparable strategy vs CABG, although the use of IVUS is advisable, since it has shown better evolution and mortality. However, the adequate stent expansion remains unclear.  Researchers carried out a sub-analyzis of the NOBLE trial. Of the total 603 patients receiving

La era del stent provisional para las bifurcaciones parece llegar a su fin

IVUS in Unprotected LMCA Angioplasty: Should We Change the Way We Use It?

Courtesy of Dr. Carlos Fava. Bifurcation lesions account for about 25% of all angioplasties and it is a challenge for which there is no single treatment strategy. Intravascular ultrasound (IVUS) has proven its usefulness, improving outcomes by reducing mortality in unprotected left main coronary artery (LMCA) angioplasty. A new strategy consists in conducting an IVUS after

¿Es seguro utilizar iFR para diferir lesiones del tronco de la coronaria izquierda?

Is the Use of iFR for the Deferral of Left Main Coronary Artery Lesions Safe?

Deferral of left main coronary artery lesions using instantaneous wave-free ratio (iFR) seems to be safe. At the least, patients with deferred lesions had similar long-term prognosis to that of patients who underwent revascularization based on that same indicator. Left main coronary artery lesions were universally excluded from studies including medical treatment among the therapeutic

Escándalo con los resultados del EXCEL que hicieron “caer” las últimas guías

More Data from the EXCEL and More Controversy

A thorough statistical analysis of the EXCEL has quite definitely shown that the likelihood of death, MI or stoke, including total mortality, is higher with PCI compared against CABG. The Bayesian analysis estimated a 3.3% difference in mortality, superior in the PCI arm, with 99% probability that EXCEL total mortality was indeed increased with PCI

El uso del ultrasonido intravascular en la angioplastia de tronco no protegido se asocia con mejores resultados en comparación con la angioplastia guiada solo por angiografía.

IVUS in Left Main Coronary Artery Angioplasty: Luxury or Necessity?

Technique advancements in left main coronary artery angioplasty have turned this procedure into a reasonable alternative to surgery, particularly in patients with a low or intermediate Syntax score and, obviously, those in whom surgery was contraindicated. Results can be credited to a refinement in technique, better drug-eluting stents, better patient selection, and frequent use of

Virtual ACC 2020 | PRECOMBAT: 10 Years for Surgery vs. Angioplasty in Left Main Coronary Artery Disease

After 10 years of follow-up, there were no significant differences in the rates of major adverse cardiovascular or cerebrovascular events among patients with left main coronary artery disease randomized to angioplasty or surgery. Since this was the first study to randomize patients with left main coronary artery disease to angioplasty or surgery, it enrolled very few

Virtual ACC 2020 | TWILIGHT-COMPLEX: Ticagrelor Monotherapy in the Most “Dangerous” Angioplasties

The original TWILIGHT findings in more than 9000 patients who underwent angioplasty were presented last year at TCT and showed a 3.1% absolute risk reduction in BARC 2, 3, or 5 bleeding with no increase in death, infarction, or stroke in patients who received ticagrelor and placebo compared with patients who received ticagrelor and aspirin. All patients

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