Lesion type articles

Highlights TCT 2019

TCT 2019 | EURO-CTO: Results at 3 Years of CTO Recanalization vs. Optimal Medical Treatment

TCT 2019 | EURO-CTO: Results at 3 Years of CTO Recanalization vs. Optimal Medical Treatment

Courtesy of SBHCI. Between 16 and 18% of coronary artery lesions in patients with chronic stable CAD are chronic total occlusions (CTO). CTO revascularization could benefit symptomatic patients, but it remains unclear whether such complex procedure is safe in the long run, given the study outcomes on PCI in CAD so far.  This study presented

Highlights TCT 2019

TCT 2019 | EXCEL: Left Main Coronary Artery Angioplasty with Favorable Results at 5 Years

Courtesy of Dr. Carlos Fava. Unprotected left main coronary artery angioplasty with drug-eluting stents has emerged as an acceptable strategy for a select group of patients, with results comparable to those of myocardial revascularization surgery at 2 or 3 years. However, beyond such term, we had no valid information. Researchers analyzed the 5-year follow-up results for the

Highlights TCT 2019

TCT 2019 | IDEAL-LM: Bioabsorbable Polymer DES vs. Permanent Polymer DES for Left Main Stenosis

Courtesy of SBHCI. This study showed that using the everolimus eluting stent with bioabsorbable polymer Synergy followed by 4 months of dual antiplatelet therapy (DAPT) to treat left main stenosis (LMS) was safe and effective, compared against using the everolimus eluting stent with permanent polymer Xience followed by the conventional 12 months DAPT.  This study

DKCRUSH-V: El tronco de la coronaria izquierda no es una bifurcación más

DK CRUSH Is Still The Best Option

Courtesy of Dr. Carlos Fava. When it comes to severe unprotected left main distal bifurcation lesions, surgery continues to be the preferred treatment option. However, due to the growing number of patients that cannot receive surgery, left main PCI has significantly advanced, and though the strategy in this scenario remains controversial, double kissing crush stenting

Score de Calcio, “dónde está” parece más importante que “cuánto hay”

Calcium Scoring: “Location” Seems to Be More Important than “Percentage”

The presence of a high percentage of calcium in the left main coronary artery is independently associated with a 20–30% greater risk for cardiovascular and all-cause death in asymptomatic adults. This highlights the fact that calcium location, and not only amount, is important. Calcium scoring reports from computerized tomography (CT) usually inform only that: how

Peri-Procedural Infarction in Angioplasty vs. Surgery in the Left Main Coronary Artery

According to the EXCEL trial, peri-procedural infarction was more common after left main coronary artery surgery compared with angioplasty, and it was strongly associated with increased 3-year mortality after controlling all possible confounding variables. This increased mortality was only present in extensive infarctions with an increase in CK-MB ≥10×. The EXCEL trial seems to want

Antianginal Medication Before and After Rechanneling

Escalation or de-escalation of antianginal medication was less common than treatment continuation without change after a chronic total occlusion rechanneling, with little variation according to the site. Further research is needed to identify patients who would benefit (or not) from these drugs and to develop strategies to adjust treatment during follow-up. This work basically tells

TAVI en insuficiencia aórtica pura, nuevos dispositivos con nuevos resultados

The FDA Affirms Mortality Signs with Paclitaxel Based Devices

Evidently, we are still uncertain. The information goes both ways, even on our own web page, we have been coming and going just like any other publication around the world. After a 2-day debate, the Circulatory System Devices FDA panel has confirmed the tendency to higher mortality with paclitaxel-based devices and is expected to debate

La meseta por la que transcurre la cirugía desde hace varios años

Outcomes of MAIN-COMPARE: A 10-Year Follow-Up for a Historical Rivalry

Angioplasty and myocardial revascularization surgery have competed over the left main coronary artery for a long time. There may be many points of view involved in the interpretation of trial outcomes. While surgeons consider the left main coronary artery to be suitable for surgery (except when faced with surgical contraindications), interventional cardiologists see the left

Tasa de stroke post cirugía vs angioplastia coronaria en un análisis de más de 10.000 pacientes

EXCEL Outcomes: PCI vs CABG in Patients with Prior Cerebrovascular disease

Most certainly, as we read this title, we imagine the conclusion (as does the editor): patients with prior cerebrovascular disease (CEVD) benefit from a less invasive revascularization strategy, such as PCI. However, the EXCEL outcomes tell us that patients with left main coronary artery disease (LMCAD) and a history of CEVD will not benefit from

Costos hospitalarios y de las complicaciones de las oclusiones totales crónicas

In-Hospital Costs and Costs of Complications of Chronic Total Occlusions

Is a chronic total occlusion worth rechanneling? This question can often be found in different studies, all of them with clinical endpoints. This study (soon to be published in J Am Coll Cardiol Intv.) analyzes another aspect: costs, not only derived from materials used for a successful procedure, but also from materials and hospital stay

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