The optimal treatment of true bifurcation lesions not affecting the left main coronary artery is widely debated. Results from randomized studies have shown neutral or worse outcomes with the two-stent technique. Regarding these studies, researchers used first-generation stents and the secondary branches were small. The EBC TWO study compared the provisional stenting strategy against the…
EuroPCR 2023 | iFR vs FFR Guided Revascularization in Left Main De Novo Lesions
Acute coronary syndrome guidelines recommend the use of iFR and FFR guided invasive management for patients with high risk ischemia regardless medical treatment. However, iFR and FFR they are often considered exchangeable. Prior literature has shown there can be a discrepancy of around 20% between these techniques when it comes to revascularization outcomes. Choosing the…
EuroPCR 2023 | KISS: Provisional Stenting in Bifurcations
Provisional stenting is the most frequent strategy and the most recommended in the treatment of bifurcations, even though in some situations the two-step kiss technique is prioritized, seeing as it offers the benefit of better rheology, less side branch occlusion, less periprocedural injury, better angina control and less restenosis. It included patients with de novo bifurcation…
EuroPCR 2023 | EBC Two – Provisional Stenting vs Culotte in Bifurcations
MD Sandeep Arunothayaraj presented the 5-year followup of EBC Two (which had not previously shown significant differences in clinical outcomes at 12 months) in patients randomized to provisional stenting vs. systematic culotte in bifurcations that were not left main. The study followed up 200 patients with true bifurcations, side branch ≥2.5mm and lesion length ≥5mm,…
Coronary Angioplasty in Chronic Total Occlusions (CTO): Are There Sex Differences?
Studies and registries assessing sex differences in chronic total occlusions (CTO) are limited and women are under-represented, accounting for only 14%-21% of included patients. Even though success rate is comparable between sexes, several studies have shown higher complications rate among women. The aim of this study was to identify sex related baseline and procedural differences,…
Comparative Study of Two Drug Coated Balloons: Angiographic and Clinical Outcomes
The incidence of in-stent restenosis (ISR) requiring repeat revascularization ranges between 5% and 10% of PCI patients receiving new generation drug eluting stents (DES). This is why the current European guidelines on myocardial revascularization recommend treating ISR with drug coated balloons (DCB) with class I recommendation, level of evidence A. DCB are mostly coated with…
CTO: Length’s Impact on Success
The rise of chronic total occlusions (CTO) percutaneous coronary interventions (PCI) goes hand in hand with technological development, through still posing a great challenge, one not exactly exempt from complications. An important criterion to successful CTO PCI is length: ≥20 mm lesions lower the odds, according to J-CTO Score. However, increasing operator experience and the…
Should We Use Drug Coated Balloons in Patients with Multivessel Disease?
Recent studies have shown that a drug coated balloons (DCB) based approach resulted non inferior when compared against drug eluting stents (DES) only approach in patients with instent restenosis and de novo lesions in small vessel disease. So far, two international consensuses have reported the use of DCB is feasible and safe to treat native…
Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis
3 Year Clinical Outcome Analysis and Failure Predictors in the Use of Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR…
Left Main Coronary Artery Percutaneous Coronary Intervention: Evolution and Results over Time
Left main coronary artery percutaneous coronary intervention (LMCA PCI) is a treatment option that is increasingly used in our setting. One of the reasons for choosing this therapeutic strategy is the improvements in devices and techniques. However, the long-term results of LMCA PCI are not well established. The aim of this retrospective study was to…
POKI: A New Bifurcations Strategy
This scientific article we briefly discuss the POKI technique, a new stent optimization strategy for bifurcation lesions. Coronary bifurcations represent 20 to 25% of percutaneous coronary interventions (PCI) and continue to be a real challenge at present; the different available treatment strategies are used to correct bifurcation carina after stenting seeing as incomplete strut apposition…