Lesion type 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,

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,

Bifurcación de tronco de coronaria distal: cantidad de stents

Wire Jailing at Side Branch to Prevent Occlusion After Main Vessel Stenting: Should It Be the Standard of Care?

While the ideal treatment for coronary bifurcation is provisional stenting, this can be associated with side branch occlusion, which leads to severe adverse events. To prevent this complication, several treatments have been proposed. One of them is wire jailing at side branch before stent implantation in the main vessel. However, the actual benefit of this

Bifurcación de tronco de coronaria distal: cantidad de stents

Provisional vs Dual Stenting in Left Main: An Endless Discussion?

True left main stem bifurcation patients have shown fewer adverse events with stepwise provisional stenting vs systematic dual stenting as first strategy, even though the difference was not significant. Usually, for any other vessel, the preferred technique is provisional stenting. However, when it comes to the left main, there is a randomized, dedicated, well designed

AHA 2021 | Meta-análisis de cirugía vs angioplastia para el tronco de la coronaria izquierda

AHA 2021 | Meta-Analysis of Surgery vs. Angioplasty in Left Main Coronary Artery Disease

According to this new meta-analysis (presented at AHA 2021 and published in The Lancet), mortality is similar between surgery and angioplasty to treat left main coronary artery in patients with simple or intermediate anatomy. This new study estimates that, after 5 years, mortality with surgery would be 11.2% vs. 10.2% with angioplasty, a non-significant difference. This debate

10 Years Treating Bifurcations: Have We Made Progress?

Bifurcations have been, are and will be challenging. However, we have to admit we have gained experience and have more tools than pioneer interventionists and many of the early experts who have made history.  This study assessed the ten-year trends in coronary bifurcation percutaneous coronary intervention (PCI) looking at patient and lesion characteristics, devices used,

The Fellow’s Corner | 3rd Clinical Case: True Bifurcation Lesion: Which Strategy Should We Use?

Here is the third Fellow’s Corner clinical case to keep discussing and learning alongside the entire community of hemodynamics fellows in Latin America. In this instance, we will present a case of True Bifurcation Lesion: Which Strategy Should We Use? Content 1- Case Presentation 2- Case Resolution 3- Expert Commentary Authors: Dr. Carlos Fava (ARG)

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

Bifurcations: A Long Return Journey

When it looked like the simplest techniques reach the best outcomes, along came the DK Crush studies. Indeed, after the COVIS III results in bifurcations, it appeared we had started to retrace our steps back to the foundation.  The purpose of this study was to compare long term outcomes of the remarkably simple 1-stent strategy