Bifurcations articles

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

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

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

The Era of Provisional Stenting for Bifurcations Comes to an End

After the large studies which set provisional stenting as the preferred strategy to treat bifurcations comes the double kissing crush technique (DK crush) to break the mold once again. This time, the DK crush technique is tested against provisional stenting in the left main, with a 3-year follow-up. The DKCRUSH-V, soon to be published in

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

doble antiagregacion plaquetaria sexo

Antiaggregation Time after Treating Bifurcations

Defining dual antiplatelet therapy (DAPT) seems a never-ending story. We go from trials showing the safety of shorter schemes thanks to new generation stents to others suggesting up to two years of DAPT. Rather than finding a general scheme, it seems to be about adjusting DAPT on a case by case basis, according to ischemia

DES de 2° vs 3° generación en bifurcaciones: nada nuevo bajo el sol

EuroPCR 2018 | 2nd and 3rd-Generation DES for Bifurcation Lesions: Nothing New Under the Sun

This study aimed to assess the outcome of Culotte stenting with newer-generation drug-eluting stents (DES) in Medina 1, 1, 1 bifurcation lesions. The 2nd-generation device used was permanent-polymer everolimus-eluting stent Xience, a device for which there is comparatively plenty of evidence available. Alternatively, the 3rd-generation stent used was thin-strut abluminal bioresorbable-polymer everolimus-eluting stent SYNERGY. Patients with

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

DKCRUSH-V: Left Main, Not Just Another Bifurcation

Cardiac Artery Bypass Graft Surgery has been shown more effective than percutaneous coronary intervention (basically because it renders lower revascularization rate) in patients with severe left main  bifurcation lesions receiving 1st generation drug eluting stents. This is why the 2014 American guidelines recommend CABG for most patients. But the EXCEL and the NOBLE trials brought back hope to

DKCRUSH-V: lo más simple no siempre es lo mejor en el tronco de la coronaria izquierda

DKCRUSH-V: What Is Simple Is Not Always Best for the Left Main Coronary Artery

Courtesy of the SBHCI. Angioplasty of true distal left main bifurcation lesions with a double-kissing (DK) crush two-stent strategy, compared with provisional stenting, results in lower rates of target lesion failure at 1 year. These findings were largely driven by lower rates of target vessel infarction and definite/probable stent thrombosis. Read also: “EXCEL-QOL Substudy: Similar Quality

Técnica Doble Crush Doble Kissing vs. stent provisional

Double Kissing Crush vs. Provisional Stenting at 5 Years

Courtesy of Dr. Guillermo Migliaro. The Provisional Stenting technique (PS) consists of sequentially placing a stent in the main branch of the bifurcation and, only when faced with a suboptimal outcome (such as < 3 TIMI flow, flow limiting dissection or high residual stenosis), a second stent in the side branch.  Several studies have shown

Bifurcación de tronco de coronaria distal: cantidad de stents

Bifurcation Lesion in Distal Left Main Coronary Artery: One or Two Stents?

Courtesy of Dr. Carlos Fava. Unprotected left main coronary artery (LMCA) angioplasty has become an important trend in the last few years.   One of the most significant unresolved questions about it is whether one stent is better than two in distal lesions, and how is their progress after treatment.   This study included 937 patients who

bifurcaciones tap o culotte provisional stenting

Culotte vs. TAP in Bifurcations: Which is Better?

Courtesy of Dr. Agustín Vecchia.   In treating bifurcations, the provisional stenting strategy continues to be preferred. However, a percentage of these lesions must be treated with two stents, which involves different techniques. In provisional stenting, when two stents are required, a recent consensus document of the European Bifurcation Club has recently recommended the TAP

stents liberadores de farmacos

Xience V: Safe in “Real-Life” Bifurcation Lesions

Courtesy of Dr. Rodrigo Abreu.   INTRODUCTION Bifurcation lesion treatment has evolved considerably in the last years: from balloon angioplasty (with high occlusion and restenosis rates) to bare metal stent angioplasty (with a procedural success around 86% and major adverse cardiac events [MACE] at 1 year around 32%). The subsequent emergence of drug-eluting stents (DES) reduced