Treating total occlusions, complex bifurcations, grossly calcified lesions or left main lesions via transradial approach is associated with significant reduction in access-site bleeding or vascular complications vs transfemoral approach. This kind of procedures have been typically excluded from studies randomizing patients to transradial vs transfemoral approach. The COLOR study used the transradial bore-guiding catheter Glidesheath…
Watch again our Webinar “SOLACI@BIOTRONIK” on our Youtube account.
Watch again our Webinar “SOLACI@BIOTRONIK“ on our Youtube account. The event was held on April 27th, 2021.
03/03 | SOLACI Webinar – Left Main PCI and Bifurcations: LATAM Bif Registry
We invite you to participate in the first free SOLACI virtual event of 2021. It is carried out with the support of Abbott, Boston Scientific, Medtronic and Terumo Interventional Systems and will have the participation of prestigious hemodynamicists from Latin America and the world. The title of the event is: “Left Main PCI and Bifurcations:…
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…
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…
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…
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…
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…
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…
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…
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…