Left Coronary Trunk articles

El uso del ultrasonido intravascular en la angioplastia de tronco no protegido se asocia con mejores resultados en comparación con la angioplastia guiada solo por angiografía.

IVUS in Left Main Coronary Artery Angioplasty: Luxury or Necessity?

IVUS in Left Main Coronary Artery Angioplasty: Luxury or Necessity?

Technique advancements in left main coronary artery angioplasty have turned this procedure into a reasonable alternative to surgery, particularly in patients with a low or intermediate Syntax score and, obviously, those in whom surgery was contraindicated. Results can be credited to a refinement in technique, better drug-eluting stents, better patient selection, and frequent use of

Virtual ACC 2020 | PRECOMBAT: 10 Years for Surgery vs. Angioplasty in Left Main Coronary Artery Disease

After 10 years of follow-up, there were no significant differences in the rates of major adverse cardiovascular or cerebrovascular events among patients with left main coronary artery disease randomized to angioplasty or surgery. Since this was the first study to randomize patients with left main coronary artery disease to angioplasty or surgery, it enrolled very few

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 cirugía parece superior a la angioplastia en pacientes jóvenes

Repeat Revascularization Is Not Benign, at Least in Left Main Disease

After the “EXCEL scandal” at the end of last year, study investigators have been publishing explanations and sub-studies that were planned from the beginning, but which can still be interpreted as explanations. This sub-study states that revascularization was more common in the angioplasty arm, but only revascularizations performed on the target lesion, regardless of the

Soon after the EXCEL “Scandal” the NOBLE 5-year Outcomes Come Out: Mere Coincidence?

There is no such thing as coincidence, at least not for the evidence-based medical science. This is what the NOBLE 5-year outcomes, soon to be published in the Lancet, seem to say, in line with the BBC exposé of the EXCEL study. The NOBLE study randomized patients with left main disease to compare PCI vs

Escándalo con los resultados del EXCEL que hicieron “caer” las últimas guías

Latest Guidelines “Dropped” After Scandal Over EXCEL Results

The European Association for Cardio-Thoracic Surgery (EACTS) formally withdrew its support for the latest coronary revascularization guidelines following a BBC investigation suggesting that data from the EXCEL trial might have been manipulated. The recommendations for left main coronary artery revascularization featured in the 2018 guidelines, which were written jointly with the European Society of Cardiology

Escándalo con los resultados del EXCEL que hicieron “caer” las últimas guías

The EXCEL Authors’ Answer to the BBC Investigation

Do to an investigation carried out by the BBC that led to the withdrawal of EACTS support from the latest coronary revascularization guidelines, the authors of the EXCEL study (indicated by this research) provided the following answers. -Defining Peri-Procedural Infarction: All researchers involved (including surgeons) agreed that the universal definition of infarction was not right

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

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

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