Left Coronary Trunk articles

Score de Calcio, “dónde está” parece más importante que “cuánto hay”

Calcium Scoring: “Location” Seems to Be More Important than “Percentage”

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

Momento óptimo para revascularizar un infarto con elevación transitoria del ST

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

La meseta por la que transcurre la cirugía desde hace varios años

Outcomes of MAIN-COMPARE: A 10-Year Follow-Up for a Historical Rivalry

Angioplasty and myocardial revascularization surgery have competed over the left main coronary artery for a long time. There may be many points of view involved in the interpretation of trial outcomes. While surgeons consider the left main coronary artery to be suitable for surgery (except when faced with surgical contraindications), interventional cardiologists see the left

Tasa de stroke post cirugía vs angioplastia coronaria en un análisis de más de 10.000 pacientes

EXCEL Outcomes: PCI vs CABG in Patients with Prior Cerebrovascular disease

Most certainly, as we read this title, we imagine the conclusion (as does the editor): patients with prior cerebrovascular disease (CEVD) benefit from a less invasive revascularization strategy, such as PCI. However, the EXCEL outcomes tell us that patients with left main coronary artery disease (LMCAD) and a history of CEVD will not benefit from

La ATC es una alternativa válida en el TCI

Left Main PCI Technique Could Change DAPT Duration

Up to 20% of patients undergoing left main PCI require a 2-stent technique, and this number should most likely grow after the DKCRUSH-V outcomes. However, this study contradicts the DKCRUSH-V and brings us back to “the simpler the better”, since patients undergoing 1 stent left main PCI presented less revascularization and less target vessel failure


Radial Access Is Always Preferred, Even for Treatment of the Left Main Coronary Artery

The potential need for a 7-Fr guidewire, the use of several coronary guidewires and/or a kissing balloon, and the requirement of indispensable monitoring by intravascular ultrasound (IVUS) have been used by some interventional cardiologists as excuses to resist radial access. In that sense, left main coronary artery angioplasty was the last stand of femoral access.

Sub análisis del EXCEL: angioplastia vs cirugía en insuficiencia renal crónica

EXCEL Sub-Analysis: Angioplasty vs. Surgery in Chronic Renal Insufficiency

EXCEL patients with chronic kidney disease and left main coronary artery disease have higher rates of acute renal failure and other events compared with the general population. However, acute renal failure was less frequent with angioplasty than with surgery, while other events such as death, stroke, or infarction at 3 years were similar for both revascularization

Angioplastia de tronco: aún con buenos resultados a largo plazo, la estrategia óptima sigue en discusión

Left Main PCI: Despite Auspicious Long-Term Outcomes, Optimal Strategy Still under Discussion

Left main coronary artery bifurcation interventions have shown very good results at long term, especially with new generation DES. The one-stent strategy has seen better results than the two-stent strategy, according to this registry recently published in J Am Coll Cardiol Intv. However, how does this registry of the daily practice between the years 2002 and

perforación coronaria en angioplastia

EXCEL Sub-Study: The Site of the Left Main Coronary Artery Lesion Does Not Alter History

The EXCEL study, originally presented at TCT 2016 and published simultaneously in the New England Journal of Medicine (NEJM), showed that angioplasty and surgery in patients with left main coronary artery disease have similar rates of mortality, infarction, and stroke at 3 years. This sub-study, recently published in J Am Coll Cardiol Intv, adds that the

¿Se debe tener en cuenta el género para revascularizar el tronco?

Should Sex Be Taken into Account with Left Main Coronary Artery Revascularization?

The EXCEL trial did not find the sex of patients with left main coronary artery disease to be an independent predictor of adverse events after revascularization. However, women who underwent angioplasty had a trend towards worse outcomes, a finding that might be related to comorbidities and somewhat increased chances of peri-procedural complications. In its formal