Left Coronary Trunk articles

La ATC es una alternativa válida en el TCI

Left Main Coronary Artery Percutaneous Coronary Intervention: Evolution and Results over Time

Left Main Coronary Artery Percutaneous Coronary Intervention: Evolution and Results over Time

Left main coronary artery percutaneous coronary intervention (LMCA PCI) is a treatment option that is increasingly used in our setting. One of the reasons for choosing this therapeutic strategy is the improvements in devices and techniques. However, the long-term results of LMCA PCI are not well established. The aim of this retrospective study was to

Evaluación funcional de las estenosis coronarias en la vida real: todavía no hicimos el click.

Left Main Coronary Artery PCI Using State-of-the-Art Zotarolimus-Eluting Stents

Percutaneous coronary intervention (PCI) to the left main coronary artery (LMCA) with drug-eluting stent implantation is currently a major challenge due to the size of the vessel, the compromise of a bifurcation lesion in important branches, and the potential risk of complications. Available information on LMCA PCI comes from studies where DES stents were implanted

ATC sobre arterias nativas o puentes venosos, ¿cuál tiene mejor pronóstico?

Real-World Revascularization Strategy for Left Main Coronary Artery: Surgery or PCI?

There are many current randomized trials comparing percutaneous coronary intervention (PCI) with myocardial revascularization surgery (MRS) for the treatment of left main coronary artery disease (LMCAD). In the European Society of Cardiology guidelines, PCI is classified as Ia (LMCAD with low-complexity coronary disease) or IIa indication (intermediate complexity), whereas, according to the American Heart Association

Claudicación Intermitente: ¿el tratamiento invasivo es superior al tratamiento farmacológico?

Long-Term Mortality in Non-Obstructive Lesions in the Left Main Coronary Artery

Left main coronary artery (LMCA) intervention with significant lesions on both coronary angiography and intravascular ultrasound (IVUS), either through angioplasty (PCI) or myocardial revascularization surgery (MRS), is directly related to a decrease in long-term adverse clinical events. However, the relationship between subclinical LMCA disease (preserved luminal diameters) and long-term mortality is still unknown. A retrospective

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

IVUS vs OCT para guiar la angioplastia ¿Cuál elegir?

IVUS vs iFR for Left Main Decision Making

No decision on the coronary tree has more impact than left main intervention. This makes interventionists prone to over and underestimation of angiographic imaging. In other words, in real life we never report on angiograms showing moderate left main lesions.   This reality should be looked into, since operating or intervening moderate left main lesions on

stent-provisional-2-stent

EuroPCR 2021 | EBC MAIN: Provisional Stenting vs. Systematic Dual Stenting in Left Main Coronary Artery

Treating the left main coronary artery with provisional stenting was non-inferior to systematic dual stenting in the EBC MAIN trial, presented at EuroPCR 2021 and simultaneously published in the European Heart Journal. The composite primary endpoint of death, infarction, and target-lesion revascularization was 14.7% for provisional stenting vs. 17.7% for systematic dual stenting (hazard ratio:

EuroPCR 2021 | COLOR: Angioplastias complejas por acceso radial vs femoral

EuroPCR 2021 | COLOR: Complex PCI via Transradial vs Transfemoral Approach

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

¿Es seguro utilizar iFR para diferir lesiones del tronco de la coronaria izquierda?

Is the Use of iFR for the Deferral of Left Main Coronary Artery Lesions Safe?

Deferral of left main coronary artery lesions using instantaneous wave-free ratio (iFR) seems to be safe. At the least, patients with deferred lesions had similar long-term prognosis to that of patients who underwent revascularization based on that same indicator. Left main coronary artery lesions were universally excluded from studies including medical treatment among the therapeutic

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