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…
Experienced Operators: 50% Lower Mortality Rates?
Courtesy of Dr. Agustín Vecchia. The link between operator volume and clinical outcomes has been long and widely debated. After years of discussion, there are promoters and detractors. Currently, interventional cardiology societies all over the world classify centers as “high-volume” or “low-volume” using arbitrary parameters, and require training fellows to perform an also arbitrary number of…
Chronic Total Occlusion: Bioresorbable Scaffolds or Drug Eluting Stents?
There is little evidence to support the safety and efficacy of bioresorbable scaffolds (BRS) for the treatment of chronic total occlusions (CTO). This multicenter registry included consecutive patients with CTO receiving BRS (Absorb; Abbott Vascular) vs. 2nd generation drug eluting stents (DES). Primary end point was target vessel failure at long term (composite…
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…
Non-Compliant Balloons Improve Bifurcation Outcomes
Courtesy of Dr. Carlos Fava. The provisional approach is the standard strategy to treat bifurcations, but it might cause dissection of the ostium, a serious complication of the side branch. The use of non-compliant balloons (NCB) ensures uniform, constant, and controlled expansion along balloon length, reducing the risk of dissection. The COBIS II registry enrolled…
Retrograde Technique: High Success Rate in CTO
Original Title: Outcomes With the Use of the Retrograde Approach for Coronary Chronic Total Occlusion Interventions in a Contemporary Multicenter US Registry. Reference: Dimitri Karmpaliotis et al. Circ Cardiovasc Interv. 2016 Jun;9(6). This study evaluated the safety and efficacy of the retrograde technique for chronic total occlusions. Researchers compared retrograde vs. anterograde technique outcomes…
Chronic total occlusions: Pilot experience with BVS
Original Title: Percutaneous coronary intervention for chronic total occlusion of the coronary artery with implantation of bioresorbable everolimus-eluting scaffolds. Poznan CTO-Absorb Pilot Registry. Reference: Maciej Lesiak, et al EuroIntervention 2016;12:e144-e151 Courtesy of Dr. Carlos Fava. Chronic total occlusion (CTO) is a real challenge and have a success rate of around 80% with trained…
Left main PCI: Requiem for the Syntax score?
Original Title: Angiographic and Clinical Outcomes After Everolimus-Eluting Stenting for Unprotected Left Main Disease and High Anatomic Coronary Complexity. Reference: JACC Cardiovascular Interventions. Doi: 10.1016/j.jcin.2016.02.016. Courtesy of Dr. Agustín Vecchia. In patients with unprotected left main disease (ULMD) associated to complex coronary anatomy, choosing a revascularization strategy can be challenging. Current guidelines recommend surgery for…
Optimal Strategy for Side Branch Intervention in Bifurcations
Original Title: Optimal Strategy for Provisional Side Branch Intervention in Coronary Bifurcation Lesions. 3 – Year Outcomes of the SMART – STRATEGY Randomized Trial. Reference: Song YB et al. J Am Coll Cardiol Intv 2016;9:517-26. Courtesy of Dr. José A. G. Álvarez. The present publication is about the three year follow up outcomes of…
In Bifurcations, less is more, also at long term
Original Title: Optimal Strategy for Provisional Side Branch Intervention in Coronary Bifurcation Lesions3-Year Outcomes of the SMART-STRATEGY Randomized Trial. Reference: Young Bin Song et al. J Am CollCardiolIntv. 2016;9(6):517-526. This study compared the long term outcomes of the conservative strategy vs. the aggressive strategy for provisional side branch intervention in coronary bifurcations. It has already…
TAVR-LM Registry: Transcatheter Aortic Valve Replacement and Left Main Stenting
Original Title: Outcomes in Patients with Transcatheter Aortic Valve Replacement and Left Main Stenting. The TAVR-LM Registry. Reference: TarunChakravarty et al. Journal of the American College of Cardiology, Vol 67, N° 8, 2016. Courtesy of Dr. Santiago F. Coroleu. High surgical risk patients with severe aortic stenosis and significant left main aortic arterydiseaseare often treated combining…