The retrograde approach for recanalizing chronic total occlusions (CTO) has undergone significant evolution since its introduction in 1990, improving both in terms of techniques and specialized materials. The increased skill applied to this strategy has resulted in increased success rates for the treatment of CTO in sites with an adequate volume of procedures. Given the…
Revascularization vs. Deferral of Physiologically Significant Lesions in the Left Main Coronary Artery
Most randomized studies on decision-making in coronary artery disease revascularization exclude left main coronary artery disease (LMCAD), as did the ISCHEMIA Study. On the other hand, the benefits of functionally assessing lesions, proven in studies such as FAME, emphasize the importance of this tool in guiding revascularization decisions. However, there is still little understanding of…
TCT 2023 | ISAR-DESIRE 3: 10-Year Results
In-stent restenosis (ISR) remains the primary limitation of percutaneous treatment for coronary artery disease. The strategy to address this limitation involves the use of drug-eluting stents (DES) or drug-coated balloons (DCB), both of which have proven to be effective and safe therapeutic alternatives. Despite current recommendations, treating ISR continues to be a challenge, and clinical…
Treatment and Gender-Based Outcomes for Coronary Bifurcation Stent Placement: Report from the e-ULTIMASTER Registry
Approximately 20% of all percutaneous coronary interventions (PCI) are performed on bifurcation lesions, which continue to pose a challenge in terms of strategy: how many stents to use, what is the most suitable strategy, and when to transition from a single stent to two during the procedure. Additionally, the use of two stents in these…
BIFURCAT Registry: 1 or 2 Stents? Treatment of Side Branch (Medina 0.0.1) Lesions According to Real-World Data
Coronary bifurcation lesions have been a subject to debate, with different approaches by various medical teams. These lesions often carry a higher risk of ischemic events compared with lesions at non-bifurcated sites. The main strategy, supported by medical society recommendations and clinical guidelines, involves using provisional stenting with one stent to minimize the number of…
BIFURCAT Registry: Long Term Diabetes Impact on Bifurcations PCI Outcomes
The impact of diabetes in patients with coronary artery disease (CAD) are well known, and after percutaneous coronary intervention (PCI), outcomes tend to be less favorable, with higher restenosis rate, repeat myocardial infarction (MI) and stent thrombosis. Despite the development of drug eluting stents, procedures and techniques, treating bifurcation lesions in diabetic patients still show…
ESC 2023 | OCTOBER TRIAL: Should We Begin to Consider OCT for Bifurcation Lesions?
The OCTOBER Study randomized 1201 patients with bifurcation lesions in a 1:1 ratio to undergo percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) or by angiography. The primary endpoint (PEP) was major adverse cardiovascular events (MACE) over a 2-year period. Group characteristics were similar. The average patient age was 66 years, most…
SOLACI-SBHCI 2023 | Optimizing CTO Procedures: Realworld Experiences from LATAM – Dr. João Eduardo Tinoco
Read the most outstanding articles from SOLACI-SBHCI 2023 Congress. In this case, check the presentation by Dr. João Eduardo Tinoco, entitled “Optimizing CTO Procedures: Realworld Experiences from LATAM”
EuroCTO: Safety and Benefit at 3 Years
Chronic total occlusions (CTOs) account for approximately 15-20% of patients with stable coronary artery disease. This field has seen various advances regarding treatment, leading to an improvement in the success rate of procedures. According to registries and randomized studies, the main indication for percutaneous coronary intervention (PCI) of CTO should be based more on clinical…
Relationship between Distal Vessel Quality and Outcomes in the Treatment of Chronic Total Occlusions
Percutaneous treatment of chronic total occlusions has increase, and has become a a more habitual therapeutic challenge. However, there is limited information on distal vessel quality and its association with outcomes and techniques. This variable appears to be excluded form CTO scores, except for the RECHARGE (REgistry of CrossBoss and Hybrid procedures in FrAnce, the…
We Should Revascularize Patients with Stable Coronary Syndromes and Ischemia Assessed by iFR
Chronic stable angina has shown a good response to medical treatment, and the Ischemia study has recently demonstrated the safety of such treatment in stable chronic angina with moderate to severe ischemia. However, this study excluded left main coronary artery (LMCA) lesions. The FAME Study has shown the safety and efficacy of fractional flow reserve…