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…
Calcified Nodules and the Importance of OCT Categorization prior PCI
TLR associated factors in patients with calcified nodules. Patients with complex cardiomyopathies undergoing percutaneous coronary intervention are increasingly common, as is the case for calcified lesions and calcified nodules (CN). Procedure complexity not only involves planning, but also establishing patient prognosis, taking into consideration the fact that most target vessel events occur at long term…
Intrastent Restenosis in Ostial Lesions in the Right Coronary Artery: Predictors of an Unfavorable Location
Predictors of intrastent restenosis in the right coronary artery ostium. The ostium of the right coronary artery (RCA) presents certain histological aspects. Atherosclerotic and fibrotic plaques in this area contain an abundance of smooth muscle, collagen, and a certain degree of calcification, along with thicker adventitia. Additionally, it has certain anatomical aspects such as poor…
Frequency and Causes of Mortality in Chronic Total Occlusion
In recent years, there has been an increase in the number of percutaneous coronary interventions (PCI) performed to treat chronic total occlusion (CTO). This increase is due to the availability of more advanced technology and greater experience of both operators and specialized centers. However, it is important to note that this technique is not free…
Provisional Stenting vs. Culotte: 5-Year Results of EBC TWO
The optimal treatment of true bifurcation lesions not affecting the left main coronary artery is widely debated. Results from randomized studies have shown neutral or worse outcomes with the two-stent technique. Regarding these studies, researchers used first-generation stents and the secondary branches were small. The EBC TWO study compared the provisional stenting strategy against the…
EuroPCR 2023 | iFR vs FFR Guided Revascularization in Left Main De Novo Lesions
Acute coronary syndrome guidelines recommend the use of iFR and FFR guided invasive management for patients with high risk ischemia regardless medical treatment. However, iFR and FFR they are often considered exchangeable. Prior literature has shown there can be a discrepancy of around 20% between these techniques when it comes to revascularization outcomes. Choosing the…
EuroPCR 2023 | KISS: Provisional Stenting in Bifurcations
Provisional stenting is the most frequent strategy and the most recommended in the treatment of bifurcations, even though in some situations the two-step kiss technique is prioritized, seeing as it offers the benefit of better rheology, less side branch occlusion, less periprocedural injury, better angina control and less restenosis. It included patients with de novo bifurcation…