The rise of chronic total occlusions (CTO) percutaneous coronary interventions (PCI) goes hand in hand with technological development, through still posing a great challenge, one not exactly exempt from complications. An important criterion to successful CTO PCI is length: ≥20 mm lesions lower the odds, according to J-CTO Score. However, increasing operator experience and the…
Should We Use Drug Coated Balloons in Patients with Multivessel Disease?
Recent studies have shown that a drug coated balloons (DCB) based approach resulted non inferior when compared against drug eluting stents (DES) only approach in patients with instent restenosis and de novo lesions in small vessel disease. So far, two international consensuses have reported the use of DCB is feasible and safe to treat native…
Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis
3 Year Clinical Outcome Analysis and Failure Predictors in the Use of Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR…
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…
POKI: A New Bifurcations Strategy
This scientific article we briefly discuss the POKI technique, a new stent optimization strategy for bifurcation lesions. Coronary bifurcations represent 20 to 25% of percutaneous coronary interventions (PCI) and continue to be a real challenge at present; the different available treatment strategies are used to correct bifurcation carina after stenting seeing as incomplete strut apposition…
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…
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…
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…
Primary vs Secondary Retrograde Approach in CTO: Differences
Successful chronic total occlusion procedures are on the rise, especially in high volume centers, seeing as they count on more sophisticated materials and different techniques, such the retrograde approach. However, the significant increase of success rate with this technique has also brought along an increase in associated complications. The aim of this study was to…
The Best of the SOLACI-SOCIME 2022 Main Arena: Day 3
Lecture by Dr. Hector García García – LM-PCI: IVUS and FFR/IFR? Dr. Hector García delivered an excellent presentation on whether we should use intravascular ultrasound (IVUS) or fractional flow reserve (FFR)/instantaneous wave-free ratio (iFR) in the left main coronary artery (LMCA) to consider severe obstruction, since there is significant interobserver variability with angiography. Although the…
The Best of SOLACI-SOCIME 2022 Main Arena – Chronic Total Occlusions (CTO)
How to Choose the Best Approach in Chronic Total Occlusions, by Dr. Jean-Michel Paradis CTO are present in around 16 to 20% of patients with coronary artery disease who get a coronary angiography. CTO Percutaneous intervention has been on the rise, mainly due to equipment and technique advancement. During his presentation, Dr. Paradis mentioned the…