The presence of calcification in the coronary arteries (CAC) remains the main challenge in the percutaneous treatment of these lesions. Various studies have demonstrated the association of CAC with unfavorable long-term outcomes. Intravascular lithotripsy (IVL) has emerged as an effective tool for fracturing calcified plaques. Studies evaluating this strategy have shown high device success rates,…
Is Intravascular Lithotripsy Equally Effective in All Coronary Calcification Patterns?
Coronary calcifications pose a complex challenge with a high incidence (25% of all angioplasties), thus implying difficult management and adverse long-term outcomes, such as an increased risk of events, especially the need for repeat revascularization. The main mechanisms of long-term failure include stent underexpansion and, in particular, minimal post-deployment stent area. Intravascular lithotripsy (IVL) has…
Functional Assessment Using QFR for the Revascularization of Non-Culprit Lesions in AMI Patients
Nowadays, evidence from studies and meta-analyses has demonstrated the benefits of complete revascularization compared to culprit-vessel-only revascularization in patients with acute myocardial infarction (AMI). The identification and treatment of non-culprit lesions can be guided by conventional angiography, intracoronary imaging, or coronary physiology; the optimal modality, however, is still unclear. Quantitative flow ratio (QFR) is a…
EuroPCR 2024 | 2 Year Outcomes of the New Sirolimus Eluting Bioadaptor vs Resolute Onyx Zotarolimus Elulting Stent
Stent related adverse events after the first year see a constant 2-3% annual increase, reaching 20% by year 5 and 50% by year 10. BIOADAPTADOR RCT outcomes at 12 months have shown the safety and efficacy of DynamX Bioadaptor, establishing new reference parameters in arterial viability restoration. The aim of this study was to report…
EuroPCR 2024 | Complete revascularization affects clinical outcomes? REVIVED.BCIS2 Insights
Complete revascularization has shown in several studies and meta-analysis a benefit in mortality vs. incomplete revascularization. The REVIVED-BCIS looked at whether there were differences in mortality and hospitalization for cardiac failure in patients with ventricular function deterioration and viability when comparing coronary angioplasty(PCI) against optimal medical treatment. This study showed that PCI was not associated…
EuroPCR 2024 | CALIPSO: CTO vs Angiography Guided Treatment of Calcified Lesions
The presence of calcified lesions worsens percutaneous coronary intervention prognosis, presenting more restenosis, thrombosis and need for new revascularization. The aim of this study was to assess the superiority of CTO with a prespecified management algorithm on a conventional angiography treatment, in addition to assessing CTO safety. A superiority randomized study was carried out including…
EuroPCR 2024 | DOCTORS-LM Trial: CTO Optimizes Stent Outcomes in Left Main Disease?
The aim of this randomized open study was to determine whether CTO guided left main percutaneous coronary intervention (PCI) is superior to fluoroscopy guided PCI, using fractional flow reserve (FFR) after stenting. The secondary outcomes were procedural success (successful implantation, malposition, edge dissection or stent collapse) and major adverse cardiovascular events (MACE) at one year.…
EuroPCR 2024 | Prognostic Value of MRR in STEMI: Group Analysis of Individual Patients
Despite primary angioplasty, many patients with ST elevation acute myocardial infarction with (STEMI) show evidence of microvascular dysfunction. This dysfunction can be characterized by two main factors: A new specific index has recently been identified to assess microcirculation called microvascular resistance reserve (MRR), which allows measuring vasodilatory capacity independent of the epicardium. The purpose of…
EuroPCR 2024 | Specific Intracoronary Tests Combined with Angiography for Diagnosing Patients with Chronic Coronary Syndrome: The AID-ANGIO Study
Invasive coronary angiography (ICA) has become the gold standard for the assessment of patients with chronic coronary syndrome (CCS) for obstructive coronary artery disease. However, its ability to detect this condition is limited and it does not detect non-obstructive myocardial ischemia, which can be overlooked. To address these limitations, a prospective, observational, multicenter study was…
EuroPCR 2024 | Influence and Effect of CAD Physiopathological Patterns in the Safety and Efficacy of PCI
Coronary revascularization aims at improving coronary flow. However, after successful percutaneous coronary intervention (PCI) a significant number of patients might experience suboptimal coronary physiology. It has been observed that low fractional flow reserve (FFR) after PCI is associated to poor prognosis. Also, improved FFR after procedure directly correlates with improved angina symptoms. Pullback pressure during…
JR-CTO Score for Percutaneous Treatment of Chronic Total Occlusions via Retrograde Approach
Technological advancements and technique improvements have significantly enhanced the success rate of percutaneous interventions for treating chronic total occlusions (CTO). Angiographic scores and CTO-PCI algorithms are valuable tools that help us select the optimal strategy when planning these procedures. The retrograde strategy, specifically, has proven beneficial in addressing complex CTOs. However, standardized tools to predict…