Percutaneous coronary intervention (PCI) with drug coated balloons (DCB) is a viable alternative, especially in patients at high risk of bleeding, side-branch lesions in coronary bifurcation, or in small coronary segments. De novo heart disease treated with DCB has been shown non-inferior to conventional DES stenting, according to the PICCOLETO-II trial. However, these interventions are...
Complex PCI in Octogenarian
The octogenarian population has already reached 137 million and continues to grow. It is estimated to triple by 2050. This increase represents a big challenge, seeing as these patients are often more fragile, present more complex coronary artery disease and multiple comorbidities. This generally requires two or more procedures and more experience both from operators...
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....
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...
ERCTO Registry: Chronic Total Occlusion Treatment Outcomes
Chronic total occlusion (CTO) affect up to 20% of patients undergoing angiographic diagnostic tests. During the last two decades, recanalization technique refinement, the development of specific devices and operator skill improvement have elevated procedural success rate up to 90%. However, there are still particular complications such as collateral perforation and access site complications. This is...
Carotid Endarterectomy vs. Carotid Angioplasty in Symptomatic and Asymptomatic Patients: 30-Day Outcomes
Extracranial carotid artery disease represents 15 to 20% of all strokes. Carotid revascularization plays a role in primary and secondary prevention of cerebrovascular events. Outcomes of two common revascularization strategies, Carotid endarterectomy (CAE) and carotid artery stenting (CAS), have been studied and compared. In recent years, complications associated to CAS have dropped thanks to technical...
Drug-Coated Balloon Angioplasty in Femoropopliteal CTOs: Intraluminal or Subintimal?
Patients with peripheral vascular disease often experience femoropopliteal compromise. It is estimated that approximately 50% of lesions in this area are chronic total occlusions (CTO). Even though success rate has improved for peripheral CTO treatments, long term clinical and technical outcomes have not been fully determined yet. Prior research has looked into stenting outcomes in...
ERCTO Registry: Current Results for Percutaneous Treatment of Chronic Total Occlusions
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access...
Contemporary Outcomes of CTO PCI in Europe: The ERCTO Registry
Roughly 20% or coronary angiographies show some form of chronic total occlusion (CTO), and this figure is twice as high for diabetic patients or those with cardiac failure and reduced ejection fraction (EF). CTO percutaneous intervention (PCI) has experienced a significant growth thanks to the development of new techniques and dedicated material. However, a considerable...