coronary stenosis

Lesión de múltiples vasos y enfermedad carotidea severa ¿Cómo proceder?

Multivessel Disease and Severe Carotid Stenosis: How to Proceed

Myocardial revascularization surgery (CABG)&nbsp;is the most frequent of all cardiovascular surgeries and is still the gold standard to treat&nbsp;multivessel disease.&nbsp; Between 6 and 8% of these patients present concomitant carotid stenosis and it is associated with increased peri and post procedural stroke rates during and after surgery. To prevent carotid stenosis, either PCI or endarterectomy<a href="https://solaci.org/en/2017/10/11/multivessel-disease-and-severe-carotid-stenosis-how-to-proceed/" title="Read more" >...</a>

La coronariografía precoz reduce la mortalidad en SCA sin supradesnivel del ST de alto riesgo

Early Coronary Angiography in High-Risk Non-ST-Elevation ACS

Coronary angiography is essential for patients admitted with non-ST-elevation acute coronary syndrome, since it allows physicians to confirm the diagnosis, stratify the risk, and define the revascularization and antithrombotic management strategies. &nbsp; There is no doubt that these patients should be studied invasively, but the timing for that is still uncertain. &nbsp; Coronary catheterization within<a href="https://solaci.org/en/2017/10/09/early-coronary-angiography-in-high-risk-non-st-elevation-acs/" title="Read more" >...</a>

¿FFR de rutina en pacientes con síndrome coronario agudo?

Routine FFR in Patients with Acute Coronary Syndrome?

Fractional flow reserve (FFR) has proven to be superior to angiography as a guide to revascularization due to a significant reduction in the number of both long-term and short-term events. Furthermore, deferring treatment of lesions without evidence of ischemia offers an excellent prognosis. Many studies including mostly stable patients showed a significant degree (as high<a href="https://solaci.org/en/2017/09/12/routine-ffr-in-patients-with-acute-coronary-syndrome/" title="Read more" >...</a>

El éxito de la angioplastia sobre las CTO por reestenosis disminuye la mortalidad cardíaca

Success in CTOs caused by restenosis lowers cardiac mortality

Courtesy of Dr. Carlos&nbsp;Fava. Nowadays, chronic total occlusions (CTO) due to in-stent restenosis (ISR) represent 5%-25% of all coronary angioplasties. These lesions pose a new and true challenge, since CTOs are often associated with stent-related problems (fractures, lack of expansion, overlapping, deformation), extreme tortuosity, severe calcification, tandem lesions after CTO, and aorto-ostial lesions, with little<a href="https://solaci.org/en/2017/06/26/success-in-ctos-caused-by-restenosis-lowers-cardiac-mortality/" title="Read more" >...</a>

TAVI_estenosis-aortica-severa

Low Gradient Aortic Stenosis Won’t Improve with TAVR

Courtesy of Dr. Carlos Fava. It is known that patients with low gradient aortic stenosis show poor evolution with medical treatment and, in addition, present high mortality rate with surgery. As regards TAVR, a far simpler procedure compared to surgery, there is contradicting evidence; while some studies claim it holds comparable risks, others have found<a href="https://solaci.org/en/2017/06/01/low-gradient-aortic-stenosis-wont-improve-with-tavr/" title="Read more" >...</a>

Stents liberadores de biolimus y everolimus

Biolimus and Everolimus Eluting Stents in Coronary Artery Disease: Similar Safety?

Courtesy of Dr. Guillermo Migliaro. Events such as very late stent thrombosis and restenosis after first generation DES stenting were associated to the inflammatory response of site implantation. The presence of a durable or permanent polymer was thought to play a central role in said inflammatory process, which caused, among other things, delayed re-endothelialization and<a href="https://solaci.org/en/2017/04/01/biolimus-and-everolimus-eluting-stents-in-coronary-artery-disease-similar-safety/" title="Read more" >...</a>

IVUS en las lesiones coronarias complejas

Why We Should Use IVUS in Complex Coronary Lesions

Courtesy of Dr. Carlos Fava. Drug eluting stents (DES) have shown benefits in terms of restenosis vs. conventional bare metal stents (BMS). Many of the advantages of DES depend on correct implantation, especially in complex lesions. &nbsp; In complex lesions, the use of intravascular ultrasound (IVUS) provides important information on lesion length, vessel diameter, calcification<a href="https://solaci.org/en/2017/03/20/why-we-should-use-ivus-in-complex-coronary-lesions/" title="Read more" >...</a>

angioplastia a tronco de coronaria izquierda vs cirugia

Left Main Coronary Artery Angioplasty vs. Surgery: A Large Meta-Analysis

Courtesy of Dr. Carlos&nbsp;Fava. Around 5% of patients undergoing coronary angiography present severe left main coronary artery (LMCA) lesions.&nbsp;Myocardial revascularization surgery (MRS) is the preferred method&nbsp;for this group, although there is evidence from different randomized trials demonstrating the safety and efficacy of unprotected LMCA angioplasty, with results similar to those obtained through the traditional strategy.<a href="https://solaci.org/en/2017/01/16/left-main-coronary-artery-angioplasty-vs-surgery-a-large-meta-analysis/" title="Read more" >...</a>

Severidad de una lesión valorada con FFR

Severity of Lesions Assessed by FFR in Coronary Disease: Is It Associated with Major Events?

In patients with coronary disease, the prognosis depends on the extent and reversibility of myocardial ischemia. Whether the outcome also depends on the severity of stenosis as determined by fractional flow reserve (FFR) has not been studied yet. &nbsp; This study investigates the relationship between fractional flow reserve values and vessel-related events. Major adverse cardiovascular<a href="https://solaci.org/en/2017/01/02/severity-of-lesions-assessed-by-ffr-in-coronary-disease-is-it-associated-with-major-events/" title="Read more" >...</a>

lesiones coronarias post tavi

Coronary Lesions After TAVR: Severity May Be Modified

Courtesy of Dr. Carlos&nbsp;Fava. Between 40% and 70% of patients undergoing transcatheter aortic valve replacement (TAVR) present coronary lesions. The fact that aortic stenosis affects how blockages act, and that, after stenosis correction, hemodynamic compromise for those same lesions may vary, has been consistently proven. Its management has not been determined yet. &nbsp; The study<a href="https://solaci.org/en/2016/12/13/coronary-lesions-after-tavr-severity-may-be-modified/" title="Read more" >...</a>

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