revascularization

Modest correlation between IVUS and FFR in intermediate lesions assessment

Original title: FIRST: Fractional Flow Reserve and Intravascular Ultrasound Relationship Study Reference: Ron Waksman et al. J Am Coll Cardiol 2013. Article in Press For patients with angiographically assessed intermediate lesions such as stenosis between 40% and 80%, criteria that favor revascularization remains under debate.  Fractional Flow Reserve (FFR) is considered the gold standard to assess intermediate lesions,...

Periprocedural stroke, unrelated to the access site?

Original title: Influence of access site choice on incidence of neurologic complications after percutaneous coronary intervention. Reference: Karim Ratib et al. Am Heart J 2012;0:1-8 Article in press. Neurological complications post coronary angioplasty (PCA) are sporadic but they are associated with eight times increased mortality.  A transradial approach has multiple advantages over femoral but could theoretically have a...

Ticagrelor, even better than we thought

Original title: Reduction in First and Recurrent Cardiovascular Events with Ticagrelor Compared with Clopidogrel in the PLATO Study. Reference: Payal Kohli et al. CIRCULATION AHA.112.124248. In analyzing randomized and monitored study outcomes, we usually observe that after the occurrence of any primary outcome event patients are typically blocked for further analysis.  This practice limits the information on subsequent...

Outpatient coronary angioplasty, is it possible?

Original title: Assessment of Clinical Outcomes related to Early Discharge alter elective Percutaneous Coronary Intervention: COED PCI Reference: Purushothaman Muthusamy MD, et al. Catheterization and Cardiovascular Intervention 81:6-13 (2013) The standard procedure in most institutions is that after angioplasty (PTCA) patients are discharged the next morning. There are some reports in which they were ambulatory but the safety...

Chronic Total Occlusions, challenging but very possible

Original title: Predictors of Reocclusion After Successful Drug-Eluting Stent–Supported Percutaneous Coronary Intervention of Chronic Total Occlusion. The Florence CTO PCI Registry. Reference: Renato Valenti et al. J Am Coll Cardiol 2013; article in press. Previous registry data have shown a reduction in mortality rates in patients with successful recanalization of a Chronic Total Occlusion (CTO) compared to patients...

More evidence supports ventricular assist devices in complex angioplasty procedures

Original title: Percutaneous Left Ventricular Assist Device with Tandem Heart for High-Risk Percutaneous Coronary Intervention: The Mayo Clinic Experience. Reference: Oluseun O Alli, et al. Catheterization and Cardiovascular Intervention 80:728:734 There is a small group of poor surgical patients admitted for surgery that due to complex comorbidity, coronary anatomy and compromised left ventricular function that can be treated...

Radial Approach, 1st choice in Acute Coronary Syndromes

Original title: Radial Versus Femoral Randomized Investigation in ST-Segment Elevation Acute Coronary síndrome. The RIFLE-STEACS (Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome) Study. Reference: Enrico Romagnoli et al. J Am Coll Cardiol 2012;60:2481–9. Bleeding in patients with acute coronary syndromes (ACS) is an independent predictor of morbidity and mortality. Until today, evidence supporting the radial...

Strategies for treating left coronary trunk restenosis.

Original title: Clinical and Procedural Predictors of Suboptimal Outcome After the Treatment of Drug-Eluting Stent Restenosis in the Unprotected Distal Left Main Stem The Milan and New-Tokyo (MITO) Registry. Reference: Circ Cardiovasc Interv. 2012;5: 491-498 We have very little data on the percutaneous treatment of restenosis of an unprotected LMCA.  The aim of this study was to evaluate...

Cilostazol reduces restenosis in infrapopliteal angioplasty

Original title: Impact of Cilostazol on Angiographic Restenosis after Balloon Angioplasty for Infrapopliteal Artery Disease in Patients with Critical Limb Ischemia Reference: Y. Soga et al. European Journal of Vascular and Endovascular Surgery 44 (2012) 577e581. Angioplasty is regularly used for patients with critical limb ischemia where restenosis is a great limitation, especially in infrapopliteal territory.  The use...

Complex angioplasty with ventricular assist

Original title: Real-Word of the Impella 2.5 Circulatory Support System in Complex High-Risk Percutaneous Coronary Intervention: The USpella Registry Reference: Brijeshwar maini, et al. Catheterization and Cardiovscular Intervention For about a decade angioplasty has begun to be performed in increasingly complex patients (PE) such as those with left coronary trunk injury, 3-vessel injury, poor ventricular function and surgically...

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