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...
Approximately 70% of hypertrophic cardiomyopathies (HCM) are associated to a left ventricular outflow tract (LVOT) obstruction and mitral valve failure leading to dyspnea and cardiac failure in a high number of patients. Even though at present there are effective drug treatments combined with pacemaker implantation, surgery (septal myomectomy (SM) continues to be the first choice...
Takayasu arteritis (TAK) is an uncommon granulomatous large-vessel vasculitis that affects the aorta and its primary branches. The most frequently types of observed vascular compromise are obstructive lesions, and aneurysmal vascular lesions or dissections. In 2021, the American College of Rheumatology recommended not to implement percutaneous intervention (PI) with these patients and only use immunosuppressive...
From a cellular standpoint, the term ‘myocardial viability’ refers to a myocyte that has no irreparable damage. From a clinical standpoint, it refers to areas with myocardial contractile dysfunction at rest that are expected to improve with correct revascularization. There are specific vessel ischemia and viability indexes that may help identify hibernation areas that could...
The use of intravascular imaging helps improve diagnosis in situations where a conventional coronary angiography might not be conclusive. That is the case of patients with myocardial infarction with non-obstructive coronary artery lesions (MINOCA). The largest MINOCA cohort reported so far has shown 5%-7% prevalence. This pathology, initially considered benign, presents a remote mortality rate...
Stent sub-expansion in coronary territory has been identified as one of the major predictors of stent failure at followup, which is why improving stent expansion will improve clinical and imaging outcomes. In percutaneous coronary interventions (PCI) of severely calcified lesions, calcified lesions present a major challenge since they impede stent delivery, causing stent under-expansion or...
Transradial access is currently the preferred access for diagnostic and therapeutic interventions. However, about 7% of patients experience radial artery occlusion (RAO), which is not expressed by clinical symptoms. However, RAO is a limit for future interventions; it reduces the potential use of that artery as a conduit for aorto-coronary bypass and for the creation...
Changes in fractional flow reserve (FFR) values after percutaneous coronary intervention (PCI) are associated with improvement in angina symptoms. The pattern of baseline coronary artery disease influences the degree of variation in FFR after stent implantation. Focal coronary artery disease leads to high post-PCI FFR values, while the improvement is not as marked in diffuse...
Use of intravascular ultrasound (IVUS) has increased rapidly, and several randomized and observational studies have shown improved results in patients who underwent coronary angioplasty using this tool. However, evidence on IVUS on peripheral interventions is more limited. Observational studies have found similar benefits when IVUS was part of the revascularization strategy. In a meta-analysis of...
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...