✔️ Complex PCI: Distal Left Main Coronary Artery – SOLACI-SOCIME 2022. ✔️ SOLACI-SOCIME 2022 Scientific Session. 👨🏫 Contents: 00:13 – Welcoming words – Dr. Álvaro Contreras (MEX) 01:18 – LM-PCI: IVUS and FFR/IFR? – Dr. Hector García-García (USA) 17:06 – DK Crush or provisional stenting? – Dr. Carlos Uribe (COL) 32:22 – Optimal antiplatelet anti...
TAVR has been associated with early valve thrombosis, characterized by thrombus formation in the prosthetic valve with or without valve dysfunction. This dysfunction is related to leaflet thickening and reduced motion, reduced effective orifice area, or increased transvalvular gradient. A multidetector CT scan allows the dynamic assessment of valves and ruling out fibrosis vs. thrombosis. ...
The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim...
Non-adherence to medication in patients with acute coronary syndrome (ACS) remains to be solved; the use of polypills and a closer follow up have been tried out (follow up calls and motivation groups). Antiaggregation guidelines recommend dual antiplatelet therapy (DAPT) for at least one year after ACS. Adherence to drug treatment is comprised of multiple...
Left atrial appendage closure (LAAC) in non-valvular atrial fibrillation with high risk of bleeding has shown promising results with first generation devices (with the Watchman) in the different studies. At present, we have a more modern device, the Watchman FLX, but we do not have much information about it. To gather more data, researchers looked...
Recent studies on antiplatelet antiaggregation support the use of short dual antiaggregation therapy (DAPT), even in unforeseen scenarios, such as complex PCI. On the contrary, in patients with high ischemic risk, there is still evidence in favor of prolonged antiaggregation, mainly through the DAPT study, which showed lower risk of major ischemic events with DAPT...
Lecture by Dr. Hector García García – LM-PCI: IVUS and FFR/IFR? Dr. Hector García delivered an excellent presentation on whether we should use intravascular ultrasound (IVUS) or fractional flow reserve (FFR)/instantaneous wave-free ratio (iFR) in the left main coronary artery (LMCA) to consider severe obstruction, since there is significant interobserver variability with angiography. Although the...
Percutaneous left atrial appendage closure (LAAO) with Watchman has FDA approval since March 2015, having shown, in the PROTECT-AF and PREVAIL studies, reduced risk of atrial fibrillation driven stroke, by excluding the left atrial appendage form systemic circulation. Both studies used post procedure standardized protocols involving followup at 45 days and 6 months, imaging, and...
Dual antiaggregation therapy (DAPT) with ASA and P2Y12 during 6 to 12 months is the indicated strategy after DES stenting to reduce ischemic events. However, in patients with elevated risk of bleeding (HBR) guideline and expert recommendations is 1-6 months, since there is plenty of evidence in favor, except for a randomized study, the MASTER...
There is a consistent number of patients presenting high risk of bleeding. In this context, receiving dual antiplatelet therapy (DAPT) for 12 months would not be advisable. Even though the European and American guidelines recommend 1 to 6 months for chronic and acute syndromes in this group, these are often complex PCI cases, which makes...