revascularization

Shall we change our daily practice to introduce complete revascularization during AMI? Another study contributes for preventive PCI in AMI.

Original title: Randomized Trial of Complete Versus Lesion-Only Revascularization in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI and Multivessel Disease: The CvLPRIT Trial.  Reference:  Gershlick AH et al. J Am Coll Cardiol. 2015 Mar 17;65(10):963-72.   Recent studies such as the PRAMI and the one we summarize here show complete revascularization of AMI patients before discharge...

CTO revascularization is beneficial

Título original: Long-Term Survival Benefit of Revascularization Compared UIT Medical Therapy in Practice UIT Coronary Chronic Total Occlusion and Well-Developed Collateral Circulation. Reference: Woo Jin Jan, el at. J Am Coll Cardiol Interv 2015;8:271-9 Multiple studies have shown the benefit of chronic total occlusion (CTO) revascularization, but for patients presenting Rentrop 3 grade collateral circulation (CC), such benefit...

Hybrid Revascularization in Multiple Vessels

Original title: Hybrid Revascularization for Multivessel Coronary Artery Disease Reference: Mariuz Gassior, et al. J Am Cardiol Intv 2014;7:1277-83   According to the international guidelines, coronary artery bypass grafting (CABG) continues to be the “Gold Standard” treatment for multiple vessels diseases. However, second generation DES and the hybrid strategy may eventually change indications.   This study randomized 102...

Target amount for reasonable incomplete revascularization

Original title: Reasonable incomplete revascularisation after percutaneouscoronary intervention: the SYNTAX Revascularisation Index. Reference: Philippe Généreux et al. EuroIntervention 2014;10-online publish-ahead-of-print. While the absolute amount of residual disease after coronary angioplasty is associated with poor prognosis, the proportion of treated coronary disease modifying the prognosis is still to be determined. This study attempted to quantify the proportion of coronary...

Worse post TAVI ejection fraction recovery in coronary artery disease patients without revascularization

Original title: Impact of coronary artery disease on left ventricular ejection fraction recovery following transcatheter aortic valve implantation. Reference: Freixa X et al. Catheter Cardiovasc Interv. 2014;Epub ahead of print. This single center study analyzed data form 56 consecutive patients with severe aortic stenosis and LVEF of ≤ 50% undergoing TAVI (transcatheter aortic valve implantation) between March 2006...

Higher event rate in those with non-ST elevation ACS who received revascularization at PLATO study. Beyond this, ticagrelor reduced mortality.

Original title: Ticagrelor vs. clopidogrel in patients with non-ST-elevation acute coronary syndrome with or without revascularization: results from the PLATO trial. Reference: Lindholm D et al. Eur Heart J. 2014; Epub ahead of print. The PLATO study randomized 18624 patients with ACS to aspirin and ticagrelor (180 mg loading dose followed by 90 mg every 12 hours) versus...

Hybrid revascularization versus conventional surgery. Advantages and disadvantages for choosing ideal patients.

Original title: Clinical Outcomes after Hybrid Coronary Revascularization versus Coronary Artery Bypass Surgery: A Meta-Analysis of 1,190 Patients. Reference: Ralf E. Harskamp et al. American Heart Journal (2014), epub ahead of print.   Hybrid revascularization combines long-term patency of the mammary artery connected to the left anterior descending with minimally invasive drug-eluting stents to other injuries. This in...

Unprotected trunk in diabetics: angioplasty with good long-term results but more revascularization

Original title: Coronary artery bypass graft versus percutaneous coronary intervention with drug-eluting stent implantation for diabetic patients with unprotected left main coronary artery disease: D-DELTA registry. Reference: Meliga Emanuele, et al. EuroIntervention 2013; 9:803-808 Diabetes increases cardiovascular risk events because of their involvement in diffuse form of the vessels, thereby generating more events and changes in revascularization strategy...

Culprit artery only versus revascularization with ST segment elevation myocardial infarction. The discussion continues

Original title: Complete Versus Culprit-Only Revascularization for Patients with Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-analysis. Reference: Kevin R et al. American Heart Journal, article in press. Primary angioplasty is the preferred reperfusion strategy in patients experiencing a STEMI as it has proven superior to fibrinolysis in reducing...

Complete revascularization in acute myocardial infarction. 1 culprit lesion , then all the others

Original title: Randomized Trial of Preventive Angioplasty in Myocardial Infarction (PRAMI trial). Referencia: David S. Wald et al. N Engl J Med 2013.DOI: 10.1056/NEJMoa1305520. Patients developing ST segment elevation myocardial infarction are effectively treated with primary angioplasty to responsible artery . It is unclear whether revascularized other significant lesions in other non culprit vessels  will prevent future events...

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