Courtesy of Dr. Carlos Fava Massive and submassive pulmonary embolism (PE) has traditionally been treated with anticoagulation and catheter direct thrombolysis (CDT), but the safety and efficacy of this treatment has not been yet properly assessed. The study analyzed 137 patients presenting acute PE massive or submassive. All patients received CTD associated to heparin...
Peripheral artery disease associated to ischemic and bleeding events after DES implantation
Patients with peripheral artery disease (PAD) have higher rates of cardiovascular events after DES implantation, which could be explained partly by higher platelet reactivity. The present work studies the relationship between platelet reactivity and clinical events after PCI in patients with and without a history of peripheral artery disease. The ADAPT-DES study (Assessment of...
Proximal anterior descending artery angioplasty: what are its long-term outcomes?
Courtesy of Dr. Javier Castro. Certain coronary lesions have been historically discouraged for endovascular treatment. Among these can be found left main coronary artery lesions, multivessel disease, and proximal anterior descending artery lesions. As a matter of fact, the latter is actually considered separately as a criterion for choosing the revascularization method. Endovascular treatment of...
Catheter-directed thrombolysis for pulmonary embolism: a safe technique
Courtesy of Dr. Brian Nazareth Donato. The conventional treatment for patients with pulmonary embolism (PE) has traditionally been anticoagulation plus systemic thrombolytics, or surgical embolectomy, reserved for high risk patients. Even though it has been shown systemic thrombolytics reduce mortality in PE patients at high or intermediate risk, its use has been limited given the...
Cardiovascular MR Perfusion Imaging: Good Initial Alternative in Stable Chronic Angina
In the initial management of patients with stable chronic angina, a non-invasive strategy with cardiovascular MR perfusion imaging seems to provide similar results to invasive strategies. At one year, MACE rate (combination of all cause death, non-fatal infarction and target vessel revascularization) resulted 3.3% for MRI vs. 3.9% for fractional flow reserve (FFR) informed...
Infarction in Cariogenic Shock: Prioritizing the Use of Impella Could Improve Survival
This small study suggests the early use of Impella ventricular support device in patients undergoing AMI complicated by cardiogenic shock could help lower mortality rate in this population. However, study design should moderate our enthusiasm, mainly because of the cost of this device. Detroit Cardiogenic Shock Initiative has stressed early identification of cardiogenic...
Higher Radiation Dose in Patients and Operators with Radial Approach (RAD-MATRIX Dosimeter)
Both physicians and patients are exposed to higher radiation doses during radial access PCI compared to femoral, according to this large contemporary study on high volume PCI operators of ACS patients. Even though the difference in radiation exposure was relatively small for patients (approximately 10% higher for radial PCI) this translated into double the...
Pregnancy and Risk of Spontaneous Coronary Artery Dissection: How to Proceed
Courtesy of Dr. Pablo Baglioni. Between the years 2000 and 2015, the authors of this article searched for reports on spontaneous coronary artery dissection (SCAD) in pregnant or immediate post-partum women aiming at defining the clinical characteristics of this pathology and offering management recommendations. Information on 120 women was analyzed; 116 were between 22...
FFR, IVUS and OCT in Chronic Coronary Syndromes
Lecture given by Dr. Mario Araya (Chile) on FFR, IVUS and CTO in acute coronary syndromes at SOLACI-SBHCI’16, Rio de Janeiro, Brazil. Recorded by TV Med – June 8, 2016.
Left Main Target Lesion Revascularization: When is it Necessary?
Courtesy of Dr. Agustín Vecchia. Incidence, predictors and impact of target lesion revascularization (TLR) on unprotected left main stenosis initially treated with second generation DES have not yet been clearly defined and this is the main goal of the present study. This is a multicenter observational retrospective study of patients with unprotected left main...