The presence of calcification in the coronary arteries (CAC) remains the main challenge in the percutaneous treatment of these lesions. Various studies have demonstrated the association of CAC with unfavorable long-term outcomes. Intravascular lithotripsy (IVL) has emerged as an effective tool for fracturing calcified plaques. Studies evaluating this strategy have shown high device success rates,<a href="https://solaci.org/en/2024/05/28/replica-epica-18-registry-using-ivl-in-calcified-coronary-lesions/" title="Read more" >...</a>
Functional Assessment Using QFR for the Revascularization of Non-Culprit Lesions in AMI Patients
Nowadays, evidence from studies and meta-analyses has demonstrated the benefits of complete revascularization compared to culprit-vessel-only revascularization in patients with acute myocardial infarction (AMI). The identification and treatment of non-culprit lesions can be guided by conventional angiography, intracoronary imaging, or coronary physiology; the optimal modality, however, is still unclear. Quantitative flow ratio (QFR) is a<a href="https://solaci.org/en/2024/05/22/functional-assessment-using-qfr-for-the-revascularization-of-non-culprit-lesions-in-ami-patients/" title="Read more" >...</a>
EuroPCR 2024 | Prognostic Value of MRR in STEMI: Group Analysis of Individual Patients
Despite primary angioplasty, many patients with ST elevation acute myocardial infarction with (STEMI) show evidence of microvascular dysfunction. This dysfunction can be characterized by two main factors: A new specific index has recently been identified to assess microcirculation called microvascular resistance reserve (MRR), which allows measuring vasodilatory capacity independent of the epicardium. The purpose of<a href="https://solaci.org/en/2024/05/17/europcr-2024-prognostic-value-of-mrr-in-stemi-group-analysis-of-individual-patients/" title="Read more" >...</a>
TAVR in Bicuspid Valves
Bicuspid aortic valve (BAV) disease affects 1%-2% of the population and manifests with severe aortic stenosis in the middle-aged. It characterizes for a very different anatomy with more calcification than the tricuspid aortic valve. At present, surgical aortic valve replacement (SAVR) is the first treatment indication. TAVR in this scenario has shown, in different studies,<a href="https://solaci.org/en/2024/05/07/tavr-in-bicuspid-valves/" title="Read more" >...</a>
LpA: 30-Year Cardiovascular Followup in Primary Prevention Cohorts
For years, treating dyslipidemia mainly focused on reducing LDL cholesterol (LDL-C) with statins, which had shown benefits in reducing atherosclerotic cardiovascular disease (ASCVD). Lipoprotein(a) [Lp(a)] is a form of apoB-containing lipoprotein bound to a hydrophilic, highly glycosylated protein called apolipoprotein(a) [apo(a)]. Circulating levels of Lp(a) are genetically determined, and are hardly affected by eating habits<a href="https://solaci.org/en/2024/04/30/lpa-30-year-cardiovascular-followup-in-primary-prevention-cohorts/" title="Read more" >...</a>
Carotid Endarterectomy vs. Carotid Angioplasty in Symptomatic and Asymptomatic Patients: 30-Day Outcomes
Extracranial carotid artery disease represents 15 to 20% of all strokes. Carotid revascularization plays a role in primary and secondary prevention of cerebrovascular events. Outcomes of two common revascularization strategies, Carotid endarterectomy (CAE) and carotid artery stenting (CAS), have been studied and compared. In recent years, complications associated to CAS have dropped thanks to technical<a href="https://solaci.org/en/2024/04/24/carotid-endarterectomy-vs-carotid-angioplasty-in-symptomatic-and-asymptomatic-patients-30-day-outcomes/" title="Read more" >...</a>
SMART Trial: What is the Best Valve for Small Annuli?
Transcatheter aortic valve intervention (TAVI) has been shown beneficial over the years. However, a significant subgroup of patients with small aortic annulus, which make approximately one third of cases and have a higher incidence in women, face additional challenge, such as higher incidence of mismatch, reduced exercise capacity and shorter durability. Self-expanding and balloon expandable<a href="https://solaci.org/en/2024/04/19/smart-trial-what-is-the-best-valve-for-small-annuli/" title="Read more" >...</a>
Use of IVL in Calcified Coronary Lesions in a Real World Population
The presence of calcification in coronary arteries (CAC) remains a challenge for the percutaneous treatment of these lesions. Several studies have established the link between CAC and poor long term results. Intravascular lithotripsy (IVL) has surged as a tool to induce calcified plaque fracture. Even though studies on this strategy are not randomized, they have<a href="https://solaci.org/en/2024/03/13/use-of-ivl-in-calcified-coronary-lesions-in-a-real-world-population/" title="Read more" >...</a>
Network Meta-Analysis of Complementary Imaging (IVUS/OCT + Conventional Angiography) for Coronary Stenting
Complementary imaging allows for the identification of numerous scenarios not visible with conventional angiography (ICA), both for the assessment of differential diagnoses and the improvement of percutaneous coronary intervention (PCI) outcomes. Advantages include assessment of plaque characteristics, vessel plaque burden, stent edge dissection, vessel diameter, and correct apposition, among others. While intravascular ultrasound (IVUS) was<a href="https://solaci.org/en/2024/02/28/network-meta-analysis-of-complementary-imaging-ivus-oct-conventional-angiography-for-coronary-stenting/" title="Read more" >...</a>
Use of Intravascular Lithotripsy in Left Main
The Left main coronary artery supplies circulation to roughly 70% of myocardium, and left main disease requires a high risk intervention with significant impact on patient prognosis. The current guidelines have set the threshold for intervention in LM disease at ≥50% stenosis, irrespective of the presence of symptoms or ischemic burden. LM calcification is an<a href="https://solaci.org/en/2024/02/27/use-of-intravascular-lithotripsy-in-left-main/" title="Read more" >...</a>