Percutaneous coronary intervention (PCI) is considered the treatment of choice in ST-segment elevation myocardial infarction (STEMI). However, it is widely acknowledged that, in many cases, there are significant lesions in other coronary arteries. Previous randomized studies have shown that complete revascularization in a second procedure is more beneficial than intervention only in the culprit artery....
Is Complete Revascularization Really Necessary after AMI in the Elderly?
The population over 75 is growing gradually, which entails an increase in acute myocardial infarction (AMI) in this group. As we all know, it is fairly common for AMI to present with multivessel disease. It has been shown that younger patients will benefit from complete revascularization vs. a simple resolution of the culprit vessel. However,...
OCT-Guided PCTA: Does It Offer any Benefits?
For many years, percutaneous transluminal coronary angioplasty (PCTA) has expanded significantly worldwide. However, despite the demonstrated advantages of intravascular ultrasound (IVUS) in terms of minimal luminal area, reduced cardiovascular events, and restenosis, its use is not very common due to various reasons. On the other hand, optical coherence tomography (OCT) offers even higher resolution than...
What to Do in Cases of AMI with Multivessel Disease
The presence of lesions in multiple vessels is common in ST-segment elevation myocardial infarction (STEMI). It has been shown that, when they are treated in a second procedure, patients have a better outcome. To date, there is limited information available on percutaneous transluminal coronary angioplasty (PTCA) in vessels with severe non-culprit lesions during primary angioplasty....
ESC 2023 | OCTIVUS TRIAL: Is OCT Superior?
Researchers conducted a multicenter randomized study involving 2008 patients undergoing coronary angioplasty (PCI). In this group, 1005 patients underwent a procedure guided by OCT, and 1003 patients by IVUS. The average age of participants was 65 years, 21% of subjects were women, and there were no significant differences between both groups. The primary endpoint was...
ESC 2023 | FIRE-Trial: Physiology Guided Complete Revascularization Benefits Elderly Patients with Myocardial Infarction
Patients over 75 with acute coronary syndrome (ACS) are often badly represented in most significant studies. In this context, the FIRE study looked to determine whether physiology guided complete revascularization is superior to culprit-only revascularization in elderly patients with multivessel disease suffering acute MI. The study included SCA patients over 75, hospitalized for both STEMI...
MACT Study: Monotherapy with P2Y12 Inhibitor Associated with Colchicine after Acute Coronary Syndrome
Dual antiplatelet therapy (DAPT) is the current standard for preventing thrombotic events in high-risk patients with coronary artery disease, as well as in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). However, this approach increases the risk of bleeding. To reduce this risk, there have been studies that discontinued the use of...
EASTBOURNE Registry: Use of Sirolimus-Coated Balloons in Coronary Artery Disease
The introduction of drug coated balloons (DCB) has become an innovative therapeutic alternative to current treatments. Paclitaxel-coated balloons (PCB) have been used to treat in-stent restenosis (ISR) and also approach CAD in native arteries. More recently, sirolimus-coated balloons (SCB) are being looked at as part of pilot studies and smaller registries with preliminary results. The...
Long Term Outcomes after Complex PCI According to Operator Experience and Use of IVUS
The use of intravascular ultrasound (IVUS) to guide percutaneous coronary interventions (PCI) has been shown to reduce the risk of major adverse cardiovascular events (MACE) across controlled randomized studies, registries and meta-analysis. Current guidelines recommend the use of IVUS in left main disease and complex lesions. As the prevalence of complex PCI increases over time,...
EuroCTO: Safety and Benefit at 3 Years
Chronic total occlusions (CTOs) account for approximately 15-20% of patients with stable coronary artery disease. This field has seen various advances regarding treatment, leading to an improvement in the success rate of procedures. According to registries and randomized studies, the main indication for percutaneous coronary intervention (PCI) of CTO should be based more on clinical...