In patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (primary PCI), multivessel disease is observed in up to 40% of cases. The optimal timing for revascularizing non-culprit lesions in these patients without cardiogenic shock remains a controversial issue. European guidelines recommend completing revascularization during the initial procedure or within 45 days...
Percutaneous coronary intervention (PCI) with drug coated balloons (DCB) is a viable alternative, especially in patients at high risk of bleeding, side-branch lesions in coronary bifurcation, or in small coronary segments. De novo heart disease treated with DCB has been shown non-inferior to conventional DES stenting, according to the PICCOLETO-II trial. However, these interventions are...
The world population is aging, and cardiovascular diseases are the leading cause of death in Western countries. It is increasingly common to find patients aged 70 or older with non-ST-segment elevation acute myocardial infarction (NSTEMI). However, this group has been excluded from most studies, and there is not enough information to determine whether a conservative...
When deciding on the optimal coronary artery revascularization treatment of coronary artery disease (CAD) patients, physicians normally assessed clinical presentation, surgical risk, survival expectation, and the likelihood of a better quality of life. Decisions are made after careful consideration, by the Heart Team, who will ponder options such as coronary artery bypass graft (CABG), percutaneous...
The octogenarian population has already reached 137 million and continues to grow. It is estimated to triple by 2050. This increase represents a big challenge, seeing as these patients are often more fragile, present more complex coronary artery disease and multiple comorbidities. This generally requires two or more procedures and more experience both from operators...
Onyx is a zotarolimus-eluting stent (ZES), designed with thin struts and a platinum core that enhances its radiological visibility. This can be beneficial in complex situations with limited visibility, such as in patients who are obese or present severe calcification, two particularly frequent characteristics in diabetic or elderly patients. The BIONYX study was a randomized...
It has been generally established that coronary procedures with local anesthesia and moderate sedation minimally require a 6 hour fast for solids and 2 hours for liquids (according to SCAI guidelines 2021). However, complications requiring emergency orotracheal intubation are extremely rare. Prolonged fasting can have adverse effects such as hypoglycemia, insulin resistance, acute renal failure...
The presence of calcified lesions worsens percutaneous coronary intervention prognosis, presenting more restenosis, thrombosis and need for new revascularization. The aim of this study was to assess the superiority of CTO with a prespecified management algorithm on a conventional angiography treatment, in addition to assessing CTO safety. A superiority randomized study was carried out including...
The aim of this randomized open study was to determine whether CTO guided left main percutaneous coronary intervention (PCI) is superior to fluoroscopy guided PCI, using fractional flow reserve (FFR) after stenting. The secondary outcomes were procedural success (successful implantation, malposition, edge dissection or stent collapse) and major adverse cardiovascular events (MACE) at one year....
Coronary revascularization aims at improving coronary flow. However, after successful percutaneous coronary intervention (PCI) a significant number of patients might experience suboptimal coronary physiology. It has been observed that low fractional flow reserve (FFR) after PCI is associated to poor prognosis. Also, improved FFR after procedure directly correlates with improved angina symptoms. Pullback pressure during...