The rise of chronic total occlusions (CTO) percutaneous coronary interventions (PCI) goes hand in hand with technological development, through still posing a great challenge, one not exactly exempt from complications. An important criterion to successful CTO PCI is length: ≥20 mm lesions lower the odds, according to J-CTO Score. However, increasing operator experience and the...
Deep vein Arterialization in patients with critical “non-revascularizable” limb ischemia. We are familiar with the poor quality of life and elevated mortality of patients with chronic limb-threatening ischemia (CLTI). In its last stages (nearly terminal), revascularization (either surgical or endovascular) has been shown to reduce amputation incidence. However, similarly to heart disease and other vascular scenarios,...
Edge-to-edge treatment has proven to be a safe and effective technique in follow-up, decreasing mortality and hospitalizations for heart failure when a good result is achieved. The MitraScore was developed to assess the outcome at the end of the procedure. In that sense, results <3 represent mild mitral regurgitation, which would be related to lower...
New unibody endologix endografts for the endovascular repair of abdominal aortic aneurysm 3-4-year safety followup At present, we have seen endovascular intervention of abdominal aortic aneurysm (EVAR) increase over surgical repair. However, the procedure is not free from complications, endoleak being the most frequent. Indeed, according to different series, it has a 20-25% incidence in AAA. Most...
Amyloidosis is a systemic disease that affects different organs and impairs their function. Recent studies with magnetic resonance imaging (MRI) have shown that between 13% and 16% of patients who undergo transcatheter aortic valve replacement (TAVR) have amyloidosis. A review of four studies showed that mortality at 20 months was twice as high when amyloidosis...
Survival analysis of patients with tricuspid regurgitation grouped according to comorbidities and echocardiographic variables. For many years, the tricuspid was classified as the “forgotten valve,” due to the scarce possibility of treatment beyond symptom control in patients with heart failure. However, in recent years, there has been an improvement in the treatment of the valve...
Analysis of percutaneous closure device placement when choosing an ultrasound-guided vs. a fluoroscopy-guided femoral approach. Transradial access is the access of choice in percutaneous coronary interventions, with a demonstrated benefit in mortality and bleeding when compared with transfemoral access. The latter, however, is still the access of choice in cases where large caliber introducers are...
Acute coronary syndromes (ACS) involve high mortality risk, especially ST elevation ACS. Their treatment is based on reperfusion, dual antiplatelet therapy (DAPT) and anticoagulation, with enoxaparin (1 mg/kg twice a day) as the preferred anticoagulant according to the contemporary guidelines. 2.5 mg or 5 mg doses of rivaroxaban might be valid alternative treatments for this...
Follow-up of drug-coated balloon angioplasty in femoropopliteal disease in a real-world population. Using drug-releasing devices has decreased the rate of restenosis in obstructive femoropopliteal lesions compared with conventional balloons or conventional stents (bare-nitinol stent, BNS). Both in the placement of BNS and of drug-eluting stents (DES) there is a mechanical risk of stent fracture or...
Event predictors in patients with plaque erosion and no stenting. A third of all acute coronary syndrome (ACS) cases are caused by plaque erosion. In the initial EROSION study, it was shown that patients with plaque erosion (as evidenced by OCT, with stenosis <70%, TIMI III flow, and asymptomatic) were stabilized without stent implantation (no...