Angioplastia

El uso del ultrasonido intravascular en la angioplastia de tronco no protegido se asocia con mejores resultados en comparación con la angioplastia guiada solo por angiografía.

IVUS in Every Step of Complex Angioplasty

Complex angioplasties require not only experience and patience but also technology. Imaging–guided pre-dilation, stent sizing, and post-dilation reduced the cardiovascular events after a 3-year follow-up in patients who received drug-eluting stents in complex angioplasties. This paper, recently published in JACC Interventions, compared the 3-year outcome of the complex angioplasty optimization technique with intravascular imaging to...

Claves para mejorar la productividad en la sala de cateterismo

Early Activation to Speed-Up Treatment of Infarcted Patients

Cath lab activation—and everything that entails—within 20 minutes was associated with the target of performing primary angioplasty in under 2 hours in at least 75% of patients. Historically, door-to-balloon time was measured, which provided a rough idea of where there could be flaws to fix. This is particularly true in the case of patients who need to...

Tratamiento médico óptimo

Is Medical Treatment Better at Lowering Bleeding-Caused Mortality than Angioplasty?

Post-discharge bleeding in patients admitted for acute coronary syndrome (ACS) is linked to higher all-cause mortality. However, this is the case for both patients who underwent angioplasty and those who were managed with medical treatment. These are interesting data, given that medical treatment is frequently preferred due to lower bleeding risk. Speculation is based on...

Nuevas estrategias en el territorio femoropoplíteo

How to Determine Optimal Balloon Size in Below-the-Knee Angioplasty

Unlike the coronary and femoral arteries, calcification of medial layers in infrapatellar arteries prevents positive remodeling and expansion capacity to maintain vessel lumen.  Long term patency of endovascular treatment is suboptimal despite the coated balloons, atherectomy devices and stents.  Standard angiographies only show vessel lumen far from its real dimension given the severe thickening of...

angioplastia primaria estrategia farmacoinvasiva

Ideal Area for Unprotected Left Main PCI

Courtesy of Dr. Carlos Fava.  Unprotected left main PCI (PCI-UPLMS) is an acceptable and comparable strategy vs CABG, although the use of IVUS is advisable, since it has shown better evolution and mortality. However, the adequate stent expansion remains unclear.  Researchers carried out a sub-analyzis of the NOBLE trial. Of the total 603 patients receiving...

iFR en lesiones no culpables: el momento de la medición parece cambiar la historia

Differences in Plaque Progression Depending on its Characteristics

The pattern of growth for each plaque differs according to the presence of certain risk factors. Atheroma volume at baseline was the most important predictor of plaque developing into obstructive lesions, as opposed to other characteristics historically considered as “dangerous.” The aim of this study was to analyze whether the pattern of non-obstructive lesion progression...

¿Es seguro utilizar iFR para diferir lesiones del tronco de la coronaria izquierda?

Is the Use of iFR for the Deferral of Left Main Coronary Artery Lesions Safe?

Deferral of left main coronary artery lesions using instantaneous wave-free ratio (iFR) seems to be safe. At the least, patients with deferred lesions had similar long-term prognosis to that of patients who underwent revascularization based on that same indicator. Left main coronary artery lesions were universally excluded from studies including medical treatment among the therapeutic...

Balancear el riesgo de sangrado vs trombótico para definir el tiempo de doble antiagregación

Antiaggregation vs. Anticoagulation after Peripheral PCI

The truth is this question has no clear answer and what with do with peripheral stenting is transfer the evidence we have on coronary stenting, given the lack of standards and poor reporting on antithrombotic therapy outcomes in randomized studies on endovascular intervention.  Heterogeneity is worse when it comes to venous territory. Some time ago...

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