Courtesy of Dr. Javier Castro. Certain coronary lesions have been historically discouraged for endovascular treatment. Among these can be found left main coronary artery lesions, multivessel disease, and proximal anterior descending artery lesions. As a matter of fact, the latter is actually considered separately as a criterion for choosing the revascularization method. Endovascular treatment of...
Courtesy of Dr. Guillermo Migliaro. Technological advancements in drug-eluting stents (DES) have shown significant improvement as regards the safety and efficacy of these devices. DES are considered to be the golden standard for the treatment of percutaneous coronary interventions. DES with permanent or durable polymers (DP) have been associated with local inflammatory reactions and...
Courtesy of Dr. Agustín Vecchia. Incidence, predictors and impact of target lesion revascularization (TLR) on unprotected left main stenosis initially treated with second generation DES have not yet been clearly defined and this is the main goal of the present study. This is a multicenter observational retrospective study of patients with unprotected left main...
Courtesy of Dr. Carlos Fava. Around 5% of patients undergoing coronary angiography present severe left main coronary artery (LMCA) lesions. Myocardial revascularization surgery (MRS) is the preferred method for this group, although there is evidence from different randomized trials demonstrating the safety and efficacy of unprotected LMCA angioplasty, with results similar to those obtained through the traditional strategy....
Courtesy of Dr. Carlos Fava. Left main coronary artery (LMCA) lesions have always been defined as high-risk, with surgery as treatment of choice. Drug-eluting stents (DES) have slowly changed that, but their use still lacks strong supporting evidence. The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) study...
Courtesy of Dr. Agustín Vecchia. The link between operator volume and clinical outcomes has been long and widely debated. After years of discussion, there are promoters and detractors. Currently, interventional cardiology societies all over the world classify centers as “high-volume” or “low-volume” using arbitrary parameters, and require training fellows to perform an also arbitrary number of...
Courtesy of Dr. Rodrigo Abreu. INTRODUCTION Bifurcation lesion treatment has evolved considerably in the last years: from balloon angioplasty (with high occlusion and restenosis rates) to bare metal stent angioplasty (with a procedural success around 86% and major adverse cardiac events [MACE] at 1 year around 32%). The subsequent emergence of drug-eluting stents (DES) reduced...
Courtesy of Dr. Carlos Fava. Drug-eluting stents (DES) have shown mid-term benefit in lesions below the knee (BTK) by reducing the rate of acute occlusion and restenosis in type A and B lesions. However, failure to recover the self-regulatory functions of the local vessel could hinder future revascularization. Drug-eluting bioresorbable scaffolds (BVS) could be a solution to this problem....
The aim of this study was to compare clinical outcomes in relation to the duration of triple antithrombotic therapy in patients with indications for oral anticoagulation undergoing coronary angioplasty. The optimal period for the prescription of these three drugs has not been studied. Between 2009 and 2013, 8772 consecutive patients undergoing coronary angioplasty were included...
Courtesy of Dr. Santiago F. Coroleu. Dual antiplatelet therapy (DAPT) with aspirin and clopidogrel after percutaneous coronary intervention (PCI) reduces the risk for coronary thrombotic events (CTEs) at the expense of increasing risk for major bleeding (MB). However, the lack of information to accurately predict the occurrence of each event in out-of-hospital patients under...