This cohort study shows that, from 2006 to 2015, the overall survival rate increased and the risk of major amputation decreased following lower limb revascularization. These population observations indicate that outcomes after lower limb revascularization have improved during the assessed period, and so have the centralization and specialization of interventional services. The availability and diversity...
The EXCEL study, originally presented at TCT 2016 and published simultaneously in the New England Journal of Medicine (NEJM), showed that angioplasty and surgery in patients with left main coronary artery disease have similar rates of mortality, infarction, and stroke at 3 years. This sub-study, recently published in J Am Coll Cardiol Intv, adds that the...
The EXCEL trial did not find the sex of patients with left main coronary artery disease to be an independent predictor of adverse events after revascularization. However, women who underwent angioplasty had a trend towards worse outcomes, a finding that might be related to comorbidities and somewhat increased chances of peri-procedural complications. In its formal...
This is one of the first studies on the use of ticagrelor in patients with stable coronary arteries who undergo elective angioplasty. Although its number of patients is low and its endpoints are soft, this work at least provides some support to what is already happening in daily clinical practice. Many patients admitted for a...
The prognosis of patients with symptoms of angina (with all their subjectivity) in a setting of no significant coronary lesions is widely varied. It is not as benign as we initially thought and patients do not present as many events as “regular” patients with associated severe coronary lesions. The literature owed us data on the...
Since the publication of the original SYNTAX trial, there have been great technical advancements that have influenced the results of angioplasty: New tools for risk stratification using the SYNTAX II score which integrate clinical and anatomical variables to the team’s decision-making process. Functional revascularization (hybrid use of fractional flow reserve or instantaneous wave-free ratio). Optimization of...
In patients with left main or three-vessel coronary disease, heart team decisions on revascularization strategy (angioplasty or surgery) may be made based solely on noninvasive computerized tomography (CT) angiography, since there is great correlation between its results and those determined by conventional angiography. For the SYNTAX III REVOLUTION study, Dr. Serruys and his colleagues randomized...
The presence of coronary artery disease (CAD) in patients with aortic stenosis is high, reaching 50% to70% of cases. This poses a great challenge as to what strategy to use and the things we can do. Even though it has been shown complete revascularization is beneficial, it is often difficult to achieve. Instead, reasonable incomplete...
The prevalence of peripheral arterial disease is between 15% and 20% of patients older than 65 years and its severity is greatly underestimated. In fact, annual mortality is higher in patients with peripheral arterial disease (8.2%) than in those after acute myocardial infarction (6.3%). Despite the above, medical advice and efforts to modify risk factors...
The 10th edition of the Latin American Congress on Structural Heart Disease (CLACE, its acronym in Spanish), founded by Dr. Antonio Enrique Dager Gómez, will take place from April 25th to April 27th in Cali, Colombia. This event addresses several cardiovascular topics (hemodynamics, endovascular intervention for peripheral vascular disease, coronary artery disease and related advancements, endovascular...