Heart disease is the most frequent cause of heart failure and, in some observational studies, transluminal coronary angioplasty (TCA) could help improve ventricular function. The only major randomized study to compare myocardial revascularization surgery (MRS) vs. medical treatment in patients with ventricular function impairment was the STICH study, which showed no difference at 5 years,...
This study, presented by Dr. Valentin Fuster, focused on the importance of medical treatment compliance, initially showing data from the FOCUS study where the poor compliance observed in patients after an acute myocardial infarction (AMI) event was improved by creating a polypill (aspirin, simvastatin, and ramipril). Based on this, the SECURE randomized study was conducted...
Endovascular treatment of femoropopliteal lesions has become the first-line treatment due to the development of devices that decrease the restenosis rate. Recently, the IMPERIAL study showed greater patency at 1 year and greater freedom from clinically guided revascularization at 2 years in favor of the ELUVIA stent (paclitaxel-eluting fluoropolymer, FP-DES) compared with the ZILVER PTX...
There are increasingly more patients who have undergone transcatheter aortic valve replacement (TAVR) and require a non-cardiac intervention, or patients with other diseases who need surgery and are diagnosed with aortic stenosis. In addition, on many occasions, surgery must be performed as soon as possible (as in cases of cancer) or is an emergency procedure....
Percutaneous coronary intervention of chronic total occlusions (CTO) is currently indicated for symptom improvement, as studies have inadequate randomization of data which hinders the assessment of hard outcomes. However, patient inclusion in randomized controlled trials has been challenging, especially for highly symptomatic and higher risk patients. This causes a selection bias in randomized studies on...
According to several registries, incomplete left atrial appendage (LAA) closure has been observed in up to 30% of cases after device implantation. The main cause of this complication is a mismatch between closure device and LAA ostium. The latter is elliptical in shape and varies in length, while the Watchman LAA closure device is round...
Coronary physiology, FFR and iFR, has been shown safe to defer lesions and effective to save stents by different randomized studies and registries. However, patients with chronic kidney disease have not been thoroughly analyzed yet, which brings us to the question about what to do in the face of their negative evolution, when atherosclerosis develops...
Currently, the number of nonagenarian patients undergoing angioplasty (whether elective, urgent or emergency) has increased. This population is linked to more comorbidities and has barely been included in most randomized studies or registries. As such, we do not have robust evidence on this group. Researchers conducted an analysis of the J-PCI OUTCOME Registry, in which...
The prevalence of coronary lesions with bifurcation involvement is about 20% in patients undergoing coronary angiography (CTA). While provisional stenting is overall the most accepted technique, the 2018 myocardial revascularization guidelines recommend the 2-stent technique for complex bifurcation lesions, defined as side branch with lesion >5mm, distal reference diameter of the side branch ≥2.75, or...
At present, percutaneous coronary intervention (PCI) is the most common coronary revascularization strategy. One of its benefits is that patients can be safely discharged when procedures are programed, which helps decompress hospital capacity. However, this strategy has not been validated for acute coronary syndromes; the evidence gathered for non-ST elevation ACS is far from robust,...