Chronic total occlusions (CTOs) account for approximately 15-20% of patients with stable coronary artery disease. This field has seen various advances regarding treatment, leading to an improvement in the success rate of procedures. According to registries and randomized studies, the main indication for percutaneous coronary intervention (PCI) of CTO should be based more on clinical...
Transcatheter aortic valve implantation (TAVI) has become the standard treatment for elderly patients with severe symptomatic aortic stenosis. While this has led to the development of new devices with different features, evidence from randomized studies on these new scaffolds is limited. The randomized SCOPE I study (Safety and Efficacy of the Symetis ACURATE Neo/TF Compared...
Reduced dosage of tenecteplase in elderly patients undergoing a pharmaco-invasive strategy. Delays in achieving timely reperfusion in patients with acute coronary syndrome with ST elevation (STEACS), whether through fibrinolysis or primary percutaneous coronary intervention (PCI), are associated with increased mortality. European guidelines establish a target reperfusion time of 120 minutes after the first medical contact...
In the early days of percutaneous coronary intervention (PCI) in patients with ST elevation acute myocardial infarction (STEMI), no reflow phenomenon was known as an indicator of the worst possible outcomes in terms of left ventricular remodeling, infarct size, ejection fraction and mortality, at long term. The TOTAL study (Routine Aspiration Thrombectomy with PCI Versus...
Secondary prevention with P2Y12 inhibitors vs aspirin monotherapy in CAD patients Antiaggregation therapy plays a central role at long term to prevent new cardiovascular events in atherosclerosis patients. After repeat myocardial infarction (MI) or stroke, prognosis can vary considerably. Even though the current guidelines prefer aspirin as the first choice for secondary prevention over P2Y12...
Patients with chronic kidney disease (CKD) undergoing coronary angiography are at increased risk of developing contrast-associated acute kidney injury (CA-AKI), which is associated with increased mortality. According to current guidelines, the standard treatment for preventing CA-AKI in patients with moderate to severe CKD is long-duration peri-procedural intravenous hydration with saline solution. This standard hydration is...
Mitral regurgitation is the most common valvular heart disease. Its cause is most frequently functional or secondary dysfunction (functional mitral regurgitation, FMR) compared with degenerative mitral regurgitation (DMR), which is associated with decreased ventricular function, hospitalization for heart failure, and mortality. While medical treatment is effective over extended periods, a significant number of patients cannot...
Percutaneous treatment of chronic total occlusions has increase, and has become a a more habitual therapeutic challenge. However, there is limited information on distal vessel quality and its association with outcomes and techniques. This variable appears to be excluded form CTO scores, except for the RECHARGE (REgistry of CrossBoss and Hybrid procedures in FrAnce, the...
Chronic stable angina has shown a good response to medical treatment, and the Ischemia study has recently demonstrated the safety of such treatment in stable chronic angina with moderate to severe ischemia. However, this study excluded left main coronary artery (LMCA) lesions. The FAME Study has shown the safety and efficacy of fractional flow reserve...
At present, transcatheter aortic valve replacement (TAVR) has become increasingly common to treat severe symptomatic aortic stenosis, with the transfemoral approach being the most common access strategy, associated to better outcomes vs. other access sites. Even though vascular complication rates (VC) have dropped given increased operation experience and improved devices, such as the use of...