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...
Predictors of intrastent restenosis in the right coronary artery ostium. The ostium of the right coronary artery (RCA) presents certain histological aspects. Atherosclerotic and fibrotic plaques in this area contain an abundance of smooth muscle, collagen, and a certain degree of calcification, along with thicker adventitia. Additionally, it has certain anatomical aspects such as poor...
Intravascular Ultrasound (IVUS) has shown, in several studies, its great benefits for both restenosis and mortality reduction. Even though several variables have been studied, so far minimal stent area (MSA) has been disregarded as important. The OPTIVUS-Complex PCI looked at 961 patients with 1,957 lesions, and found 1.6% TLR incidence (30 lesions). There were no...
In recent years, there has been an increase in the number of percutaneous coronary interventions (PCI) performed to treat chronic total occlusion (CTO). This increase is due to the availability of more advanced technology and greater experience of both operators and specialized centers. However, it is important to note that this technique is not free...