One of the challenges of percutaneous coronary interventions (PCI) are <2.5 mm vessels, since complications and restenosis complications rate are higher than with >3.0 mm vessels. Drug Coated Balloons (DCB) can be a useful tool, but their efficacy and safety [vs. plain old balloon angioplasty] remains unclear. PEPCAD China SVD is a prospective and multicenter...
This scientific article we briefly discuss the POKI technique, a new stent optimization strategy for bifurcation lesions. Coronary bifurcations represent 20 to 25% of percutaneous coronary interventions (PCI) and continue to be a real challenge at present; the different available treatment strategies are used to correct bifurcation carina after stenting seeing as incomplete strut apposition...
Short-duration dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with DES is growing steadily, especially for chronic coronary syndromes. There is also some evidence regarding its use in acute coronary syndrome. However, diabetes is a well-known risk factor for both restenosis and thrombosis, since it involves more complex and longer lesions in vessels that...
Aortic stenosis is associated to significant coronary artery disease (CAD) in nearly 50% of cases. When we decide to treat aortic disease using surgery, it has been established we should also treat heart disease. However, when using transcatheter aortic valve replacement (TAVR), this is still unclear, given that in many occasions we see stable lesions...
Stent sub-expansion in coronary territory has been identified as one of the major predictors of stent failure at followup, which is why improving stent expansion will improve clinical and imaging outcomes. In percutaneous coronary interventions (PCI) of severely calcified lesions, calcified lesions present a major challenge since they impede stent delivery, causing stent under-expansion or...
Currently, many randomized studies have suggested that short-term dual antiplatelet therapy (DAPT) followed by monotherapy reduces bleeding without increasing major cardiovascular events after percutaneous coronary intervention (PCI). A meta-analysis of six randomized studies has shown this benefit using ticagrelor monotherapy after short DAPT. However, there is no data on the results of clopidogrel monotherapy. Researchers...
The ISAR-REACT 5 showed a significant reduction in the composite outcome of death, acute myocardial infarction (AMI), or stroke when using prasugrel vs. ticagrelor in patients with acute coronary syndrome (ACS), mainly at the expense of an AMI reduction. While this study changed clinical practice, it has stirred some criticism regarding certain methodological aspects, such...
Revascularization and antiaggregation guidelines have typically recommended aspirin (AAS) as first choice for secondary prevention of cardiovascular events after DES stenting. However, these past few years this strategy has been called into question, seeing as studies have shown the superiority of P2Y12 inhibitor monotherapy (IP2Y12) with clopidogrel or ticagrelor. There is little data comparing both...
Much research has been done on the usefulness of functional testing such as fractional Flow reserve (FFR) after percutaneous coronary intervention (PCI), resulting in the correlation of pathological FFR values with major adverse events at 6 months, as shown by Pijls, et al. The impact of post PCI FFR on prognosis has not been studied...
The use of intravascular imaging such as intravascular ultrasound or optical coherence tomography (OCT) both for decision making optimization and percutaneous intervention planning have introduced changes in some scenarios, such as the left main, improving trial end points. There are ongoing studies set to deliver more evidence on its long term safety and efficacy (especially...