Chronic total occlusion (CTO) affect up to 20% of patients undergoing angiographic diagnostic tests. During the last two decades, recanalization technique refinement, the development of specific devices and operator skill improvement have elevated procedural success rate up to 90%. However, there are still particular complications such as collateral perforation and access site complications. This is...
Lithotripsy in the Left Main Coronary Artery
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
ERCTO Registry: Current Results for Percutaneous Treatment of Chronic Total Occlusions
Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access...
Use of Intravascular Lithotripsy in Left Main
The Left main coronary artery supplies circulation to roughly 70% of myocardium, and left main disease requires a high risk intervention with significant impact on patient prognosis. The current guidelines have set the threshold for intervention in LM disease at ≥50% stenosis, irrespective of the presence of symptoms or ischemic burden. LM calcification is an...
Transcatheter Mitral Valve Replacement: DOAC or VKA?
Severe mitral disease is common and currently constitutes a frequent cause of hospitalization and death. While surgery is the treatment of choice, transcatheter mitral valve replacement (TMVR) emerges as a valid alternative in cases of bioprosthesis failure, ring malfunction, or severe mitral annular calcification (MAC). Furthermore, the latest medical guidelines support the recommendation of TMVR...
Intramural Hematoma
Intramural hematoma (IMH) is considered a subtype of acute aortic syndrome (AAS), and some authors describe it as a developmental stage that might cause high morbimortality events such as dissection, aneurysm, or aortic rupture. One of the CT findings associated with IMH is focal contrast enhancement (FCE) within the intramural hematoma, with a reported incidence...
Relationship of Radial Wall Strain with Functional and Morphological Assessment of Coronary Artery Lesions
Radial wall strain (RWS) has been recently linked with plaque vulnerability and has been identified as a predictor of lesion progression and clinical outcomes. However, RWS should be assessed together with physiological indices and plaque characteristics. The aim of this post hoc analysis of the CCTA-FFR registry was to look into the link between RWS...
Cilostazol in Diabetic Patients with Endovascular Peripheral Revascularization: One Step Beyond Symptom Improvement
In patients with peripheral vascular disease (PVD), the presence of diabetes has been significantly associated with increased failure of critical lower limb ischemia (CLI) treatment, and higher incidence of amputation. This relationship has been attributed mainly to comorbidities and patient characteristics, concomitant peripheral neuropathy and marked microvascular alteration. Also, a high proportion of these patients...
Impella in High Risk Coronary Angioplasty before TAVR
The population is aging, which is closely related with the presence of aortic stenosis. This condition, as we know, is associated with coronary artery disease (CAD) approximately in 50% of cases. In high risk surgical patients, this calls for procedures such as percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). PCI with ventricular...
Left Main Coronary Artery PCI: In What Scenario Could We Not Use IVUS?
Lesions in the left main coronary artery (LMCA) continue to pose a significant challenge. The use of coronary imaging before percutaneous coronary implantation (PCI) has proven useful in analyzing the lesion, identifying the presence and location of calcification, and determining lesion length in the LMCA, the left anterior descending artery, and the circumflex artery. Various...