Original title: Comparative safety of vascular closure devices and manual closure among patients having percutaneous coronary intervention. Reference: Gurm HS et al. Ann Intern Med. 2013; Epub ahead of print. The use of percutaneous closure devices in patients who undergo coronary angioplasty by femoral access is controversial and its use has gradually changed over time. This record analyzed...
Courtesy of Dr. Carlos Fava. Bifurcation lesions account for about 25% of all angioplasties and it is a challenge for which there is no single treatment strategy. Intravascular ultrasound (IVUS) has proven its usefulness, improving outcomes by reducing mortality in unprotected left main coronary artery (LMCA) angioplasty. A new strategy consists in conducting an IVUS after...
1) Radiation Exposure in Chronic Total Occlusions Even in the hands of experienced operators, rechanneling and angioplasty of a chronic total occlusion (CTO) results in patients and the whole cath lab team receiving high doses of radiation, according to this registry presented at the American Heart Association 2017 Scientific Sessions. Read more 2) Should We Begin to Use IVUS in CTO?...
Courtesy of Dr. Carlos Fava. Coronary perforation (CP) is a very uncommon event (≈0.4%), associated with severe complications that entail risk of death. It has usually been related to patients with a history of myocardial revascularization surgery (MRS). However, this group usually presents lower rates of cardiac tamponade due to pericardial fibrosis caused by surgery. This...
Courtesy of Dr. Carlos Fava. Currently, chronic total occlusions (CTO) are one of the obstacles that coronary angioplasties must overcome, particularly with the development of drug-eluting stents (DES) and new devices and strategies for these challenging lesions. However, there is little information on the safety, efficacy, and real clinical benefit of implanting stents of over 60 mm (known as full metal jackets, FMJ)....
Courtesy of Dr. Carlos Fava. Nowadays, chronic total occlusions (CTO) due to in-stent restenosis (ISR) represent 5%-25% of all coronary angioplasties. These lesions pose a new and true challenge, since CTOs are often associated with stent-related problems (fractures, lack of expansion, overlapping, deformation), extreme tortuosity, severe calcification, tandem lesions after CTO, and aorto-ostial lesions, with little...
Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and...
Performing coronary angioplasties at hospitals without surgical backup seems to be safe for a wide variety of patients, from those presenting ST-segment elevation myocardial infarction to those undergoing elective procedures. This work responds to a long-running debate over whether centers without on-site surgery capabilities in case of complications can be considered as referral centers...
Conventional radial access (CRA) has a proven great benefit as it lowers the rates for bleeding and complications. Also, this access is more comfortable for the patient. Currently, distant radial access (DRA) is being used in some patients. However, its benefit remains unclear, as few studies have analyzed it. In this sense, this meta-analysis that...
Critical lower limb ischemia (CLLI) is associated with a major deterioration in quality of life and a significant increase in morbidity and mortality. Its estimated annual incidence is 220 to 3500 cases per million people, with an expected prevalence of 11% of patients with peripheral arterial disease. CLLI is the “terminal” stage of peripheral artery...