Conventional transradial access (TRA) is already established as the access of choice for percutaneous coronary procedures, regardless of clinical presentation. This choice is based on multiple randomized studies and meta-analyses that have shown reduced bleeding at the puncture site, less vascular complications, and benefits on mortality (mainly in high-risk patients). The practicality of recovery allows...
Introduction Chronic total occlusion (CTO) represents the most challenging setting for percutaneous coronary intervention (PCI) and multivessel coronary disease (MCD) is often treated in a staggered manner and in a deferred procedure. Although transfemoral is one of the common access site, the transradial access (TRA) has been used with similar procedural success [1]. The distal...
There has been a significant decline in vascular complications in the last few years due to improvements in device profiles and operator experience on transcatheter aortic valve replacement (TAVR). Unilateral vascular access for transfemoral TAVR is as safe as bilateral access and it could be more comfortable for patients according to this study recently published...
The EXCEL study, originally presented at TCT 2016 and published simultaneously in the New England Journal of Medicine (NEJM), showed that angioplasty and surgery in patients with left main coronary artery disease have similar rates of mortality, infarction, and stroke at 3 years. This sub-study, recently published in J Am Coll Cardiol Intv, adds that the...
The left distal radial artery has been recently proposed as an alternative in selected patients with high success rate and low complications rate. This study evaluated the feasibility and safety of this puncture both for coronary angiography and angioplasty. It included 200 consecutive patients with palpable left distal radial artery punctured by three expert operators....
Cardiac Artery Bypass Graft Surgery has been shown more effective than percutaneous coronary intervention (basically because it renders lower revascularization rate) in patients with severe left main bifurcation lesions receiving 1st generation drug eluting stents. This is why the 2014 American guidelines recommend CABG for most patients. But the EXCEL and the NOBLE trials brought back hope to...
Courtesy of the SBHCI. Angioplasty of true distal left main bifurcation lesions with a double-kissing (DK) crush two-stent strategy, compared with provisional stenting, results in lower rates of target lesion failure at 1 year. These findings were largely driven by lower rates of target vessel infarction and definite/probable stent thrombosis. Read also: “EXCEL-QOL Substudy: Similar Quality...
Summary: Second-generation drug-eluting stents have shown better results than their predecessors. In this study we compare two second-generation drug stents in patients with unprotected left coronary trunk injuries. Methods and results: 650 patients with unprotected trunk injury were randomized to either XIENCE V (everolimus eluting) or RESOLUTE (zotarolimus eluting) stents. The primary endpoint was the...
Angioplasty of the unprotected distal left main coronary artery with 2 stents presents the less favorable results in the segment. The double kissing (DK) technique and Culotte technique have been reported as effective for the treatment of bifurcation lesions, however this has never been tested for left main coronary artery. The DKCRUSH-III study investigated the...
Original title: Frecuency domain optical coherente tomography to assess non-ostial left main artery. Reference: Francesco Burzotta, et al. EuroIntervention 2015;10e1-e8 Optical coherence tomography (OCT) has proved valuable in making decisions and monitoring stents implanted in coronary arteries, but its role in the assessment of left main (LM) lesions remains unclear. The study included 54 patients presenting moderate...