In coronary artery disease (CAD), lumen area and plaque burden, characteristics and physiological impact are what define prognosis. At present, coronary angiography continues to be the gold standard for CAD assessment. When considering PCI to treat intermediate lesions, FFR has been shown beneficial and safe. Not yet IVUS. 1682 patients with intermediate lesions (40 –...
Percutaneous coronary interventions have improved during the last decade with 15% rate of target vessel failure (TVF) at 5 years according to the latest reports. We are already familiar with the benefits of functional assessment of lesions with FFR and its clinical outcomes. Additionally, low post PCI FFR values (FFR ≤ 0.83-≤0.91) have been associated...
Endovascular treatment of femoropopliteal lesions has become the first-line treatment due to the development of devices that decrease the restenosis rate. Recently, the IMPERIAL study showed greater patency at 1 year and greater freedom from clinically guided revascularization at 2 years in favor of the ELUVIA stent (paclitaxel-eluting fluoropolymer, FP-DES) compared with the ZILVER PTX...
Second generation drug-eluting stents have lower frequency of thrombotic complications and in-stent restenosis. While clinical results have significantly improved, having a 2-3% annual rate of these complications within the first year after angioplasty is still worrisome. This resulted in the development of stents with struts <70 µm (ultrathin), with bioresorbable polymer and abluminal cover. Stents...
We all know the benefits of ultravascular ultrasound (IVUS) in the development of percutaneous coronary intervention, such as more accurate vessel measurement, improved stent expansion and apposition, and complication identification. This is why the use of IVUS is a class IIa recommendation in AHA and ESC guidelines. The aim of this retrospective study was to...
Intravascular ultrasound (IVUS) to guide drug-eluting stent (DES) implantation has been evaluated in several studies. Two randomized studies, IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) and ULTIMATE (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in All-Comers Coronary Lesions), have shown fewer repeat revascularizations compared with angiography-guided...
FLAVOUR was a prospective randomized non-inferiority study in patients with intermediate coronary lesions (40%-70%) that compared two imaging modalities: IVUS (intravascular imaging) and FFR (fractional flow reserve). According to this research—presented at ACC 2022—, FFR-guided angioplasty was non-inferior to IVUS-guided angioplasty at 2 years of follow-up. Furthermore, using FFR-based imaging led to fewer stent implantations....
For approximately two decades now, PCI has been the treatment of choice in femoropopliteal territory, and even though technological developments and increasing operator experience have indeed improved outcomes, IVUS (which has showed great benefits in PCI, even reducing left main mortality) is hardly used in this territory. This was a prospective randomized controlled study including...
The use of intravascular ultrasound (IVUS) has seen exponential growth across registries over the years, combined with mounting and increasingly robust evidence. The fact that it will enable us to characterize plaque morphology and extension prior the intervention, and even assess stent expansion post intervention, has turned it into a pillar of our efforts to...
No decision on the coronary tree has more impact than left main intervention. This makes interventionists prone to over and underestimation of angiographic imaging. In other words, in real life we never report on angiograms showing moderate left main lesions. This reality should be looked into, since operating or intervening moderate left main lesions on...