The EBC MAIN LM study randomized 467 patients with severe left main coronary artery (LCA) lesions to receive provisional stenting or a two-sent strategy (Resolute or Onix stent). The two-stent strategy was decided by the operator (culotte, DK-minicrush, T/TAP). The crossover rate from those randomized to provisional stenting was 22%. After a 3-year follow-up, the composite...
Acute coronary syndrome guidelines recommend the use of iFR and FFR guided invasive management for patients with high risk ischemia regardless medical treatment. However, iFR and FFR they are often considered exchangeable. Prior literature has shown there can be a discrepancy of around 20% between these techniques when it comes to revascularization outcomes. Choosing the...
In the field of percutaneous coronary intervention (PCI) and myocardial revascularization surgery (MRS), previous analyses have shown a link between in-hospital and 30-day complications, in terms of complicated progress and/or mortality. Most of this information comes from non-randomized or old studies, which translates into contradictory data. Researchers analyzed the EXCEL study, which included patients with...
The current indication for severe left main lesion continues to be coronary artery bypass graft surgery (CABG) but percutaneous coronary intervention (PCI) has come far in this territory thanks to increasing operator experienced and the use of IVUS during procedures. At present, left main disease have a Class IIa indication in the American guidelines when...
Left main coronary artery percutaneous coronary intervention (LMCA PCI) is a treatment option that is increasingly used in our setting. One of the reasons for choosing this therapeutic strategy is the improvements in devices and techniques. However, the long-term results of LMCA PCI are not well established. The aim of this retrospective study was to...
Percutaneous coronary intervention (PCI) to the left main coronary artery (LMCA) with drug-eluting stent implantation is currently a major challenge due to the size of the vessel, the compromise of a bifurcation lesion in important branches, and the potential risk of complications. Available information on LMCA PCI comes from studies where DES stents were implanted...
There are many current randomized trials comparing percutaneous coronary intervention (PCI) with myocardial revascularization surgery (MRS) for the treatment of left main coronary artery disease (LMCAD). In the European Society of Cardiology guidelines, PCI is classified as Ia (LMCAD with low-complexity coronary disease) or IIa indication (intermediate complexity), whereas, according to the American Heart Association...
Left main coronary artery (LMCA) intervention with significant lesions on both coronary angiography and intravascular ultrasound (IVUS), either through angioplasty (PCI) or myocardial revascularization surgery (MRS), is directly related to a decrease in long-term adverse clinical events. However, the relationship between subclinical LMCA disease (preserved luminal diameters) and long-term mortality is still unknown. A retrospective...
✔️ Complex PCI: Distal Left Main Coronary Artery – SOLACI-SOCIME 2022. ✔️ SOLACI-SOCIME 2022 Scientific Session. 👨🏫 Contents: 00:13 – Welcoming words – Dr. Álvaro Contreras (MEX) 01:18 – LM-PCI: IVUS and FFR/IFR? – Dr. Hector García-García (USA) 17:06 – DK Crush or provisional stenting? – Dr. Carlos Uribe (COL) 32:22 – Optimal antiplatelet anti...
True left main stem bifurcation patients have shown fewer adverse events with stepwise provisional stenting vs systematic dual stenting as first strategy, even though the difference was not significant. Usually, for any other vessel, the preferred technique is provisional stenting. However, when it comes to the left main, there is a randomized, dedicated, well designed...