According to this recent analysis of the MASS II trial, which will soon be published in JAMA, baseline ischemia is not associated with events at 10 years in patients with chronic stable angina. The ischemic burden induced through exercise does not predict events or long-term ventricular function. Such data add some suspense to the results<a href="https://solaci.org/en/2019/08/05/amount-of-baseline-ischemia-in-patients-with-multivessel-disease-and-long-term-progress/" title="Read more" >...</a>
According to this new study, in patients with coronary disease, diabetes, and chronic kidney disease who underwent revascularization through angioplasty or surgery, events are similar. This is one of the first studies painting the real picture for the prognosis of patients revascularized in these conditions (diabetes plus chronic kidney disease). At first sight, these<a href="https://solaci.org/en/2019/03/04/revascularization-in-patients-with-multivessel-disease-diabetes-and-kidney-disease/" title="Read more" >...</a>
In diabetic patients with multivessel disease, anatomical complexity assessed by SYNTAX score is an independent predictor of combined events only por PCI patients, and has absolutely no consequence for surgery. The score should not be used to decide on a revascularization strategy. If the patient is diabetic and has multivessel disease, they simply ought to<a href="https://solaci.org/en/2019/01/04/in-diabetics-with-multivessel-disease-syntax-score-calculations-are-redundant-2/" title="Read more" >...</a>
Since the publication of the original SYNTAX trial, there have been great technical advancements that have influenced the results of angioplasty: New tools for risk stratification using the SYNTAX II score which integrate clinical and anatomical variables to the team’s decision-making process. Functional revascularization (hybrid use of fractional flow reserve or instantaneous wave-free ratio). Optimization of<a href="https://solaci.org/en/2018/05/31/syntax-ii-results-at-2-years-for-best-angioplasty-vs-surgery-in-multivessel-disease/" title="Read more" >...</a>
In patients with left main or three-vessel coronary disease, heart team decisions on revascularization strategy (angioplasty or surgery) may be made based solely on noninvasive computerized tomography (CT) angiography, since there is great correlation between its results and those determined by conventional angiography. For the SYNTAX III REVOLUTION study, Dr. Serruys and his colleagues randomized<a href="https://solaci.org/en/2018/05/24/syntax-iii-revolution-excellent-correlation-between-angiography-and-computerized-tomography-in-patients-with-left-main-and-multivessel-disease/" title="Read more" >...</a>
Courtesy of SBHCI. Hybrid revascularization, which combines CABG with PCI, failed to reduce myocardial ischemia and major cardiac and cerebrovascular events, compared to cardiac artery bypass graft or PCI separately. However, this small study does not provide conclusive evidence, which calls for further randomized studies with enough statistical power to answer this question. Fortunately, we won’t have<a href="https://solaci.org/en/2017/11/01/hrevs-hybrid-revascularization-offers-no-advantage-in-multivessel-disease/" title="Read more" >...</a>
Myocardial revascularization surgery (CABG) is the most frequent of all cardiovascular surgeries and is still the gold standard to treat multivessel disease. Between 6 and 8% of these patients present concomitant carotid stenosis and it is associated with increased peri and post procedural stroke rates during and after surgery. To prevent carotid stenosis, either PCI or endarterectomy<a href="https://solaci.org/en/2017/10/11/multivessel-disease-and-severe-carotid-stenosis-how-to-proceed/" title="Read more" >...</a>
Courtesy of Dr Carlos Fava. The association of primary angioplasty with multivessel lesions is not infrequent and has been analyzed in various studies and meta-analyses. However, the proper course of action remains unclear. According to this study, fractional flow reserve (FFR) could better define the ischemic impact of lesions and help with the identification of<a href="https://solaci.org/en/2017/05/04/primary-angioplasty-and-multivessel-lesions-how-should-we-proceed/" title="Read more" >...</a>
Location: Hospital dos Servidores do Estado (HSE). Operators: Valério Fuks, Marcus Lacativa, André Duque Estrada, Maria Cristina Ferreira. Chairpersons: Marcelo Antônio Cartaxo Queiroga Lopes, Constantino Gonzalez Salgado. Panelists: Valério Fuks, Rodolfo Staico, Alcides Ferreira Junior, Carlos Cabrera Arroyo, Leonardo Cogo Beck. Broadcasted on June 9, 2016 by TBR Productions.
Location: Aloysio de Castro State Cardiology Institute – (IECAC). Operators: Fernando Sant`Anna, Marcus Lacativa. Chairpersons: Sérgio Luiz Navarro Braga, Cyro Vargues Rodrigues. Panelists: Fernando Mendes Santanna, José Mariani Junior, Paulo Sérgio de Oliveira, José Carlos Raimundo Brito, Erick Hornes. Broacasted June 9, 2016 by TBR Productions.