The recommended treatment for ST elevation acute myocardial infarction (STEMI) is early PCI, typically stenting. However, stent implantation always involves the risk of intravascular complications, such as stent thrombosis or restenosis. Sometimes stable flow is restored to the target vessel after initial PCI and we can omit stenting when there is no angiographically significant residual<a href="https://solaci.org/en/2022/04/04/stemi-can-we-omit-stenting/" title="Read more" >...</a>
While the ideal treatment for coronary bifurcation is provisional stenting, this can be associated with side branch occlusion, which leads to severe adverse events. To prevent this complication, several treatments have been proposed. One of them is wire jailing at side branch before stent implantation in the main vessel. However, the actual benefit of this<a href="https://solaci.org/en/2022/03/29/wire-jailing-at-side-branch-to-prevent-occlusion-after-main-vessel-stenting-should-it-be-the-standard-of-care/" title="Read more" >...</a>
Watch again “Advanced double stenting strategies for the treatment of coronary bifurcations” on our youtube channel. The event was part of the LATAM Bif-SOLACI Group course, entitled “How to achieve optimal and safe treatment of coronary bifurcations in 2021”. Check it out below! Advanced Double Stenting Strategies for the Treatment of Coronary Bifurcations
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<a href="https://solaci.org/en/2021/11/30/provisional-vs-dual-stenting-in-left-main-an-endless-discussion/" title="Read more" >...</a>
This registry of daily clinical practice suggests that this specifically designed double-mesh carotid stent is safe and associated with a minimal and acceptable occurrence of neurological events up to 12 months of follow-up. This double-mesh stent has already been tested, and its short- and long-term efficacy has been proven. However, more recent data have challenged the<a href="https://solaci.org/en/2021/09/27/one-year-of-successful-carotid-artery-stenting-with-the-cguard-device/" title="Read more" >...</a>
Treating the left main coronary artery with provisional stenting was non-inferior to systematic dual stenting in the EBC MAIN trial, presented at EuroPCR 2021 and simultaneously published in the European Heart Journal. The composite primary endpoint of death, infarction, and target-lesion revascularization was 14.7% for provisional stenting vs. 17.7% for systematic dual stenting (hazard ratio:<a href="https://solaci.org/en/2021/05/29/europcr-2021-ebc-main-provisional-stenting-vs-systematic-dual-stenting-in-left-main-coronary-artery/" title="Read more" >...</a>
For many patients, the first symptom of heart disease is acute MI, or even sudden death. Changes in lifestyle and optimal medical treatment (OMT) are vital to the prevention of serious events, but we cannot help wondering whether preventive stenting might do it. Intravascular ultrasound (IVUS), optical coherence tomography (OCT), NIRS near-infrared spectroscopy (NIRS) and computed<a href="https://solaci.org/en/2021/04/16/the-future-of-prevention-stenting-vulnerable-fractional-ffr-negative-lesions/" title="Read more" >...</a>
Suboptimal fractional flow reserve (FFR) results after stenting only have a moderate impact on clinical hard points but might predict a much higher risk of reintervention. FFR has shown a huge impact on the decision-making process when it comes to revascularizing (or not) a lesion. Its impact after angioplasty has not been fully studied, particularly<a href="https://solaci.org/en/2021/04/12/impact-of-ffr-after-stenting-useful-or-mere-fun-fact/" title="Read more" >...</a>
Coronary PCI with contemporary drug eluting stents (DES) in lipidic-rich plaques were not associated with increased periprocedural events at long term compared against plaques with no significant lipidic composition. This study recently published in J Am Coll Cardiol looked into the association between lipidic rich plaques detected by near-infrared spectroscopy (NIRS) and clinical events in<a href="https://solaci.org/en/2020/06/24/stenting-of-lipid-rich-vs-fibrous-and-calcified-plaques-different-prognosis/" title="Read more" >...</a>