When deciding on the optimal coronary artery revascularization treatment of coronary artery disease (CAD) patients, physicians normally assessed clinical presentation, surgical risk, survival expectation, and the likelihood of a better quality of life. Decisions are made after careful consideration, by the Heart Team, who will ponder options such as coronary artery bypass graft (CABG), percutaneous...
Achieving rapid and maximum inhibition of platelet aggregation can reduce complications related to scheduled percutaneous coronary intervention (PCI) in chronic coronary syndromes (CCS). Over the last few decades, the optimal timing for initiating P2Y12 inhibitors and their appropriate dosage have been the subject of numerous studies; however, they have not been clearly established yet. Higher...
Diabetic patients have twice as high a risk of developing coronary artery disease (CAD). Additionally, CAD increases mortality risk. Patients with a history of percutaneous coronary intervention (PCI) tend to need repeat revascularization, even with second generation stents. To date, there are few studies assessing the role of glycemic control in stent failure, stent thrombosis,...
Drug-eluting balloons (DEB) with paclitaxel have shown efficacy and safety in the treatment of femoropopliteal disease. Sirolimus-eluting balloons (DEB S) are currently being introduced. This new drug acts during the cellular resting phase (G0) and is considered potentially more effective than paclitaxel, which is a cytostatic drug. However, there is no conclusive evidence in this...
The retrograde technique has significantly improved the success of percutaneous treatment of chronic total occlusions (CTO). After crossing a collateral channel, creating a connection between the anterograde and retrograde systems is key. The most common technique for this is reverse controlled antegrade and retrograde subintimal tracking (reverse CART). This technique involves inflating a balloon over...
Bicuspid aortic valve (BAV) disease affects 1%-2% of the population and manifests with severe aortic stenosis in the middle-aged. It characterizes for a very different anatomy with more calcification than the tricuspid aortic valve. At present, surgical aortic valve replacement (SAVR) is the first treatment indication. TAVR in this scenario has shown, in different studies,...
Coronary artery disease is common among patients considered for transcatheter aortic valve implantation (TAVI). With the expansion of the indication for TAVI to a population with lower surgical risk, and therefore younger, there has been a gradual increase in the incidence of coronary events. However, there is limited data on treatment strategy and outcomes in...
In-stent restenosis (ISR) remains the main limitation in the percutaneous treatment of coronary artery disease, with a prevalence between 5% and 10% after implantation of latest-generation drug-eluting stents (DES). Therapeutic recommendations for it include the implantation of a new DES and the use of drug-coated balloons (DCB). The rate of recurrent ISR ranges from 10%...
Regardless of whether it is attempted through percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS), complete revascularization (CR) is not always achieved. Overall, it is more frequent with surgery than with percutaneous treatment. Additionally, incomplete revascularization (IR) has proven to be associated with worse outcomes compared to CR. Researchers conducted an analysis of the...
On the one hand, chronic peripheral vascular disease is on the rise. On the other, over the past 20 years, percutaneous coronary intervention (PCI) has gained considerable ground thanks to various new devices, replacing surgery as an alternative in most scenarios. Both strategies have shown similar results, but PCI has fewer complications and shorter hospital stays....