Almost 80% of all patients randomized in this study reported Canadian Cardiovascular Society class II or III angina, and almost all of them (97%) had more than 1 positive non-invasive ischemia test that matched the area of their single diseased coronary vessel. Beyond fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR), the study randomized patients to...
A new edition of EuroPCR has come and gone. Now is the time to make a balance and review the main presentations at one of the most important European congresses on cardiovascular interventions. Thus, we have selected the six most relevant studies presented at the event. In our opinion, you cannot afford to miss them!...
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...
Invasive physiology tests used in the ORBITA trial could not predict which patients would benefit from angioplasty more than placebo (sham procedure) in terms of the trial’s primary endpoint, improvement in exercise time. These data were presented at EuroPCR 2018 and published simultaneously in Circulation. Results encourage debate over the importance of ischemia reduction with angioplasty...
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...
All interventional cardiologists must be able to perform a pericardiocentesis. Whether we deal with a chronic total occlusion, a supposedly simple coronary angioplasty (we all have witnessed the perforation of a supposedly risk-free coronary artery), or a transcatheter aortic valve replacement (whose rise gave us another significant source of tamponades), we must all be ready...
Using instantaneous wave-free ratio (iFR) to guide decisions on revascularization of intermediate lesions is cheaper than using fractional flow reserve (FFR). Based on costs from the DEFINE-FLAIR trial, researchers estimate the difference to be almost USD 1000. This should not be seen as good news for any given technology (iFR, in this case), but for physiologic...
1) The CULPRIT-SHOCK Study Is Finally Published in NEJM and It Is Bound to Change Guidelines During SOLACI’s coverage of the TCT 2017 Congress in Denver, Colorado, we already mentioned some of the outcomes of this study that has arrived to revolutionize clinical practice, given the differences between its results and those of the classic SHOCK trial, which has marked...
Several studies show that patients with multivessel lesions who undergo angioplasty with incomplete revascularization experience more events, including higher mortality, than a cohort of patients who have undergone complete revascularization. In most cases, the analysis was dichotomic (complete vs. incomplete revascularization), but more recent studies show that there may be a gradient, a continuum, in...
The PROTECT AF (WATCHMAN Left Atrial Appendage System for Embolic Protection in Patients With Atrial Fibrillation) trial demonstrated that left atrial appendage closure with the Watchman device was equivalent to warfarin for preventing stroke in atrial fibrillation, but it had a high rate of peri-procedural complications. The follow-up randomized trial was PREVAIL (Evaluation of the...