The use of ultravascular ultrasound (IVUS) to guide coronary angioplasty procedures (PCI) has been shown to reduce the risk of major adverse events in numerous randomized controlled studies, registries and meta-analysis. The current guidelines recommend the use of IVUS in left main disease and complex lesions. The proportion of complex PCI procedures has increased over...
The antegrade dissection and re-entry (ADR) technique is considered essential for the management of chronic total occlusions (CTO). It serves as the primary option in some protocols for complex and extensive lesions or as a backup strategy in case of failure with other initial strategies. Dissection techniques include guided methods such as scratch and go,...
Approximately 30% of patients undergoing percutaneous coronary intervention (PCI) present moderate to severe calcified lesions, which presents a significant challenge involving a high incidence of major adverse cardiovascular events (MACE). Rotational atherectomy (RA) is used to modify these calcified lesions and facilitate balloon angioplasty followed by stent implantation. The combination of RA with other plaque...
The presence of cardiogenic shock (CS) in a setting of aortic stenosis ranges from 1% to 4%. The prognosis for this scenario is ominous due to subendocardial ischemia, which presents as a decrease in ventricular preload and an increase in afterload. Aortic valvuloplasty has been used in this context, but, unfortunately, it has been associated...
This was a randomized study including 261 patients treated with infrapatellar percutaneous transluminal angioplasty.173 of these patients received an everolimus bioresorbable scaffold while the remaining 88 were treated with balloon angioplasty. The efficacy primary end point was limb salvage and primary patency rates at 12 months and the safety primary end point was freedom from...
Ultrathin drug eluting stents (60 µm) had been shown beneficial vs. thin-strut stents in terms of target lesion failure (TLF) at 2, 3 and 5 years in randomized studies, but they had not been yet assessed in “real world” patients. The BIOFLOW VII is a prospective, multicenter study including 556 “real world”patients with a total...
Approximately 20% of all percutaneous coronary interventions (PCI) are performed on bifurcation lesions, which continue to pose a challenge in terms of strategy: how many stents to use, what is the most suitable strategy, and when to transition from a single stent to two during the procedure. Additionally, the use of two stents in these...
Coronary bifurcation lesions have been a subject to debate, with different approaches by various medical teams. These lesions often carry a higher risk of ischemic events compared with lesions at non-bifurcated sites. The main strategy, supported by medical society recommendations and clinical guidelines, involves using provisional stenting with one stent to minimize the number of...
For many years, percutaneous transluminal coronary angioplasty (PCTA) has expanded significantly worldwide. However, despite the demonstrated advantages of intravascular ultrasound (IVUS) in terms of minimal luminal area, reduced cardiovascular events, and restenosis, its use is not very common due to various reasons. On the other hand, optical coherence tomography (OCT) offers even higher resolution than...
Researchers conducted a multicenter randomized study involving 2008 patients undergoing coronary angioplasty (PCI). In this group, 1005 patients underwent a procedure guided by OCT, and 1003 patients by IVUS. The average age of participants was 65 years, 21% of subjects were women, and there were no significant differences between both groups. The primary endpoint was...