In stent restenosis (ISR) continues to be the main limitation to the percutaneous treatment of coronary artery disease, with 5 to 10% prevalence after new generation DES stenting. Guideline recommendations for this intervention include new DES stenting and the use of drug coated balloons (DCB). Recurrent ISR stenting rate ranges between 10 and 40%, and...
The first experiences with distal radial access (DRA) have revealed significant benefits compared against the transradial approach (TRA), showing reduced bleeding events and better puncture site occlusion rate. Even the spectrum of diseases treated with DRA has grown, and now includes chronic total occlusion (CTO) though 7Fr inductors, such as Terumo’s Glidesheath Slender. The aim...
The Treatment of severe aortic stenosis has experienced a significant revolution with TAVR, especially in high and intermediate risk patients, and it is now extending to low risk patients. In the US, nearly half of patients under 64 are being treated with TAVR. One of the fundamental questions that still remains unanswered revolves around device...
The purpose of myocardial viability testing is to identify patients that might benefit from revascularization by diagnosing three types of myocardium: normal, viable or hibernating, and scarred (non-viable). Non-randomized studies have shown recovery of a viable ventricle after myocardial revascularization surgery (CABG) and improved survival. However, a sub-analysis of the main study on viability testing,...
Several scientific societies support performing left atrial appendage occlusion (LAAO) as a stand-alone procedure, even though it is often associated to other cardiomyopathies requiring transcatheter intervention. Though still controversial, combining LAAO and any other cardiac intervention might reduce hospitalizations, as well as the need for additional punctures, anesthesia, red tape, a longer stay and higher...
The main studies carried out on patients with chronic coronary syndromes (CCS), such as the MASS II, COURAGE, BARI 2D and FAME-2, failed to show benefits in terms of mortality with the invasive approach. The ISCHEMIA, a large randomized study including patients with moderate to severe ischemia, with without left main disease and with acceptable...
Aortic stenosis shares risk factors with coronary artery disease (CAD), and its prevalence varies according to age, reaching approximately 50% or more in some registries. Deciding when to treat and the need for percutaneous intervention presents a challenge. It has been established that epicardial stenosis at proximal level, or the medial segment, requires intervention, especially...
Short dual antiplatelet therapy (DAPT) has shown benefits in patients receiving drug eluting stents (DES), reducing bleeding with no concomitant increase in major adverse cardiovascular events (MACE). Traditionally, the therapeutic window was limited to monotherapy with P2Y12 inhibitors during the first year and there are few data on short DAPT followed by long term monotherapy...
Advanced stages of peripheral artery disease cause significant limitations in patients, such as critical limb ischemia (CLI), which manifests with resting pain and gangrene or ulcers of difficult resolution. Uncontrolled progression of this pathology might lead to major amputation, reduced life expectancy and increased healthcare costs. Prior research on infrapopliteal territory have shown contradicting results....
Severe aortic stenosis due to a bicuspid aortic valve (BAV) is uncommon, especially in individuals under 65 years of age. While there are usually no significant differences according to the type of valve when it comes to surgery, with transcatheter aortic valve replacement (TAVR) some may arise. TAVR has seen significant advancements in the treatment...