The presence of calcified lesions worsens percutaneous coronary intervention prognosis, presenting more restenosis, thrombosis and need for new revascularization. The aim of this study was to assess the superiority of CTO with a prespecified management algorithm on a conventional angiography treatment, in addition to assessing CTO safety. A superiority randomized study was carried out including...
The aim of this randomized open study was to determine whether CTO guided left main percutaneous coronary intervention (PCI) is superior to fluoroscopy guided PCI, using fractional flow reserve (FFR) after stenting. The secondary outcomes were procedural success (successful implantation, malposition, edge dissection or stent collapse) and major adverse cardiovascular events (MACE) at one year....
Despite primary angioplasty, many patients with ST elevation acute myocardial infarction with (STEMI) show evidence of microvascular dysfunction. This dysfunction can be characterized by two main factors: A new specific index has recently been identified to assess microcirculation called microvascular resistance reserve (MRR), which allows measuring vasodilatory capacity independent of the epicardium. The purpose of...
Invasive coronary angiography (ICA) has become the gold standard for the assessment of patients with chronic coronary syndrome (CCS) for obstructive coronary artery disease. However, its ability to detect this condition is limited and it does not detect non-obstructive myocardial ischemia, which can be overlooked. To address these limitations, a prospective, observational, multicenter study was...
Coronary revascularization aims at improving coronary flow. However, after successful percutaneous coronary intervention (PCI) a significant number of patients might experience suboptimal coronary physiology. It has been observed that low fractional flow reserve (FFR) after PCI is associated to poor prognosis. Also, improved FFR after procedure directly correlates with improved angina symptoms. Pullback pressure during...
Technological advancements and technique improvements have significantly enhanced the success rate of percutaneous interventions for treating chronic total occlusions (CTO). Angiographic scores and CTO-PCI algorithms are valuable tools that help us select the optimal strategy when planning these procedures. The retrograde strategy, specifically, has proven beneficial in addressing complex CTOs. However, standardized tools to predict...
This study analyzed 2,493 “real world” patients, 1,352 receiving the Evolut R/Pro, 675 the SAPIEN, 3,270 the Acurate Neo and 192 the Portico. Primary end point was all cause mortality and major adverse cardiovascular events (MACE) at 5 years. Populations were similar, with EuroSCORE 4.9%, and there were no significant differences in comorbidities or echocardiographic...
This was a randomized study with 447 patients carried out to compare the 5-year evolution of TAVR using Evolut R and SAPIEN 3, as well as general anesthesia vs. conscious sedation. Randomization was in two stages: first valve selection and later the anesthesia technique, that is, conscious sedation vs general anesthesia. The populations were similar....
Aortic stenosis is an increasingly common valvulopathy because people are living longer now. A present, the main treatment consists of surgical (SAVR) or transcatheter aortic valve replacement. (TAVR). One of the main challenges of this disease is its progression. The European guidelines recommend Doppler echocardiograms every 2 to 3 years for mild cases, mildly calcified,...
Venous thromboembolism represents one of the main causes of cardiovascular death. Pulmonary embolism (PE) can vary from asymptomatic to manifesting with shock and sudden death, with a wide clinical spectrum. Patient followup is crucial, seeing as survival PE patients usually experience residual symptoms at long term, such as dyspnea or functional capacity deterioration. For decades,...