The left distal radial artery has been recently proposed as an alternative in selected patients with high success rate and low complications rate. This study evaluated the feasibility and safety of this puncture both for coronary angiography and angioplasty. It included 200 consecutive patients with palpable left distal radial artery punctured by three expert operators....
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...
Intravascular imaging, which includes ultrasound intravascular (IVUS) and optical coherence tomography (OCT), shows live details that better characterize post stenting plaque, anatomy and outcomes. The already familiar limitations of the angiography has lead us to think that IVUS and OCT could improve clinical outcomes; however, we should still find the evidence to support this claim. To shed some...
Coronary angiography is essential for patients admitted with non-ST-elevation acute coronary syndrome, since it allows physicians to confirm the diagnosis, stratify the risk, and define the revascularization and antithrombotic management strategies. There is no doubt that these patients should be studied invasively, but the timing for that is still uncertain. Coronary catheterization within...
Courtesy of Dr. Gustavo Leiva. Coronary Artery Bypass Graft (CABG) has traditionally been the procedure of choice in patients with left main coronary artery disease. However, the use of percutaneous techniques in this kind of lesions has been on the rise, partly due to recent research showing similar outcomes with both procedures. Unprotected left main...
Courtesy of Dr. Guillermo Migliaro. The latest 2011 American College of Cardiology (ACC) guideline states that “coronary intravascular ultrasonography (IVUS) may be considered for guidance of coronary stent implantation, particularly in cases of left main coronary artery stenting (Class IIB, Level of Evidence: B).” This has been long debated with no clear winners. This analysis provides new information...
Original Title: Image-based FFR during coronary catheterization. Presenter: Mariano Pellicano. Fractional flow reserve (FFR) is considered the gold standard to detect myocardial ischemia; however, due to its elevated cost, increased procedural time and potential complications associated to the guiding catheter, it is still underused. The FFRangio is a new technology based of angiographic images...
Original Title: Diagnostic accuracy of a fast computational approach to derive FFR from coronary X-ray angiography: results from the international multicenter FAVOR (Functional Assessment by Varios flow Reconstruction) pilot study. Presenter: Shengxian Tu. Pressure gradient across coronary stenosis is associated to flow and influenced by obstruction geometry. The QFR (quantitative flow ratio) is a...
Original Title: CT Angiography for the Prediction of Hemodynamic Significance in Intermediate and Severe Lesions. Head-to-Head Comparison with Quantitative Coronary Angiography Using Fractional Flow Reserve as the Reference Standard. Reference: Matthew J. Budoff et al. J Am Coll Cardiol Img. 2016;9(5):559-564. The aim of this study was to compare the diagnostic accuracy of non-invasive...
Original Title: Transfemoral Access Assessment for Transcatheter Aortic Valve Replacement Evidence Based Application of Computed Tomography over Invasive Angiography. Reference: Circ Cardiovas Imaging 2015 DOI:10.1161/CIRCIMAGING.114.0011995. Courtesy of Dr. Guillermo Migliaro Transfemoral access for TAVI was introduced in 2006 and is considered first choice. Vascular complications (VCs) are important events that correlate to increased mortality. According to the...