Among patients undergoing percutaneous coronary intervention (PCI), there is a need for risk stratification for successful planning and post procedural management. Risk stratification is paramount for effective decision making. For a long time, the SYNTAX score has been the preferred tool for complex PCI patient risk assessment. However, it has important limitations, such as inter-observer...
Coronary Angioplasty in Chronic Total Occlusions (CTO): Are There Sex Differences?
Studies and registries assessing sex differences in chronic total occlusions (CTO) are limited and women are under-represented, accounting for only 14%-21% of included patients. Even though success rate is comparable between sexes, several studies have shown higher complications rate among women. The aim of this study was to identify sex related baseline and procedural differences,...
CLOUT Registry: Thrombectomy in TVP with ClotTriever
Safety and efficacy of the ClotTriever device in extended deep vein thrombosis. The endovascular treatment of thromboembolic disease has evolved and new devices have come out in the last few years to reduce morbimortality from its complications. Sub-treating this pathology has long term implications, such as reduced quality of life, limiting functional class and, worst...
CTO: Length’s Impact on Success
The rise of chronic total occlusions (CTO) percutaneous coronary interventions (PCI) goes hand in hand with technological development, through still posing a great challenge, one not exactly exempt from complications. An important criterion to successful CTO PCI is length: ≥20 mm lesions lower the odds, according to J-CTO Score. However, increasing operator experience and the...
FLASH Registry: Mechanical Thrombectomy with FlowTriever
Prospective registry of PTE patients who underwent FlowTriever, with 6 months of follow-up. The clinical relevance of interventional treatment in pulmonary thromboembolism (PTE) is often discussed, and no clinical studies have demonstrated a decrease in “hard” outcomes such as mortality. However, in recent years the use of catheter-directed therapies has increased, either through its main indication,...
Comparação dos meios de contraste e seu impacto na dose recebida
By Erika Gondim Gurgel Ramalho Lima.
Plaque Erosion with No Stenting in Acute Coronary Syndrome: Are There Event Predictors to Avoid This Strategy?
Event predictors in patients with plaque erosion and no stenting. A third of all acute coronary syndrome (ACS) cases are caused by plaque erosion. In the initial EROSION study, it was shown that patients with plaque erosion (as evidenced by OCT, with stenosis <70%, TIMI III flow, and asymptomatic) were stabilized without stent implantation (no...
Resistant Obstructive Hypertrophic Cardiomyopathy: Myomectomy or Septal Ablation?
Approximately 70% of hypertrophic cardiomyopathies (HCM) are associated to a left ventricular outflow tract (LVOT) obstruction and mitral valve failure leading to dyspnea and cardiac failure in a high number of patients. Even though at present there are effective drug treatments combined with pacemaker implantation, surgery (septal myomectomy (SM) continues to be the first choice...
Is Rehospitalization a Relevant Factor after Aortic Valve Replacement?
Patients with severe symptomatic aortic stenosis treated with aortic valve replacement might still present cardiac failure, even after successful procedures. According to some reports, the incidence of cardiac failure after TAVR varies between 9% and 24%. The prognostic relevance of rehospitalization in these patients has not been studied yet; in fact, it remains unclear whether...
Trans-Stent Gradient as a Predictor of Adverse Events at Followup
Stenting a coronary lesion should not present a drop in pressure when measuring the treated segment with fractional flow reserve (FFR). FFR based trans-stent gradient should involve a segment of the sub-expanded vessel or instent obstruction as plaque prolapse or thrombus. The link between post-stenting physiology and long-term outcomes have been looked at in several...