Chronic total occlusions (CTO) occur in up to 20% of patients undergoing diagnostic angiographic studies. Over the past two decades, the optimization of recanalization techniques, the development of new specialized devices, and improvement in operator skill have contributed to an increased procedural success rate, reaching 90%. However, specific complications such as collateral perforation and access...
Complementary imaging allows for the identification of numerous scenarios not visible with conventional angiography (ICA), both for the assessment of differential diagnoses and the improvement of percutaneous coronary intervention (PCI) outcomes. Advantages include assessment of plaque characteristics, vessel plaque burden, stent edge dissection, vessel diameter, and correct apposition, among others. While intravascular ultrasound (IVUS) was...
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...
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...
The effects of diabetes on patients with coronary artery disease are well-known, and their outcomes after angioplasty are less favorable, with a higher rate of restenosis, recurrent acute myocardial infarction, and stent thrombosis. Despite advances in drug-eluting stents and procedural techniques, the treatment of coronary bifurcation lesions in diabetic patients shows less positive clinical outcomes...
Discover the most read scientific articles on interventional cardiology of 2022 in our website. No Reflow after Primary PCI in STEMI: An Angiographic Analysis of the TOTAL Study In the early days of percutaneous coronary intervention (PCI) in patients with ST elevation acute myocardial infarction (STEMI), no reflow phenomenon was known as an indicator of...
Severely calcified lesions currently pose a significant challenge, as they require adequate preparation through non-compliant balloons or cutting balloons to achieve effective stent expansion. Another option is the use of orbital or rotational atherectomy (RA), but this carries the risk of complications such as slow/no reflow, perforations, dissections, peri-procedural infarction, or guidewire rupture. Despite the...
The population is aging, which is closely related with the presence of aortic stenosis. This condition, as we know, is associated with coronary artery disease (CAD) approximately in 50% of cases. In high risk surgical patients, this calls for procedures such as percutaneous coronary intervention (PCI) and transcatheter aortic valve replacement (TAVR). PCI with ventricular...
Coronary calcification, whether concentric or eccentric, has always posed a challenge in percutaneous coronary intervention (PCI) due to difficulties in plaque preparation, device navigability, proper stent apposition, drug release, and potential complications during the procedure. This study analyzed 262 patients who participated in the four Disrupt CAD OCT Studies and underwent PCI using coronary lithotripsy followed...