Courtesy of Dr. Carlos Fava. The presence of Chronic Total Occlusion (CTO) is about 30%, with an ischemic threshold between 10% and 12.5% to justify rechannelization. Using the new devices, the new guidelines and with more experience operators, these procedures are successful in 10% to 30% of cases. More often than not these patients are not treated...
PCI Mortality and Volume in One Center: Associated?
The relationship between procedure volume and prognosis after a percutaneous coronary intervention remains unclear. Intuitively, we tend to think the larger the volume, the better the results and, consequently, the lower the mortality. But when analyzing the literature, we find studies for and against this thesis. Evidence does support the idea that volume improves outcomes...
Glycemic control and risk of repeat revascularization
The association between glycemic control after coronary angioplasty and outcomes of the latter is controversial in many studies. We have come to think that the risk lies in suffering from diabetes, as if it was an unmodifiable factor. We have also come to believe that glycemic control can impact microvascular complications while it cannot do...
New generation DES present better results in vein grafts than older DES and BMS
There is little information comparing contemporary drug eluting stents (DES) against bare metal stents (BMS), for PCI in saphenous vein grafts in patients receiving (CABG). This study aimed to assess clinical outcomes after PCI in saphenous vein grafts in patients receiving BMS, first generation DES, and new generation DES between 2006 and 2013. The study...
Successful angioplasty in elderly patients with chronic total occlusion reduces mortality
Courtesy of Dr. Carlos Fava. Nowadays, the number of coronary angioplasties carried out on patients with chronic total occlusion (CTO) is increasing due to many studies showing that it improves ventricular function, reduces symptoms, and improves survival. However, most of these works do not include patients of over 75 years old due to their frailty and...
Everolimus DES are more effective and less costly than conventional BMS
Courtesy of Dr. Guillermo Migliaro. Drug eluting stents (DES) represented the greatest technological advance in the treatment of instent restenosis from conventional metallic stents (BMS), especially cobalt chromium everolimus eluting stents (CoCr EES), which have shown an excellent profile, and are mostly safer, compared to first generation DES. Indeed, several randomized studies and meta-analyzis have...
SOLACI symposium at EURO PCR 2017
The Latin American Society of Interventional Cardiology proudly joined the international meeting “Euro PCR 2017”, celebrated on May 16 to 19 in the city of Paris, France. During the event, a delegation of prominent professionals, headed by SOLACI Chair Dr. Ricardo Lluberas, presented a live case entitled “Complex Left Main PCI”. The transmission took...
Second-Generation DES Present Lower Mortality Rates for Vein Grafts
Courtesy of Dr. Carlos Fava. The treatment of vein graft lesions has always been difficult in relation to angioplasty, due to their characteristics. While drug-eluting stents (DES) have proven to be superior to bare-metal stents (BMS) for coronary arteries, such superiority is unclear as regards vein grafts. Several studies with first-generation DES (DES1) have even reported...
In-stent CTO: different prognosis from that of De Novo CTO?
Courtesy of Dr. Carlos Fava. Chronic Total Occlusions (CTO) are truly challenging and different technologies are being developed to treat them, but currently our most pressing questions about them are whether in-stent CTO present the same success rate as de novo CTO, and what their prognosis is. The present trial analyzed 899 CTO: 111(12.3%)...
Is Impella an option in high-risk angioplasty?
Courtesy of Dr. Carlos Fava. Provitional ventricular assist devices are increasingly used in high-risk angioplasties, particularly those involving unprotected left main coronary artery (LMCA) with defective ventricular functioning. However, so far its true role has not been well-studied. This study analyzed 127 consecutive patients in the USpella registry from 2008 to 2015. These subjects underwent high-risk...