Acute myocardial infarction (AMI) continues to be a clinically significant condition due to its association with morbidity and mortality after the initial event. Therefore, the prognostic stratification of these patients is of vital importance. One of the tools that have been used for several years for this purpose is the SYNTAX I (SS) and SYNTAX...
ISCHEMIA Trial: Does Complete Anatomical or Functional Revascularization Modify Anything Compared with Medical Treatment?
Chronic coronary syndrome (CCS) has been considered another comorbidity in previous studies, and there has been no significant reduction in cardiovascular mortality or myocardial infarction (MI) rates with revascularization through percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS) compared with optimal medical treatment (OMT). One possible reason for the lack of benefit has been...
BIFURCAT Registry: Long Term Diabetes Impact on Bifurcations PCI Outcomes
The impact of diabetes in patients with coronary artery disease (CAD) are well known, and after percutaneous coronary intervention (PCI), outcomes tend to be less favorable, with higher restenosis rate, repeat myocardial infarction (MI) and stent thrombosis. Despite the development of drug eluting stents, procedures and techniques, treating bifurcation lesions in diabetic patients still show...
Hypertrophic Cardiomyopathy: Long Term Survival with Alcohol Septal Ablation according to Hemodynamic Variables
Left ventricular outflow tract (LVOT) obstruction is an integral component of hypertrophic cardiomyopathy (HCM). Both chemical myomectomy and alcohol septal ablation (ASA) have been shown effective in the reduction of residual gradients and symptoms in several studies and clinical registries, and are normally reserved for patients who continue experiencing symptoms despite medical treatment. Even though...
OCT-Guided PCTA: Does It Offer any Benefits?
For many years, percutaneous transluminal coronary angioplasty (PCTA) has expanded significantly worldwide. However, despite the demonstrated advantages of intravascular ultrasound (IVUS) in terms of minimal luminal area, reduced cardiovascular events, and restenosis, its use is not very common due to various reasons. On the other hand, optical coherence tomography (OCT) offers even higher resolution than...
TAVI-in-TAVI with Balloon-Expandable Valves
TAVI (Transcatheter Aortic Valve Implantation) has proven to be beneficial and is currently performed in increasingly younger and lower-risk patients. However, as with surgical bioprostheses, structural deterioration, whether due to stenosis or regurgitation, is one of the challenges we must address. While currently uncommon, this is an issue we will probably see more and more...
What to Do in Cases of AMI with Multivessel Disease
The presence of lesions in multiple vessels is common in ST-segment elevation myocardial infarction (STEMI). It has been shown that, when they are treated in a second procedure, patients have a better outcome. To date, there is limited information available on percutaneous transluminal coronary angioplasty (PTCA) in vessels with severe non-culprit lesions during primary angioplasty....
AMI following Coronary Artery Dissection: Higher Mortality?
Though rare, spontaneous coronary artery dissection (SCAD) might lead to MI, most commonly affecting young middle aged women. In these cases, the angiographic image will present a characteristic double lumen, and an intramural hematoma in the coronary artery wall. Normally, it will be treated medically. However, a small number of cases presenting STEMI will require...
ESC 2023 | Anticoagulation After Primary PCI in STEMI Patients
The empirical prescription of anticoagulants after percutaneous coronary intervention (PCI), also know as post-procedural anticoagulation (PPA), is nowadays a common practice that uses various types of medications. Despite studies like HORIZONS-AMI and EUROMAX, in which 41% of patients received PPA, and the CCC-ACS registry, where 75% of subjects received PPA after primary PCI, European and...
Left Atrial Appendage Occlusion: Clinical Outcomes according to Device Implantation Depth
Continuous improvement of left atrial appendage occlusion (LAAO) devices has had a positive impact on the safety and efficacy of this technique. However, device related thrombus formation (DRT) is still a major concern because of the associated increased risk of thromboembolic events. Approaching this complication calls for more intense antithrombotic treatments, which in turn involves...