Cardiogenic shock will develop in approximately 10% of patients with ST elevated acute MI (STEMI), and unfortunately, only half of these patients will survive. Researchers have been looking into the Impella system to manage this severe complication. It consists of an aortic transvalvular pump designed to deliver blood from the left ventricle into the systemic...
The international guidelines recommend the use of dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor during 12 months in patients receiving percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), to prevent events such as MI and stent thrombosis. This was a multicenter, placebo controlled, double blind study to determine whether ticagrelor alone,...
Severe persistent calcification of the coronary arteries has been associated with different factors, such as advanced age, hypertension, dyslipidemia, smoking, and kidney failure, among others, and continues to be one of the challenges to stent implantation because of it impact on device advancing, drug release and adequate positioning. Intravascular lithotripsy (IVL) is a technique that...
Assessing intermediate coronary lesions with intracoronary physiology tests such as fractional flow reserve (FFR) or other non-hyperemic indices is considered the standard of care by both American and European societies. Likewise, intravascular imaging techniques (IVI), be it IVUS or optical coherence tomography (OCT), are of great use in assessing and guiding complex coronary lesions and...
Septal reduction therapies are used to mitigate the symptoms caused by dynamic left ventricular outflow tract (LVOT) obstruction and the associated mitral regurgitation (MR) that can surge in hypertrophic cardiomyopathy (HCM). Alternative therapies to treat LVOT obstruction include surgical procedures, i.e. surgical myotomy or myomectomy, or alcohol and radiofrequency septal ablation (intracardiac, transthoracic and endocardial,...
Individual randomized studies have shown variable results regarding the mortality risk following treatment of left main coronary artery disease (LMCAD), either through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). However, upon assessment of the latest meta-analyses (with matched data), similar risks of all-cause and cardiovascular mortality have been reported for both groups....
The presence of calcification in coronary arteries (CAC) remains a challenge for the percutaneous treatment of these lesions. Several studies have established the link between CAC and poor long term results. Intravascular lithotripsy (IVL) has surged as a tool to induce calcified plaque fracture. Even though studies on this strategy are not randomized, they have...
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
Over time, percutaneous coronary intervention (PCI) with drug coated balloons (DCB) have been shown more beneficial than conventional PCI. However, in many cases, stenting is required to treat suboptimal results. Even though several studies have looked into this scenario, long term durability still calls for research. This was a 5 year thorough analysis of the...
Proximal optimization technique (POT) has been recommended as a standard strategy in bifurcation lesions because it facilitates proper stent implantation and apposition in the proximal main vessel, according to the European Bifurcation Club. Percutaneous coronary intervention (PCI) of the unprotected left main coronary artery (LMCA) has specific characteristics, and the long-term impact of this strategy...