Regardless of whether it is attempted through percutaneous coronary intervention (PCI) or myocardial revascularization surgery (MRS), complete revascularization (CR) is not always achieved. Overall, it is more frequent with surgery than with percutaneous treatment. Additionally, incomplete revascularization (IR) has proven to be associated with worse outcomes compared to CR. Researchers conducted an analysis of the...
Patients with peripheral vascular disease often experience femoropopliteal compromise. It is estimated that approximately 50% of lesions in this area are chronic total occlusions (CTO). Even though success rate has improved for peripheral CTO treatments, long term clinical and technical outcomes have not been fully determined yet. Prior research has looked into stenting outcomes in...
On the one hand, chronic peripheral vascular disease is on the rise. On the other, over the past 20 years, percutaneous coronary intervention (PCI) has gained considerable ground thanks to various new devices, replacing surgery as an alternative in most scenarios. Both strategies have shown similar results, but PCI has fewer complications and shorter hospital stays....
Drug-coated balloons (DCB) have proven to be effective in the treatment of femoropopliteal pathology, although they entail complications such as recoil, residual stenosis, and dissection. Their outcomes could be improved through proper and enhanced vessel preparation, both before and after the procedure. Intravascular ultrasound (IVUS) offers the advantage of characterizing plaque and assessing vessel diameter....
Most randomized studies on revascularization in stable coronary artery disease exclude left main coronary artery disease (LMCAD). One example of this was the ISCHEMIA study. However, the benefits of functional lesion assessment, as demonstrated in the FAME studies, highlight the importance of this tool in guiding decisions regarding revascularization. Nevertheless, the clinical outcomes of patients...
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...
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 use of drug-covered balloons (DCBs) has increased significantly for the endovascular treatment of femoropopliteal arterial disease. Previous studies on first-generation high-dose DCB (HD-DCB) have validated its benefits, thus supporting its recommendation in current clinical guidelines. However, there have been reports of adverse effects associated with paclitaxel and its excipients. Second-generation, lower-dose DCBs (LD-DCB) have...
The Left main coronary artery supplies circulation to roughly 70% of myocardium, and left main disease requires a high risk intervention with significant impact on patient prognosis. The current guidelines have set the threshold for intervention in LM disease at ≥50% stenosis, irrespective of the presence of symptoms or ischemic burden. LM calcification is an...
The purpose of myocardial viability testing is to identify patients that might benefit from revascularization by diagnosing three types of myocardium: normal, viable or hibernating, and scarred (non-viable). Non-randomized studies have shown recovery of a viable ventricle after myocardial revascularization surgery (CABG) and improved survival. However, a sub-analysis of the main study on viability testing,...