Computed tomographic (CT) angiography showed a high degree of agreement with conventional angiography to detect significant coronary artery disease and rule out left main disease. This imaging study was done on a group of patients before their randomization in the ISCHEMIA trial. Data are soon to be published in JACC Cardiovascular Imaging and add plenty...
Despite robust information supporting the use of intravascular imaging during coronary angioplasty, its use in clinical practice remains low. This paper proposes using an algorithm for decision-making throughout the procedure to promote increased intravascular imaging use. Regardless of the many technologies that have been incorporated into strut design struts and polymer type, the rate of...
Complex angioplasties require not only experience and patience but also technology. Imaging–guided pre-dilation, stent sizing, and post-dilation reduced the cardiovascular events after a 3-year follow-up in patients who received drug-eluting stents in complex angioplasties. This paper, recently published in JACC Interventions, compared the 3-year outcome of the complex angioplasty optimization technique with intravascular imaging to...
Shear stress has been incorporated to our jargon to identify this turbulent flow in certain places of the arterial tree (curves, bifurcations, etc.) that make these sectors more prone to plaque buildup. Seeing we often use the original term, no Spanish translation has been coined; we all refer to this phenomenon as shear stress and...
Technique advancements in left main coronary artery angioplasty have turned this procedure into a reasonable alternative to surgery, particularly in patients with a low or intermediate Syntax score and, obviously, those in whom surgery was contraindicated. Results can be credited to a refinement in technique, better drug-eluting stents, better patient selection, and frequent use of...
Courtesy of SBHCI. The aim of this work, which was presented during the TCT 2019 Scientific Session and simultaneously published in JACC Intv, was to prove the benefit of intravascular ultrasound (IVUS) in angioplasty. The IVUS-XPL trial randomized 1400 patients with long coronary lesions (≥28 mm) to IVUS-guided angioplasty (n = 700) vs. angiography-guided angioplasty (n = 700). All procedures were...
Fractional Flow reserve (FFR) guided myocardial revascularization surgery (CABG) has similar graft failure rate and clinical outcomes as angiography guided CABG. When planning PCI, the value of FFR for lesion assessment pose no questions, but we know little when it comes to CABG. Since the early start, back when Dr. Mason Sones performed catheterizations and...
All over the world, functional lesion measurement remains underutilized due to the need for a hyperemic stimulus (which may be avoided with instantaneous wave-free ratio [iFR]) and, above all, the invasiveness of guidewire placement (crossing the intended lesion) for the measurement. These guidewires have improved a lot, but they still lack the navigating capacity of...
Symptomatic patients with <1 cm² aortic valve area will benefit from an intervention regardless parameters such as flow and gradient, even if these are normal (or at least not severe). A valve replacement will be indicated without question (either surgical or percutaneous) in patients with >40 mHg mean gradient or low gradient justified by low...
The left distal radial artery has been recently proposed as an alternative in selected patients with high success rate and low complications rate. This study evaluated the feasibility and safety of this puncture both for coronary angiography and angioplasty. It included 200 consecutive patients with palpable left distal radial artery punctured by three expert operators....