Functional assessment with fractional flow reserve (FFR) was not better than conventional angiography to guide complete revascularization in patients with multivessel lesions in a setting of ST-segment elevation myocardial infarction and successful primary angioplasty. These results were published in the New England Journal of Medicine (NEJM) and presented during the American College of Cardiology (ACC)<a href="https://solaci.org/en/2021/06/07/flower-mi-ffr-vs-angiography-for-complete-revascularization-in-infarction/" title="Read more" >...</a>
Should Total Occlusion Influence on Revascularization Strategy?
Success or failure of total occlusion (TO) revascularization does not affect mortality at 10 years, and this does not depend on revascularization strategy (PCI vs surgery) or location. The long-term clinical benefit of recanalization and PCI or TO artery bypass graft remains nuclear. This is a sub-study of the SYNTAXES (Synergy Between PCI With Taxus<a href="https://solaci.org/en/2021/03/19/should-total-occlusion-influence-on-revascularization-strategy/" title="Read more" >...</a>
Contralateral Occluded Carotid Defines Revascularization Strategy
A significative lesion to the carotid artery in addition to contralateral carotid occlusion is an obvious factor of high risk for a revascularization procedure. However, this might be true for surgery but not for carotid artery stenting according to this recent publication in JACC. The presence of contralateral carotid occlusion has been established as high<a href="https://solaci.org/en/2021/03/11/contralateral-occluded-carotid-defines-revascularization-strategy/" title="Read more" >...</a>
Revascularization Is Needed Before TAVR
Disease prevalence in patients with severe aortic stenosis is highly variable: from 80% in inoperable patients to only 15% according to the most recent research including low-risk patients. Given the high mortality observed in patients with heart disease, guidelines suggest considering coronary bypass revascularization in those in need of a valve replacement. This experience with<a href="https://solaci.org/en/2021/03/08/revascularization-is-needed-before-tavr/" title="Read more" >...</a>
AHA 2020 | Effect of Evolocumab in Complex Coronary Revascularization
Evolocumab, a PCSK9 inhibitor, has shown significant reduction of complex coronary disease requiring revascularization (be it PCI or CABG). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors induce plaque regression and could eventually reduce the risk of coronary revascularization, especially complex revascularization. The FOURIER study randomized 27564 patients with stable CAD already on statins to evolocumab<a href="https://solaci.org/en/2020/11/25/aha-2020-efecto-del-evolocumab-en-coronaria-compleja-que-requiere-revascularizacion-2/" title="Read more" >...</a>
Visual Assessment for Non-Culprit Lesion Revascularization
There is evidence in favor of complete revascularization in the context of ST elevation MI with multivessel disease where primary PCI has been successful. However, the small print in these studies should be read carefully. Should revascularization be completed during index intervention, index hospitalization or after discharge? Should complete revascularization be based on visual assessment,<a href="https://solaci.org/en/2020/09/22/visual-assessment-for-non-culprit-lesion-revascularization/" title="Read more" >...</a>
ESC 2020 | Revascularization Strategies: Ventricular Dysfunction Might Tilt the Scales
Patients included in the ISCHEMIA trial who had a history of cardiac failure or ventricular function deterioration will benefit from revascularization vs. optimal medical treatment. This is a pre-specified analysis of the paradigmatic ISCHEMIA trial. The ISCHEMIA was published in March 2020 in NEJM and went somewhat unnoticed due to the COVID-19 pandemic. At the<a href="https://solaci.org/en/2020/09/08/esc-2020-revascularization-strategies-ventricular-dysfunction-might-tilt-the-scales/" title="Read more" >...</a>
Long Term Changes ACS Revascularization
Long term outcomes support complete revascularization in multivessel patients undergoing acute coronary syndrome (ACS). This large contemporary registry recently published in J Am Coll Cardiol Intv. has shown complete revascularization is gaining ground in the daily practice and is associated to clinical benefits in patients undergoing ACS. It included 9094 individuals with ACS and multivessel<a href="https://solaci.org/en/2020/08/07/long-term-changes-acs-revascularization/" title="Read more" >...</a>
Webinar SOLACI | NSTE-ACS Revascularization: Times and Methods in the COVID-19 Era
Watch again our Webinar on “NSTE-ACS Revascularization: Times and Methods in the COVID-19 Era” on our Youtube account. We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.
SOLACI Webinar | NSTE-ACS Revascularization: Times and Methods in the COVID-19 Era
[wysija_form id=”3″] We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.