Short-duration dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) with DES is growing steadily, especially for chronic coronary syndromes. There is also some evidence regarding its use in acute coronary syndrome. However, diabetes is a well-known risk factor for both restenosis and thrombosis, since it involves more complex and longer lesions in vessels that...
Takayasu arteritis (TAK) is an uncommon granulomatous large-vessel vasculitis that affects the aorta and its primary branches. The most frequently types of observed vascular compromise are obstructive lesions, and aneurysmal vascular lesions or dissections. In 2021, the American College of Rheumatology recommended not to implement percutaneous intervention (PI) with these patients and only use immunosuppressive...
In this article, we will examine the use of hybrid coronary revascularization to treat multivessel coronary artery disease. Coronary artery disease (CAD) is the most common cause of morbidity and mortality in the western world. The presence of multivessel CAD is associated to high short and midterm mortality and coronary artery bypass graft (CABG) is...
From a cellular standpoint, the term ‘myocardial viability’ refers to a myocyte that has no irreparable damage. From a clinical standpoint, it refers to areas with myocardial contractile dysfunction at rest that are expected to improve with correct revascularization. There are specific vessel ischemia and viability indexes that may help identify hibernation areas that could...
We are already familiar with the strong impact of secondary mitral valve regurgitation (SMR) in survival and quality of life. Most of these patients present heart failure (HF) with reduced ejection fraction (HFrEF). Stages of heart failure based on extra-mitral cardiac involvement has been shown relevant. There is also extensive research on aortic valve disease...
Discover the most read scientific articles on interventional cardiology of 2022 in our website. The FDA Approves Intravascular Lithotripsy for Calcified Lesions The US Food and Drug Administration (FDA) has cleared the shockwave lithotripsy system to treat severely calcified plaque lesions. Is Epinephrine Superior to Adenosine in No-REFLOW? In patients with acute coronary syndrome, no-reflow prevalence is 32%. Different drugs—such as adenosine, verapamil,...
Acute kidney injury (AKI) following acute coronary syndrome (ACS) is associated with prolonged hospital stay and worse prognosis at followup. However, serum creatinine level increase can either be transient or permanent. At present, retrospective studies show transient AKI patients present similar survival rate to patients with no AKI. The prognostic implications of transient and persistent...
The use of intravascular imaging helps improve diagnosis in situations where a conventional coronary angiography might not be conclusive. That is the case of patients with myocardial infarction with non-obstructive coronary artery lesions (MINOCA). The largest MINOCA cohort reported so far has shown 5%-7% prevalence. This pathology, initially considered benign, presents a remote mortality rate...
The duration of percutaneous aortic valve implants can be increasingly observed over time, regardless of their corresponding surgical risk. In the follow-up of different registries, the presence of subclinical valvular thrombosis, evidenced in tomographic studies as an increase in valvular thickness with hypoattenuation (a term known as HALT), was observed from protocolized images. This subclinical...
Stent sub-expansion in coronary territory has been identified as one of the major predictors of stent failure at followup, which is why improving stent expansion will improve clinical and imaging outcomes. In percutaneous coronary interventions (PCI) of severely calcified lesions, calcified lesions present a major challenge since they impede stent delivery, causing stent under-expansion or...