Resultados a 2 años de los stents liberadores de Zotarolimus vs stents libres de polímero liberadores de Biolimus. ¿Son seguros en pacientes con alto riesgo de sangrado?

Intrastent Restenosis in Ostial Lesions in the Right Coronary Artery: Predictors of an Unfavorable Location

Predictors of intrastent restenosis in the right coronary artery ostium. The ostium of the right coronary artery (RCA) presents certain histological aspects. Atherosclerotic and fibrotic plaques in this area contain an abundance of smooth muscle, collagen, and a certain degree of calcification, along with thicker adventitia. Additionally, it has certain anatomical aspects such as poor<a href="https://solaci.org/en/2023/06/16/intrastent-restenosis-in-ostial-lesions-in-the-right-coronary-artery-predictors-of-an-unfavorable-location/" title="Read more" >...</a>

EuroPCR 2023 | EBC Two – Provisional Stenting vs Culotte in Bifurcations

MD Sandeep Arunothayaraj presented the 5-year followup of EBC Two (which had not previously shown significant differences in clinical outcomes at 12 months) in patients randomized to provisional stenting vs. systematic culotte in bifurcations that were not left main.  The study followed up 200 patients with true bifurcations, side branch ≥2.5mm and lesion length ≥5mm,<a href="https://solaci.org/en/2023/05/17/europcr-2023-ebc-two-provisional-stenting-vs-culotte-in-bifurcations/" title="Read more" >...</a>

Pronóstico al año en lesiones ateroscleróticas vs las no ateroscleróticas en pacientes con MINOCA

One Year Prognosis of Atherosclerotic vs. Non-Atherosclerotic Lesions in MINOCA Patients

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<a href="https://solaci.org/en/2023/01/04/one-year-prognosis-of-atherosclerotic-vs-non-atherosclerotic-lesions-in-minoca-patients/" title="Read more" >...</a>

How Do We Manage Antiaggregation in BARC I Bleeding after AMI?

Dual antiplatelet therapy (DAPT) after acute myocardial infarction (AMI) has been shown useful to reduce thrombotic events, but one of its downsides is bleeding, especially in elderly patients. BARC bleeding type I, also called nuisance bleeding (NB), is of low frequency, but its evolution and impact remain unclear, as does its management.  A subanalysis of<a href="https://solaci.org/en/2022/12/07/how-do-we-manage-antiaggregation-in-barc-i-bleeding-after-ami/" title="Read more" >...</a>

Isquemia crítica de miembros inferiores: las re-hospitalizaciones frecuentes muestran la magnitud del problema

BEST-CLI: Revascularization of Critical Lower Limb Ischemia, a Pragmatic Study

Critical lower limb ischemia (CLLI) is associated with a major deterioration in quality of life and a significant increase in morbidity and mortality. Its estimated annual incidence is 220 to 3500 cases per million people, with an expected prevalence of 11% of patients with peripheral arterial disease. CLLI is the “terminal” stage of peripheral artery<a href="https://solaci.org/en/2022/11/22/best-cli-revascularization-of-critical-lower-limb-ischemia-a-pragmatic-study/" title="Read more" >...</a>

Nueva y discrepante información sobre los vasos no culpables en el infarto

Early invasive Strategy for Non-ST Elevation ACS in Chronic Kidney Disease

Many randomized studies and systematic revisions have shown that an early invasive approach (within 24hrs. after diagnosis) will not reduce mortality across the non-ST elevation acute coronary syndrome (NST-ACS) population, hence the relevance of NST-ACS; patients with a GRACE score higher than 140 were the ones showing improved outcomes.  Roughly 40% of NST-ACS patients have<a href="https://solaci.org/en/2022/10/24/early-invasive-strategy-for-non-st-elevation-acs-in-chronic-kidney-disease/" title="Read more" >...</a>

TCT 2022 | PCSK9 Inhibitor in Patients with STEMI to Lower LDL Cholesterol

In patients with ST-elevation myocardial infarction (STEMI), early treatment with statins —regardless of low-density lipoprotein (LDL) cholesterol levels — is routine around the world. Adding a potent LDL lowering agent, as a PCSK9 inhibitor, has proven clinical benefits in patients with a history of acute coronary syndrome or atherosclerosis, since treatment with statins have not<a href="https://solaci.org/en/2022/09/26/tct-2022-pcsk9-inhibitor-in-patients-with-stemi-to-lower-ldl-cholesterol/" title="Read more" >...</a>

La clave para tratar strokes: saber cuando detenerse

Should We Treat Stroke Percutaneously in TAVR?

Since its inception, transcatheter aortic valve replacement (TAVR) has improved greatly. However, there still are five big challenges to be solved: paravalvular leak, conduction disturbances, debilitating stroke, impaired kidney function, and major vascular complications and bleeding. Most cases of stroke are periprocedural and ischemic. So far, they have not been well analyzed in terms of<a href="https://solaci.org/en/2022/09/14/should-we-treat-stroke-percutaneously-in-tavr/" title="Read more" >...</a>

Heparin Pretreatment in STEACS Treatment: A New Old Ally?

The treatment of ST-segment elevation acute coronary syndromes (STEACS) is undoubtedly reperfusion therapy with primary percutaneous coronary intervention. Similarly, nobody doubts that the pretreatment with more stronger antiplatelet agents has a role in such a treatment. In certain sites, unfractionated heparin (UFH) pretreatment is also administered before the patient enters the cath lab; its aim<a href="https://solaci.org/en/2022/09/12/heparin-pretreatment-in-steacs-treatment-a-new-old-ally/" title="Read more" >...</a>

IVUS en las lesiones coronarias complejas

Are FFR and IVUS Similar to Assess Intermediate Lesions?

In coronary artery disease (CAD), lumen area and plaque burden, characteristics and physiological impact are what define prognosis.  At present, coronary angiography continues to be the gold standard for CAD assessment.  When considering PCI to treat intermediate lesions, FFR has been shown beneficial and safe. Not yet IVUS. 1682 patients with intermediate lesions (40 –<a href="https://solaci.org/en/2022/09/06/are-ffr-and-ivus-similar-to-assess-intermediate-lesions/" title="Read more" >...</a>