Left main lesions in acute coronary syndrome (ACS) represent a major risk and, at present, the best revascularization strategy is a matter of debate. Though many studies and registries have excluded this group of patients, there is data on the pros and cons of both percutaneous coronary intervention (PCI) and cardiac artery bypass graft (CABG). ...
Useful Predictor of Adverse Events in Complex PCI: BCIS CHIP Score
Among patients undergoing percutaneous coronary intervention (PCI), there is a need for risk stratification for successful planning and post procedural management. Risk stratification is paramount for effective decision making. For a long time, the SYNTAX score has been the preferred tool for complex PCI patient risk assessment. However, it has important limitations, such as inter-observer...
Provisional Stenting vs. Culotte: 5-Year Results of EBC TWO
The optimal treatment of true bifurcation lesions not affecting the left main coronary artery is widely debated. Results from randomized studies have shown neutral or worse outcomes with the two-stent technique. Regarding these studies, researchers used first-generation stents and the secondary branches were small. The EBC TWO study compared the provisional stenting strategy against the...
Coronary Angioplasty in Chronic Total Occlusions (CTO): Are There Sex Differences?
Studies and registries assessing sex differences in chronic total occlusions (CTO) are limited and women are under-represented, accounting for only 14%-21% of included patients. Even though success rate is comparable between sexes, several studies have shown higher complications rate among women. The aim of this study was to identify sex related baseline and procedural differences,...
Abbreviated Antiaggregant Treatment in High Bleeding Risk Patients from the MASTER-DAPT (15-Month Followup)
Benefits of abbreviated antiaggregant treatment in high bleeding risk patients. Dual antiplatelet therapy (DAPT), established by different guidelines, reduces the risk of ischemic events at the expense of increased bleeding. This habitual APT strategy cannot be applied to patients at high risk of bleeding, which is why this populations are treated with shorter DAPT schemes...
Is IVUS Useful in Lower Limb PCI?
Peripheral vascular disease is on the rise and peripheral PCI is at present the first choice of treatment for most patients. The use of IVUS in femoropopliteal territory has shown great benefits, especially in left main and complex PCI, reducing mortality and restenosis but, though promising, in lower limb ischemia we have little information as...
Post PCI Angina: Inevitable or Avoidable?
Predictors of post PCI angina Among the complications of ischemic cardiomyopathy stenting, those called chronic, with significant functional and mental compromise, might affect patient quality of life. This can be observed in different scenarios, such as instent restenosis and post PCI angina. This kind of complications is associated with anxiety and depression at long term. ...
BASILICA: a Complex Strategy, Yet Safe
Coronary artery obstruction (CAO) after TAVR is rare, but it entails extremely high mortality (50% or more), especially after valve-in-valve (V-in-V) or when the coronary ostia are is too close to the valve annulus. This is why the BASILICA technique was developed (Bioprosthetic or Native Aortic Scallop Intentional Laceration to Prevent Iatrogenic Coronary Artery Obstruction)....
Retrograde Tibial Access for Endovascular Treatment of Femoropopliteal Occlusions: Is it a Safe Strategy?
Endovascular recanalization of femoropopliteal occlusions continues to be one of the initial therapeutic strategies to treat this pathology. The anterograde approach via the common femoral is the most frequently used. However, it is not always viable, especially in long occlusions with severe calcification or when the femoral artery cannot be reached. In these cases, the...
ISAR Score: Can We Predict the Need for Repeat PCI in DES Restenosis?
Score to predict the risk of repeat PCI in DES restenosis. With the use of drug eluting stents (DES) instent restenosis (ISR) has seen a significant reduction vs. bare metal stents (BMS) restenosis. The main cause of DES failure is ISR. This entity is difficult to manage because of its high recurrence and reintervention risk....