multivessel disease.

Incomplete Revascularization

CTO Revascularization Improves Quality of Life

Courtesy of Dr. Carlos Fava. The presence of CTO hovers around 15, 20% in coronary angiographies of patients with chronic stable angina, but only 5% receive percutaneous coronary intervention (PCI). One of the obstacles to percutaneous revascularization is the lack of relevant studies justifying it, though we do have different comparative studies that improve symptoms, ventricular...

SPYRAL HTN-ON MED: La denervación renal vuelve a la vida

EuroPCR 2018 | SPYRAL HTN-ON MED: Renal Denervation Comes Back to Life

After several trials with neutral outcomes, renal denervation had been demoted for some time. However, this new study presented at EuroPCR 2018 and simultaneously published in the LANCET brings back the technique with improved devices that seem to yield improved outcomes. The study included patients with uncontrolled arterial hypertension under medical treatment.   Eligible patients...

TAVI-proteccion-cerebral2

EuroPCR 2018 | Meta-Analyzis on Cerebral Protection Devices during TAVR

The risk of stroke is inherent to TAVR and, apart from clinically manifest events, there is abundant evidence of cerebral embolic lesions during TAVR provided by studies using diffusion weighted MRI or transcranial doppler ultrasound. Several devices have been developed to reduce the risk of stroke, though they have been assessed by relatively small trials...

ORBITA: Todavía no terminamos de entender la relación entre la isquemia y los síntomas

EuroPCR 2018 | ORBITA: The Link Between Ischemia and Symptoms Is Still Not Entirely Understood

Invasive physiology tests used in the ORBITA trial could not predict which patients would benefit from angioplasty more than placebo (sham procedure) in terms of the trial’s primary endpoint, improvement in exercise time. These data were presented at EuroPCR 2018 and published simultaneously in Circulation. Results encourage debate over the importance of ischemia reduction with angioplasty...

THEMIS: eventos isquémicos y hemorrágicos en difícil equilibrio para el ticagrelor crónico

New Study Shows Ticagrelor + Aspirin Reduce Events Rate

Just when we were starting to understand how long dual antiplatelet therapy should be for our patients, JACC publishes this study where ticagrelor combined with aspirin significantly reduces relative and absolute events rate at long term, especially in patients with multivessel disease. The PEGASUS-TIMI 54 assessed the long-term benefits of two different doses of ticagrelor (60 mg or...

Routine FFR/iFR Reclassifies Treatment Strategies in Half of Cases

Routine invasive physiology assessment at time of angiography reclassifies treatment strategies in a big number of patients with lesions in 2 or 3 vessels, according to the multicenter prospective study DEFINE REAL, recently published in JACC Cardiovascular Interventions. The information obtained by measuring fractional flow reserve (FFR) or instantaneous wave free ratio (iFR) made interventionists modify their original plans in...

Ischemia

Latest articles about peripheral vascular diseases

1) Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable. Read more    2) Multivessel Disease and Severe Carotid Stenosis: How to Proceed Myocardial revascularization surgery (CABG) is...

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