Diferentes técnicas para mejorar los resultados en claudicación intermitente

Different Techniques for the Improvement of Outcomes in Intermittent Claudication

Peripheral vascular diseases affect over 20% of the population and can affect up to 30% of people with cardiovascular risk factors. The most important treatment points include modification of risk factors, exercise, optimal medical treatment, and timely revascularization.   Given its lower risk of peri-procedural complications (when compared to surgery), endovascular therapy is generally the first<a href="https://solaci.org/en/2017/08/14/different-techniques-for-the-improvement-of-outcomes-in-intermittent-claudication/" title="Read more" >...</a>

Clinical Significance of Collaterals in Chronic Total Occlusions

Collateral circulation develops during the gradual progression of coronary occlusions in order to replace the original artery and supply blood to areas jeopardized by ischemia. However, the relevance of collaterals has remained controversial for many years. Several works have suggested a rapid regression of collaterals after rechanneling of chronic total coronary occlusions, which could render<a href="https://solaci.org/en/2017/08/08/clinical-significance-of-collaterals-in-chronic-total-occlusions/" title="Read more" >...</a>

Pretratamiento con estatinas para prevenir eventos peri angioplastia carotidea

Statin Pre-Treatment for the Prevention of Peri-Procedural Events in Carotid Artery Stenting

Recent randomized studies have shown that the rates of combined peri-procedural events for carotid artery stenting and carotid endarterectomy are similar. While the final numbers are similar, the actual events are different: more infarction events for endarterectomy and more stroke (particularly minor stroke) events for carotid artery stenting. The reduction of these rates of stroke has been the aim of<a href="https://solaci.org/en/2017/07/31/statin-pre-treatment-for-the-prevention-of-peri-procedural-events-in-carotid-artery-stenting/" title="Read more" >...</a>

El aumento de la experiencia de los operadores mejora los resultados en el TAVI

Increasing operator experience improves TAVR outcomes

The introduction of transcatheter aortic valve replacement (TAVR) into clinical practice in the United States has been a tightly controlled process aimed at optimizing patient outcomes and minimizing the learning curve. Many strategies have been used to reach a rational dispersion for this new technology, including choosing sites with enough volume, and adequate operator training<a href="https://solaci.org/en/2017/07/26/increasing-operator-experience-improves-tavr-outcomes/" title="Read more" >...</a>

CRM vs DES: ¿Cuál se asocia mejor calidad de vida a largo plazo?

MRS vs. DES: Which one is associated with better long-term quality of life?

The SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, which included patients with 3-vessel or left main coronary artery lesions, showed that myocardial revascularization surgery (MRS) turned out to be superior to angioplasty with drug-eluting stents (DES), mainly due to differences in acute myocardial infarction and repeat revascularization. Up to this work, patient sensations (which can be<a href="https://solaci.org/en/2017/07/21/mrs-vs-des-which-one-is-associated-with-better-long-term-quality-of-life/" title="Read more" >...</a>

¿En qué pacientes intentar la recanalización de una oclusión crónica total?

In which patients should we attempt chronic total occlusion rechanneling?

Although chronic total occlusion (CTO) is a common finding, there is little consensus as to when such lesions should be treated routinely with angioplasty. Benefits of successful rechanneling include relief of symptoms, resolution of ischemia, improvement in ventricular function, and avoidance of myocardial revascularization surgery.   Unsuccessful rechanneling is common and may be associated with several adverse events,<a href="https://solaci.org/en/2017/07/19/in-which-patients-should-we-attempt-chronic-total-occlusion-rechanneling/" title="Read more" >...</a>

El éxito en las CTO reduce la isquemia residual local y a distancia

Successful CTO reduces local and remote residual ischemia

Courtesy of Dr. Carlos Fava. The presence of Chronic Total Occlusion (CTO) is about 30%, with an ischemic threshold between 10% and 12.5% to justify rechannelization. Using the new devices, the new guidelines and with more experience operators, these procedures are successful in 10% to 30% of cases. More often than not these patients are not treated<a href="https://solaci.org/en/2017/07/19/successful-cto-reduces-local-and-remote-residual-ischemia/" title="Read more" >...</a>

Glycemic control and risk of repeat revascularization

The association between glycemic control after coronary angioplasty and outcomes of the latter is controversial in many studies. We have come to think that the risk lies in suffering from diabetes, as if it was an unmodifiable factor. We have also come to believe that glycemic control can impact microvascular complications while it cannot do<a href="https://solaci.org/en/2017/07/12/glycemic-control-and-risk-of-repeat-revascularization/" title="Read more" >...</a>

La asistencia previa con Impella 2.5 disminuye la mortalidad a 30 días en el shock cardiogénico por tronco de coronaria izquierda no protegido

Prior assistance with Impella 2.5 lowers 30-day mortality in cardiogenic shock due to unprotected left main coronary artery lesion

Courtesy of Dr. Carlos Fava. The prevalence of cardiogenic shock in acute myocardial infarction (MI) is 7%-10%, and it is associated with high mortality rates. Unfortunately, 0.7% of these cases are a consequence of unprotected left main coronary artery (ULMCA) as MI-culprit lesion. Its evolution is generally disastrous.   Ventricular assist device support and its implementation time may<a href="https://solaci.org/en/2017/07/05/prior-assistance-with-impella-2-5-lowers-30-day-mortality-in-cardiogenic-shock-due-to-unprotected-left-main-coronary-artery-lesion/" title="Read more" >...</a>

Las CTO en el infarto agudo de miocardio aumentan la mortalidad

CTO in patients with acute myocardial infarction increases long term mortality

Courtesy of Dr. Carlos Fava. It has been proved that in a setting of acute myocardial infarction with multivessel lesions, only the culprit vessel must be treated (if there is no hemodynamic compromise) at first, and other severe lesions are to be treated during a second session. However, proper conduct in cases with presence of chronic<a href="https://solaci.org/en/2017/06/29/cto-in-patients-with-acute-myocardial-infarction-increases-long-term-mortality/" title="Read more" >...</a>

Angioplasty