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...
There is an important group of patients presenting low flow, low-gradient severe aortic stenosis (defined as mean gradient <40 mmHg). This is why we do dobutamine stress echocardiogram (DSE), to confirm whether we are dealing with truly severe aortic stenosis. However, it might not be well tolerated and a CT angiography will be done to...
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)....
Transcatheter aortic valve replacement has shown important benefits but one of its biggest challenges is showing its safety and efficacy at followup in low risk patients. At present we have 2-year data from the Evolute Low Risk, but the we lack information at longer followup. The study looked at 3-year followup of the Evolute Low...
The rise of chronic total occlusions (CTO) percutaneous coronary interventions (PCI) goes hand in hand with technological development, through still posing a great challenge, one not exactly exempt from complications. An important criterion to successful CTO PCI is length: ≥20 mm lesions lower the odds, according to J-CTO Score. However, increasing operator experience and the...
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....
At present, surgical aortic valve replacement (SAVR) uses bioprostheses. However, when these fail, we are presented with a great challenge, seeing as repeat SAVR involves a higher risk. In this context, valve-in-valve (V-in-V TAVR) has surged as a very attractive alternative. Bioprosthesis fracture (BPF) is a new interesting strategy that has shown lower gradient and...
In the field of percutaneous coronary intervention (PCI) and myocardial revascularization surgery (MRS), previous analyses have shown a link between in-hospital and 30-day complications, in terms of complicated progress and/or mortality. Most of this information comes from non-randomized or old studies, which translates into contradictory data. Researchers analyzed the EXCEL study, which included patients with...
Severe tricuspid regurgitation (TR) is difficult to manage and is associated to high morbimortality. Surgical repair is complex and not free from complications: its mortality rate ranges from 5 to 20% and depends on series, surgeon and center expertise. Edge-to-edge repair with clips has become a valid alternative to treat this disease, but most data...
In ST elevation ACS the preferred treatment is primary PCI. However, one its limitations is thrombus presence and its distal embolization, which threatens microcirculation perfusion and is therefore associated to ventricular function deterioration and bad evolution. Manual thrombus aspiration has been tested in different studies but the problem remains unsolved; mechanical thrombectomy might be a...