Prior registries have shown that 65% of patients with chronic coronary syndrome (CSS) and angina do not present obstructive atherosclerosis. This phenomenon, called myocardial ischemia with no obstructive coronary arteries (INOCA) is more common in women and has been associated with high hospitalization costs and diminished quality of life. INOCA patients can present microvascular dysfunction...
Diabetic patients have twice as high a risk of developing coronary artery disease (CAD). Additionally, CAD increases mortality risk. Patients with a history of percutaneous coronary intervention (PCI) tend to need repeat revascularization, even with second generation stents. To date, there are few studies assessing the role of glycemic control in stent failure, stent thrombosis,...
Coronary calcifications pose a complex challenge with a high incidence (25% of all angioplasties), thus implying difficult management and adverse long-term outcomes, such as an increased risk of events, especially the need for repeat revascularization. The main mechanisms of long-term failure include stent underexpansion and, in particular, minimal post-deployment stent area. Intravascular lithotripsy (IVL) has...
The aim of this randomized open study was to determine whether CTO guided left main percutaneous coronary intervention (PCI) is superior to fluoroscopy guided PCI, using fractional flow reserve (FFR) after stenting. The secondary outcomes were procedural success (successful implantation, malposition, edge dissection or stent collapse) and major adverse cardiovascular events (MACE) at one year....
Invasive coronary angiography (ICA) has become the gold standard for the assessment of patients with chronic coronary syndrome (CCS) for obstructive coronary artery disease. However, its ability to detect this condition is limited and it does not detect non-obstructive myocardial ischemia, which can be overlooked. To address these limitations, a prospective, observational, multicenter study was...
On the one hand, chronic peripheral vascular disease is on the rise. On the other, over the past 20 years, percutaneous coronary intervention (PCI) has gained considerable ground thanks to various new devices, replacing surgery as an alternative in most scenarios. Both strategies have shown similar results, but PCI has fewer complications and shorter hospital stays....
Most randomized studies on revascularization in stable coronary artery disease exclude left main coronary artery disease (LMCAD). One example of this was the ISCHEMIA study. However, the benefits of functional lesion assessment, as demonstrated in the FAME studies, highlight the importance of this tool in guiding decisions regarding revascularization. Nevertheless, the clinical outcomes of patients...
A lesion ≥50% in the left main coronary artery (LMCA) is considered severe, according to various scientific societies, regardless of the presence of symptoms or ischemia, due to the extent of myocardium at risk. In such cases, revascularization is indicated. In many patients, lesions in this section of the coronary artery have severe calcification, which...
Complementary imaging allows for the identification of numerous scenarios not visible with conventional angiography (ICA), both for the assessment of differential diagnoses and the improvement of percutaneous coronary intervention (PCI) outcomes. Advantages include assessment of plaque characteristics, vessel plaque burden, stent edge dissection, vessel diameter, and correct apposition, among others. While intravascular ultrasound (IVUS) was...
Infiltrative diseases (ID) consist of a heterogeneous series of genetic conditions that cause infiltration and extracellular deposits which alter the diverse systems and organs affected. Amyloidosis, sarcoidosis and hemochromatosis affect the heart, altering the myocardium and the conduction system. PCI is often used at present to treat heart disease, and some of these patients present...