Original title: Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial ischemia: A collaborative meta-analysis of contemporary randomized clinical trials. Reference: Stergiopoulos K el al. JAMA Intern Med 2013; DOI:10.1001/jamainternmed.2013 The amount in ischemic patients with stable coronary heart disease is associated with poor prognosis. However, it is unclear whether revascularization to reduce...
Infrapatellar balloon angioplasty, the easiest option and with better results in critical ischemia with tissue loss
Original title: Longitudinal outcomes After Tibioperoneal Angioplasty Alone Compared to Tibial Stenting and Atherectomy for Critical Limb ischemia. Reference: Shaun Reynolds et al. Vascular and and Endovascular Surgery 2013 47(7):507-512 The Infrapatellar peripheral vascular disease has increased in recent years, relating to tissue loss and amputation. The therapeutic strategy is not clear, let alone the use of stents...
Critical limb ischemia with infrapatellar disease. High odds of limb salvage despite restenosis.
Original title: Long-term outcomes following infrapopliteal angioplasty for critical limb ischemia. Reference: Ruby C. Lo et al. J Vasc Surg 2013;-:1-10. Angioplasty has established itself as an alternative for the treatment of infrainguinal peripheral disease with comparable results in terms of limb salvage for surgery. However, this data refers to the iliac or femoral territory but it is...
Critical limb ischemia, always try to revascularize
Original title: Endovascular Treatment for Infrainguinal Vessels in Patients With Critical Limb Ischemia : OLIVE Registry, a Prospective, Multicenter Study in Japan With 12-Month Follow-up. Reference: Osamu Iida et al. Circ Cardiovasc Interv. 2013;6:00-00 Patients with critical limb ischemia typically reveal rest pain and ischemic ulcers or gangrene. Prognosis is poor and mortality and amputation rate are elevated....
Initial Complete Revascularization vs. Staged Revascularization in Patients with STEMI and Multivessel Disease
In patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (primary PCI), multivessel disease is observed in up to 40% of cases. The optimal timing for revascularizing non-culprit lesions in these patients without cardiogenic shock remains a controversial issue. European guidelines recommend completing revascularization during the initial procedure or within 45 days...
ULTIMATE III: Use of IVUS for Coronary De Novo Lesion Drug Coated Balloon Angioplasty
Percutaneous coronary intervention (PCI) with drug eluting stents (DES) can present limitations, especially in the form of stent thrombosis or instent restenosis (ISR). These findings have furthered the development of drub coated balloons (DCB). The safety and efficacy of DCB have already been shown in the context of ISR and de novo small vessel coronary...
Invasive Correlation (CFR – IMR) with Coronary Slow Flow
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...
Complex PCI in Octogenarian
The octogenarian population has already reached 137 million and continues to grow. It is estimated to triple by 2050. This increase represents a big challenge, seeing as these patients are often more fragile, present more complex coronary artery disease and multiple comorbidities. This generally requires two or more procedures and more experience both from operators...
Coronary Angioplasty with Sirolimus Eluting Stents
At present, most percutaneous coronary intervention procedures (PCI) are done with drug eluting stents (DES). However, drug coated balloons (DCB) have shown benefits in restenosis and small vessel de novo lesions. Intravascular ultrasound (IVUS) has been shown effective in left main PCI and complex procedures, even though there is little infomration on its use for...
Long Term Outcomes of Hyperemic Stenosis Resistance Index (HSR) in Patients with Stable Chronic Angina
The hyperemic stenosis resistance index (HSR) was introduced as a more complete hemodynamic severity indicator of a coronary lesion. HSR combines both pressure drop across a lesion and the flow through it, therefore overcoming the limitations of traditional indices such as fractional flow reserve (FFR) and coronary flow reserve (CFR). The aim of this multicenter...