Courtesy of Dr. Carlos Fava. Unprotected left main PCI (PCI-UPLMS) is an acceptable and comparable strategy vs CABG, although the use of IVUS is advisable, since it has shown better evolution and mortality. However, the adequate stent expansion remains unclear. Researchers carried out a sub-analyzis of the NOBLE trial. Of the total 603 patients receiving...
Courtesy of Dr. Carlos Fava. Chronic total occlusions (CTO) are still one of the greatest challenges in our field, thus forcing the development of different complex strategies to resolve them. Additionally, the use of imaging techniques during these procedures has improved long-term results. The CONSISTENT CTO (Conventional Antegrade Versus Sub-Intimal Synergy Stenting in Chronic Total Occlusions)...
The trick is to avoid testing empirically more to the right or to the left, a more caudal or cranial angular, and check what a multislice computed tomography suggests. The increase in coronary computed tomography imaging studies—due to guideline recommendations, practicality, and patient comfort—means that we frequently have these data in the cath lab even...
Courtesy of Dr. Carlos Fava. Bifurcation lesions account for about 25% of all angioplasties and it is a challenge for which there is no single treatment strategy. Intravascular ultrasound (IVUS) has proven its usefulness, improving outcomes by reducing mortality in unprotected left main coronary artery (LMCA) angioplasty. A new strategy consists in conducting an IVUS after...
This small study tested the pharmacodynamic effects of several antiplatelet agents. It concluded that tirofiban (Aggrastat) provides “more potent and consistent” inhibition of platelet aggregation compared with cangrelor in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty. Thirty minutes after the initiation of treatment, there was a nearly threefold difference between tirofiban and cangrelor...
There is no survival advantage with invasive coronary revascularization over initial medical treatment in patients with chronic coronary artery disease. However, revascularization did reduce the incidence of unstable angina and its symptoms, according to this new meta-analysis published in Circulation and presented virtually at EuroPCR 2020. There was no significant difference in spontaneous infarctions overall, but...
Additional analyses from the Global SYMPLICITY Registry and the RADIANCE-HTN SOLO trial, presented virtually at EuroPCR 2020, can contribute to the comeback of renal denervation as another alternative for patients with uncontrolled hypertension. The 3-year results from the SYMPLICITY registry showed significant and durable reductions in blood pressure regardless of how many medications patients were taking....
The “arms race”among transcatheter valves has been vertiginous. By the time we received the mid- or long-term outcomes of studies focused on a given valve, we were already using its next generation in clinical practice. As a result, there is little information addressing which valve is the best. Nowadays, this “arms race” has reached a...
SOLACI’s Department of Peripheral Endovascular Interventions is promoting the analysis of challenging clinical cases on peripheral interventions so as to foster the participation and engagement of all SOLACI members. In this first issue, we present a clinical case around carotid artery stenting. Read thoroughly the case below and take part in an unrestricted discussion through...
The aim of this study was to determine the prognostic value of fractional flow reserve (FFR) of non-culprit lesions in STEMI patients. We analyzed data of all Compare-Acute patients (Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With MVD) after PCI, from lesions assessed with FFR and treated medically. The treating...