The initial strategy for the treatment of patients at high risk of bleeding (HBR) after percutaneous coronary intervention (PCI) has consisted of a short dual antiaggregation therapy (DAPT). Stents continue to improve, which has allowed the reduction of DAPT schemes and therefore the incidence of bleeding. However, researchers are also looking into another strategy to...
It has been observed that the persistence of an opening in the left atrial appendage after percutaneous closure (LAAC) is associated with a higher risk of embolic events. Among the most commonly used devices for left atrial appendage closure are the Watchman FLX and Amulet devices. This study, known as SwissApero, represents the first randomized...
Cardiovascular disease is the leading cause of death in elderly adults (individuals aged 75 years or older). In turn, coronary heart disease is one of the main causes of morbidity in this population. In addition to anatomical complexities, there are other factors that may complicate its management, such as polypharmacy, frailty, and procedure-related risks. All of...
Currently, transfemoral access (TFA) is used in large-caliber procedures and when transradial access is not successful. The use of ultrasound (US) to guide access has emerged as a technique that allows for precise cannulation, avoiding accesses above and below the inguinal ligament. However, evidence regarding the effectiveness of this tool has shown variable results. Two...
Lesions in the left main coronary artery (LMCA) continue to pose a significant challenge. The use of coronary imaging before percutaneous coronary implantation (PCI) has proven useful in analyzing the lesion, identifying the presence and location of calcification, and determining lesion length in the LMCA, the left anterior descending artery, and the circumflex artery. Various...
For many years, percutaneous transluminal coronary angioplasty (PCTA) has expanded significantly worldwide. However, despite the demonstrated advantages of intravascular ultrasound (IVUS) in terms of minimal luminal area, reduced cardiovascular events, and restenosis, its use is not very common due to various reasons. On the other hand, optical coherence tomography (OCT) offers even higher resolution than...
In the context of TAVR, one of the current challenges is the need for permanent pacemaker implantation (PPM), especially when using self-expanding valves (SEV). The information available in this regard remains controversial; while some studies suggest new PPM implantation will have no significant effect on clinical evolution, others have associated them with worse prognosis. As...
The OCTOBER Study randomized 1201 patients with bifurcation lesions in a 1:1 ratio to undergo percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) or by angiography. The primary endpoint (PEP) was major adverse cardiovascular events (MACE) over a 2-year period. Group characteristics were similar. The average patient age was 66 years, most...
Researchers conducted a randomized study that included a total of 1233 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) guided by optical coherence tomography (OCT) and 1254 patients who underwent the same procedure but were guided by angiography. The latter had complex lesions. The initial groups were similar. The average age was 65 years, most...
The use of intravascular ultrasound (IVUS) to guide percutaneous coronary interventions (PCI) has been shown to reduce the risk of major adverse cardiovascular events (MACE) across controlled randomized studies, registries and meta-analysis. Current guidelines recommend the use of IVUS in left main disease and complex lesions. As the prevalence of complex PCI increases over time,...