Nowadays, evidence from studies and meta-analyses has demonstrated the benefits of complete revascularization compared to culprit-vessel-only revascularization in patients with acute myocardial infarction (AMI). The identification and treatment of non-culprit lesions can be guided by conventional angiography, intracoronary imaging, or coronary physiology; the optimal modality, however, is still unclear. Quantitative flow ratio (QFR) is a...
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....
Coronary sinus reduction (CSR) is a relevant area of study for the treatment of refractory angina, with hopes of improving myocardial perfusion. However, to date, there are no conclusive data. The ORBITA-COSMIC study is a randomized, double-blind, placebo-controlled trial conducted at six centers in the UK. Researchers recruited patients with angina and chronic ischemia who...
Drug-coated balloons (DCB) have proven to be effective in the treatment of femoropopliteal pathology, although they entail complications such as recoil, residual stenosis, and dissection. Their outcomes could be improved through proper and enhanced vessel preparation, both before and after the procedure. Intravascular ultrasound (IVUS) offers the advantage of characterizing plaque and assessing vessel diameter....
The use of intravascular imaging to identify vulnerable plaque (VP) has proven to be very useful, as such plaque is associated with an increase in major adverse cardiac events. Optimal medical treatment is currently considered the standard strategy to stabilize VP. However, the safety and effectiveness of preventive treatment with percutaneous coronary intervention (PCI) in...
Cardiogenic shock will develop in approximately 10% of patients with ST elevated acute MI (STEMI), and unfortunately, only half of these patients will survive. Researchers have been looking into the Impella system to manage this severe complication. It consists of an aortic transvalvular pump designed to deliver blood from the left ventricle into the systemic...
The international guidelines recommend the use of dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 inhibitor during 12 months in patients receiving percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), to prevent events such as MI and stent thrombosis. This was a multicenter, placebo controlled, double blind study to determine whether ticagrelor alone,...
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...