Courtesy of Dr. Agustín Vecchia. The link between operator volume and clinical outcomes has been long and widely debated. After years of discussion, there are promoters and detractors. Currently, interventional cardiology societies all over the world classify centers as “high-volume” or “low-volume” using arbitrary parameters, and require training fellows to perform an also arbitrary number of...
There is little evidence to support the safety and efficacy of bioresorbable scaffolds (BRS) for the treatment of chronic total occlusions (CTO). This multicenter registry included consecutive patients with CTO receiving BRS (Absorb; Abbott Vascular) vs. 2nd generation drug eluting stents (DES). Primary end point was target vessel failure at long term (composite...
Gentileza del Dr. Javier Castro In the daily practice, a high percentage of ST elevation myocardial infarction patients (STEMI) present multivessel disease (40-65%). This group of patients presents worse clinical evolution and higher mortality than patients with one culprit lesion. When PCI is indicated to a patient with significant lesions in more than...
The use of non-invasive imaging can identify or rule out subclinical atheromatosis and help reduce the number of elderly patients unnecessarily treated with statins without increasing the risk of cardiovascular events. Using calcium score and carotid ECG to find elderly patients without atheromatosis helps to safely avoid the use of statins with no clinical...
There are no data outside controlled studies, neither are there long term outcomes, on carotid artery stenting. This study was designed to assess the long term effectiveness of carotid stenting to prevent strokes in a large number of real life patients. This registry included prospective data with a strict follow up protocol on 901...
The Strategic Reperfusion Early After Myocardial Infarction trial and the French Registry of Acute Myocardial Infarction 2015 suggest that pharmacoinvasive strategy compares favorably with primary percutaneous coronary intervention (PCI). This study compared the impact of pharmacoinvasive strategy with the impact of primary angioplasty in real-world patients admitted with acute coronary syndrome with ST-segment elevation. The...
Deferring treatment through angioplasty in non-ischemic lesions by fractional flow reserve (FFR) is associated with excellent long-term prognosis in patients with chronic ischemic heart disease. FFR is beginning to be used for clinical decision-making in patients with acute coronary syndromes, and its long-term effect on stable chronic patients has not been established. This...
A comprehensive analyzis of cerebrovascular events in major randomized controlled studies on transcatheter aortic valve replacement (TAVR) has shown some interesting data on both risks and timing of stroke in this setting. The study carried out by Dr. Neal Kleiman, reviewed data on stroke and stroke predictors among 3,687 patients included in the CoreValve...
Courtesy of Dr. Agustín Vecchia. In treating bifurcations, the provisional stenting strategy continues to be preferred. However, a percentage of these lesions must be treated with two stents, which involves different techniques. In provisional stenting, when two stents are required, a recent consensus document of the European Bifurcation Club has recently recommended the TAP...
Courtesy of Dr. Guillermo Migliaro. Fractional flow reserve (FFR) is the radio of two flows expressed as the ratio of two pressures ─ distal pressure across stenosis (Pd) to aortic pressure (pa) ─ obtained only under maximal coronary hyperemia, which is a state of drug induced maximal vasodilation. The gold standard to create...