The FUTURE study, testing the utility of functional revascularization by measuring the fractional flow reserve (FFR), was halted early by its safety committee due to an increased mortality rate at 1 year among patients guided by FFR. In this unexpected unprecedented outcome, 17 patients in the FFR-guided group died at a year of follow-up, compared with 7 patients…
Is Angioplasty at Centers Without Surgical Backup Safe?
Performing coronary angioplasties at hospitals without surgical backup seems to be safe for a wide variety of patients, from those presenting ST-segment elevation myocardial infarction to those undergoing elective procedures. This work responds to a long-running debate over whether centers without on-site surgery capabilities in case of complications can be considered as referral centers…
Non-Cardiac Surgery with Incomplete Revascularization, Associated to Events
This study presented at the American Heart Association Scientific Sessions 2016 and simultaneously published in the Journal of the American College of Cardiology, showed incomplete revascularization is associated with an increased risk of adverse cardiac events, particularly infarction, in patients that must later receive non-cardiac surgery. Patients with incomplete revascularization (defined as a ≥ 50% left…
Women: More Prone to Lower Coronary Flow Reserve
Compared to men, women have less chances of developing obstructive coronary artery disease (CAD), but this new study suggests they are more prone to have lower coronary flow reserve, which is also a risk factor. Evidently, ischemic cardiomyopathy entails far more than assessing and treating plaque burden in epicardial arteries. In women, the most…
How to Make Radial Access Even Safer with Minimum Effort
Courtesy of Dr. Agustín Vecchia. Since 1990, radial access has progressively gained ground, currently becoming the default technique in most endovascular intervention centers. One of its few associated complications is radial artery occlusion. While most frequently clinically silent and non-serious, this complication could hinder the performance of future procedures in the patient and, in some…
The role of ischemia, complete revascularization and intravascular imaging in contemporaneous PCI
Exhibitor: Ajay Kirtane Recorded by TV Med
Coronary Perforation in PCI: Associated to Negative Outcomes
Courtesy of Dr. Guillermo Migliaro. Coronary perforation (CP) is a rare but serious complication of percutaneous coronary intervention (PCI) with an estimated incidence of 0.5%. Arterial blood entering the pericardium may cause a rapid elevation of intrapericardial pressure and collapse the right cavities (tamponade) creating hemodynamic compromise. Historically, surgical drainage has been the…
Anticoagulation and PCI: How Long Should Triple Therapy Last?
The aim of this study was to compare clinical outcomes in relation to the duration of triple antithrombotic therapy in patients with indications for oral anticoagulation undergoing coronary angioplasty. The optimal period for the prescription of these three drugs has not been studied. Between 2009 and 2013, 8772 consecutive patients undergoing coronary angioplasty were included…
Beta-Blockers for Revascularized Patients: To Prescribe or Not?
This study examines predictors and outcomes associated with the prescription of beta-blockers at discharge after a successful coronary angioplasty in patients with stable chronic angina WITHOUT prior history of acute myocardial infarction or heart failure. The benefit of beta-blockers in patients with acute myocardial infarction or systolic heart failure is well documented. However, their…
TR-PCI: Upper Extremity Function Post Transradial PCI
Original Title: Upper extremity function post-transradial (TR)-PCI: interim results. Presenter: Eva Zwaan. The use of transradial access has increased in the clinical practice thanks to the reduction of vascular and bleeding complications in addition to the shorter time of hospitalization. The aim of this study was to assess prevalence, magnitude and mechanisms responsible…