Tag Archives: multiple vessel

perforación coronaria en angioplastia

Complex PCI: Complex Characteristics Impact Results

Complex PCI: Complex Characteristics Impact Results

Patients with a bigger number of complex anatomical characteristics that increase PCI complexity have worse results at one-year followup. These data come from a large multicenter study (e-Ultimaster) recently published in EuroIntervention. The more complex the characteristics, the greater the increase in events.  It is important to see past the obvious anatomical challenges (bifurcations, calcification,

Doble puente mamario para reducir la chance de nuevas revascularizaciones

Visual Assessment for Non-Culprit Lesion Revascularization

There is evidence in favor of complete revascularization in the context of ST elevation MI with multivessel disease where primary PCI has been successful.  However, the small print in these studies should be read carefully. Should revascularization be completed during index intervention, index hospitalization or after discharge? Should complete revascularization be based on visual assessment,

infarto peri-procedimiento

Long Term Changes ACS Revascularization

Long term outcomes support complete revascularization in multivessel patients undergoing acute coronary syndrome (ACS). This large contemporary registry recently published in J Am Coll Cardiol Intv.  has shown complete revascularization is gaining ground in the daily practice and is associated to clinical benefits in patients undergoing ACS.  It included 9094 individuals with ACS and multivessel

AHA 2018 | Seguimiento a largo plazo del Freedom: se mantiene el beneficio a favor de la cirugía

AHA 2018 | Freedom Long-Term Follow-up: Still in Favor of CABG

Nearly 8 years later, CABG maintains its benefit over PCI-DES in terms of mortality in diabetic patients with multivessel disease, according to the Freedom trial, presented by Dr. Fuster at AHA and simultaneously published in JACC. CABG is superior to PCI-DES, with 36% higher mortality in these last years.   Considering the nature of atherosclerosis,

CULPRIT-SHOCK: los resultados a 1 año continúan soportando tratar solo la arteria culpable

ESC 2018 | CULPRIT-SHOCK: 1-Year Results Continue to Support Treatment of the Culprit Artery Only

Increases in the rates of revascularization and heart failure do not justify the early mortality advantage shown by treatment of the culprit artery only in patients with acute myocardial infarction and cardiogenic shock. The 1-year follow-up of the CULPRIT-SHOCK trial reinforces the idea of only treating the culprit artery, with an option for revascularization of

FUTURE: una piedra en el zapato para el FFR y más preguntas que respuestas

ESC 2018 | FUTURE: A Thorn in FFR and More Questions than Answers

As observed at the preliminary analysis that motivated the FUTURE trial early termination, the use of fractional flow reserve (FFR) to guide revascularization in an unselected population with multivessel disease was associated to twice the mortality rate in one year, with no beneficial impact on other end points. Even though the combined end point of

EuroPCR 2018 | SYNTAX II: resultados a 2 años de la mejor angioplastia vs cirugía en múltiples vasos

EuroPCR 2018 | SYNTAX II: Results at 2 Years for Best Angioplasty vs. Surgery in Multivessel Disease

Since the publication of the original SYNTAX trial, there have been great technical advancements that have influenced the results of angioplasty: New tools for risk stratification using the SYNTAX II score which integrate clinical and anatomical variables to the team’s decision-making process. Functional revascularization (hybrid use of fractional flow reserve or instantaneous wave-free ratio). Optimization of

Does a Combination of Diabetes and Acute Coronary Syndrome Change the Revascularization Strategy?

The results of the FREEDOM (Future Revascularization Evaluation in Patients With Diabetes Mellitus: Optimal Management of Multi-vessel Disease) trial have shown a lower rate of events in patients with diabetes and stable multivessel disease who were randomized to undergo myocardial revascularization surgery, compared to those who underwent angioplasty. Surgery even showed a mortality reduction that

Doble puente mamario para reducir la chance de nuevas revascularizaciones

Bilateral Mammary Artery Graft to Reduce the Chance of Repeat Revascularization

According to previous studies, patients receiving bilateral internal mammary artery conduits during coronary artery bypass grafting have better survival than those receiving a single internal mammary artery. The reason behind this remains unclear, let alone whether there really is lower repeat revascularization rate. This analysis compared timing, frequency, and type of repeat coronary revascularization among patients

HREVS: la revascularización híbrida no ofrece ventajas en la enfermedad de múltiples vasos

HREVS: Hybrid Revascularization Offers No Advantage in Multivessel Disease

Courtesy of SBHCI. Hybrid revascularization, which combines CABG with PCI, failed to reduce myocardial ischemia and major cardiac and cerebrovascular events, compared to cardiac artery bypass graft  or PCI separately. However, this small study does not provide conclusive evidence, which calls for further randomized studies with enough statistical power to answer this question. Fortunately, we won’t have