Tag Archives: primary angioplasty

¿Endarterectomía o angioplastia carotídea? la pregunta sigue motivando más estudios

Non-Culprit Vessel Angioplasty in the Elderly: Choosing the Right Cases Is Important

Non-Culprit Vessel Angioplasty in the Elderly: Choosing the Right Cases Is Important

This large analysis found no benefit at a 1-year follow-up to angioplasty of non-culprit vessels in elderly patients admitted with ST-segment elevation myocardial infarction. The COMPLETE study was presented at the European Society of Cardiology 2019 Congress (and simultaneously published in NEJM) with evidence that seemed to leave no doubt regarding this issue. However, new

angulación aórtica post TAVR

Complete Revascularization after Pharmacoinvasive Strategy

Patients initially receiving pharmacoinvasive strategy for ST elevation myocardial infarction (STEMI) also presenting multivessel disease consistently benefit from complete revascularization. This benefit is similar to that of primary PCI.   The COMPLETE showed that staged non-culprit lesion percutaneous coronary intervention (PCI) reduced major cardiovascular events in STEMI patients with multivessel coronary artery disease. This benefit was

Nuevo dispositivo para medición del FFR permite cruzar la lesión con nuestra guía preferida

FLOWER-MI: FFR vs. Angiography for Complete Revascularization in Infarction

Functional assessment with fractional flow reserve (FFR) was not better than conventional angiography to guide complete revascularization in patients with multivessel lesions in a setting of ST-segment elevation myocardial infarction and successful primary angioplasty. These results were published in the New England Journal of Medicine (NEJM) and presented during the American College of Cardiology (ACC)

ACC 2021 | Cirugía de emergencia en el infarto: beneficios a pesar del alto riesgo

ACC 2021 | Emergent CABG for acute MI: Benefits Despite Risk

The latest figures show a lower number of emergency CABG for acute MI, and in turn increased primary PCI.  The combination of surgeons not willing to take risks and interventional cardiologists empowered to treat practically any lesion has resulted in fewer patients receiving emergency CABG. Only a few years ago, interventional cardiologists at least had

Nueva y discrepante información sobre los vasos no culpables en el infarto

New Unexpected Data on Non-Culprit Vessels in MI

Patients with acute myocardial infarction presenting lesions in multiple vessels is not associated with reduced infarct size in non-culprit lesions, even when functionally significant.  Animal models suggest brief periods of ischemia in non-infarct territories (non-culprit) might protect culprit territory thanks to remote ischemic preconditioning.  This pre-conditioning, according to this perspective, would reduce reperfusion injury and

El aumento de la experiencia de los operadores mejora los resultados en el TAVI

ST-Segment Elevation Infarction After TAVR: Problems in Every Aspect

For interventional cardiologists, treating an ST-segment elevation infarction in a patient with transcatheter aortic valve replacement (TAVR) is challenging in many ways. Longer door-to-balloon times and higher rates of primary angioplasty failure than in the general population are translated into very high short- and mid-term mortality. This multicenter study, recently published in JACC, included 118 patients

ticagrelor_enfermedad_vascular_periférica

Ticagrelor: Yet Another Pleiotropic Effect?

Studies in animals have shown ticagrelor offers better myocardial protection against reperfusion injury after ST elevation MI than clopidogrel.  This had to be tested in the clinical arena, which is the aim of this study (published in JACC Intv): to assess left ventricular remodeling after reperfusion.  The study included patients undergoing their first ST elevation

Desafíos pendientes con el acceso radial

Pending Challenges in Transradial Access

The recent SAFARI-STEMI study compared transradial and femoral access in patients with ST-segment elevation myocardial infarction, and no significant differences were found. These results have a sour taste for those in favor of transradial access, as they are convinced of its benefits and unwilling to go back to previous practices. This bitter taste is based

El acceso radial se asocia a menor mortalidad y menor sangrado en los pacientes cursando un infarto con supradesnivel del segmento ST que reciben angioplastia primaria.

The Transradial Approach Continues to Be the Best for Primary PCI

The transradial approach has been associated to lower mortality and bleeding rates in patients receiving primary PCI for ST elevation MI.  This had been called into question by the recent SAFARI-STEMI, but after including its outcomes in a new meta-analysis, the scales tilted slightly in favor of the transradial approach vs. the transfemoral.  The transradial

ticagrelor vs. aspirina

Ticagrelor or Prasugrel in ST Elevation MI

In patients undergoing ST elevation acute myocardial infarction (STEMI) receiving primary PCI, no significative differences between prasugrel and ticagrelor were found. However, the latter was associated to a significantly higher number of repeat MI when considered separately.  Few studies have compared the efficacy and safety of the two most potent oral P2Y12 receptor inhibitors in

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