Journal of Transcatheter Interventions

ABSTRACT Since the mid-1990s, the dual antiplatelet therapy, consisting of the association between acetylsalicylic acid and a platelet P2Y12 receptor inhibitor, is the core of thrombosis prevention after coronary stent implantation, regardless of the models used. It is also used to prevent the occurrence of atherothrombotic events in the late phase after the intervention. The clinical presentation of coronary artery disease influences the duration of dual therapy, which tends to be longer in treated cases of acute coronary syndrome (usually […]

ABSTRACT Background Improvements in percutaneous coronary intervention have reduced complications in the treatment of left main coronary artery disease. The objective of this study was to characterize percutaneous coronary intervention procedures in left main coronary artery, and evaluate patients’ outcomes. Methods A retrospective study performed from January 2015 to December 2018, in patients submitted to percutaneous coronary intervention in left main coronary artery for stable coronary artery disease or myocardial infarction, with second-generation drug-eluting stents. Results A total of 82 […]

ABSTRACT The volume of complex coronary interventions has grown in Brazil and worldwide. Since they are performed in patients at increasingly higher risks, new techniques have been developed when interventional cardiologists are faced with uncommon situations, such as no safe arterial access for the procedure. We report a case of a patient with severe peripheral artery disease and occluded right femoral artery, in whom a single access (left femoral artery) was used for positioning the Impella™ and the guidewire for […]

ABSTRACT Background Same-day discharge for percutaneous coronary interventions is an attractive and safe strategy. Observational and randomized data show equivalent results as compared to overnight observation. In addition, it ensues great savings for the healthcare system. Nevertheless, in Brazil, this approach is underused. The objective of this study was to describe the characteristics and outcomes of patients undergoing percutaneous coronary intervention with same-day discharge. Methods A single-center study with patients who underwent selected procedures, uneventful, discharged on the same day. […]

ABSTRACT Chronic total occlusion recanalization still represents the last frontier in percutaneous coronary intervention. Retrograde recanalization is one of the most significant amendments of the technique, and has recently become an essential complement to the classical antegrade approach. It has a high success rate with a low complication profile, despite frequent utilization in the most complex patients. Since its initial description, important iterations have occurred and made the technique safer, faster and more successful.

Abstract Left main coronary artery bifurcation represents one of the most challenging settings for the interventional cardiologists. The conventional stents are designed and shaped to restore tubular geometry, while the left main coronary artery bifurcation is far more complex with different diameters and non-tubular cross-sections. In relevant patients, two stent strategy is preferred over provisional T-stenting. The double-kissing crush has been the preferred double stent technique. We present a case in which the double-kissing approach was used in left main […]

ABSTRACT Acute coronary syndromes are common situations in medical practice, with high morbidity and mortality. Consequent to its relevance, its clinical management has always been subject of discussion and controversy. Since the past decade, the dual antiplatelet regimen has been the main therapeutic option used in its passivation, whereas percutaneous interventions have become the most common therapeutic option. Clopidogrel, the drug initially used in combination with aspirin, is effective and safe; however, it has disadvantages that led to the development […]

ABSTRACT Bifurcation lesions are present in one out of every five percutaneous coronary interventions. Despite the progress of techniques, materials, and imaging technologies, the bifurcation approach remains challenging, and its percutaneous treatment results in higher rates of adverse cardiac events when compared to treatment of lesions with no bifurcation involvement. The best technique to treat bifurcation lesions is still a subject of debate. For most cases, the provisional technique is preferred, since it is simpler, easier, faster, less expensive, and […]

ABSTRACT The ideal antithrombotic management in patients with atrial fibrillation undergoing elective percutaneous coronary intervention or in acute coronary syndrome has not been definitively established yet. Dual antiplatelet therapy (aspirin and P2Y12 receptor inhibitors) reduces stent thrombosis and subsequent ischemic events. In turn, the presence of atrial fibrillation requires oral anticoagulation to prevent stroke and other thromboembolic complications. However, the combination of these two treatments, known as triple therapy, increases the risk of severe bleeding, with a negative prognostic impact. […]

ABSTRACT Since the introduction of coronary stents, in-stent restenosis has been one of the main stumbling blocks for its application in coronary artery disease. The drug-eluting stents have effectively reduced and become the mainstay of the interventional therapy of coronary artery disease. However, concerns of delayed stent thrombosis, dependency on prolonged dual antiplatelet therapy, and recurrent restenosis led to a quest for new treatment modalities that could address restenosis rates without drug-eluting-stent-related drawbacks. The drug-coated balloon has emerged as an […]