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    1. The Next Innovation in PCI Is Not a Stent: The Value of Optical Coherence Tomography (OCT)

      The Next Innovation in PCI Is Not a Stent: The Value of Optical Coherence Tomography (OCT)

      For decades, percutaneous coronary intervention (PCI) has largely been guided solely by angiography, despite its well-documented limitations. 1 Angiography offers a two-dimensional view of a three-dimensional structure and does very little to delineate the composition of the coronary artery. Additionally, angiography poorly quantitates the severity and location of calcium, does not provide information about plaque morphology, nor does it provide highly accurate and reproducible lumen sizing. For PCI, the operator is limited by angiography in identifying stent malapposition or under-expansion, edge dissections, or plaque protrusion. In short, we have not been seeing the full story. By providing the highest resolution ...

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      Mentions: Abbot
    2. Updates on PCI Guidelines and Trials From the European Society of Cardiology (ESC) Congress

      Updates on PCI Guidelines and Trials From the European Society of Cardiology (ESC) Congress

      Radial Access and Provisional T-Stenting Preferred for PCI: Another important procedural recommendation from the ESC was that radial access should be the preferred approach for coronary angiography and PCI (class I recommendation). While this approach has been a standard for many years in the European communities, it has now been codified as part of the ESC guidelines and may one day be part of the ACC/SCAI guidelines. For those addressing bifurcations with stenting, the ESC/EACTS guidelines upgraded provisional T-stenting for bifurcation lesions from class IIa to class I, and upgraded the use of optical coherence tomography (OCT) for ...

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    3. Optical Coherence Tomography-Guided Bioresorbable Vascular Scaffold Implantation With Orbital Atherectomy for Calcified Chronic Total Occlusion

      Optical Coherence Tomography-Guided Bioresorbable Vascular Scaffold Implantation With Orbital Atherectomy for Calcified Chronic Total Occlusion

      A 67-year-old male with a past history of hypertension, diabetes, and dyslipidemia complained of neck and jaw pain after walking. Stress myocardial perfusion imaging showed ischemia in the left anterior descending artery (LAD) area. Coronary angiography at an outside hospital revealed a severely calcified chronic total occlusion of the proximal LAD with collateral flow from the right coronary artery. He was referred for revascularization of the LAD. Bilateral femoral access was obtained to perform simultaneous angiography of the left and right coronary artery systems (Figure 1). A 6 French VL3.5 guide was engaged in the left coronary artery. An ...

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