Unprotected left main stenting with chronic total occlusion of right coronary artery

Unprotected left main stenting (ULM) with low SYNTEX score may be considered for PCI with DES.  ULM with chronic total occlusion of Dominant Right coronary vessel (CTO- RCA) increase syntax score to more than 32 and advice in such patients

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Shall we dare or wait thrombus aspiration during primary PCI.

Although TAPAS trial showed benefit manual thrombectomy during primary PCI and further few trials are saying thrombus aspiration alone without balloon angioplasty or stenting may be sufficient during primary angioplasty click here , there seems to only few cardiologist we

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Caution before Direct stenting during PCI: NIC Kolkata 2013

At NIC Kolkata 2013 conference after presentation of case in Cath hall, there came a discussion of direct stenting i.e. stenting without predilatation.  This session was chaired DR A B Mehta

During discussion Dr A B Mehta was pleased with
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Long term aspirin following Renal nerve Denervation

Renal nerve Denervation is catheter based ablation at distal end of renal arteries. This kind of therapy is used for patients with resistant hypertension, i.e. uncontrolled perisistant systolic blood pressure more than 160mmhg even with three or more different group
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Low gradient preserved ejection fraction severe aortic stenosis (Paradoxic aortic stenosis)

We all know low gradient reduced ejection fraction severe aortic stenosis, it evaluation and management. But occurrence of low gradient severe aortic stenosis with preserved ejection fraction is controversial and most of often it is concluded as echo error.Classically Severe

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Colchicine reduces re-stenosis in Bare Metal Stents with diabetes.

Drug eluting stents (DES) have reduced rate of re-stenosis, more so third generation ones.  This reduced rate of re-stenosis has come with price of stent thrombosis. DES patients have to be on prolonged dual antiplatelet (DAPT), at least for Read the rest

Predicting obstructive CAD, by blood based Gene Expression Score.

Invasive Coronary angiography is gold standard for diagnosing CAD, but this is invasive process and involves exposure to radiation and also contrast agent. Vast majority of angiography done, end with non obstructive CAD diagnosis, to overcome this problem good

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Stroke in PCI versus CABG: SYNTAX posthoc analysis

Incidence of stroke Following CABG is more than PCI within 30 days of procedure but long term i.e. 4 years follow-up revealed similar incidence of Stroke in both groups. Although stroke incidence was similar in both groups, totally six patients

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Revascularization for Silent ischemia

Revascularization is done for two reasons i.e. improve symptoms and improve survival. In case of silent ischemia symptomatic improvement is out of question.

Several studies have shown that silent ischemia worsens prognosis in patients with stable ischemic heart disease. ACIP Read the rest