Interventional Cardiology

Questions discussed in this category

In patients with post-MI LV thrombus which resolves after 3-6 months of anticoagulation, would you consider surveillance imaging for thrombus recurrence if there is persistent apical akinesis?

1 Answer available

How do you decide between using a self-expanding supraannular valve and a balloon-expandable valve for TAVR in patients with severe aortic stenosis and a small aortic annulus?

Hermann, et al., SMART Trial, PMID 38587261

1 Answer available

Do you recommend avoiding radial artery access for cardiac catheterization to preserve potential future dialysis access sites in patients with advanced CKD?

7 Answers available

Do you recommend routine use of protamine for hemostasis at the end of a transfemoral TAVI?

1 Answer available

Do shorter door-to-balloon (D2B) times impact outcomes in STEMI, if it's already less than 90 minutes, and to what degree (i.e., 30 vs 60 minutes would have a more significant impact)?

1 Answer available

What techniques do you use in the lab to reduce the amount of contrast that needs to be used in patients with CKD?

2 Answers available

How do you decide between manual pressure versus opting for a specific vascular closure device at the conclusion of a femoral access case?

1 Answer available

How do you decide between administering or deferring upstream P2Y12 inhibitor treatment until patient is in the lab for NSTEMI or STEMI cases with unknown coronary anatomy?

2 Answers available

How do you approach revascularization in patients over 75 years with NSTEMI, given recent evidence from the SENIOR-RITA trial that an invasive strategy does not significantly reduce cardiovascular events compared to a conservative strategy?

Kunadian, et al., PMID 39225274

1 Answer available

What factors influence your choice between low-dose DOAC therapy and dual antiplatelet therapy for the first 3 months after percutaneous left atrial appendage occlusion?

Freixa, et al., PMID 39110427

1 Answer available

For SVG graft stenting, do you consider routinely embolic protection devices (EPD), and do you factor lesion location (prox vs distal) for decision making?

3 Answers available

What is your approach to using beta-blockers in patients with acute myocardial infarction with preserved LV ejection fraction who undergo early coronary angiography in light of the REDUCE-AMI trial findings?

REDUCE-AMI trial

2 Answers available

Would you recommend normal saline for pre- and post-LHC hydration in patients with CKD stage III to IV with reduced LV systolic function, and if so, what is a reasonable amount of volume?

2 Answers available

Following completion of antiplatelet monotherapy (i.e. Plavix) plus oral anticoagulation in patients with Afib post-PCI, would you favor continuing antiplatelet therapy + OAC, switching from Plavix to aspirin and continuing OAC, or stopping antiplatelet therapy and continuing OAC?

2 Answers available

What is your preferred monotherapy antiplatelet agent to continue after completion of DAPT post-PCI for patients with stable ischemic heart disease?

Would coronary disease anatomy influence your selection of which type of antiplatelet agent to continue?

6 Answers available

What is your intraprocedural approach to reducing time to reperfusion in STEMI cases: opting for culprit lesion PCI first then complete angiography, or complete angiography followed by culprit lesion PCI?

Levi et al., PMID 38551563

2 Answers available

Do you favor aspirin or P2Y12 inhibitor monotherapy following completion of 12 months of DAPT post-PCI in patients with elevated bleeding risk?

5 Answers available

When pursuing complex PCI of the RCA (especially when lesion preparation is required), when do you consider placing a transvenous pacemaker in anticipation of conduction abnormalities?

5 Answers available

How soon after an elective, uncomplicated coronary intervention would you feel comfortable having a patient travel by air?

1 Answer available

Do you prefer a loading dose of 300mg or 600mg plavix for patients presenting with NSTEMI or unstable angina about to undergo LHC?

Does your preferred dose change if this were in a non-ACS setting with elective outpatient PCI?

2 Answers available

How have the findings from DanGer Shock RCT changed your perspective on which patients presenting with acute MI complicated by cardiogenic shock would benefit from Impella for additional hemodynamic support?

2 Answers available

Following left main bifurcation stenting, do you routinely proceed with kissing balloon inflation of the side branch, either LCx or LAD?

6 Answers available

How do you view the balance between opting for percutaneous coronary intervention and prioritizing optimal medical therapy as the initial treatment choice for patients with stable angina?

ORBITA-2 Trial

3 Answers available

What are your top takeaways from ACC 2024?

3 Answers available

What is your standard approach (i.e. choice of medication, type of sheath) in the cath lab to reduce the likelihood of radial artery spasm?

6 Answers available

What are alternate approaches to medical therapy and/or interventions to consider in patients with refractory, severe coronary vasospasm despite short-acting nitrates, calcium channel blockers, L-arginine, and clonidine?

5 Answers available

How frequently do you opt to use IVUS as opposed to OCT or invasive hemodynamic assessment when evaluating coronary lesions?

1 Answer available

What is your approach to counseling a patient with stable but severe multivessel coronary disease if the patient does not wish to undergo bypass surgery?

And when would you consider referral for staged/complex PCI instead?

1 Answer available

Given that high coronary calcium scores portend significantly increased cardiac mortality rates over 5-6 years, is there any data to support performing coronary angiography when the score is very high, e.g. over 1000, even in asymptomatic patients with no objective evidence of ischemia?

1 Answer available

What is the best approach for single vessel mid-LAD CTO in patient with preserved EF and no anginal symptoms?

7 Answers available

How will you decide between using paclitaxel-coated balloons versus conventional uncoated balloons for managing in-stent restenosis?

1 Answer available

What is your preferred anticoagulation/antiplatelet regimen for younger patients presenting with ACS, found to have an acute thrombotic event requiring aspiration thrombectomy without need for stent deployment?

1 Answer available

For patients presenting with ACS and severe aortic stenosis with critical left main disease, would you consider BAV prior to PCI to the left main?

1 Answer available

Would you consider switching choice of P2Y12 inhibitor for patients with ISR (non-ACS presentation), with acceptable bleeding risk?

1 Answer available

What is a reasonable hemoglobin goal for patients with chronic anemia presenting with acute MI?

1 Answer available

In patients presenting with ACS and multivessel disease, when do you favor immediate versus delayed complete revascularization?

If delayed complete revascularization is favored, would you consider staged PCI during that same admission or PCI outpatient?

3 Answers available

What is a reasonable length of time for systemic anticoagulation in patients presenting with MI in the setting of coronary artery aneurysm with large thrombus formation?

5 Answers available

Should intervention be considered for an intermediate flow-limiting coronary lesion that does not correlate with perfusion defects on stress testing in a patient with atypical anginal symptoms?

7 Answers available

What is your approach to considering geriatric patients for complex PCI given their overall frailty and increased risk of complications such as bleeding and stroke?

2 Answers available

What are your top takeaways from AHA 2023?

4 Answers available

Should bare metal stents be favored over drug eluting stents for pregnant patients presenting with acute coronary syndrome?

1 Answer available

What is your preferred method of lesion interrogation for intermediate left main coronary artery stenosis?

1 Answer available

Should we routinely include geriatric functional assessments to determine candidacy for TAVR?

(ie., assessing gait speed, cognition, physical function, fall history, orthostatic vital signs, etc.)

1 Answer available

For patients maintained on antiplatelet monotherapy post-DAPT following PCI, what is your recommendation for holding antiplatelet therapy prior to non-cardiac surgery?

Do you ever recommend "bridging" with low-dose aspirin?

1 Answer available

What is your approach to correlating stenotic lesions on coronary angiography to magnitude of decline in LV systolic function or cardiomyopathy severity when deciding to intervene or medically manage stable ischemic heart disease as an outpatient?

1 Answer available

What is your approach to abbreviated DAPT in post-PCI patients (ACS and non-ACS) with high bleeding risk?

1 Answer available

What is a reasonable duration of time for dual anti-platelet therapy in patients who have undergone placement of a covered coronary stent?

1 Answer available

Is there emerging and compelling enough evidence to maintain patients on P2Y12i monotherapy (in lieu of aspirin) following completion of DAPT?

1 Answer available

Should we have a lower threshold to consider revascularization of coronary lesions in athletes, compared to non-athletes?

1 Answer available

Which factors favor extended dual antiplatelet therapy beyond one year in ACS patients with low bleeding risk?

1 Answer available

Papers discussed in this category

Journal of the American College of Cardiology, 2023 Nov 21

Long-Term Outcomes of Invasive vs Conservative Strategies for Older Patients With Non-ST-Segment Elevation Acute Coronary Syndromes.

The New England journal of medicine, 2023 Aug 26

Complete or Culprit-Only PCI in Older Patients with Myocardial Infarction.

JACC. Cardiovascular interventions, 2014-07

Futility, benefit, and transcatheter aortic valve replacement.

Eur Heart J,

2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy.

Circulation, 2021 Oct 28

2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

JAMA, 2020 Dec 15

Association Between Adherence to Fractional Flow Reserve Treatment Thresholds and Major Adverse Cardiac Events in Patients With Coronary Artery Disease.

J Am Coll Cardiol, 2020 Jun 09

Survival of Patients With Angina Pectoris Undergoing Percutaneous Coronary Intervention With Intracoronary Pressure Wire Guidance.

J Am Heart Assoc, 2019 Oct 02

Extended Duration of Dual-Antiplatelet Therapy After Percutaneous Coronary Intervention: How Long Is Too Long?

Circulation, 2022 Nov 07

Aspirin Versus Clopidogrel for Long-Term Maintenance Monotherapy After Percutaneous Coronary Intervention: The HOST-EXAM Extended Study.

JAMA Cardiol, 2022 Nov 01

Long-term Effects of P2Y12 Inhibitor Monotherapy After Percutaneous Coronary Intervention: 3-Year Follow-up of the SMART-CHOICE Randomized Clinical Trial.

Lancet (London, England), 2015 Jul 15

Small bites versus large bites for closure of abdominal midline incisions (STITCH): a double-blind, multicentre, randomised controlled trial.

The New England journal of medicine, 2020 Mar 30

Initial Invasive or Conservative Strategy for Stable Coronary Disease.

Circulation, 2019 Jan 29

Open-Label Randomized Trial Comparing Oral Anticoagulation With and Without Single Antiplatelet Therapy in Patients With Atrial Fibrillation and Stable Coronary Artery Disease Beyond 1 Year After Coronary Stent Implantation.

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2019 Jun 20

Percutaneous recanalisation of chronic total occlusions: 2019 consensus document from the EuroCTO Club.

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022 Sep 20

Recanalisation of coronary chronic total occlusions.

The New England journal of medicine, 2023 Aug 27

Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction.

The New England journal of medicine, 2023 Nov 11

Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia.

Circulation, 2023 Nov 13

Sudden Cardiac Death in National Collegiate Athletic Association Athletes: A 20-Year Study.

Circulation, 2023 Nov 11

Arrhythmic Risk In Biventricular Pacing Compared with Left Bundle Branch Area Pacing: Results From The International LBBAP Collaborative Study (I-CLAS).

Circulation. Cardiovascular quality and outcomes, 2023 Nov 06

Off-Label Dosing of Direct Oral Anticoagulants Among Inpatients with Atrial Fibrillation in the United States.

American heart journal, 2017 Apr 24

Rationale and design of the Apixaban for the Reduction of Thrombo-Embolism in Patients With Device-Detected Sub-Clinical Atrial Fibrillation (ARTESiA) trial.

The New England journal of medicine, 2023 Nov 11

Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.

American heart journal, 2023 Mar 25

Screening for peripartum cardiomyopathies using artificial intelligence in Nigeria (SPEC-AI Nigeria): Clinical trial rationale and design.

JAMA, 2023 Nov 11

Aspirin and Hemocompatibility Events With a Left Ventricular Assist Device in Advanced Heart Failure: The ARIES-HM3 Randomized Clinical Trial.

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2020 Sep 09

Usefulness of oral anticoagulation in patients with coronary aneurysms: Insights from the CAAR registry.

Circulation research, 2019 Feb

Synergy of Dual Pathway Inhibition in Chronic Cardiovascular Disease.

JAMA, 2024 Mar 09

Paclitaxel-Coated Balloon vs Uncoated Balloon for Coronary In-Stent Restenosis: The AGENT IDE Randomized Clinical Trial.

American heart journal, 2020 Oct 13

Rationale and design of ApoA-I Event Reducing in Ischemic Syndromes II (AEGIS-II): A phase 3, multicenter, double-blind, randomized, placebo-controlled, parallel-group study to investigate the efficacy and safety of CSL112 in subjects after acute myocardial infarction.

The New England journal of medicine, 2024 Apr 07

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock.

Circulation, 2016-12-13

Safety and Tolerability of CSL112, a Reconstituted, Infusible, Plasma-Derived Apolipoprotein A-I, After Acute Myocardial Infarction: The AEGIS-I Trial (ApoA-I Event Reducing in Ischemic Syndromes I).

American heart journal, 2022 May 17

Empagliflozin in patients post myocardial infarction rationale and design of the EMPACT-MI trial.

The New England journal of medicine, 2024 Apr 06

Semaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes.

Current cardiology reviews, 2021

Access-site Complications of the Transradial Approach: Rare But Still There.

Interactive cardiovascular and thoracic surgery, 2013 Nov 19

Should the radial artery be used as a bypass graft following radial access coronary angiography.

The American journal of cardiology, 2021 Aug 11

Meta-Analysis of Transradial Versus Transfemoral Access for Percutaneous Coronary Intervention in Patients With Chronic Kidney Disease.

Circulation, 2019 Nov 17

The Evolving Landscape of Impella Use in the United States Among Patients Undergoing Percutaneous Coronary Intervention With Mechanical Circulatory Support.

JACC. Heart failure, 2020 Nov

Complete Hemodynamic Profiling With Pulmonary Artery Catheters in Cardiogenic Shock Is Associated With Lower In-Hospital Mortality.

The New England journal of medicine, 2013-09-05

Door-to-balloon time and mortality among patients undergoing primary PCI.

Lancet (London, England), 2014-05-24

Haemodynamic-guided fluid administration for the prevention of contrast-induced acute kidney injury: the POSEIDON randomised controlled trial.

JAMA cardiology, 2024 Aug 07

Low-Dose Direct Oral Anticoagulation vs Dual Antiplatelet Therapy After Left Atrial Appendage Occlusion: The ADALA Randomized Clinical Trial.

The New England journal of medicine, 2024 Sep 01

Invasive Treatment Strategy for Older Patients with Myocardial Infarction.

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