Spiros Tsiamis

Ringer perfusion balloon catheter-assisted reverse CART may facilitate retrograde wire crossing in complex CTO PCI when conventional approaches are unsuccessful. A potential adjunct for selected challenging cases. #Cardiology #CTO #PCI 🔗eurointervention.pcronline.com/article/revers… @DrPrimeroNg @LAzzaliniMD

In patients with non–LM bifurcation lesions a conservative strategy without systematic side branch intervention is associated with very rare procedural complications and is noninferior to a systematic side branch intervention regarding MI jacc.org/doi/10.1016/j.…

In this study, cangrelor provided effective platelet inhibition during PCI, with low HRPR rates during infusion. Transition to oral P2Y12 inhibitors—particularly clopidogrel—was associated with a transient increase in high residual platelet reactivity. #EIJBestOf #InterventionalCardiology #Cangrelor #AntiplateletTherapy 🔗eurointervention.pcronline.com/article/pharma… @GargiuloG83 @espogiov @CirilloPlinio @DSCastiello @IForzano46837 @d_florimonte @FiorenzoSimo @me_canonico @llddss80 @franzone_anna @piccoloraf @vlgmrc

NO reflow and challenges @SCAI #SCAI2026 Newer option > IC epinephrine @KAlaswadMD @Allison_Dupont @esbrilakis @SVRaoMD @Pooh_Velagapudi @JDawnAbbott1 @SanjitSJolly @rajivxgulati @mandeep_mayo @chadialraies @arnoldseto @BinitaShahMD @nadia_sutton

How to correct incomplete crush and how to prevent lack of carina coverage Episode 2⃣ of this series on "How to perform DK-Crush for left main bifurcation stenting" is now online! 📺pcronline.com/Cases-resource… In this episode, learn about: 🟣Differentiating between complete and incomplete crush 🟣The importance of sequential crush and bigger balloons, adequately sized according to proximal vessel diameter Includes an additional analysis by @GoranEBC & William Wijns. @twj1974 @NievesGonzalo1 @BURZOTTA_F @M_Lesiak @gabor_gt @RhianEDavies1 @esbrilakis @VisibleHeartLab #interventionalcardiology #CardioEd #EuroPCR

Watch the full step-by-step tutorial to set up Perclose device at hcp.medicalvisual.com/register. #CathLab #Perclose #VascularClosure #InterventionalCardiology #StructuralHeart #CathLabTech #CathLabNurse #MedicalVisual #CardioVisual

New #JACCCaseReports case of a 67M highlights the long-term mechanical limitations of early-generation drug-eluting stents and underlines the importance of individualized decision-making guided by symptoms and objective ischemia assessment. jacc.org/doi/10.1016/j.…

Some points of reflection about the OPTIMAL and IVUS CHIP trials coming from my talk at #CHANGEINCARDIOLOGY. Clear lack of actionable imaging points between the two arms. but also inability to prepare the lesion or to reach stent optimization definition? do we need new debulking devices or new stent optimization criteria? @PCRonline @TCTMD @SIC_CARDIOLOGIA @sicigise @mirvatalasnag @secardiologia @hospitalclinic @idibaps

Is #PCI superior to medical therapy for chronic total coronary occlusion in patients with chronic coronary syndrome? Find out from the post-hoc pooled analysis of the EUROCTO and DECISION-CTO trials published in #JACC ➡️ bit.ly/4vHeUOQ

Síndrome Coronario Agudo Sin Elevación del ST 🫀⚡ 🔰📚European Heart Journal 2025 doi.org/10.1093/eurhea… Enlace a Artículo Completo👇🏻🆓✅ t.me/SoMELaguna

In-stent restenosis remains a persistent challenge in #PCI🫀 When choosing a drug-coated balloon, does the drug matter? Comparative evidence between limus and paclitaxel continues to shape clinical decisions. 🔗 brnw.ch/21x1FO2 @APSIC6 @EuroInterventio @PCRonline

DCB in bifurcation PCI 🎯 (when to use?) Use DCB if: • Small side branch • Good lesion prep ✅ • No heavy calcium • TIMI 3 flow Avoid DCB if: • Heavy calcification ⚠️ • Large thrombus • Poor flow • Acute recoil 💡 DCB = no metal, less DAPT 🫀 Select carefully → outcomes ≈ DES #ACCAsia @JACCJournals @ACCinTouch

@realarainmd There is that brilliant technique publish bt @PCRonline pcronline.com/Cases-resource… I actually did a video at bedside to try it yesterday, I will post it shortly did you try this @realarainmd

New Journal Club review: NOBLE 10-year outcomes of PCI vs CABG in left main disease 🔗pcronline.com/PCR-Publicatio… Long-term evidence comparing PCI and CABG for unprotected left main coronary disease has been limited and sometimes conflicting. The 10-year results from the NOBLE trial now provide important clarity on all-cause mortality outcomes with both revascularisation strategies. Read this review by @RuxSava #interventionalcardiology #clinicaltrial #MedX

Journal Club: Intravascular imaging vs angiography guided complex PCI The RENOVATE-COMPLEX-PCI 5-year outcomes confirm the long-term durability of benefits seen with intracoronary imaging over angiography guided PCI in complex lesions. Selected in @JACCJournals & reviewed ✍️ by @McInerneyAngela #interventionalcardiology #imagefirst

RCA CTO w/ ambiguous proximal cap. Knuckle wire advanced subintimally and probably inadvertently tracked an RV marginal branch, exploding... Luckily, perforation was into the RV cavity. No pericardial effusion, no tamponade. No need this time but always have echo + pericardiocentesis kit ready.

Great question @TinoCostantini . I think it helps to separate polymer-jacketed knuckle wires into 3 families: 1) soft tapered wires such as Fielder XT/Fighter/Bandit, 2) stiffer nontapered wires such as Pilot 200/Raider/Gladius EX, and 3) the dedicated knuckle wire, Gladius MG.

They also create 2 different knuckles. Rolling knuckle = catch, coil, and roll. Best starter. Stronger (overcome initial hardness). It opens a larger dissection plane though. Traveling knuckle = catch, fold, and travel. Best finisher. It keeps a smaller, more controlled fold for distal tracking and re-entry. As a practical rule, the heavier the polymeric wire, the stronger and larger the knuckle it tends to create. A larger loop usually means a more powerful rolling knuckle, with more dissection force and less tendency to dive into small side branches. Know all polymeric wires (table below), there are some interesting new ones with 6g and 12g tip load, cant imagine the power!! @RinfretStephane dissected the type of knuckle and its characteristic in his phenomenous article: jacc.org/doi/10.1016/j.…

Clopidogrel vs aspirin after PCI: 10-year HOST-EXAM follow-up shows lower ischemic and bleeding events with clopidogrel—but no difference in mortality. Read more: spkl.io/6010ANGOw #ACC26

📢DK Crush like you’ve never seen it before! Episode 1⃣ of this series on "How to perform DK-Crush for left main bifurcation stenting" now online 📺pcronline.com/Cases-resource… In this episode, learn about: 🟣Multi-modality simulation to unveil the hidden parts & small obstacles that can result in complications 🟣Angioscopy directly inside the coronary artery to provide a better understanding of 3D stent configuration In-depth commentary and perspective and perspective provided by @GoranEBC & William Wijns. @twj1974 @NievesGonzalo1 @BURZOTTA_F @M_Lesiak @gabor_gt @RhianEDavies1 @esbrilakis @VisibleHeartLab #interventionalcardiology #CardioEd #EuroPCR