Raymundo Ocaranza Sánchez - Academia.edu (original) (raw)
Papers by Raymundo Ocaranza Sánchez
Revista Española de Cardiología
REC: interventional cardiology (English Edition)
Journal of the American College of Cardiology
Journal of Interventional Cardiology, 2021
Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the ... more Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. Materials and Methods. Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR “grey zone” in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). Results. A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (...
REC: interventional cardiology (English Edition), 2021
REC: interventional cardiology, 2021
Journal of Thrombosis and Thrombolysis, 1997
Circulation, Nov 22, 2011
Archivos de cardiología de México
Arterial coronary occlusion produces ischaemic changes, and alter the aerobic metabolism, creatin... more Arterial coronary occlusion produces ischaemic changes, and alter the aerobic metabolism, creatinephosphate depletion and accumulation of anoxic metabolites in the ischaemic tissue, with an alteration in the calcium regulation. With the recovery of the blood flow, the myocardial ischaemic injury and infarct zone are diminished, leading to an improvement of survival. The adverse effect induced by the reperfusion of ischaemic cells with the production of free radicals and dearrangements in the glucose metabolism, fatty acids and intracellular calcium flow as well, has been proven. There are 4 kinds of reperfusion damage: stunned myocardium, reperfusion arrhythmia, no-reflow phenomena, and cellular death, all of them with a particular physiopathology. Nowadays, there are too many paraclinics in order to reach a diagnosis, and perhaps the only available treatment is still under research. This field has great expectancy in the future. In this article, some of the contemporary concepts ar...
Haase/Cardiovascular Interventions in Clinical Practice, 2010
Background Paclitaxel-coated balloon (PCB) coronary angioplasty is an alternative treatment for d... more Background Paclitaxel-coated balloon (PCB) coronary angioplasty is an alternative treatment for de-novo coronary lesions in small vessels. This study with the new Essential PCB aimed to evaluate early and mid-term clinical outcomes following angioplasty with the Essential PCB in the treatment of de-novo lesions in small vessels. Patients and methods We included all patients who underwent PCB angioplasty for treating de-novo coronary lesions in small vessels (reference diameter <2.5 mm) between October 2015 and June 2016 in 2 centres. The primary endpoint was the 12-month target lesion failure (TLF) rate: a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization. The secondary endpoints were rates of target vessel failure and global major adverse cardiac events (MACE). Results A total of 71 patients (comprising 71 lesions) were included, with a mean age of 66 ± 11 years. A 56% were diabetic and 70% had an acute coronary syndrome as an indication for coronary revascularization. The mean vessel diameter and lesion length were 2.21 ± 0.41 and 20.7 ± 9.2 mm, respectively. Predilatation was performed in 85.9% of patients. The median diameter, length, and inflation pressure of the Essential balloon were 2.0 [interquartile range (IQR): 2.0-2.5] mm, 20 (IQR: 15-30) mm, and 12 ± 2 atmospheres, respectively. Angiographic success was achieved in 97.2% of cases, and bail-out stenting was required in nine (12.7%) cases. The incidence of TLF at the 12-month follow-up was 4.2%, with a target lesion revascularization rate of 4.2%. Target vessel failure and global MACE rates were 4.2 and 9.9%, respectively. Conclusion Use of the Essential PCB for treating de-novo coronary lesions in small vessels was safe, with low TLF and MACE rates at the 12-month follow-up. Coron Artery Dis
Revista Española de Cardiología, 2013
Introducción y objetivos: La Secció n de Hemodiná mica y Cardiología Intervencionista presenta su... more Introducción y objetivos: La Secció n de Hemodiná mica y Cardiología Intervencionista presenta su informe anual con los datos del registro de actividad nacional correspondientes a 2012. Me´todos: Los centros proporcionan sus datos voluntariamente. La informació n se introduce online y la
The American Journal of Cardiology, 2013
The aim of this study is to investigate the feasibility and safety of using a single transradial ... more The aim of this study is to investigate the feasibility and safety of using a single transradial guiding catheter (MAC 3.5) for both coronary angiography and intervention in patients with ST elevation myocardial infarction (STEMI). Methods: This was a single-center, prospective, randomized study conducted from August 2011 to April 2012, 150 patients with STEMI indicated for transradial primary percutaneous coronary intervention (PCI) were randomized into two groups: MAC group (75 cases) consisted of patients who underwent coronary angiography and primary PCI by using a single guiding catheter (MAC3.5). Control group (75 cases) included patients who first underwent coronary angiography with diagnosticTiger catheter followed by guiding catheter selection for intervention. Several parameters were evaluated: puncture success rate, times for patient preparation, the study endpoints were sheath placement time, total procedure time, fluoroscopy time, cathlab door to balloon time (C2B), contrast consumption(ml), vascular access-site complications and 6-month major adverse cardiac events (MACE), including death, myocardial infarction, and target lesion revascularization. Results: Baseline patient characteristics were similar between the MAC group and control group. The overall rates of access site crossover were 4.0% (3/75) in the MAC group and 5.3% (4/75) in the control group. The reasons for crossover in the MAC group were radial artery loop in 2 patients and radial artery stenosis in 1 patient. In the control group the reasons were radial artery loop in 2 patients, radial artery stenosis in 1 patient and radial artery spasm with failure to advance guide catheter in 1 patient. The puncture success rate (100% vs 100%), times (min) for patient preparation (4.05O1.00 vs 4.12O1.04; p¼0.698), sheath placement time (1.75O1.77 vs 1.62O0.87; p¼0.460), the PCI procedural success rate (88.9% vs 85.9%; p¼0.592) and contrast consumption (126.3O30.1 ml vs 129.3O33.3 ml; p¼) were comparable between the 2 groups. Compare with the Control group, the total procedure time、C2B time and the overall fluoroscopy time were significantly lower in MAC Group (29.60O7.93 vs 35.88O11.96, p<0.001; 15.83O3.93 vs 18.70O4.21, p<0.001; 8.40 O2.73 vs 10.08 O4.88 min, p¼0.012, respectively). Local hematoma occurred in 3 cases in each of the two groups that improved after physiotherapy and no radial artery occlusion was noted in the two groups. There were no differences in 6-month MACE (4.17% vs 4.23%, p>0.05). Conclusion: A single transradial MAC guiding catheter for coronary angiography and intervention in STEMI patients is feasible and safe. It can shorten procedure time, fluoroscopy time and C2B time.
Acta Cardiologica, 2006
Sinus of Valsalva aneurysm is an infrequent cardiac anomaly. In the United States, it accounts fo... more Sinus of Valsalva aneurysm is an infrequent cardiac anomaly. In the United States, it accounts for only 0.15 to 1.5% of all cardiopulmonary bypass procedures. Sinus of Valsalva aneurysms can be acquired, secondary to infectious, degenerative or traumatic processes. This paper describes the case report of an 81-year-old woman, with an unruptured aneurysm of the right Valsalva sinus, who was admitted to the emergency department with a history of chest pain. After surgical repair of the sinus ofValsalva aneurysm, the prognosis is usually good, and the risk of recurrence is rare.
Revista Española de Cardiología, 2004
Revista Española de Cardiologia, 2004
European Heart Journal, 2015
The Szabo technique provides a unique way to accurately position a stent in ostial lesions, avoid... more The Szabo technique provides a unique way to accurately position a stent in ostial lesions, avoiding geographic miss and shifting of plaque to non-affected adjacent vessels. A 64-year-old woman with dyslipidemia presented to the emergency department with unstable angina. Coronary angiography showed single-vessel disease, with severe proximal left anterior descending (LAD) artery stenosis and a critical bifurcation lesion of the mid LAD and the first major septal branch (Medina score 1,1,1) (Figure 1A and B). The left coronary ostium was cannulated with a 3.5F Extra Back-up guide catheter, two BMW wires were advanced to the LAD and the first septal branch, and the latter was treated with a 2.0 mm×15 mm drugeluting balloon. After proximal and mid LAD predilation (Figure 1C), a 3.5 mm×28 mm Absorb GT1 bioresorbable scaffold (BRS) was advanced to the LAD, but deployment
Scientific reports, Dec 22, 2016
The platelet-specific collagen receptor glycoprotein VI (GPVI) is critical for the formation of a... more The platelet-specific collagen receptor glycoprotein VI (GPVI) is critical for the formation of arterial thrombosis in vivo. We analyzed GPVI-activated platelets from ST-elevation myocardial infarction (STEMI) patients and matched stable coronary artery disease (SCAD) controls in order to provide novel clues on the degree of involvement of GPVI signaling in the acute event. Firstly, platelets were isolated from systemic venous blood and activated with the GPVI specific agonist CRP (collagen-related peptide). STEMI and SCAD samples were compared by a phosphoproteomics approach. Validations were by immunoblotting in systemic and intracoronary blood from independent cohorts of patients. Twenty-six differentially regulated proteins were identified when comparing CRP-activated systemic platelets from STEMI and SCAD patients, 4 of which were selected for validation studies: PLCɣ2, G6f, SLP-76, and Dok-2. Immunoblot analyses showed these four proteins had higher tyrosine phosphorylation le...
Revista Española de Cardiología
REC: interventional cardiology (English Edition)
Journal of the American College of Cardiology
Journal of Interventional Cardiology, 2021
Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the ... more Background. The resting full‐cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. Materials and Methods. Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR “grey zone” in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). Results. A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (...
REC: interventional cardiology (English Edition), 2021
REC: interventional cardiology, 2021
Journal of Thrombosis and Thrombolysis, 1997
Circulation, Nov 22, 2011
Archivos de cardiología de México
Arterial coronary occlusion produces ischaemic changes, and alter the aerobic metabolism, creatin... more Arterial coronary occlusion produces ischaemic changes, and alter the aerobic metabolism, creatinephosphate depletion and accumulation of anoxic metabolites in the ischaemic tissue, with an alteration in the calcium regulation. With the recovery of the blood flow, the myocardial ischaemic injury and infarct zone are diminished, leading to an improvement of survival. The adverse effect induced by the reperfusion of ischaemic cells with the production of free radicals and dearrangements in the glucose metabolism, fatty acids and intracellular calcium flow as well, has been proven. There are 4 kinds of reperfusion damage: stunned myocardium, reperfusion arrhythmia, no-reflow phenomena, and cellular death, all of them with a particular physiopathology. Nowadays, there are too many paraclinics in order to reach a diagnosis, and perhaps the only available treatment is still under research. This field has great expectancy in the future. In this article, some of the contemporary concepts ar...
Haase/Cardiovascular Interventions in Clinical Practice, 2010
Background Paclitaxel-coated balloon (PCB) coronary angioplasty is an alternative treatment for d... more Background Paclitaxel-coated balloon (PCB) coronary angioplasty is an alternative treatment for de-novo coronary lesions in small vessels. This study with the new Essential PCB aimed to evaluate early and mid-term clinical outcomes following angioplasty with the Essential PCB in the treatment of de-novo lesions in small vessels. Patients and methods We included all patients who underwent PCB angioplasty for treating de-novo coronary lesions in small vessels (reference diameter <2.5 mm) between October 2015 and June 2016 in 2 centres. The primary endpoint was the 12-month target lesion failure (TLF) rate: a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization. The secondary endpoints were rates of target vessel failure and global major adverse cardiac events (MACE). Results A total of 71 patients (comprising 71 lesions) were included, with a mean age of 66 ± 11 years. A 56% were diabetic and 70% had an acute coronary syndrome as an indication for coronary revascularization. The mean vessel diameter and lesion length were 2.21 ± 0.41 and 20.7 ± 9.2 mm, respectively. Predilatation was performed in 85.9% of patients. The median diameter, length, and inflation pressure of the Essential balloon were 2.0 [interquartile range (IQR): 2.0-2.5] mm, 20 (IQR: 15-30) mm, and 12 ± 2 atmospheres, respectively. Angiographic success was achieved in 97.2% of cases, and bail-out stenting was required in nine (12.7%) cases. The incidence of TLF at the 12-month follow-up was 4.2%, with a target lesion revascularization rate of 4.2%. Target vessel failure and global MACE rates were 4.2 and 9.9%, respectively. Conclusion Use of the Essential PCB for treating de-novo coronary lesions in small vessels was safe, with low TLF and MACE rates at the 12-month follow-up. Coron Artery Dis
Revista Española de Cardiología, 2013
Introducción y objetivos: La Secció n de Hemodiná mica y Cardiología Intervencionista presenta su... more Introducción y objetivos: La Secció n de Hemodiná mica y Cardiología Intervencionista presenta su informe anual con los datos del registro de actividad nacional correspondientes a 2012. Me´todos: Los centros proporcionan sus datos voluntariamente. La informació n se introduce online y la
The American Journal of Cardiology, 2013
The aim of this study is to investigate the feasibility and safety of using a single transradial ... more The aim of this study is to investigate the feasibility and safety of using a single transradial guiding catheter (MAC 3.5) for both coronary angiography and intervention in patients with ST elevation myocardial infarction (STEMI). Methods: This was a single-center, prospective, randomized study conducted from August 2011 to April 2012, 150 patients with STEMI indicated for transradial primary percutaneous coronary intervention (PCI) were randomized into two groups: MAC group (75 cases) consisted of patients who underwent coronary angiography and primary PCI by using a single guiding catheter (MAC3.5). Control group (75 cases) included patients who first underwent coronary angiography with diagnosticTiger catheter followed by guiding catheter selection for intervention. Several parameters were evaluated: puncture success rate, times for patient preparation, the study endpoints were sheath placement time, total procedure time, fluoroscopy time, cathlab door to balloon time (C2B), contrast consumption(ml), vascular access-site complications and 6-month major adverse cardiac events (MACE), including death, myocardial infarction, and target lesion revascularization. Results: Baseline patient characteristics were similar between the MAC group and control group. The overall rates of access site crossover were 4.0% (3/75) in the MAC group and 5.3% (4/75) in the control group. The reasons for crossover in the MAC group were radial artery loop in 2 patients and radial artery stenosis in 1 patient. In the control group the reasons were radial artery loop in 2 patients, radial artery stenosis in 1 patient and radial artery spasm with failure to advance guide catheter in 1 patient. The puncture success rate (100% vs 100%), times (min) for patient preparation (4.05O1.00 vs 4.12O1.04; p¼0.698), sheath placement time (1.75O1.77 vs 1.62O0.87; p¼0.460), the PCI procedural success rate (88.9% vs 85.9%; p¼0.592) and contrast consumption (126.3O30.1 ml vs 129.3O33.3 ml; p¼) were comparable between the 2 groups. Compare with the Control group, the total procedure time、C2B time and the overall fluoroscopy time were significantly lower in MAC Group (29.60O7.93 vs 35.88O11.96, p<0.001; 15.83O3.93 vs 18.70O4.21, p<0.001; 8.40 O2.73 vs 10.08 O4.88 min, p¼0.012, respectively). Local hematoma occurred in 3 cases in each of the two groups that improved after physiotherapy and no radial artery occlusion was noted in the two groups. There were no differences in 6-month MACE (4.17% vs 4.23%, p>0.05). Conclusion: A single transradial MAC guiding catheter for coronary angiography and intervention in STEMI patients is feasible and safe. It can shorten procedure time, fluoroscopy time and C2B time.
Acta Cardiologica, 2006
Sinus of Valsalva aneurysm is an infrequent cardiac anomaly. In the United States, it accounts fo... more Sinus of Valsalva aneurysm is an infrequent cardiac anomaly. In the United States, it accounts for only 0.15 to 1.5% of all cardiopulmonary bypass procedures. Sinus of Valsalva aneurysms can be acquired, secondary to infectious, degenerative or traumatic processes. This paper describes the case report of an 81-year-old woman, with an unruptured aneurysm of the right Valsalva sinus, who was admitted to the emergency department with a history of chest pain. After surgical repair of the sinus ofValsalva aneurysm, the prognosis is usually good, and the risk of recurrence is rare.
Revista Española de Cardiología, 2004
Revista Española de Cardiologia, 2004
European Heart Journal, 2015
The Szabo technique provides a unique way to accurately position a stent in ostial lesions, avoid... more The Szabo technique provides a unique way to accurately position a stent in ostial lesions, avoiding geographic miss and shifting of plaque to non-affected adjacent vessels. A 64-year-old woman with dyslipidemia presented to the emergency department with unstable angina. Coronary angiography showed single-vessel disease, with severe proximal left anterior descending (LAD) artery stenosis and a critical bifurcation lesion of the mid LAD and the first major septal branch (Medina score 1,1,1) (Figure 1A and B). The left coronary ostium was cannulated with a 3.5F Extra Back-up guide catheter, two BMW wires were advanced to the LAD and the first septal branch, and the latter was treated with a 2.0 mm×15 mm drugeluting balloon. After proximal and mid LAD predilation (Figure 1C), a 3.5 mm×28 mm Absorb GT1 bioresorbable scaffold (BRS) was advanced to the LAD, but deployment
Scientific reports, Dec 22, 2016
The platelet-specific collagen receptor glycoprotein VI (GPVI) is critical for the formation of a... more The platelet-specific collagen receptor glycoprotein VI (GPVI) is critical for the formation of arterial thrombosis in vivo. We analyzed GPVI-activated platelets from ST-elevation myocardial infarction (STEMI) patients and matched stable coronary artery disease (SCAD) controls in order to provide novel clues on the degree of involvement of GPVI signaling in the acute event. Firstly, platelets were isolated from systemic venous blood and activated with the GPVI specific agonist CRP (collagen-related peptide). STEMI and SCAD samples were compared by a phosphoproteomics approach. Validations were by immunoblotting in systemic and intracoronary blood from independent cohorts of patients. Twenty-six differentially regulated proteins were identified when comparing CRP-activated systemic platelets from STEMI and SCAD patients, 4 of which were selected for validation studies: PLCɣ2, G6f, SLP-76, and Dok-2. Immunoblot analyses showed these four proteins had higher tyrosine phosphorylation le...