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April 25 (Wed.), 2012
FFR Guided and IVUS Supported Functional Angioplasty
Let’s Overcome our Visual Bias for more Optimal Stent Results
In this TATAP 2012 meeting, Seung-Jung Park, MD from Asan Medical Center, Seoul, Korea summarized the concept of Visual Functional Mismatch.
During the past several decades, revascularization for acute coronary syndrome was considered as life saving procedure. In fact, the studies demonstrated that the revascularization was associated with lower mortality in STEMI patients or lower hard endpoints (death or myocardial infarction) in ACS patients. In contrast, the efficacy of revascularization in patients with stable coronary artery disease has been debatable. Large randomized clinical trials comparing the revascularization and the optimal medical treatment such as COURAGE or BARI2D trials failed to demonstrate the benefit of stent implantation. Therefore, stent seems to be implanted only in medically refractory patients having objective evidence of ischemia.......
Identification of High-Risk Patients: From Vulnerable Plaque to Ischemia
Vulnerable Plaque: Anatomic Features Linked to Future Events
Acute coronary syndromes (ACS) and sudden cardiac death are the main causes of morbidity and mortality worldwide. ACS is an acute clinical manifestation of the chronic process of atherosclerosis. In the majority of patients, ACS events are caused by plaque rupture in flow-limiting and nonflow- limiting angiographically intermediate stenoses. Histopathologic analyses have shown that plaque composition is related to the occurrence of acute clinical events and therefore, to the vulnerability of the plaque. The original concept of vulnerable plaque, an assumed precursor lesion of plaque rupture, was introduced by Muller and defined as a coronary lesion that morphologically resembles ruptured plaque but has an intact fibrous cap without thrombosis.......
TCTAP Highlights: Updates and Controversies

Multivessel and Left Main Disease
For several decades, coronary-artery bypass grafting (CABG) has been regarded as the treatment of choice for patients with multivessel and unprotected left main coronary artery (LMCA) disease. However, because of marked advancements in techniques of percutaneous coronary intervention (PCI) and CABG as well as adjunctive pharmacologic therapy, a new evaluation and review of current indications for optimal revascularization therapy for multivessel and LMCA disease may be required to determine the standard of care for these atients.......

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