Quality improvement research brings evidence-based interventions to clinical practice.

This single-center study demonstrated that simple clinical guidelines, computer prompts, and education were able to reduce the duration of triple therapy after percutaneous coronary intervention.

Behavioral interventions are an important tool to drive clinical improvement but must be tailored to respect physician autonomy and professionalism.

Women are less frequently referred to CTO recanalizations according to their ambiguous presentation

Gender has a great impact on technical procedural success and also on procedural complication rate

It is important to adopt tricks to avoid the most common complications in women such as cardiac tamponade, access problems, and contrast nephropathy

An increasing number of complex higher risk indicated patients (CHIP) are referred to percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS) provided by devices like the Impella CP is being increasingly used in such procedures.

Impella CP placement and PCI performance can be achieved through the same vascular access (“single-access technique”), avoiding vascular complications and bleeding associated with gaining multiple arterial access sites.

When looking for an 8-Fr system to perform CHIP-PCI, a sheathless guiding catheter can be directly inserted within the Impella CP sheath, with the use of the Rotaglide™ as a lubricant solution to minimize the friction between the guide catheter and the Impella CP drive shaft.

Extracardiac Fontan conduits often narrow over time and can be returned safely to nominal diameter and larger with stents.

Conduit expansion often produces short term benefits. Long-term benefits seem likely but data are limited.

A conduit pressure gradient at rest is often absent and is not required to identify potential benefit. Understanding of patient selection criteria and procedure timing is evolving.

The Smart stent has been “battle-hardened” with years of experience to treat femoropopliteal lesions.

Many patients with femoropopliteal lesions require multiple interventions.

Are there any therapies that can be performed for long-term success for longer femoral lesions?

TAVR effective in CS, but mortality still high and outcomes determined by non-procedural factors

AS with intact LV ejection fraction rarely induces CS: Must delineate non-valvular hemodynamic compromise factors

“Primary” TAVR strategy preferable, with BAV reserved as “Bridge” to Definitive Decision

No randomized trials have been done for TAVR in bicuspid aortic valve (BAV) and probably will never be done.

TAVR for BAV has a similar risk profile to tricuspid aortic valve patients except for a higher risk of permanent pacemaker implantation at 30 and 180 days after the index procedure.

Further real-world data are needed to refine patient selection, procedural technique, and lifetime planning of intervention.

Between 2009 and 2017 23.4% of 424,290 elective complex high-risk percutaneous interventions (CHiP) were performed in patients aged ≥80 years. Octogenarians had the highest in hospital mortality, bleeding events and major adverse cardiovascular and cerebrovascular events.

CHiP can and should be offered to ≥80-year-old patients when the potential benefits outweigh the risks.

Careful procedural planning and meticulous execution are important for optimizing the outcomes of CHiP in ≥80-year-old patients.

Atherosclerosis is a systemic disease and frequently coronary artery disease is intertwined with peripheral arterial disease (PAD).

This large study showed that PAD and its extension (multisite atherosclerosis) negatively affects the risk of in-hospital mortality in patients with coronary artery disease undergoing PCI.

PAD status and its extension in the principal vascular territories should be carefully assessed during hospitalization for coronary revascularization and should be regarded as important risk factors.

Provisional stenting strategy is the most common technique for treatment of bifurcation lesion in the ‘real world' patients undergoing percutaneous coronary intervention.

The technical success appears to be lower in provisional stent strategy compared to upfront two stent strategy due to worsening of the ostial side branch lesions after main branch stenting; following wire recrossing and side branch dilation/stent implantation stenting leads to equivalent procedural success and in hospital outcomes.

Side branch access after main branch stenting is technically challenging and an algorithmic approach helps to achieve procedural success.