Feasibility of guiding catheter exchange using extension wire in percutaneous coronary intervention after transcatheter aortic valve replacement.

IF 3.1 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Makoto Saigan, Masaki Miyasaka, Daishi Tazawa, Momo Kosuga, Manabu Maeda, Yun Teng, Natsuko Satomi, Yuta Kobayashi, Masaki Nakashima, Yusuke Enta, Yoshiko Munehisa, Yukihiro Hayatsu, Norio Tada
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引用次数: 0

Abstract

Percutaneous coronary intervention (PCI) after transcatheter aortic valve replacement (TAVR) is technically challenging because of the presence of the transcatheter heart valve (THV), which complicates coronary artery engagement. Owing to their flexibility, diagnostic catheters (DCs) facilitate coronary access, but require subsequent exchange to guiding catheters (GCs) for PCI. The feasibility of using an extension wire (EW) to facilitate DC-to-GC exchange in this context remains unexplored. A retrospective analysis was conducted at our institution, examining 11 PCI cases performed after TAVR between January 6, 2020, and June 1, 2024, in which an EW was employed to transition from a DC to a GC. Clinical, angiographic, and procedural data were reviewed. Procedural success was defined as a successful DC-to-GC exchange and completion of PCI. DC-to-GC exchange using an EW was successfully achieved in all 11 cases (100%). Revascularization was achieved in 10/11 cases (91%). The lesions were uniformly classified as American College of Cardiology/American Heart Association Type B2/C. The GCs included Judkins-type in 7/11 cases (64%) and backup-type in 4/11 cases (36%). The THV types included SAPIEN in 6/11 cases (55%), Evolut in 3/11 cases (27%), and Navitor in 2/11 cases (18%). A 6Fr GC was utilized in 10/11 cases (91%), and rotational atherectomy was performed in 1/11 cases (9%). The use of an EW to facilitate the transition from DC to GC in PCI after TAVR resulted in high procedural success, providing a feasible approach for addressing complex lesions and optimizing procedural outcomes.

经导管主动脉瓣置换术后经皮冠状动脉介入治疗中延长丝引导导管置换的可行性。
经导管主动脉瓣置换术(TAVR)后经皮冠状动脉介入治疗(PCI)在技术上具有挑战性,因为经导管心脏瓣膜(THV)的存在使冠状动脉介入复杂化。由于其灵活性,诊断导管(dc)便于冠状动脉通路,但随后需要更换引导导管(gc)进行PCI。在这种情况下,使用延长线(EW)促进dc到gc交换的可行性仍未得到探索。我们的机构进行了一项回顾性分析,研究了2020年1月6日至2024年6月1日期间在TAVR后进行的11例PCI病例,其中使用EW从DC过渡到GC。我们回顾了临床、血管造影和手术资料。程序性成功被定义为成功的dc - gc交换和PCI的完成。使用EW的dc - gc交换在所有11例中都成功实现(100%)。10/11例(91%)实现血运重建。病变被美国心脏病学会/美国心脏协会统一分类为B2/C型。GCs包括7/11的judkins型(64%)和4/11的backup型(36%)。THV类型包括SAPIEN(6/11)(55%)、Evolut(3/11)(27%)和Navitor(2/11)(18%)。10/11例(91%)采用6Fr GC, 1/11例(9%)采用旋转动脉粥样硬化切除术。在TAVR后的PCI中,使用EW促进从DC到GC的过渡,获得了很高的手术成功率,为处理复杂病变和优化手术结果提供了可行的方法。
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来源期刊
Cardiovascular Intervention and Therapeutics
Cardiovascular Intervention and Therapeutics CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
6.30
自引率
12.50%
发文量
68
期刊介绍: Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.
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