Cardiovascular Revascularization Medicine: Interesting Cases最新文献

{"title":"Supersaturated oxygen therapy in anterior ST-elevation myocardial infarction beyond pivotal-trial criteria: A focused case series in cardiogenic shock, mechanical circulatory support, stent failure, and multivessel disease","authors":"Akbar Ali,&nbsp;Christopher E. Potts,&nbsp;Mohamed Shelig,&nbsp;Davinder Singh,&nbsp;Jason Mader","doi":"10.1016/j.crmic.2026.100180","DOIUrl":"10.1016/j.crmic.2026.100180","url":null,"abstract":"<div><h3>Background</h3><div>Supersaturated oxygen (SSO2) therapy delivers hyperoxemic autologous blood into the infarct-related artery after primary percutaneous coronary intervention (PCI) and reduces infarct size in selected anterior ST-elevation myocardial infarction (STEMI). Its prospective evidence base and labeled indication are confined to anterior STEMI with a de-novo culprit lesion reperfused within six hours, and exclude cardiogenic shock. Whether the therapy can practicably be delivered outside those boundaries is unreported.</div></div><div><h3>Methods</h3><div>From a single-center institutional cohort of consecutive anterior-STEMI patients treated with SSO2 after primary PCI, we identified those with one or more beyond-criteria features: cardiogenic shock or mechanical circulatory support (MCS); a non-de-novo culprit lesion (stent thrombosis or in-stent occlusion); or severe multivessel disease requiring staged revascularization. Shock severity was classified retrospectively using the Society for Cardiovascular Angiography and Interventions (SCAI) SHOCK stages. For each case we abstracted arterial access sites and sheath calibers, the route of SSO2 delivery, anticoagulation, procedural intervals, and post-PCI epicardial flow from the contemporaneous catheterization record.</div></div><div><h3>Results</h3><div>Five patients (ages 38 to 76 years; two women) met the definition. Beyond-criteria features comprised cardiogenic shock with microaxial support and severe left ventricular dysfunction with intra-aortic balloon counterpulsation; stent thrombosis and in-stent occlusion; and severe multivessel disease with staged PCI. All five completed a 60-min SSO2 infusion alongside complex revascularization, including a two-stent bifurcation strategy, intravascular lithotripsy, aspiration thrombectomy, and intracoronary imaging in every case. Four of five met the pre-specified composite definition of procedural success; the patient in cardiogenic shock achieved 0% residual stenosis but persistent TIMI grade 2 flow, and therefore did not. SSO2 required an arterial puncture that the intervention itself did not in one of four evaluable patients; in the remainder the therapy sheath was an in-place upsize of an existing arteriotomy. One patient died of refractory cardiogenic shock nine hours after PCI; the other four survived to follow-up beyond 14 months.</div></div><div><h3>Conclusions</h3><div>SSO2 was feasible to deliver across a spectrum of anterior STEMI that the pivotal trials excluded or did not study. The principal practical costs were obligatory femoral access of at least 7 French caliber, incremental access-site burden when combined with MCS, and a 60-min periprocedural dwell in unstable patients. These trade-offs, rather than the observed left ventricular trajectories, are the substantive material for anyone considering the therapy in such patients.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"13 ","pages":"Article 100180"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Third time's the charm: Left internal jugular transcatheter pulmonary valve replacement in interrupted IVC with innominate vein stenosis","authors":"Waseem Raja,&nbsp;Cristina Font,&nbsp;Darin Busby,&nbsp;Jian Marie Garcia,&nbsp;Georges El Khoury,&nbsp;Hussam F. Hawamdeh,&nbsp;Thomas Zeyl,&nbsp;Erol Belli,&nbsp;Calvin Choi,&nbsp;Daniel Soffer,&nbsp;Valentin Suma,&nbsp;Ali Zgheib","doi":"10.1016/j.crmic.2026.100177","DOIUrl":"10.1016/j.crmic.2026.100177","url":null,"abstract":"<div><h3>Background</h3><div>The Harmony transcatheter pulmonary valve (TPV) system is designed to treat severe pulmonary regurgitation in patients with native or surgically repaired right ventricular outflow tracts.</div></div><div><h3>Case summary</h3><div>A 22-year-old woman with prior balloon valvuloplasty for congenital pulmonary valve stenosis presented with symptomatic severe pulmonary valve regurgitation. Femoral transcatheter valve delivery was unsuccessful due to an interrupted inferior vena cava (IVC) with azygos continuation to the superior vena cava. A subsequent right internal jugular attempt failed because of innominate-SVC stenosis related to prior venous instrumentation. Successful implantation of a 25-mm Harmony TPV was achieved via the left internal jugular vein.</div></div><div><h3>Discussion</h3><div>Interrupted IVC with azygos continuation can complicate large-bore venous access and necessitate alternative strategies.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"13 ","pages":"Article 100177"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148854435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary calcification masking an anomalous right coronary artery during primary percutaneous coronary intervention for inferior ST-elevation myocardial infarction","authors":"Saroj Kumar Sahoo,&nbsp;Ramachandra Barik,&nbsp;Debasis Acharya,&nbsp;Mohan Kumar,&nbsp;Debasis Panda,&nbsp;Prabhat Kumar Singh,&nbsp;Rubel Hossain,&nbsp;Melvin Baby,&nbsp;Muhiyyud Deen","doi":"10.1016/j.crmic.2026.100178","DOIUrl":"10.1016/j.crmic.2026.100178","url":null,"abstract":"<div><div>Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST-elevation myocardial infarction (STEMI). Anomalous aortic origin of the right coronary artery (RCA) is uncommon but can substantially complicate emergency angiography and PCI when conventional catheter strategies fail. Coronary calcification increases procedural complexity. Here, we report a case in which fluoroscopic calcification may have contributed to the diagnostic uncertainty during coronary cannulation. A 74-year-old man with diabetes mellitus and hypertension presented with acute chest pain and syncope. Following the syncopal episode, no recurrent loss of consciousness or overt hemodynamic instability was documented before catheterization. Electrocardiography revealed inferior STEMI, and echocardiography revealed inferior wall hypokinesia with a left ventricular ejection fraction of approximately 40%. Angiography revealed significant disease in the left anterior descending and obtuse marginal artery. Repeated attempts to engage the RCA using multiple diagnostic and guiding catheters were unsuccessful until non-selective aortic root angiography identified the anomalous origin. Dense calcification adjacent to the expected RCA ostial region may have reinforced the initial impression of flush ostial occlusion and delayed the consideration of anomalous anatomy. During catheter manipulation, the inadvertent passage of a guidewire into an unidentified vessel provided the first clue to its anomalous origin. Non-selective aortic root angiography using a pigtail catheter identified a high-takeoff anomalous RCA, allowing for selective engagement with an Amplatz left-1 catheter. This case suggests that fluoroscopic calcification may reinforce an alternative diagnosis of ostial occlusion and delay the recognition of anomalous anatomy, highlighting a potential diagnostic challenge during primary PCI.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"13 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148854366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “‘Mother infant’ technique. 4 French pigtail inside a 6 French XBLAD 3.0 to prevent ‘razor effect’ in a patient with NSTEMI” in a patient with NSTEMI [Cardiovascular Revascularization Medicine: Interesting Cases 13 (2026) 100167]","authors":"Richard Casazza,&nbsp;Emmanuel U. Emeasoba,&nbsp;Darren Gibson,&nbsp;Enrico “.V.G”. Montagna,&nbsp;Andres Palacio,&nbsp;Habiba Beginyazova,&nbsp;Arsalan Hashmi","doi":"10.1016/j.crmic.2026.100174","DOIUrl":"10.1016/j.crmic.2026.100174","url":null,"abstract":"","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"13 ","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative IVUS-guided scoring balloon fenestration of a post-PCI coronary intramural hematoma, with sirolimus-coated balloon as a stent-sparing finish","authors":"Emrah Acar,&nbsp;Melike Acar,&nbsp;Yilmaz Gunes,&nbsp;Ibrahim Akin Izgi","doi":"10.1016/j.crmic.2026.100181","DOIUrl":"10.1016/j.crmic.2026.100181","url":null,"abstract":"<div><div>Coronary intramural hematoma (IMH) is an under-recognised mechanical complication of percutaneous coronary intervention (PCI) that can compress the true lumen and compromise flow; no treatment algorithm has been validated. A 70-year-old woman with prior drug-eluting stents in the right coronary and circumflex arteries presented with persistent exertional angina and 8% inferolateral ischaemia on perfusion imaging. Angiography showed patent prior stents and 80% stenosis of the posterolateral branch. After predilatation, drug-eluting stent implantation and non-compliant balloon postdilatation, a new hazy filling defect appeared at the distal stent edge with TIMI grade 2 distal flow and new chest pain. IVUS confirmed a distal-edge IMH with a maximum hematoma thickness of 1.85 mm, minimum true-lumen diameter of 1.42 mm and minimum lumen area (MLA) of 1.69 mm². No entry tear or edge dissection was identified and the stent was fully apposed. A 2.5 × 15 mm scoring balloon was used for fenestration; repeat IVUS documented a reduction in hematoma thickness to 0.93 mm and an increase in MLA to 3.60 mm². Angiography immediately after fenestration, before drug delivery, showed restoration of TIMI 3 flow with 28% residual diameter stenosis. Only after these mechanical and angiographic endpoints had been achieved was a sirolimus-coated balloon applied as a stent-sparing anti-restenotic finish rather than as hematoma therapy. The patient remained asymptomatic and 1-year angiography showed a patent stent without visible restenosis. This case illustrates that IVUS can convert an ambiguous angiographic finding into a measurable mechanical endpoint that governs bailout decisions.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"13 ","pages":"Article 100181"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Angio-Seal migration causing acute limb ischemia: A case report","authors":"Subaina Khalid ,&nbsp;Shiva Sah ,&nbsp;Vivek Bhat ,&nbsp;Vishal Phogat ,&nbsp;Andrew Weinberg","doi":"10.1016/j.crmic.2026.100162","DOIUrl":"10.1016/j.crmic.2026.100162","url":null,"abstract":"","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"12 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A bailout solution of misplaced stent implantation, a deployed stent extraction to the ostium of left anterior descending artery: A case report","authors":"Habibe Sena Yıldırım ,&nbsp;Ersin Doğanözü","doi":"10.1016/j.crmic.2026.100137","DOIUrl":"10.1016/j.crmic.2026.100137","url":null,"abstract":"<div><div>Ostial stent deployments are commonly prone to misplacement during coronary interventions. In recent years, intentional extraction of deployed stents has been reported more frequently, in parallel with advances in complex coronary procedures. Here, we present a case report of the purposeful extraction of a previously deployed stent from the ostium of the left anterior descending artery.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"11 ","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous retrieval of a right atrial mass for diagnostic evaluation in a patient with prior melanoma","authors":"Pal Shah ,&nbsp;Jeffrey Taylor ,&nbsp;Woodson Petit-Frere ,&nbsp;Khalil Ibrahim ,&nbsp;Mayank Kansal ,&nbsp;Joaquim Spadoni Barboza","doi":"10.1016/j.crmic.2026.100136","DOIUrl":"10.1016/j.crmic.2026.100136","url":null,"abstract":"<div><div>We report a case of percutaneous transcatheter retrieval of a large, right atrial mass in a 71-year-old woman with a history of recurrent melanoma. Although asymptomatic, concern for cardiac metastasis prompted intervention, as imaging alone could not reliably exclude malignant disease. The mass was removed en bloc via right internal jugular access using an ŌNŌ retrieval system and En Snare under transesophageal echocardiographic and fluoroscopic guidance. Histopathology ultimately confirmed papillary fibroelastoma. This case highlights the role of catheter-based mass retrieval as a minimally invasive diagnostic strategy for intracardiac masses in patients with cancer histories.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"11 ","pages":"Article 100136"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular outflow tract obstruction due to anterior mitral valve leaflet displacement following transcatheter mitral valve replacement: Considerations for future digital planning","authors":"Lucas Uchoa de Assis ,&nbsp;Mark M.P. van den Dorpel ,&nbsp;Ben J.L. Van den Branden ,&nbsp;Nicolas M. Van Mieghem","doi":"10.1016/j.crmic.2026.100148","DOIUrl":"10.1016/j.crmic.2026.100148","url":null,"abstract":"<div><div>Transcatheter mitral valve replacement (TMVR) is a less invasive alternative for patients with mitral valve disease who are at high surgical risk. TMVR demonstrates favorable outcomes, however left ventricular outflow tract obstruction (LVOTO) remains a notorious, potentially life-threatening complication. Three-dimensional computational models (3DCMs) have been developed to simulate the residual neo-LVOT and assess the risk of LVOTO. However, they do not account for the interaction between the anterior mitral valve leaflet (AMVL) and the transcatheter heart valve. We present the case of an 81-year-old female who had reassuring pre-procedural neo-LVOT assessment but experienced acute LVOTO due to AMVL displacement following TMVR. This case emphasizes the strengths and limitations of current 3DCMs in accurately predicting LVOT obstruction. Furthermore, we discuss techniques to prevent and manage LVOT obstruction after TMVR.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"11 ","pages":"Article 100148"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of pseudoaneurysm following primary percutaneous coronary intervention","authors":"Saroj Kumar Sahoo,&nbsp;Sindhu Rao Malla,&nbsp;Ramachandra Barik,&nbsp;Sai Karthik Kowtarapu,&nbsp;Prabhat Kumar Singh,&nbsp;Debasis Panda,&nbsp;Saran P. Mohanan,&nbsp;Melvin Baby","doi":"10.1016/j.crmic.2025.100130","DOIUrl":"10.1016/j.crmic.2025.100130","url":null,"abstract":"<div><div>Coronary pseudoaneurysm followi<!--> <!-->ng drug-eluting stent implantation is rare but potentially life-threatening. We report a case of a 55-year-old man with diabetes and hypertension who presented with rest-induced angina three months after percutaneous coronary intervention. Angiography revealed in-stent restenosis with a pseudoaneurysm in the left anterior descending artery. The pseudoaneurysm was successfully treated using a covered stent under intravascular ultrasound (IVUS) guidance. Angiogram showed complete exclusion of the aneurysm and restoration of TIMI-3 flow. This case highlights the role of IVUS-guided covered stent placement as a safe alternative to surgery in selected patients with coronary pseudoaneurysm.</div></div>","PeriodicalId":100217,"journal":{"name":"Cardiovascular Revascularization Medicine: Interesting Cases","volume":"11 ","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}