Circulation: Cardiovascular Interventions最新文献

{"title":"Femoropopliteal Endovascular Intervention: A Review of the Current Landscape.","authors":"Manasi Tannu, W Schuyler Jones, Rajesh V Swaminathan, Jennifer A Rymer, J Antonio Gutierrez","doi":"10.1161/CIRCINTERVENTIONS.124.014024","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014024","url":null,"abstract":"<p><p>Superficial femoral artery disease poses significant challenges in patients with peripheral artery disease due to its unique anatomic and physiological characteristics. While conservative measures remain the initial approach for chronic, stable symptoms, endovascular therapies have gained prominence due to their minimally invasive nature, expedited recovery times, and preservation of future treatment options when performed correctly. Options for endovascular interventions include balloon angioplasty (percutaneous transluminal angioplasty [standard], drug-coated balloon), stenting (bare metal, drug-eluting, covered stents), with or without adjunct therapy (atherectomy or intravascular lithotripsy). Randomized controlled trials have demonstrated superior outcomes with drug-coated balloons and drug-eluting stents over bare metal stents or percutaneous transluminal angioplasty alone, particularly in long, heavily calcified lesions. However, challenges such as in-stent restenosis, stent fracture, and in-stent thrombosis persist, driving ongoing innovation in device technology and drug formulations on devices. Emerging therapies such as bioresorbable scaffolds and percutaneous bypass devices offer promising alternatives. Further research is needed to refine treatment strategies, minimize risks, and optimize outcomes.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014024"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term DAPT After Complex PCI With Third-Generation DES: A Post Hoc Analysis of the HOST-IDEA Trial.","authors":"Jung-Kyu Han, Keehwan Lee, Sang-Hyeon Park, Seokhun Yang, Doyeon Hwang, Jeehoon Kang, Han-Mo Yang, Kyung Woo Park, Hyun-Jae Kang, Bon-Kwon Koo, Seung-Ho Hur, Weon Kim, Sang-Hyun Park, Seung Hwan Han, Sang-Hyun Kim, Yong Hoon Kim, Namho Lee, Seung Jin Lee, Sanghoon Shin, Hyo-Soo Kim","doi":"10.1161/CIRCINTERVENTIONS.124.014623","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014623","url":null,"abstract":"<p><strong>Background: </strong>The optimal duration of dual antiplatelet therapy (DAPT) after complex percutaneous coronary intervention (PCI) remains unclear. We aim to investigate the efficacy and safety of 3 to 6 months of DAPT over 12 months after complex PCI.</p><p><strong>Methods: </strong>A post hoc analysis of the HOST-IDEA (Harmonizing Optimal Strategy for Treatment of Coronary Artery Stenosis-Coronary Intervention With Next-Generation Drug-Eluting Stent Platforms and Abbreviated Dual Antiplatelet Therapy) randomized trial which enrolled patients undergoing PCI with third-generation drug-eluting stents was performed. Complex PCI was defined by any of the following: ≥3 stents implanted, ≥3 lesions treated, bifurcation PCI with 2-stenting, total stent length ≥60 mm, left main PCI, or heavy calcification. The major end points were target lesion failure, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization for ischemic outcomes, and major bleeding, defined as BARC (Bleeding Academic Research Consortium) type 3 or 5, for bleeding outcomes at 12 months.</p><p><strong>Results: </strong>Among 1992 patients, 624 underwent complex PCI. The complex PCI group had clinical features associated with high bleeding risk. A shortened DAPT duration did not increase the risk of target lesion failure, with hazard ratios of 0.818 (95% CI, 0.403-1.659) for the complex PCI group and 1.282 (95% CI, 0.506-3.249) for the noncomplex PCI group (<i>P</i>_interaction=0.451). Conversely, it decreased the risk of major bleeding in the complex PCI group (hazard ratio, 0.269 [95% CI, 0.075-0.965]), but not in the noncomplex PCI group (hazard ratio, 1.534 [95% CI, 0.627-3.754], showing a significant interaction; <i>P</i>_interaction=0.029).</p><p><strong>Conclusions: </strong>In patients undergoing complex PCI with a third-generation drug-eluting stent, a 3- to 6-month duration of DAPT was associated with a reduced risk of bleeding without an increased risk of ischemic events compared with 12-month DAPT.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique Identifier: NCT02601157.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014623"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postimplantation Size of WATCHMAN FLX Pro: A New Left Atrial Appendage Closure System.","authors":"Tetsuma Kawaji, Shun Hojo, Ryota Takahashi, Masashi Kato, Takafumi Yokomatsu","doi":"10.1161/CIRCINTERVENTIONS.124.015056","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.015056","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015056"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Cost and Resource Utilization After Aortic Valve Replacement According to the Extent of Cardiac Damage.","authors":"Philippe Généreux, Björn Redfors, Philippe Pibarot, Brian R Lindman, Gennaro Giustino, Alissa Dratch, Shannon Murphy, Soumya Chikermane, Martin B Leon, Suzanne J Baron","doi":"10.1161/CIRCINTERVENTIONS.124.014945","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014945","url":null,"abstract":"<p><strong>Background: </strong>The extent of cardiac damage has been shown to be associated with increased mortality, repeat hospitalization, and decreased quality of life after aortic valve replacement (AVR). However, the association between the extent of cardiac damage at the time of AVR and health care costs and resource utilization has never been described.</p><p><strong>Methods: </strong>The Optum de-identified Market Clarity database was used to identify patients with aortic stenosis treated with AVR between 2016 and 2022. Patients were categorized into 5 groups (stages 0-4) based on their stage of cardiac damage in the year before AVR. Health care costs and resource utilization (including all-cause hospitalizations, heart failure hospitalizations, and total inpatient days) were assessed for the AVR hospitalization and the following year. Cost and utilization outcomes by stage of cardiac damage were estimated using covariate-adjusted generalized linear models.</p><p><strong>Results: </strong>A total of 24 644 patients with AVR were included in our analysis. Patients were distributed across the 5 stages of cardiac damage as follows: 8.1% in stage 0, 17.1% in stage 1, 37.3% in stage 2, 36.2% in stage 3, and 1.4% in stage 4. Total costs increased with the extent of cardiac damage (increased by $2746 in stage 1, $19 511 in stage 2, $19 198 in stage 3, and $35 663 in stage 4, compared with stage 0; <i>P</i><0.01). Similarly, length of stay, number of all-cause and heart failure hospitalizations, and all-cause and heart failure days in-hospital significantly increased with the extent of cardiac damage. Risk-adjusted models demonstrated that advanced stages of cardiac damage were associated with both higher cost and resource utilization when compared with patients with stage 0 damage.</p><p><strong>Conclusions: </strong>Among patients undergoing AVR for aortic stenosis, the extent of cardiac damage before AVR was independently associated with increased costs and health care resource utilization during the index AVR admission and through 1 year post-AVR.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014945"},"PeriodicalIF":7.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Target Lesion Revascularization After Intravascular Ultrasound-Guided Percutaneous Coronary Intervention.","authors":"Ko Yamamoto, Hiroki Shiomi, Takeshi Morimoto, Akiyoshi Miyazawa, Hiroki Watanabe, Masahiro Natsuaki, Hirotoshi Watanabe, Kyohei Yamaji, Masanobu Ohya, Sunao Nakamura, Satoru Mitomo, Satoru Suwa, Takenori Domei, Shojiro Tatsushima, Koh Ono, Hiroki Sakamoto, Kiyotaka Shimamura, Masataka Shigetoshi, Ryoji Taniguchi, Yuji Nishimoto, Hideki Okayama, Kensho Matsuda, Takafumi Yokomatsu, Masahiro Muto, Ren Kawaguchi, Koichi Kishi, Mitsuyoshi Hadase, Tsutomu Fujita, Yasunori Nishida, Masami Nishino, Hiromasa Otake, Nobuhiro Suematsu, Tsuneki Ajimi, Kengo Tanabe, Mitsuru Abe, Kiyoshi Hibi, Kazushige Kadota, Kenji Ando, Takeshi Kimura","doi":"10.1161/HCV.0000000000000097","DOIUrl":"https://doi.org/10.1161/HCV.0000000000000097","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":"18 5","pages":"e000097"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve-in-Valve TAVR in Patients With Failed Trifecta Bioprosthetic Aortic Valves.","authors":"Mohammad Zmaili, Nikolaos Spilias, Shivabalan Kathavarayan Ramu, Tikal Kansara, Akhilesh Khuttan, Maryam Muhammad Ali Majeed-Saidan, Besir Besir, Rohan Prasad, Judah Rajendran, Feras Alkhalaileh, Ahmad Gharaibeh, Agam Bansal, Abdelrahman Abushouk, Serge Harb, Rishi Puri, Grant Reed, James Yun, Amar Krishnaswamy, Samir Kapadia","doi":"10.1161/CIRCINTERVENTIONS.124.014532","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014532","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014532"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges and Evolving Strategies in the Treatment of In-Stent Restenosis With Drug-Coated Balloons.","authors":"Valeria Paradies, Fernando Alfonso","doi":"10.1161/CIRCINTERVENTIONS.125.015359","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015359","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015359"},"PeriodicalIF":6.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter Mitral Valve Replacement With Atrial Fixation for Treatment of Atrial Functional Mitral Regurgitation.","authors":"John T Saxon, Philippe Genereux, Vlasis Ninios, Thomas Waggoner, Naeem Tahirkheli, Marek Grygier, Krzysztof Wrobel, Matti Adam, Georg Nickenig, Tsuyoshi Kaneko, Paul Sorajja","doi":"10.1161/CIRCINTERVENTIONS.124.014985","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.014985","url":null,"abstract":"<p><strong>Background: </strong>Many patients with atrial functional mitral regurgitation are not suitable candidates for surgery or transcatheter repair. For transcatheter mitral valve replacement, a common contraindication is the risk of left ventricular outflow tract obstruction, particularly in patients with atrial functional mitral regurgitation, who have characteristically small left ventricles. Herein, we examine the outcomes of transcatheter mitral valve replacement using the AltaValve system, which employs atrial fixation thus minimizing left ventricular outflow tract obstruction risk.</p><p><strong>Methods: </strong>Patients with severe, symptomatic mitral regurgitation who were treated in the AltaValve early feasibility study or on the basis of a compassionate use exemption. The definition of atrial functional mitral regurgitation required the presence of: (1) severe mitral regurgitation; (2) atrial fibrillation; (3) normal left ventricular size; (4) left ventricular ejection fraction ≥50%; and (5) absence of organic mitral disease. Procedural outcomes, 30-day survival, and echo findings are reported.</p><p><strong>Results: </strong>Fourteen patients (71% women, mean age 77.9 years, Society of Thoracic Surgeons Predicted Risk of Mortality score 5.4%) were treated, including 11 via transseptal delivery and 3 via a transapical approach. Technical success and mitral regurgitation reduction from severe to none/trace were achieved in all cases. There were no cases of left ventricular outflow tract obstruction. All-cause mortality at 30 days was 14% (2/14). Class III/IV New York Heart Association status was reduced from 79% at baseline to 0% at 30 days. At 30 days, 11 of 12 surviving patients had an available echocardiogram; mitral regurgitation severity was trace/none in 90.9% (10/11) and mild in 9.1% (1/11).</p><p><strong>Conclusions: </strong>The AltaValve system shows promising early procedural and clinical results for the unique anatomy of patients with atrial functional mitral regurgitation. Long-term clinical studies to demonstrate the benefit of this system are warranted.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e014985"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repeatability and Correlation of Coronary Physiology Indices Measured With Bolus and Continuous Thermodilution.","authors":"Christopher C Y Wong, Luke P Dawson, Pascal Theriault-Lauzier, Annette Skoda, Helen Luikart, Jennifer A Tremmel, Kiran K Khush, William F Fearon","doi":"10.1161/CIRCINTERVENTIONS.124.014919","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.124.014919","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown weak agreement between coronary physiology indices derived from continuous and bolus thermodilution, and suggested greater variability with bolus thermodilution measurements. This study aimed to evaluate the repeatability and correlation of continuous and bolus thermodilution-derived physiology indices in cardiac transplant recipients.</p><p><strong>Methods: </strong>Paired fractional flow reserve (FFR), coronary flow reserve (CFR), index of microcirculatory resistance (IMR), absolute hyperemic resistance (R_Hyp), and microvascular resistance reserve (MRR) using continuous and bolus thermodilution were performed in consecutive cardiac transplant recipients.</p><p><strong>Results: </strong>In 20 patients, IMR was more repeatable than CFR and MRR derived from either continuous thermodilution (intraclass correlation coefficient, 0.95 versus 0.70 and 0.59; <i>P</i>=0.004 and <i>P</i>=0.002, respectively) or bolus thermodilution (intraclass correlation coefficient, 0.95 versus 0.20 and 0.33; <i>P</i><0.001 and <i>P</i>=0.002, respectively), and similarly repeatable compared with R_Hyp (intraclass correlation coefficient, 0.95 versus 0.87; <i>P</i>=0.188). FFR by continuous thermodilution correlated with standard FFR measurements (<i>R</i>=0.89, <i>P</i><0.001) but were significantly lower in value (0.87±0.05 versus 0.89±0.05; <i>P</i>=0.004). CFR and MRR measurements using continuous thermodilution did not correlate with measurements using bolus thermodilution (<i>R</i>=0.33, <i>P</i>=0.170; <i>R</i>=0.34, <i>P</i>=0.155, respectively) and were significantly lower in value (2.9±1.0 versus 3.7±0.8, <i>P</i>=0.003; 3.4±1.1 versus 4.8±1.3, <i>P</i><0.001, respectively). IMR and R_Hyp did not correlate (<i>R</i>=0.28, <i>P</i>=0.226).</p><p><strong>Conclusions: </strong>In cardiac transplant recipients, IMR had superior repeatability compared with CFR and MRR derived from either bolus or continuous thermodilution, and was equally repeatable compared with R_Hyp. FFR, CFR, and MRR values obtained from continuous thermodilution were systematically lower compared with their counterparts obtained from bolus thermodilution.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":"18 4","pages":"e014919"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Pre-Procedural Fasting for Elective Percutaneous Cardiac Procedures.","authors":"Sammudeen Ibrahim, Shreyas Singireddy, Chidubem Ezenna, Laura M Romero Acero, Armin Nouri, Zafer Akman, Golsa Babapour, Jennifer Frampton, Andrew M Goldsweig, Abdulla A Damluji, Michael G Nanna","doi":"10.1161/CIRCINTERVENTIONS.124.015089","DOIUrl":"10.1161/CIRCINTERVENTIONS.124.015089","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015089"},"PeriodicalIF":6.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}