Circulation: Cardiovascular Interventions最新文献

{"title":"Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement.","authors":"Antonin Trimaille, Pedro Cepas-Guillén, Marina Urena, Alberto Alperi, Gabriela Veiga-Fernandez, Luis Nombela-Franco, Victoria Vilalta, Maria Del Trigo, Antonio J Muñoz-García, Giovanni Esposito, Vincent Auffret, David Del Val, Vicenç Serra, Jorge Nuche, Lluis Asmarats, Ander Regueiro, Adrien Carmona, Quentin Fisher, Pablo Avanzas, Víctor Fradejas-Sastre, Ivan Sanchez, Michele Trichilo, Juan Francisco Oteo, Anna Franzone, Maxime Nolf, Fernando Alfonso, Pedro Díaz Pockels, Rocío Rodríguez-Santolino, Dabit Arzamendi, Eduardo Flores-Umanzor, Olivier Morel, Marisa Avvedimento, Josep Rodés-Cabau","doi":"10.1161/CIRCINTERVENTIONS.126.016892","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016892","url":null,"abstract":"<p><strong>Background: </strong>Data on the long-term incidence and clinical impact of bioprosthetic valve failure (BVF) after transcatheter aortic valve replacement remain limited. This study aimed to assess the incidence, predictors, and clinical impact of BVF following transcatheter aortic valve replacement.</p><p><strong>Methods: </strong>We analyzed data from an international, multicenter registry including consecutive patients undergoing transcatheter aortic valve replacement at 13 centers. The primary outcome was BVF according to Valve Academic Research Consortium-3 criteria. The cumulative incidence of BVF was estimated using a competing-risk approach. The association between BVF and clinical outcomes was assessed using competing-risk models with BVF as a time-dependent covariate.</p><p><strong>Results: </strong>Among 7501 patients, BVF occurred in 380 (5.1%) patients over a median follow-up of 4 (interquartile range, 2-5) years. The cumulative incidence of BVF increased over time, reaching 1.4% at 1 year, 4.6% at 5 years, and 8.3% at 10 years. Independent predictors of BVF included younger age, smoking, balloon-expandable valve, prosthesis size <26 mm, valve-in-valve procedure, mean gradient at discharge ≥15 mm Hg, moderate or severe aortic regurgitation at discharge, and early hemodynamic valve deterioration. BVF was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio, 1.72 [95% CI, 1.47-2.01]; <i>P</i><0.001), cardiovascular mortality (adjusted hazard ratio, 3.23 [95% CI, 2.73-3.82]; <i>P</i><0.001), stroke (adjusted hazard ratio, 2.08 [95% CI, 1.08-4.23]; <i>P</i>=0.043), and heart failure hospitalization (adjusted hazard ratio, 1.43 [95% CI, 1.03-1.98]; <i>P</i>=0.032). Consistent findings were observed in different sensitivity analyses.</p><p><strong>Conclusions: </strong>BVF is a clinically relevant event associated with adverse long-term outcomes. These findings support the implementation of tailored surveillance and preventive strategies to mitigate BVF-related risk.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016892"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808233","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":"Paclitaxel-Coated Devices in Patients With Chronic Limb-Threatening Ischemia and Tissue Loss Undergoing Infrainguinal Endovascular Revascularization: Insights From the SWEDEPAD-1 Trial.","authors":"Fredrik Sellgren, Mårten Falkenberg, Manne Andersson, Mattias Andersson, Tom Le Corvec, Martin Delle, Jan Engström, Torbjörn Fransson, Anna Hilbertson, Tal M Hörer, Eva Jacobsson, Stefan James, Björn Kragsterman, Johan Lindbäck, Hans Lindgren, Stefan Mellander, Robert Olin, Birgitta Sigvant, Per Skoog, Christian Smedberg, Joachim Starck, Gustaf Tegler, Knut Thorbjørnsen, Maria Truedson, Per Törnqvist, Carl-Magnus Wahlgren, Jonas Wallinder, Andreas Öjersjö, Joakim Nordanstig","doi":"10.1161/CIRCINTERVENTIONS.126.016977","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.016977","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic limb-threatening ischemia and tissue loss (Rutherford 5-6) are at high risk of major amputation. Drug-coated technologies are effective in coronary interventions, but their impact on limb outcomes in advanced ischemia remains uncertain. We evaluated whether drug-coated devices improve limb salvage in this high-risk population.</p><p><strong>Methods: </strong>This post hoc subgroup analysis used data from SWEDEPAD-1 (Swedish Drug-Elution Trial in Peripheral Arterial Disease), a multicenter registry-based randomized controlled trial of endovascular treatment for infrainguinal arterial disease. Adults with chronic limb-threatening ischemia were randomized 1:1 to treatment with paclitaxel-coated or uncoated endovascular devices. Only patients with tissue loss (Rutherford 5 or 6) were included. The primary end point was time to ipsilateral major amputation. Secondary end points were target vessel reintervention and a composite of major amputation or target vessel reintervention. Outcomes were assessed at 3 months, 1 year, and 5 years using intention-to-treat analyses and adjusted Cox proportional hazards models.</p><p><strong>Results: </strong>Among 1761 patients (median age, 77 years; 60.1% male; 58.4% diabetes), ipsilateral major amputation within 3 months was more frequent in the paclitaxel-coated group than in the uncoated group (10.4% versus 7.5%; adjusted hazard ratio, 1.43 [95% CI, 1.04-1.96]). Amputation rates were similar at 1 year (16.3% versus 14.6%) and remained comparable through 5 years. Target vessel reintervention at 1 year was lower with paclitaxel-coated devices (13.6% versus 18.0%; adjusted hazard ratio, 0.77 [95% CI, 0.61-0.97]), but this difference was attenuated when early limb loss was included in a composite end point. No significant between-group differences were observed at 5 years.</p><p><strong>Conclusions: </strong>In patients with chronic limb-threatening ischemia and tissue loss, paclitaxel-coated devices did not improve limb salvage and were associated with a higher early risk of major amputation. Although target vessel reintervention was reduced at 1 year, this apparent benefit was not maintained when accounting for the competing risk of limb loss in a composite end point.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02051088.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016977"},"PeriodicalIF":7.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029854","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":"Contrasting Prognostic Value of Discordance Between Resting Distal-to-Aortic Coronary Pressure Ratio and Fractional Flow Reserve in Coronary Artery Disease.","authors":"So-Min Lim, Jung-Min Ahn, Do-Yoon Kang, Eun-Seok Shin, Bon-Kwon Koo, Chang Wook Nam, Hanbit Park, Bong-Ki Lee, Jin Bae Lee, Seong-Bong Wee, Ha Hye Jo, Joong Min Lee, Young-Sun Park, Ju Hyeon Kim, Hwa Jung Kim, Duk-Woo Park, Seung-Jung Park","doi":"10.1161/CIRCINTERVENTIONS.126.016865","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.016865","url":null,"abstract":"<p><strong>Background: </strong>Discordance between nonhyperemic pressure ratios and fractional flow reserve (FFR), observed in up to 20% of cases, complicates clinical decision-making for coronary revascularization and warrants further investigation of its clinical implications. This study aimed to evaluate the outcomes of medically managed discordant lesions between FFR and the resting whole-cycle distal-to-aortic coronary pressure ratio (Pd/Pa).</p><p><strong>Methods: </strong>From the prospective IRIS-FFR registry (Interventional Cardiology Research In-Cooperation Society Fractional Flow Reserve), 9737 lesions in 7376 patients treated medically were analyzed. The lesions were grouped based on resting Pd/Pa (≤0.93) and FFR (≤0.80) values. The primary outcome was 5-year target-vessel failure, including target-vessel myocardial infarction and target-vessel revascularization, with death from any cause considered as a competing risk. The key secondary outcome was death from any cause.</p><p><strong>Results: </strong>Discordance between resting Pd/Pa and FFR was present in 15.91% of lesions treated medically (n=1549). Lesions with resting Pd/Pa >0.93 and FFR ≤0.80 had a higher risk of target-vessel failure than those with resting Pd/Pa ≤0.93 and FFR >0.80 (adjusted hazard ratio, 1.67 [95% CI, 1.09-2.55]; <i>P</i>=0.020) but a lower risk of all-cause death (adjusted hazard ratio, 0.23 [95% CI, 0.11-0.52]; <i>P</i><0.001). The reduction in target-vessel failure with revascularization was observed only in the group with resting Pd/Pa >0.93 and FFR ≤0.80.</p><p><strong>Conclusions: </strong>FFR predicts vessel-specific coronary events, whereas resting Pd/Pa is associated with overall survival. The contrasting prognostic value of discordant lesions underscores the clinical importance of a complementary assessment using both resting and hyperemic coronary physiological indices.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT01366404.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016865"},"PeriodicalIF":7.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029861","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":"Artificial Intelligence-Derived Volumetric High-Risk Plaque Features Are Predominantly Located Proximal to Maximal Luminal Stenosis.","authors":"Leah Heil, Thijs J Luttikholt, Joske L van der Zande, Jan-Quinten Mol, Ruben G A van der Waerden, Pierandrea Cancian, Xiaojin Gu, Clara I Sánchez, Bram van Ginneken, Ivana Išgum, Simone Saitta, Jos Thannhauser, Niels van Royen, Rick H J A Volleberg","doi":"10.1161/CIRCINTERVENTIONS.126.017300","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.017300","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e017300"},"PeriodicalIF":7.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024072","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":"Letter by Güner et al Regarding Article, \"Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE\".","authors":"Ahmet Güner, Murat Kemal Şahin, İbrahim Faruk Aktürk","doi":"10.1161/CIRCINTERVENTIONS.126.017390","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.017390","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e017390"},"PeriodicalIF":7.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024070","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":"Response by Bangalore et al to Letter Regarding Article, \"Is There a Golden Hour for Thrombectomy in Intermediate-Risk Pulmonary Embolism? Insights From SYMPHONY-PE\".","authors":"Sripal Bangalore, Vivian Bishay","doi":"10.1161/CIRCINTERVENTIONS.126.017440","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.017440","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e017440"},"PeriodicalIF":7.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024155","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":"Composite Pulmonary Embolism Shock Score and Outcomes in Intermediate-Risk Acute Pulmonary Embolism: A Multicenter PERT Consortium Registry Study.","authors":"Joseph M Kim, Steven R Horbal, Lorenzo V Arvanitis, Christian Mewaldt, Sripal Bangalore, Robert W Yeh, Eric A Secemsky, Brett J Carroll","doi":"10.1161/CIRCINTERVENTIONS.126.016881","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.016881","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016881"},"PeriodicalIF":7.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024034","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":"Hemodynamic Flow Signatures: A Novel Paradigm for the Evaluation of Transcatheter Aortic Valve Performance.","authors":"Annette Maznyczka, Ole De Backer, Vinayak N Bapat, Charanjit S Rihal, Amar Krishnaswamy, Hasan Jilaihawi, Imran Rashid, Alexander M K Rothman, Arif A Khokhar, Niels Vejlstrup, Bernard Prendergast, Stephan Windecker, Guilherme F Attizzani, João L Cavalcante, Pankaj Garg","doi":"10.1161/CIRCINTERVENTIONS.126.017313","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.017313","url":null,"abstract":"<p><p>A new paradigm for understanding transcatheter aortic valve (TAV) success is emerging, which hinges on whether a device reinstates physiological aortic flow. Limitations of echocardiography prevent complex flow assessment. Meanwhile, 4-dimensional flow cardiac magnetic resonance offers superior quantification of time-resolved 3-dimensional flow dynamics, permitting assessment of systolic flow displacement (reflecting eccentricity), systolic flow reversal ratio (reflecting conduit inefficiency), wall shear stress, and energetic efficiency. Abnormal aortic flow can persist after TAV replacement, despite reduction in transvalvular gradient. Persistent nonphysiological flow is thought to increase energy losses, reduce left ventricular ejection efficiency, and impair optimal afterload reduction, which theoretically may limit left ventricular reverse remodeling. Restoration of near-normal flow is a plausible therapeutic target for evaluating TAV performance. However, whether physiological flow restoration post-TAV replacement may enhance left ventricular mass reduction, increase TAV durability, and improve patient-relevant outcomes is unknown, and further research is crucial. Future clinical translation of cardiac magnetic resonance flow metrics also depends on automated extraction of systolic flow displacement and systolic flow reversal ratio, and postprocessing standardization. This review provides a perspective on 4-dimensional flow cardiac magnetic resonance for evaluating aortic flow post-TAV replacement, which may have the potential to refine TAV platform selection, inform next-generation device design, and hypothetically predict left ventricular recovery.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e017313"},"PeriodicalIF":7.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015912","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":"Influence of Chronic Kidney Disease on Outcomes After Paclitaxel-Coated Balloon Angioplasty for Coronary In-Stent Restenosis.","authors":"Behnam N Tehrani, Ilan Vavilin, Richard Shlofmitz, Jeffrey Moses, William Bachinsky, Suhail Dohad, Steven Rudick, Robert Stoler, Brian K Jefferson, William Nicholson, John Altman, Cinthia Bateman, Jennifer A Tremmel, J Dawn Abbott, Wayne Batchelor, Rafael Cavalcante, Robert W Yeh, Ajay J Kirtane","doi":"10.1161/CIRCINTERVENTIONS.126.016978","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.016978","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloons (DCB) are superior to conventional balloon angioplasty in coronary in-stent restenosis. The influence of chronic kidney disease (CKD) on outcomes after DCB for in-stent restenosis is not well described.</p><p><strong>Methods: </strong>A post hoc analysis of the AGENT IDE trial was performed to compare the efficacy and safety of DCB versus balloon angioplasty in patients with CKD (estimated glomerular filtration rate <60 mL/min per 1.73 m²) and those without renal impairment. The primary outcome was target lesion failure, a composite of ischemia-driven target lesion revascularization (TLR), target vessel myocardial infarction, or cardiac death. The 2 cohorts were compared using time-to-first-event and recurrent event methods through 2 years.</p><p><strong>Results: </strong>Of the 406 patients randomized to DCB, 149 (25%) had CKD (mean estimated glomerular filtration rate 47.3±9.2). They were older and had greater multivessel disease and congestive heart failure than those without CKD. There were no differences in clinical presentation, Mehran in-stent restenosis patterns or technical success. The effect of DCB versus balloon angioplasty on 2-year target lesion failure was similar in patients with CKD (23.6% versus 30.0%; hazard ratio, 0.70 [95% CI, 0.35-1.39]) compared with those without CKD (28.1% versus 34.9%; hazard ratio, 0.74 [95% CI, 0.52-1.05]; <i>P</i>_Int=0.90). Similarly, the effect of DCB on outcomes in the recurrent events analysis was not influenced by baseline renal function.</p><p><strong>Conclusions: </strong>Among patients undergoing intervention for in-stent restenosis, the benefit of DCB versus balloon angioplasty was consistent irrespective of baseline CKD status. Baseline renal function also did not influence outcomes in the recurrent event analysis.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT04647253.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016978"},"PeriodicalIF":7.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988477","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":"Minicrush or T-Stenting and Minimal Protrusion in Complex Coronary Bifurcation Lesions: The Multicenter TREX Registry.","authors":"Giulio Piedimonte, Enrico Cerrato, Lorenzo Azzalini, Alicia Quirós, Rosanna Di Fonzo, Valerio Maffi, Manuel Bosco, Giampiero Vizzari, Gabriele Carciotto, Francesco Maiellaro, Riccardo Mangione, Dario Calderone, Marco Borgi, Massimo Leoncini, Francesco Tomassini, Cristina Rolfo, Marco Pavani, Alfonso Franzè, Greca Zanda, Simone Zecchino, Alessio La Manna, Alfredo Galassi, Ferdinando Varbella","doi":"10.1161/CIRCINTERVENTIONS.126.016666","DOIUrl":"https://doi.org/10.1161/CIRCINTERVENTIONS.126.016666","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention of complex coronary bifurcation lesions frequently requires an upfront 2-stent strategy. Although the double kissing crush technique has been extensively studied, limited contemporary data are available comparing alternative 2-stent approaches, particularly Minicrush and T-stenting and minimal protrusion (TAP), in complex bifurcation anatomy. This study aimed to compare procedural characteristics and long-term clinical outcomes of Minicrush versus TAP stenting techniques in patients undergoing percutaneous coronary intervention for complex coronary bifurcation lesions.</p><p><strong>Methods: </strong>The TREX registry is a multicenter, retrospective cohort study including consecutive patients treated with an upfront 2-stent strategy using Minicrush or TAP between November 2015 and April 2025. The primary end point was target lesion failure. Secondary end points included major adverse cardiac events and definite or probable stent thrombosis. Clinical outcomes were assessed for up to 10 years.</p><p><strong>Results: </strong>Among 601 screened patients, 469 (78%) underwent an upfront 2-stent strategy (Minicrush: n=257; TAP: n=212). TLF occurred in 10.4% of patients, with no significant differences between groups at 1, 5, or 10 years. Major cardiovascular event rates were also comparable across all time points. In multivariable analyses, distal left main involvement and severe coronary calcification were the strongest predictors of TLF, whereas reduced left ventricular ejection fraction was the main predictor of major cardiovascular events. Definite or probable stent thrombosis occurred more frequently with TAP than with Minicrush (5.7% versus 0.8%; <i>P</i><0.01).</p><p><strong>Conclusions: </strong>Minicrush and TAP provide comparable long-term efficacy in complex coronary bifurcation percutaneous coronary intervention; however, Minicrush is associated with a lower risk of stent thrombosis, suggesting a more favorable safety profile.</p><p><strong>Registration: </strong>URL: https://clinicaltrials.gov/; Unique Identifier: NCT06484647.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016666"},"PeriodicalIF":7.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963157","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}