Circulation: Cardiovascular Interventions最新文献

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Nicorandil to Prevent Contrast-Associated Kidney Injury in High-Risk PCI. 尼可地尔预防高危PCI造影剂相关肾损伤。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-09-01 Epub Date: 2026-06-23 DOI: 10.1161/CIRCINTERVENTIONS.126.016928
Minqi Liao, Weiliang Zhou, Wenbin Wang, Yanhua Yang, Yongzhao Yao, Guoxiang Zhou, Zhihao Wu, Xiaoming Zhang, Bailiang Wei, Guangzhu Liang, Zheng Li, Zhanyang Wei, Jiongbin Lu, Zekui Wu, Yanna Wang, Ailing Lin, Yan Chen, Bin Zhang, Suxia Guo
{"title":"Nicorandil to Prevent Contrast-Associated Kidney Injury in High-Risk PCI.","authors":"Minqi Liao, Weiliang Zhou, Wenbin Wang, Yanhua Yang, Yongzhao Yao, Guoxiang Zhou, Zhihao Wu, Xiaoming Zhang, Bailiang Wei, Guangzhu Liang, Zheng Li, Zhanyang Wei, Jiongbin Lu, Zekui Wu, Yanna Wang, Ailing Lin, Yan Chen, Bin Zhang, Suxia Guo","doi":"10.1161/CIRCINTERVENTIONS.126.016928","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016928","url":null,"abstract":"<p><strong>Background: </strong>Patients with renal dysfunction remain at high risk for contrast-associated acute kidney injury despite standard peri-procedural volume administration. This study aims to investigate whether peri-procedural oral nicorandil provides additional protection in this population, and to evaluate its potential dose-response relationship.</p><p><strong>Methods: </strong>We conducted a prospective, multicenter, randomized controlled trial enrolling patients with renal dysfunction undergoing percutaneous coronary intervention. Participants were randomized into 3 groups, including a high-dose nicorandil group (30 mg/d, 10 mg 3× daily), a conventional-dose nicorandil group (15 mg/d, 5 mg 3× daily), and a saline hydration-only control group. The primary end point was the incidence of contrast-associated acute kidney injury. Secondary end points included changes in serum creatinine, blood urea nitrogen, CysC (cystatin C), and CRP (C-reactive protein).</p><p><strong>Results: </strong>A total of 585 patients were recruited and randomized. The incidence of contrast-associated acute kidney injury was significantly lower in both nicorandil groups, with 19.8% (39/197) in the control group, compared with 10.9% (21/193) in the conventional-dose group and 8.7% (17/195) in the high-dose group (<i>P</i><0.001). This represented a relative risk reduction of 50% and 61% for the conventional- and high-dose groups, respectively.</p><p><strong>Conclusions: </strong>Adjunctive nicorandil, particularly at a dose of 10 mg 3× daily, significantly reduced the incidence of contrast-associated acute kidney injury in patients with renal dysfunction undergoing percutaneous coronary intervention. Oral nicorandil represents a readily available, effective, and dose-dependent prophylactic strategy to enhance renoprotection. Future studies are warranted to evaluate the long-term clinical benefits of this intervention.</p><p><strong>Registration: </strong>URL: https://www.chictr.org.cn; Unique identifier: CTR2200064264.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016928"},"PeriodicalIF":7.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301113","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}
引用次数: 0
Impact of Coronary Diameter Stenosis and Proximal Lesion Location on Outcomes Following PCI in Patients Undergoing TAVI: Prespecified NOTION-3 Substudy. 冠状动脉直径狭窄和近端病变位置对TAVI患者PCI治疗后预后的影响:预先指定的notion3亚研究。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-09-01 Epub Date: 2026-07-24 DOI: 10.1161/CIRCINTERVENTIONS.125.016286
Matti Riihiniemi, Jasmine Melissa Marquard, Jarkko Piuhola, Matti Niemelä, Charlotte Glinge, Reza Jabbari, Muhammad Sabbah, Karsten Tange Veien, Phillip Freeman, Rickard Linder, Dan Ioanes, Christian Juhl Terkelsen, Olli A Kajander, Sasha Koul, Mikko Savontaus, Pasi Karjalainen, Evald Høj Christiansen, Ashkan Eftekhari, Lene Holmvang, Rikke Sørensen, Julia Ellert-Gregersen, Andreas Rück, Oskar Angerås, Gintautas Bieliauskas, Troels Højsgaard Jørgensen, Juhani Junttila, Lars Søndergaard, Ole De Backer, Thomas Engstrøm, Jacob Lønborg
{"title":"Impact of Coronary Diameter Stenosis and Proximal Lesion Location on Outcomes Following PCI in Patients Undergoing TAVI: Prespecified NOTION-3 Substudy.","authors":"Matti Riihiniemi, Jasmine Melissa Marquard, Jarkko Piuhola, Matti Niemelä, Charlotte Glinge, Reza Jabbari, Muhammad Sabbah, Karsten Tange Veien, Phillip Freeman, Rickard Linder, Dan Ioanes, Christian Juhl Terkelsen, Olli A Kajander, Sasha Koul, Mikko Savontaus, Pasi Karjalainen, Evald Høj Christiansen, Ashkan Eftekhari, Lene Holmvang, Rikke Sørensen, Julia Ellert-Gregersen, Andreas Rück, Oskar Angerås, Gintautas Bieliauskas, Troels Højsgaard Jørgensen, Juhani Junttila, Lars Søndergaard, Ole De Backer, Thomas Engstrøm, Jacob Lønborg","doi":"10.1161/CIRCINTERVENTIONS.125.016286","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016286","url":null,"abstract":"<p><strong>Background: </strong>Optimal treatment of coronary artery disease in patients undergoing transcatheter aortic valve implantation remains debated. Here, our aim was to analyze the impact of the diameter and location of coronary stenosis on outcomes in patients undergoing percutaneous coronary intervention (PCI) with transcatheter aortic valve implantation.</p><p><strong>Methods: </strong>This study was a prespecified subanalysis of the NOTION-3 trial (Nordic Aortic Valve Intervention), which randomized patients with severe symptomatic aortic stenosis and physiologically significant stable coronary artery disease to receive either PCI or conservative treatment of coronary artery disease with transcatheter aortic valve implantation. In this substudy, patients were stratified according to diameter stenosis (<90% or ≥90%) and stenosis location (proximal or nonproximal). The primary outcome was major adverse cardiovascular event, a composite of all-cause death, myocardial infarction, and urgent revascularization.</p><p><strong>Results: </strong>Of 455 randomized patients, 184 (40%) had diameter stenosis <90% and 271 (60%) ≥90%. A total of 294 (65%) patients had at least 1 proximal stenosis, while in 161 (35%) patients stenoses were nonproximal. At a median follow-up of 2 years (interquartile range, 1-4), PCI reduced the absolute risk of major adverse cardiovascular event by 13% in patients with diameter stenosis ≥90% (PCI 24% versus conservative treatment 37%; hazard ratio, 0.53 [95% CI, 0.34-0.82]), whereas no benefit was observed in patients with diameter stenosis <90% (31% versus 33%; hazard ratio, 1.04 [95% CI, 0.62-1.73]; <i>P</i> for interaction=0.051). PCI reduced major adverse cardiovascular events in case of proximal stenosis (26% versus 38%; hazard ratio, 0.61 [95% CI, 0.40-0.93]), although the difference in effect remained nonsignificant when compared with patients with nonproximal stenosis (28% versus 32%; hazard ratio, 0.91 [95% CI, 0.52-1.61]; <i>P</i> for interaction=0.27).</p><p><strong>Conclusions: </strong>The beneficial effect of PCI in patients undergoing transcatheter aortic valve implantation with physiologically significant stable coronary artery disease was seemingly pronounced in patients with high-grade stenosis, while stenosis location was not found to modify the outcome despite an almost similar beneficial effect with PCI in patients with proximal stenosis.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016286"},"PeriodicalIF":7.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577286","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}
引用次数: 0
Technical Success of Fetal Aortic Valvuloplasty in Relation to Center Volumes: A Report From the International Fetal Cardiac Intervention Registry. 与中心容积相关的胎儿主动脉瓣成形术的技术成功:一份来自国际胎儿心脏介入登记的报告。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-06-09 DOI: 10.1161/CIRCINTERVENTIONS.125.015593
Manon Gijtenbeek, Shaine A Morris, Ulrike Herberg, Sofia Grinenco, Pablo Marantz, Lucas Otaño, Sarah K Gelehrter, Alberto Galindo, Sophie Malekzadeh-Milani, Joanna H Dangel, Monica Cruz-Lemini, Edgar T Jaeggi, Simone R Pedra, Carlos A C Pedra, Fabio Peralta, John Simpson, Trisha V Vigneswaran, Helena M Gardiner, Aimee K Armstrong, Jay Pruetz, Ramen Chmait, Rogelio Cruz-Martinez, James Strainic, Monique C Haak, Anita J Moon-Grady
{"title":"Technical Success of Fetal Aortic Valvuloplasty in Relation to Center Volumes: A Report From the International Fetal Cardiac Intervention Registry.","authors":"Manon Gijtenbeek, Shaine A Morris, Ulrike Herberg, Sofia Grinenco, Pablo Marantz, Lucas Otaño, Sarah K Gelehrter, Alberto Galindo, Sophie Malekzadeh-Milani, Joanna H Dangel, Monica Cruz-Lemini, Edgar T Jaeggi, Simone R Pedra, Carlos A C Pedra, Fabio Peralta, John Simpson, Trisha V Vigneswaran, Helena M Gardiner, Aimee K Armstrong, Jay Pruetz, Ramen Chmait, Rogelio Cruz-Martinez, James Strainic, Monique C Haak, Anita J Moon-Grady","doi":"10.1161/CIRCINTERVENTIONS.125.015593","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015593","url":null,"abstract":"<p><strong>Background: </strong>The relationship between fetal aortic valvuloplasty procedural volume and outcomes is crucial to understand whether regionalization should be advised worldwide. This study utilizes the International Fetal Cardiac Intervention Registry to examine the relationship between center volume for fetal aortic valvuloplasty and outcome metrics including procedure success, complications, and fetal death.</p><p><strong>Methods: </strong>Data were included from institutions performing ≥3 procedures (2001-2018). The primary outcome was technical success, defined as ≥1 balloon inflation across the aortic valve, with increased antegrade flow across the valve, new aortic regurgitation, or both. Secondary end points were procedural complications and fetal periprocedural death (within 48 hours). Univariable and Classification and Regression Tree analyses were performed.</p><p><strong>Results: </strong>Eleven centers, with volumes ranging from 6 to 31 cases, performed 162 fetal aortic valvuloplasties with a technical success rate of 80.2%. Higher volume was not associated with better technical success or fewer complications but was associated with fewer periprocedural fetal deaths. Employing Classification and Regression Tree modeling, the largest drivers of improved outcomes for all measures were greater estimated fetal weight and gestational age. A single cardiac puncture was associated with greater technical success and fewer procedural complications after accounting for fetal estimated fetal weight and gestational age.</p><p><strong>Conclusions: </strong>In this registry cohort, higher-volume centers did not have greater fetal aortic valvuloplasty technical success or fewer complications but did have fewer periprocedural fetal deaths. Fetal gestational age and number of cardiac punctures influenced outcomes, suggesting that unmeasured fetal selection criteria, such as different referral patterns, and technical expertise, indicative of overall center/team experience, may influence fetal survival.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015593"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204282","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}
引用次数: 0
One-Year Outcomes of Screen Failures for Transcatheter Tricuspid Valve Repair: Insights From the TriSelect Study. 经导管三尖瓣修复筛查失败的一年结果:来自TriSelect研究的见解。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-05-05 DOI: 10.1161/CIRCINTERVENTIONS.125.016124
Felix Rudolph, Arseniy Goncharov, Akhil Narang, Maria I Körber, Jyothy J Puthumana, S Chris Malaisrie, Zhiying Meng, Abigail S Baldridge, Tanja K Rudolph, Kai P Friedrichs, Roman Pfister, James D Thomas, Max Potratz, Volker Rudolph, Charles J Davidson, Muhammed Gerçek
{"title":"One-Year Outcomes of Screen Failures for Transcatheter Tricuspid Valve Repair: Insights From the TriSelect Study.","authors":"Felix Rudolph, Arseniy Goncharov, Akhil Narang, Maria I Körber, Jyothy J Puthumana, S Chris Malaisrie, Zhiying Meng, Abigail S Baldridge, Tanja K Rudolph, Kai P Friedrichs, Roman Pfister, James D Thomas, Max Potratz, Volker Rudolph, Charles J Davidson, Muhammed Gerçek","doi":"10.1161/CIRCINTERVENTIONS.125.016124","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016124","url":null,"abstract":"<p><strong>Background: </strong>Observational registries have shown improved survival among patients with severe or greater tricuspid regurgitation (TR) undergoing transcatheter tricuspid valve repair (TTVr) compared with conservative management. However, it remains unclear whether this survival benefit persists when specifically comparing patients undergoing TTVr with those who screen failed.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 547 patients from the TriSelect registry evaluated for TTVr-either transcatheter tricuspid valve edge-to-edge repair or direct transcatheter tricuspid valve annuloplasty at 3 tertiary centers in the United States and Germany between 2016 and 2021. The end point of 1-year survival was stratified by treatment group (TTVr versus screen fail) and procedural success (residual TR ≤ moderate versus > moderate).</p><p><strong>Results: </strong>Of the 547 patients, 219 (41.9%) screen failed and 318 (58.1%) underwent TTVr (transcatheter tricuspid valve edge-to-edge repair, 61.6%; transcatheter tricuspid valve annuloplasty, 38.4%). Among treated patients, 224 (70.4%) achieved residual TR ≤ moderate. Unadjusted Kaplan-Meier-derived 1-year survival was significantly higher in patients who underwent TTVr compared with screen-fail patients (82.5% versus 68.4%, log-rank <i>P</i><0.001). In multivariable Cox proportional hazards analysis, treatment with TTVr was independently associated with lower 1-year mortality (hazard ratio, 0.40 [95% CI, 0.18-0.86]; <i>P</i>=0.020). Among treated patients, survival was significantly higher in those with residual TR ≤ moderate versus those with greater than moderate residual TR (88.0% versus 69.2%, unadjusted log-rank <i>P</i>=0.005). Notably, in patients with residual TR > moderate, there was no survival benefit compared with screen-fail patients (unadjusted log-rank <i>P</i>=0.74).</p><p><strong>Conclusions: </strong>In this registry-based analysis, TTVr was associated with improved 1-year survival compared with screen-fail patients, but only when TR was reduced to moderate or less. These findings highlight the critical importance of achieving procedural success with a TTVr along with early referral and transcatheter tricuspid valve intervention device selection.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016124"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834400","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}
引用次数: 0
Use of Paclitaxel-Coated Balloons in the United States: Early Results From the AGENT Postapproval Study. 紫杉醇包覆气球在美国的使用:AGENT批准后研究的早期结果。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-05-12 DOI: 10.1161/CIRCINTERVENTIONS.126.016625
Christina Lalani, Eric A Secemsky, Yang Song, Huaying Dong, Ajay J Kirtane, Saroj Neupane, Amar Krishnaswamy, Matthew J Price, Rhian E Davies, Jarrod D Frizzell, Kathleen E Kearney, Jordan G Safirstein, Ziad A Ali, Rafael Cavalcante, Robert W Yeh
{"title":"Use of Paclitaxel-Coated Balloons in the United States: Early Results From the AGENT Postapproval Study.","authors":"Christina Lalani, Eric A Secemsky, Yang Song, Huaying Dong, Ajay J Kirtane, Saroj Neupane, Amar Krishnaswamy, Matthew J Price, Rhian E Davies, Jarrod D Frizzell, Kathleen E Kearney, Jordan G Safirstein, Ziad A Ali, Rafael Cavalcante, Robert W Yeh","doi":"10.1161/CIRCINTERVENTIONS.126.016625","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016625","url":null,"abstract":"<p><strong>Background: </strong>AGENT is the only coronary drug-coated balloon (DCB) approved for treatment of in-stent restenosis (ISR) in the United States to date. In this study, we describe trends in DCB use and compare characteristics and in-hospital outcomes between patients who received DCB versus alternative treatments.</p><p><strong>Methods: </strong>We included patients in the American College of Cardiology National Cardiovascular Disease Registry CathPCI Registry who underwent percutaneous coronary intervention between April 2024 and June 2025 and received DCB, drug-eluting stent (DES), or plain old balloon angioplasty. Treatment groups were compared using standard mean differences.</p><p><strong>Results: </strong>Between April 2024 and June 2025, 14 946 DCBs were used in 12 337 patients across 704 CathPCI Registry sites. The monthly rate of DCB use for ISR percutaneous coronary intervention grew from <1% to 17.5% during the study period. Of 96 452 ISR procedures performed overall, 9269 (9.61%) involved the use of DCB. DCB procedures were more likely to involve the use of specialty balloons (DCB 45.3% versus DES 17.5% versus plain old balloon angioplasty 28.3%), intravascular imaging (DCB 54.5% versus DES 35.1% versus plain old balloon angioplasty 30.9%), and atherectomy (DCB 14.9% versus DES 6.0% versus plain old balloon angioplasty 7.3%). Among patients treated with DCB, 0.4% experienced myocardial infarction, 0.7% developed cardiogenic shock, 0.2% had an ischemic stroke, and 0.9% died. DCB was separately used in 3459 of 810 483 (0.43%) non-ISR percutaneous coronary interventions. Unadjusted rates of in-hospital adverse outcomes after ISR and non-ISR DCB use were like those for DES (standard mean difference <10%).</p><p><strong>Conclusions: </strong>Real-world DCB use is increasing rapidly in the United States, driven by use in ISR lesions but also with growth among non-ISR lesions.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016625"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873654","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}
引用次数: 0
Laser- and Optics-Based Intravascular Lithotripsy for the Treatment of Calcified Coronary Stenoses: The RESTORE First-In-Human Study. 激光和光学血管内碎石治疗钙化冠状动脉狭窄:RESTORE首次人体研究。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-05-11 DOI: 10.1161/CIRCINTERVENTIONS.126.016874
Matthew J Price, Povilas Budrys, Arvydas Baranauskas, Gabor Toth-Gayor, Frane Runjic, Temistocles Diaz, Nilay K Patel, Briahnna Austin, Timothy E Meyer, Rafael Cavalcante, Andrius Berukstis
{"title":"Laser- and Optics-Based Intravascular Lithotripsy for the Treatment of Calcified Coronary Stenoses: The RESTORE First-In-Human Study.","authors":"Matthew J Price, Povilas Budrys, Arvydas Baranauskas, Gabor Toth-Gayor, Frane Runjic, Temistocles Diaz, Nilay K Patel, Briahnna Austin, Timothy E Meyer, Rafael Cavalcante, Andrius Berukstis","doi":"10.1161/CIRCINTERVENTIONS.126.016874","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016874","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016874"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867027","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}
引用次数: 0
Impact of Intravascular Imaging on Clinical Outcomes in Focal Versus Diffuse Coronary Artery Disease. 血管内成像对局灶性与弥漫性冠状动脉疾病临床结果的影响
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-05-20 DOI: 10.1161/CIRCINTERVENTIONS.126.016735
Taito Arai, Koshiro Sakai, Kazumasa Ikeda, Takuya Mizukami, Frédéric Bouisset, Han Zhang, Mitsuaki Matsumura, Jeroen Sonck, Adriaan Wilgenhof, Hitoshi Matsuo, Tetsuya Amano, Hirohiko Ando, Masahiro Hada, Brian Ko, Simone Biscaglia, Fernando Rivero, Thomas Engstrøm, Antonio Maria Leone, Lokien X van Nunen, William F Fearon, Evald Høj Christiansen, Stephane Fournier, Liyew Desta, Andy Yong, Julien Adjedj, Javier Escaned, Masafumi Nakayama, Ashkan Eftekhari, Danielle Keulards, Frederik M Zimmermann, Ethan Korngold, Daniel Munhoz, Gianluca Campo, Colin Berry, Damien Collison, Thomas W Johnson, Divaka Perera, Allen Jeremias, Ziad Ali, Bernard De Bruyne, Gary S Mintz, Nils Johnson, Toshiro Shinke, Carlos Collet
{"title":"Impact of Intravascular Imaging on Clinical Outcomes in Focal Versus Diffuse Coronary Artery Disease.","authors":"Taito Arai, Koshiro Sakai, Kazumasa Ikeda, Takuya Mizukami, Frédéric Bouisset, Han Zhang, Mitsuaki Matsumura, Jeroen Sonck, Adriaan Wilgenhof, Hitoshi Matsuo, Tetsuya Amano, Hirohiko Ando, Masahiro Hada, Brian Ko, Simone Biscaglia, Fernando Rivero, Thomas Engstrøm, Antonio Maria Leone, Lokien X van Nunen, William F Fearon, Evald Høj Christiansen, Stephane Fournier, Liyew Desta, Andy Yong, Julien Adjedj, Javier Escaned, Masafumi Nakayama, Ashkan Eftekhari, Danielle Keulards, Frederik M Zimmermann, Ethan Korngold, Daniel Munhoz, Gianluca Campo, Colin Berry, Damien Collison, Thomas W Johnson, Divaka Perera, Allen Jeremias, Ziad Ali, Bernard De Bruyne, Gary S Mintz, Nils Johnson, Toshiro Shinke, Carlos Collet","doi":"10.1161/CIRCINTERVENTIONS.126.016735","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016735","url":null,"abstract":"<p><strong>Background: </strong>Intravascular imaging (IVI) during percutaneous coronary intervention (PCI) improves outcomes. Pullback pressure gradient (PPG) characterizes coronary artery disease patterns as focal or diffuse; however, the benefit of IVI across this spectrum remains incompletely understood. We aimed to evaluate clinical outcomes after PCI with or without IVI guidance in patients with focal and diffuse disease defined by PPG.</p><p><strong>Methods: </strong>Prospective, multicenter, single-arm study of 811 patients (840 vessels) undergoing PCI. PPG was calculated from manual fractional flow reserve pullbacks to define focal (PPG ≥0.62) or diffuse coronary artery disease. IVI use was at the operator's discretion. The primary outcome was target vessel failure at 1-year follow-up.</p><p><strong>Results: </strong>IVI-guided PCI was performed in 41% of patients. In the overall cohort, target vessel failure was lower with IVI guidance (adjusted hazard ratio, 0.60 [95% CI 0.36-0.99]; <i>P</i>=0.044), with a lower incidence of cardiac death (<i>P</i>=0.042). IVI significantly reduced target vessel failure in focal disease (unadjusted HR, 0.41 [95% CI, 0.18-0.91]; <i>P</i>=0.029), whereas no difference was observed in diffuse disease (unadjusted HR, 0.91 [95% CI, 0.48-1.73]; <i>P</i>=0.771). There was no interaction between PPG and IVI guidance for target vessel failure (<i>P</i> for interaction=0.128).</p><p><strong>Conclusions: </strong>In patients undergoing physiology-guided PCI, the use of IVI reduced clinical events at 1 year. These findings suggest that the benefit of IVI extends across the full spectrum of coronary artery disease.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016735"},"PeriodicalIF":7.2,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971063","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}
引用次数: 0
Letter by Pedaballe Regarding Article, "Ultra-Low-Dose Noise-Free Technology to Reduce Radiation Exposure During Coronary Angiography". Pedaballe关于文章“降低冠状动脉造影期间辐射暴露的超低剂量无噪声技术”的信。
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-05-28 DOI: 10.1161/CIRCINTERVENTIONS.126.016950
Komal Sai Pedaballe
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引用次数: 0
Pullback Pressure Gradient and Intravascular Imaging in Focal and Diffuse Coronary Disease: The Next Step in Precision PCI? 局灶性和弥漫性冠状动脉疾病的回拉压力梯度和血管内成像:精准PCI的下一步?
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-07-02 DOI: 10.1161/CIRCINTERVENTIONS.126.017073
Ozan M Demir, John R Davies, Thomas R Keeble
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引用次数: 0
Leaving No Metal Behind in PCI: Is This Concept Ready for Primetime? PCI:这个概念准备好进入黄金时代了吗?
IF 7.2 1区 医学
Circulation: Cardiovascular Interventions Pub Date : 2026-08-01 Epub Date: 2026-07-15 DOI: 10.1161/CIRCINTERVENTIONS.126.017074
Jennifer A Rymer, Husam M Salah, Jonathan M Hanna, J Antonio Gutierrez
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引用次数: 0
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