{"title":"Seeing More With Less: AI to Reduce Radiation Exposure in the Cath Lab.","authors":"Thomas Meredith, Celina M Yong, William F Fearon","doi":"10.1161/CIRCINTERVENTIONS.126.016980","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016980","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016980"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216699","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}
Mohammed A Elbahloul, Shrouk Ramadan, Eman E Labeeb, Shahed Aldalahmeh, Ahella Ismail A Mousa, Ahmed Elazab, Ahmed N Mohamed, Ahmad Elashery, Mehiar O El-Hamdani, Carl J Lavie, Gregg W Stone
{"title":"Timing of Complete Revascularization in Patients With STEMI and Multivessel Disease: An Updated Meta-Analysis of Randomized Clinical Trials.","authors":"Mohammed A Elbahloul, Shrouk Ramadan, Eman E Labeeb, Shahed Aldalahmeh, Ahella Ismail A Mousa, Ahmed Elazab, Ahmed N Mohamed, Ahmad Elashery, Mehiar O El-Hamdani, Carl J Lavie, Gregg W Stone","doi":"10.1161/CIRCINTERVENTIONS.126.016601","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016601","url":null,"abstract":"<p><strong>Background: </strong>The ideal timing for complete revascularization (CR) in patients with ST-segment-elevation myocardial infarction and multivessel disease is uncertain. This meta-analysis examined outcomes of immediate CR (ICR) versus staged CR (SCR).</p><p><strong>Methods: </strong>Four databases were searched for randomized controlled trials that compared ICR and SCR in ST-segment-elevation myocardial infarction and multivessel disease. The primary end points of interest were short-term and long-term all-cause mortality. Outcomes are presented as risk ratios for short-term outcomes and incidence rate ratios for long-term outcomes with 95% CIs.</p><p><strong>Results: </strong>The analysis included 9 randomized controlled trials in which 4213 patients were enrolled. Short-term all-cause mortality occurred in 2.0% of patients after ICR compared with 1.2% of patients after SCR (risk ratio, 1.66 [95% CI, 0.99-2.78], <i>P</i>=0.053; <i>I</i><sup>2</sup>=0%). Short-term cardiac death was increased after ICR (risk ratio, 2.19 [95% CI, 1.08-4.44], <i>P</i>=0.03; <i>I</i><sup>2</sup>=0%). At a median 1-year follow-up, all-cause mortality occurred in 4.7% of patients after ICR compared with 3.5% of patients after SCR (incidence rate ratio, 1.40 [95% CI, 0.97-2.03], <i>P</i>=0.07; <i>I</i><sup>2</sup>=0%). No significant differences were identified between the ICR and SCR strategies at either short-term or long-term follow-up for other outcomes, including myocardial infarction, repeat revascularization, stent thrombosis, stroke, major bleeding, and the composite of major adverse cardiac or cerebrovascular events.</p><p><strong>Conclusions: </strong>In hemodynamically stable patients with ST-segment-elevation myocardial infarction and multivessel disease, an ICR strategy may increase short-term cardiac death compared with SCR, and the possibility of increased early and late all-cause mortality cannot be excluded. Despite some uncertainty, these results currently favor a staged CR strategy for most patients with ST-segment-elevation myocardial infarction and multivessel disease.</p><p><strong>Registration: </strong>URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD420251163719.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016601"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764385","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}
Rumi Yokota, Yulin Zhang, Ayush Jaggi, Tristan Perry, Elisabeth Martin, Michael Ma, Rajesh Punn, Frank L Hanley, Doff B McElhinney
{"title":"Durability of Bioprosthetic and Mechanical Valves Implanted for Aortic Valve Replacement in Pediatric Patients.","authors":"Rumi Yokota, Yulin Zhang, Ayush Jaggi, Tristan Perry, Elisabeth Martin, Michael Ma, Rajesh Punn, Frank L Hanley, Doff B McElhinney","doi":"10.1161/CIRCINTERVENTIONS.125.015931","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015931","url":null,"abstract":"<p><strong>Background: </strong>There is limited published information on bioprosthetic aortic valve durability. The purpose of this study was to assess the durability of bioprosthetic valves used for aortic valve replacement (AVR) in pediatric patients.</p><p><strong>Methods: </strong>We reviewed all surgical AVR procedures performed from May 2002 to July 2024 in patients ≤21 years of age using a mechanical valve or bioprosthesis. Long-term valve-related outcomes were assessed with propensity-score-adjusted analysis.</p><p><strong>Results: </strong>During the study period, 180 AVR procedures were performed in pediatric patients (median age, 14.3 years) using a bioprosthetic valve (n=79) or mechanical prosthesis (n=101). Freedom from reintervention was significantly shorter in patients with a bioprosthetic valve (77% at 5 years, 29% at 10 years) than those with a mechanical valve (88% at 5 years, 82% at 10 years; <i>P</i><0.001). By propensity score-adjusted multivariable Cox regression, a bioprosthetic valve (hazard ratio, 4.66 [95% CI, 2.26-9.62]; <i>P</i><0.001) and age <12 years at AVR (3.26 [1.81-5.87]; <i>P</i><0.001) were associated with shorter freedom from reintervention. Endocarditis was diagnosed in 16 patients, and thromboembolic or bleeding complications were reported in 8.</p><p><strong>Conclusions: </strong>In pediatric patients undergoing AVR, bioprosthetic valves have significantly worse durability than mechanical prostheses, with the disparity most pronounced in younger patients. Valve-related mortality and complications were relatively common. These findings should focus attention on the need for better replacement valves or therapeutic options in young patients with aortic valve disease.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015931"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764365","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":"Prognostic Impact of Renal Function on Outcomes After Physiology-Guided Coronary Revascularization: Insights From the J-PRIDE Registry.","authors":"Hirofumi Ohashi, Shoichi Kuramitsu, Hirohiko Ando, Tomohiro Shinozaki, Yoshiaki Kawase, Takenori Domei, Futoshi Yamanaka, Umihiko Kaneko, Tsunekazu Kakuta, Kazunori Horie, Hidenobu Terai, Yasutsugu Shiono, Toru Tagashira, Kazutaka Nogi, Takashi Kubo, Taku Asano, Jun Shiraishi, Hiromasa Otake, Akinori Sugano, Hiroki Okabe, Atsushi Iwai, Yuetsu Kikuta, Hidetaka Nishina, Masashi Iwabuchi, Hiroyoshi Yokoi, Takashi Akasaka, Hitoshi Matsuo, Nobuhiro Tanaka, Tetsuya Amano","doi":"10.1161/CIRCINTERVENTIONS.125.016454","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016454","url":null,"abstract":"<p><strong>Background: </strong>The clinical utility of physiology-guided revascularization for decision-making in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) remains uncertain. The aim of this study is to evaluate the diagnostic performance and prognostic significance of fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs) according to the severity of CKD.</p><p><strong>Methods: </strong>This subanalysis of the J-PRIDE registry, a prospective multicenter study conducted at 20 Japanese centers between September 2019 and February 2021, included 4296 lesions from 3194 patients who underwent both FFR and NHPR assessment. Patients were categorized by estimated glomerular filtration rate into non-CKD (≥60 mL/min per 1.73 m<sup>2</sup>; n=1639), CKD (15-59; n=1321), and ESRD (<15 or on dialysis; n=234). The primary end point was 1-year target vessel failure, defined as a composite of cardiac death, target vessel myocardial infarction, and clinically driven target vessel revascularization.</p><p><strong>Results: </strong>The 1-year incidence of target vessel failure was significantly higher in the ESRD group than in CKD and non-CKD groups (8.4% versus 2.4% and 2.6%; for CKD, adjusted hazard ratio, 3.09 [95% CI, 1.60-5.96]; <i>P</i><0.001; for non-CKD, adjusted hazard ratio, 2.88 [95% CI, 1.98-5.47]; <i>P</i>=0.001). The NHPR cutoff predicting FFR ≤0.80 was lower in ESRD compared with CKD and non-CKD (0.85 versus 0.89 versus 0.89). Although the overall prevalence of FFR/NHPR discordance was comparable (23.6%, 19.7%, and 19.7%; <i>P</i>=0.24), FFR-/NHPR+ discordance predominated in ESRD (18.6% versus 9.3% versus 7.0%; <i>P</i><0.001). FFR-/NHPR+ lesions in the ESRD group exhibited an excess risk compared with other lesions. Revascularization was beneficial in non-CKD patients with FFR+/NHPR- lesions, whereas no clear benefit was observed in patients with CKD and ESRD.</p><p><strong>Conclusions: </strong>Patients with ESRD exhibited distinct physiological characteristics and substantially worse outcomes, highlighting the need for tailored coronary revascularization strategies in this population.</p><p><strong>Registration: </strong>URL: https://www.umin.ac.jp/ctr; Unique identifier: UMIN000038403.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016454"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764363","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}
Mauro Gitto, Pier Pasquale Leone, Tuomas T Rissanen, Natasha Corballis, Gianmaria Calamita, Francesco Tartaglia, Andrea Buono, Marco Ferrone, Alfonso Ielasi, Siamion Pismiankou, Marco Luciano Rossi, Ioannis Merinopoulos, Vassilios S Vassiliou, Luigi Salemme, Mauro Chiarito, Michele Galasso, Michele Morosato, Kasper Kyhl, Giovanni Occhipinti, Jonathan Hinton, Elodi Bacci, Guido Vellucci, Marcello Marchetta, Francesca De Micco, Damiano Regazzoli, Antonio Mangieri, Thomas Johnson, Fabrizio Ugo, Gabriele Gasparini, Bernhard Reimers, Peter O' Kane, Giuseppe Massimo Sangiorgi, Giulio G Stefanini, Stefano Galli, Fernando Alfonso, Diego Arroyo, Manel Sabaté, Carlo Briguori, Tullio Tesorio, Kambis Mashayekhi, Diego Maffeo, Azeem Latib, Simon Eccleshall, Antonio Colombo
{"title":"Clinical Outcomes of Bail-Out Stenting After Drug-Coated Balloon Angioplasty: The International Multicenter BAILOUT Registry.","authors":"Mauro Gitto, Pier Pasquale Leone, Tuomas T Rissanen, Natasha Corballis, Gianmaria Calamita, Francesco Tartaglia, Andrea Buono, Marco Ferrone, Alfonso Ielasi, Siamion Pismiankou, Marco Luciano Rossi, Ioannis Merinopoulos, Vassilios S Vassiliou, Luigi Salemme, Mauro Chiarito, Michele Galasso, Michele Morosato, Kasper Kyhl, Giovanni Occhipinti, Jonathan Hinton, Elodi Bacci, Guido Vellucci, Marcello Marchetta, Francesca De Micco, Damiano Regazzoli, Antonio Mangieri, Thomas Johnson, Fabrizio Ugo, Gabriele Gasparini, Bernhard Reimers, Peter O' Kane, Giuseppe Massimo Sangiorgi, Giulio G Stefanini, Stefano Galli, Fernando Alfonso, Diego Arroyo, Manel Sabaté, Carlo Briguori, Tullio Tesorio, Kambis Mashayekhi, Diego Maffeo, Azeem Latib, Simon Eccleshall, Antonio Colombo","doi":"10.1161/CIRCINTERVENTIONS.125.016461","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.016461","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloons (DCBs) are increasingly adopted in percutaneous coronary intervention. Bail-out drug-eluting stent (DES) implantation due to suboptimal immediate results after DCB angioplasty is not infrequent, and the clinical outcomes of percutaneous coronary intervention with DCB angioplasty followed by bail-out DES implantation remain unexplored. The aim of this study was to evaluate the safety of bail-out DES implantation following DCB angioplasty in percutaneous coronary intervention.</p><p><strong>Methods: </strong>The BAILOUT registry included consecutive patients undergoing bail-out DES implantation after DCB angioplasty at 17 European centers between 2011 and 2024. The primary end point was target lesion failure (TLF) at 1 year, defined as the composite of target lesion revascularization, target vessel myocardial infarction, and cardiac death. The TLF rate was compared with a performance goal of 7.0% for an upfront DES-only strategy, derived from a meta-analysis of contemporary randomized controlled trials.</p><p><strong>Results: </strong>A total of 733 patients were included, accounting for 5.5% of all DCB-based percutaneous coronary interventions. At 1 year, the cumulative TLF incidence in the overall population was 7.0% (95% CI, 5.2%-9.3%), which was comparable to the performance goal (<i>P</i>=0.916). This was mainly driven by target lesion revascularization (4.1%), while cardiac death and target vessel myocardial infarction occurred both in 1.9% of patients. The incidence of stent thrombosis was 0.6%. Independent predictors of 1-year TLF included lesion length (hazard ratio, 1.02 per mm increase [95% CI, 1.01-1.03]; <i>P</i><0.001), moderate-to-severe calcification (hazard ratio, 2.82 [95% CI, 1.48-5.40]; <i>P</i>=0.002), and the use of paclitaxel- versus sirolimus-coated balloons (hazard ratio, 1.99 [95% CI, 1.01-4.05]; <i>P</i>=0.048).</p><p><strong>Conclusions: </strong>In cases of suboptimal angiographic results after DCB angioplasty, bail-out DES implantation is safe, with no increased risk of TLF at 1 year compared with the expected performance goal for an upfront DES-only strategy.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016461"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764404","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}
Tommaso Fabris, Federico Arturi, Andrea Buono, Chiara de Biase, Michele Bellamoli, Andrea Zito, Antonio Mangieri, Nicholas Montarello, Giuliano Costa, Mesfer Alfadhel, Ofi Koren, Simone Fezzi, Barbara Bellini, Mauro Massussi, Andrea Scotti, Lin Bai, Giulia Costa, Alessandro Mazzapicchi, Enrico Giacomin, Riccardo Gorla, Karsten Hug, Carlo Briguori, Luca Bettari, Antonio Messina, Mauro Boiago, Matthias Renker, Mario Garcia Gomez, Massimo Napodano, Chiara Fraccaro, Luca Nai Fovino, Giulia Masiero, Francesco Cardaioli, Francesco Putortì, Andrea Panza, Maria Luisa De Rosa, Carlo Trani, Giulia Laterra, Alessia Latini, Dario Pellegrini, Alfonso Ielasi, Ady Orbach, Uri Landes, Tobias Rheude, Luca Testa, Ignacio Amat Santos, Francesco Saia, Luca Favero, Carlo Cernetti, Mao Chen, Marianna Adamo, Azeem Latib, Anna Sonia Petronio, Matteo Montorfano, Raj R Makkar, Francesco Burzotta, Marco Barbanti, Daniel J Blackman, Darren Mylotte, Ole De Backer, Didier Tchètchè, Diego Maffeo, Won-Keun Kim, Giuseppe Tarantini
{"title":"Measured Versus Predicted Prosthesis-Patient Mismatch after TAVR in Sievers Type 1 BAV: Incidence, Determinants, and Outcomes From the AD-HOC Registry.","authors":"Tommaso Fabris, Federico Arturi, Andrea Buono, Chiara de Biase, Michele Bellamoli, Andrea Zito, Antonio Mangieri, Nicholas Montarello, Giuliano Costa, Mesfer Alfadhel, Ofi Koren, Simone Fezzi, Barbara Bellini, Mauro Massussi, Andrea Scotti, Lin Bai, Giulia Costa, Alessandro Mazzapicchi, Enrico Giacomin, Riccardo Gorla, Karsten Hug, Carlo Briguori, Luca Bettari, Antonio Messina, Mauro Boiago, Matthias Renker, Mario Garcia Gomez, Massimo Napodano, Chiara Fraccaro, Luca Nai Fovino, Giulia Masiero, Francesco Cardaioli, Francesco Putortì, Andrea Panza, Maria Luisa De Rosa, Carlo Trani, Giulia Laterra, Alessia Latini, Dario Pellegrini, Alfonso Ielasi, Ady Orbach, Uri Landes, Tobias Rheude, Luca Testa, Ignacio Amat Santos, Francesco Saia, Luca Favero, Carlo Cernetti, Mao Chen, Marianna Adamo, Azeem Latib, Anna Sonia Petronio, Matteo Montorfano, Raj R Makkar, Francesco Burzotta, Marco Barbanti, Daniel J Blackman, Darren Mylotte, Ole De Backer, Didier Tchètchè, Diego Maffeo, Won-Keun Kim, Giuseppe Tarantini","doi":"10.1161/CIRCINTERVENTIONS.125.015994","DOIUrl":"10.1161/CIRCINTERVENTIONS.125.015994","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding prosthesis-patient mismatch (PPM), measured (mPPM), and predicted (pPPM), after transcatheter aortic valve replacement in bicuspid aortic valve stenosis remains limited. This study sought to evaluate the incidence, predictors, and prognostic implications of mPPM and pPPM in patients with Sievers type 1 bicuspid aortic valve undergoing transcatheter aortic valve replacement.</p><p><strong>Methods: </strong>The AD-HOC registry is a retrospective, multicenter study including 781 patients with severe aortic stenosis and bicuspid aortic valve treated with transcatheter aortic valve replacement between 2016 and 2023 across 24 centers. PPM was defined according to Valve Academic Research Consortium-3 criteria. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Moderate-to-severe mPPM was more frequent than pPPM (22% versus 8%; <i>P</i><0.001). Balloon-expandable valves were independently associated with both mPPM and pPPM, while smaller valve size and supra-annular sizing predicted only pPPM. During a mean follow-up of 621±470 days, neither mPPM nor pPPM was associated with mortality in the overall cohort. Among patients with a small annulus (≤430 mm<sup>2</sup>; n=145), pPPM occurrence was significantly higher (19% versus 5.5%; <i>P</i><0.001) and was associated with increased all-cause mortality, but not with cardiovascular mortality.</p><p><strong>Conclusions: </strong>In patients with Sievers type 1 bicuspid aortic valve undergoing transcatheter aortic valve replacement, pPPM occurred less frequently than mPPM and was predominantly driven by anatomic characteristics and sizing strategies. Although pPPM was associated with increased all-cause mortality among patients with small annuli, this association did not extend to cardiovascular mortality and should be considered hypothesis-generating. Further prospective investigations are warranted to better delineate the impact of anatomic constraints on clinical outcomes in this anatomically challenging subset.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e015994"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873727","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}
Domenico Galante, Ciro Pollio Benvenuto, Andrea Viceré, Simona Todisco, Chiara Giuliana, Vincenzo Viccaro, Pierpaolo Tarzia, Lazzaro Paraggio, Mattia Lunardi, Cristina Aurigemma, Enrico Romagnoli, Rocco A Montone, Gennaro Capalbo, Carlo Trani, Filippo Crea, Francesco Burzotta, Antonio Maria Leone
{"title":"Contrast-Derived Index of Microcirculatory Resistance: A Novel Index for Measuring Coronary Microvascular Resistance.","authors":"Domenico Galante, Ciro Pollio Benvenuto, Andrea Viceré, Simona Todisco, Chiara Giuliana, Vincenzo Viccaro, Pierpaolo Tarzia, Lazzaro Paraggio, Mattia Lunardi, Cristina Aurigemma, Enrico Romagnoli, Rocco A Montone, Gennaro Capalbo, Carlo Trani, Filippo Crea, Francesco Burzotta, Antonio Maria Leone","doi":"10.1161/CIRCINTERVENTIONS.126.016489","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016489","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016489"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834355","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":"Ultra-Low-Dose Noise-Free Technology to Reduce Radiation Exposure During Coronary Angiography.","authors":"Jinying Zhou, Qiyu Zhang, Hao Lu, Yizhe Wu, Li Shen, Jianying Ma, Rende Xu, Feng Zhang, Zhangwei Chen, Juying Qian, Chenguang Li, Junbo Ge","doi":"10.1161/CIRCINTERVENTIONS.126.016542","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016542","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) is a cornerstone treatment for coronary artery disease. As procedural volumes continue to rise, the associated radiation risk from angiography systems has drawn increasing concern. Thus, we developed a novel ultra-low-dose Noise-Free technology to optimize angiography systems. This study aims to investigate whether it effectively reduces radiation exposure in real-world coronary interventions.</p><p><strong>Methods: </strong>A comparative study on a single-center, real-world, observational cohort. The primary end point was an intergroup comparison of procedural radiation exposure, including dose area product, air kerma, and dose rate, stratified by exposure mode (fluoroscopy or cine) and procedure type (diagnostic coronary angiography, single-vessel PCI, or chronic total occlusion PCI). The secondary end point included an expert semi-quantitative assessment and a quantitative contrast-to-noise ratio for image quality.</p><p><strong>Results: </strong>A total of 380 procedures (102 coronary angiography, 78 single-vessel PCI, and 200 chronic total occlusion PCI) were performed in 380 patients using 4 different angiography systems. There was no significant difference in baseline patient characteristics, procedural time, or operator experience. In coronary angiography procedures, the ultra-low-dose technique demonstrated a total air kerma of 60.3 (38.5-74.1) mGy, total dose area product of 4.0 (2.9-5.2) Gy·cm<sup>2</sup>, fluoroscopy dose rate of 7.9 (6.0-9.6) mGy/min, and cine dose rate of 51.7 (37.4-64.9) mGy/min, corresponding to 40% to 70%, 37% to 66%, 16% to 62%, and 25% to 79% reductions than others, respectively. Similar radiation reductions were observed for single-vessel PCI. For chronic total occlusion PCI, the corresponding percentages of radiation reduction in total air kerma, total dose area product, fluoroscopy dose rate, and cine dose rate were 59% to 73%, 54% to 69%, 22% to 64%, and 60% to 79%, respectively, relative to the other 3 systems. The semi-quantitative assessment and contrast-to-noise ratio analysis showed comparable image quality between the 4 systems.</p><p><strong>Conclusions: </strong>The Noise-Free technique reduced radiation exposure across cumulative and rate metrics while preserving diagnostic image quality, with the greatest reduction observed in complex cases. These findings support its clinical utility for lowering radiation risk.</p>","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016542"},"PeriodicalIF":7.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728711","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":"Novel Application of a Familiar Concept: TR Proportionality and T-TEER Outcomes.","authors":"Jonathan E Labin, Serge Harb, Grant W Reed","doi":"10.1161/CIRCINTERVENTIONS.126.016819","DOIUrl":"10.1161/CIRCINTERVENTIONS.126.016819","url":null,"abstract":"","PeriodicalId":10330,"journal":{"name":"Circulation: Cardiovascular Interventions","volume":" ","pages":"e016819"},"PeriodicalIF":7.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764440","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}