International Journal of Angiology最新文献

{"title":"Coronary Artery Bypass Grafting: A Review of Short- and Long-Term Outcomes.","authors":"Adekemi Adeyemi, Lorin Berman, Mark Staroselsky, Dessiree Cordero, Ofek Hai, Amgad N Makaryus, Roman Zeltser","doi":"10.1055/a-2655-2479","DOIUrl":"10.1055/a-2655-2479","url":null,"abstract":"<p><p>Coronary artery bypass grafting (CABG) remains a cornerstone in the management of complex coronary artery disease (CAD), offering significant improvements in both survival and quality of life. This review evaluates the short- and long-term outcomes associated with CABG. Despite its benefits, CABG carries perioperative complications, including atrial fibrillation, acute kidney injury, stroke, and surgical site infection. While early mortality rates, including in-hospital and 30-day outcomes, are comparable to those observed with percutaneous coronary intervention (PCI), long-term data often favor CABG in specific patient populations. Multiple studies have demonstrated superior long-term survival with CABG over PCI in patients with multivessel disease, left main CAD, and comorbid conditions such as diabetes mellitus. Perioperative morbidity and mortality are significantly influenced by patient-specific risk factors, such as advanced age, female sex, reduced ejection fraction, and elevated biomarkers (e.g., troponin, NT-proBNP, C-reactive protein). Since its introduction in the 1960s, CABG techniques have evolved with off-pump and minimally invasive approaches offering reduced hospital length of stay, shorter intensive care unit duration, and lower transfusion requirements, while maintaining comparable safety and efficacy to conventional on-pump surgery. In addition, graft selection is an important determinant of long-term success of CABG. In conclusion, CABG continues to be a highly effective revascularization strategy. Surgical technique, graft type, and careful patient selection remain essential to optimizing both perioperative safety and long-term outcome.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"34 4","pages":"296-302"},"PeriodicalIF":0.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Fibrillation After Coronary Artery Bypass Grafting: A Single-Center Study.","authors":"Dominic Armagno, Sibu Saha","doi":"10.1055/a-2650-7339","DOIUrl":"10.1055/a-2650-7339","url":null,"abstract":"<p><p>Postoperative atrial fibrillation (POAF) is a common complication following coronary artery bypass grafting (CABG), associated with increased morbidity and health care costs. This study examines the incidence and impact of POAF on outcomes in CABG patients at a single institution. This retrospective observational study included patients undergoing isolated CABG between 2006 and 2022, excluding those with preoperative atrial fibrillation. Data include demographics, length of stay (LOS), mortality, and complications (Bleeding, stroke, and infection rates), comparing outcomes in patients with and without POAF. Among 2,671 patients, 238 (8.9%) developed POAF. POAF patients had higher rates of infection (7.56 vs. 5.75%), postoperative bleeding (5.04 vs. 2.84%), and stroke (5.46 vs. 2.01%). Thirty-day, 2-year, and 5-year mortality rates were 1.3, 7.8, and 24%, respectively. Intensive care unit (ICU) and hospital LOS were also prolonged in POAF patients as well. A total of 63.6 and 8.44% of POAF patients were discharged within 5 days from the hospital and ICU, respectively. Compared with 73.1 and 15.8% of non-POAF patients experienced no complications. POAF significantly impacts CABG patient outcomes, increasing morbidity, mortality, and resource utilization. Monitoring and early intervention are essential to mitigate these effects.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"35 2","pages":"98-102"},"PeriodicalIF":0.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary Intervention: History and Current Status.","authors":"Catherine R Glazier, James J Glazier","doi":"10.1055/a-2645-2283","DOIUrl":"10.1055/a-2645-2283","url":null,"abstract":"<p><p>On September 16, 1977, Dr Andreas Roland Grüntzig performed the world's first successful percutaneous transluminal coronary angioplasty at the University Hospital Zurich, Switzerland. This spectacular event ushered in the era of interventional cardiology. The technique has had a major influence on the practice of cardiology, right up to the current day. While Grüntzig remains the undisputed father of interventional cardiology, the observations and techniques developed by preceding pioneers in the fields of angiology, radiology, cardiology, and vascular and cardiac surgery paved the way for this procedure. Coronary stents were first developed by Ulrich Sigwart and his team in Lausanne, Switzerland. The aim of the stents was to reduce the considerable rates of restenosis and abrupt closure associated with balloon angioplasty. Current second-generation drug-eluting stents have very low abrupt closure and restenosis rates. Drug-eluting stents have performed favorably when compared with coronary artery bypass surgery in the treatment of patients with complex coronary artery disease. It is estimated that, in approximately one-third of such patients, treatment with these stents is an excellent alternative to coronary artery bypass surgery. Currently, coronary angioplasty with drug-eluting stents remains the preferred treatment of acute myocardial infarction, provided this can be done in timely fashion. With regard to patients with acute coronary syndrome, the benefit for angioplasty is greatest for those patients at moderate to high risk for cardiac complications. It is now accepted that most patients with stable ischemic heart disease are best managed with medical treatment rather than angioplasty.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"34 4","pages":"264-271"},"PeriodicalIF":0.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revascularization in Stable Coronary Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Nushrat Sultana, Francis J Ha, Anthony White, Adam J Brown, Nitesh Nerlekar","doi":"10.1055/a-2652-1902","DOIUrl":"10.1055/a-2652-1902","url":null,"abstract":"<p><p>The optimal management strategy for stable coronary artery disease (CAD) remains contentious. While revascularization benefits acute coronary syndromes, its role in stable CAD compared with medical therapy (MT) is less clear. This systematic review and meta-analysis evaluated the safety and efficacy of coronary revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) versus MT in patients with stable CAD. A systematic search identified randomized trials comparing revascularization with optimal MT in stable CAD. Trials included documented CAD via angiography and excluded acute coronary syndromes. The primary safety endpoint was all-cause mortality, non-fatal myocardial infarction (MI), and stroke. The primary efficacy endpoint also included unplanned revascularization, cardiac hospitalization, and major bleeding. The secondary endpoint included the percentage free from angina. Relative risk (RR) was calculated using random-effects models. Ten trials with 14,171 participants were included. There was no difference in the primary safety endpoint (RR 0.96 [0.90-1.03], <i>p</i>  = 0.23). The primary efficacy endpoint favored revascularization (RR 0.81 [0.69-0.96], <i>p</i>  = 0.01), primarily driven by unplanned revascularization (RR 0.5 [0.29-0.85], <i>p</i>  = 0.01), though with increased procedural MI risk (RR 2.21 [1.44-3.39], <i>p</i>  < 0.001). More patients had freedom from angina with revascularization compared with MT (71.8% vs. 62.9%, <i>p</i>  < 0.001). In stable CAD, initial revascularization did not improve outcomes for the primary safety endpoint; however, it did reduce unplanned revascularization compared with MT. More patients had freedom from angina in the revascularization arm, at the cost of increased procedural MI. Decision regarding optimal management strategy for stable CAD remains a patient-centered discussion, recognizing the largely symptomatic rather than prognostic benefit that patients derive from early revascularization.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"34 4","pages":"360-369"},"PeriodicalIF":0.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Life after Coronary Artery Bypass Grafting: Lifestyle Changes, Secondary Prevention, and Quality of Life.","authors":"Jaineet Chhabra, Mohamad Mubder, Nadia Tak, Nazanin Houshmand, Arsalan Siddiqui, Tillmann Cyrus, Tahir Tak","doi":"10.1055/a-2644-4370","DOIUrl":"10.1055/a-2644-4370","url":null,"abstract":"<p><p>Approximately 200 million people worldwide suffer from ischemic heart disease. Coronary artery bypass grafting (CABG) is known as a treatment option for multivessel and left main coronary artery disease, with better survival rates and lower major adverse cardiac events compared with medical therapy or percutaneous cardiovascular intervention alone in several cases. Lifestyle following CABG has been written about extensively; however, the creation of a general, evidence-based guide for both patients and physicians across different specialties appears necessary, given the overwhelming amount of literature available, the continued refinement of guidelines, and technological advancements over time. We reviewed the latest data on CABG in both the United States and worldwide, utilizing consensus statements from the American Heart Association/American College of Cardiology and European Society of Cardiology literature, as well as the PubMed database and UpToDate, to obtain the most up-to-date information on these topics. We then organized our findings into multiple categories detailing surgical techniques, postoperative care, medication types, long-term prognosis, the importance of cardiopulmonary rehabilitation, as well as future directions.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"34 4","pages":"332-343"},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Management of Coronary Artery Disease: An Update.","authors":"Darshan Hullon, Mohammad Bilal, Nicolas W Shammas","doi":"10.1055/a-2645-8838","DOIUrl":"10.1055/a-2645-8838","url":null,"abstract":"<p><p>Chronic coronary artery disease (CAD) remains a leading cause of global morbidity and mortality, necessitating a nuanced approach to long-term management. While revascularization strategies play a crucial role in select high-risk patients, optimal medical therapy (OMT) is the foundation of care for most individuals with stable disease. This review critically appraises contemporary pharmacological strategies for CAD, integrating the latest information from randomized trials and guideline-directed recommendations. Antihypertensive therapy, particularly renin-angiotensin system inhibitors and beta-blockers, remains central to reducing myocardial workload and preventing adverse cardiovascular events. Lipid-lowering agents, including high-intensity statins, ezetimibe, PCSK9 inhibitors, and inclisiran, have redefined risk stratification by demonstrating incremental reductions in low-density lipoprotein and atherosclerotic progression and event recurrence. The emergence of novel antidiabetic agents-SGLT2 inhibitors and GLP-1 receptor agonists-has expanded the therapeutic landscape, offering cardioprotective benefits independent of glycemic control. Additionally, the growing recognition of inflammation as a driver of CAD progression has led to the exploration of anti-inflammatory agents such as colchicine and interleukin-1 beta inhibitors. Landmark trials, including COURAGE, ISCHEMIA, and FREEDOM, reaffirm the noninferiority of OMT to revascularization in stable CAD, underscoring the need for an individualized approach. Future directions encompass precision medicine, artificial intelligence-driven risk stratification, and gene-based interventions, which may redefine therapeutic paradigms in CAD management.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"34 4","pages":"320-331"},"PeriodicalIF":0.8,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145481981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning-Based Ensemble Predictive Model for Cardiovascular Disease Prevention.","authors":"Neeraj Kumar, Rekha Agarwal, Lokesh Kumar Sharma, Rashmi Vashisth","doi":"10.1055/a-2644-4444","DOIUrl":"10.1055/a-2644-4444","url":null,"abstract":"<p><p>Cardiovascular diseases (CVDs) are a primary cause of death globally, with an increasing incidence in India. Machine learning (ML) has emerged as a viable approach for CVD prediction; however, dataset size and generalizability limit model robustness. This study aims to develop an enhanced ML prediction model for CVD detection using ensemble methods. Six datasets were considered, including 7,916 records with clinical parameters. The records were classified into Dataset 1 ( <i>n</i>  = 3,676) and Dataset 2 ( <i>n</i>  = 4,240) based on available features to establish a feature set. Dataset 1 underwent analysis utilizing two approaches: binary classification of target variable (0: absence of CVD, 1: presence of CVD) and multiclass classification of target variable (based on CVD severity). Likewise, Dataset 2 underwent further analysis using binary classification of target variable (risk of CVD in 10 years). Identical data preprocessing and exploratory data analysis steps were performed for both dataset groups. Subsequently, 18 ML algorithms were used to develop distinct models for both dataset groups, from which <i>LazyPredict</i> picked the top 10 performing models. The Voting Classifier was used to build an ensemble model to integrate the models and enhance predictive performance. In the case of Dataset 1, our framework was obtained an accuracy of 96.5% in binary classification and 85.5% in multiclass classification. Similarly, our framework achieved an accuracy of 81.18% for Dataset 2. Utilizing ensemble modeling and an extensive dataset, our framework surpasses traditional and existing ML models in predicting stability, mitigating bias and improving decision support in CVD detection.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"35 1","pages":"50-63"},"PeriodicalIF":0.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12909081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146213034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Through Catastrophe: Successful Unsheathed Stent Extraction in Acute Myocardial Infarction.","authors":"Joel Shah, Sidhartha Senapati, Tariq Siddiqui, Debabrata Mukherjee","doi":"10.1055/a-2641-8571","DOIUrl":"10.1055/a-2641-8571","url":null,"abstract":"<p><p>Stent detachment during coronary angioplasty may lead to life-threatening complications. Existing retrieval techniques may exacerbate risks, especially in narrow vessels. This case report introduces a rarely utilized wire braiding technique for stent retrieval, demonstrating its efficacy in a critical situation. A 55-year-old male with STEMI underwent an attempt at a complex angioplasty, resulting in stent detachment. Traditional retrieval methods were unsuccessful due to anatomical constraints. The wire braiding technique involved maneuvering a secondary buddy wire through the stent struts, interweaving with the primary wire, and extracting the stent. This versatile method can be utilized in confined spaces. This report illustrates the importance of the wire braiding technique as a means of minimizing procedural risks associated with stent detachment.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"35 2","pages":"147-150"},"PeriodicalIF":0.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Transthoracic Echocardiography and Multislice Computed Tomography in the Preoperative Assessment of Tetralogy of Fallot.","authors":"Van Hoang, Giang Tran Tra, Dong Tran Van, Duong Nguyen Dang, Dung Tran Ngoc","doi":"10.1055/a-2644-4520","DOIUrl":"10.1055/a-2644-4520","url":null,"abstract":"<p><strong>Background: </strong>Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, requiring precise anatomical assessment for optimal surgical planning. Transthoracic echocardiography (TTE) and multislice computed tomography (MSCT) are widely used imaging modalities for TOF evaluation, yet their relative diagnostic value, particularly in infants, remains an area of active investigation. This study aims to compare the diagnostic performance of TTE and MSCT in assessing intracardiac and extracardiac abnormalities in infants with TOF, with surgical findings as the reference standard.</p><p><strong>Materials and methods: </strong>A prospective, single-center study was conducted on 35 infants diagnosed with TOF who underwent both TTE and 128-slice MSCT before surgical repair. Imaging findings were compared with intraoperative measurements, evaluating the sensitivity, specificity, and agreement (Cohen's kappa) between modalities.</p><p><strong>Results: </strong>TTE and MSCT demonstrated comparable accuracy in assessing intracardiac abnormalities, with TTE showing slightly better agreement with surgical findings for ventricular septal defect (VSD) localization (κ = 0.581) than MSCT (κ = 0.485). Both modalities underestimated VSD size compared with intraoperative measurements, with MSCT showing a greater degree of underestimation ( <i>p</i>  < 0.001). In contrast, MSCT exhibited superior sensitivity in detecting extracardiac abnormalities, including coronary artery anomalies (100 vs. 50%) and major aortopulmonary collateral arteries (90 vs. 25%). While higher-generation MSCT scanners offer improved image resolution, the use of a 128-slice MSCT scanner proved to be a feasible alternative when more advanced technology is unavailable.</p><p><strong>Conclusion: </strong>TTE remains a reliable imaging modality for intracardiac assessment and is not inferior to MSCT in evaluating cardiac deformities in TOF. However, MSCT provides superior anatomical delineation of extracardiac structures, making it valuable for comprehensive preoperative planning. Despite its operator dependency, TTE remains the preferred first-line imaging tool due to its noninvasiveness and real-time functional assessment, whereas MSCT serves as a complementary modality, particularly for extracardiac evaluation. Further multicenter studies with larger cohorts are warranted to refine imaging protocols and optimize TOF assessment strategies in infants.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"35 2","pages":"90-97"},"PeriodicalIF":0.8,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Endovascular Treatment for Ruptured Atypical Aortoiliac Mycotic Aneurysm Cause from <i>Vibrio cholerae</i> : A Case Report.","authors":"Supong Worathanmanon, Boonprasit Kritpracha, Wittawat Tantarattanapong, Pong Jantarapatin, Pitikorn Srianakkawanich, Sorracha Rookkapan","doi":"10.1055/a-2640-0683","DOIUrl":"10.1055/a-2640-0683","url":null,"abstract":"<p><p>Mycotic aneurysms, a rare condition (0.6-1.3% incidence), pose significant mortality risks if untreated, even with surgical intervention. Diagnosis challenges arise from nonspecific presentations. An integrated approach involving clinical suspicion, examinations, inflammatory markers, blood culture, and imaging is crucial. While emerging endovascular treatments exist, conventional methods like surgical resection remain pivotal. This report highlights a unique case-a ruptured infected aortoiliac aneurysm caused by <i>Vibrio cholerae</i> -successfully treated with an endovascular strategy. The patient demonstrated favorable outcomes during a 17-month follow-up period.</p>","PeriodicalId":13798,"journal":{"name":"International Journal of Angiology","volume":"35 2","pages":"143-146"},"PeriodicalIF":0.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13171188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}