JACC. Cardiovascular interventions最新文献

Characteristics, Trends, and Outcomes of Intravascular Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Replacement in United States 美国血管内碎石辅助经股动脉经导管主动脉瓣置换术的特点、趋势和结果

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.08.033

{"title":"Characteristics, Trends, and Outcomes of Intravascular Lithotripsy-Assisted Transfemoral Transcatheter Aortic Valve Replacement in United States","authors":"","doi":"10.1016/j.jcin.2024.08.033","DOIUrl":"10.1016/j.jcin.2024.08.033","url":null,"abstract":"<div><h3>Background</h3><div>Transfemoral (TF) access is the preferred approach for transcatheter aortic valve replacement (TAVR). Limited data exist regarding the outcomes of intravascular lithotripsy (IVL)-assisted TF TAVR in patients with peripheral artery disease.</div></div><div><h3>Objectives</h3><div>This study sought to examine contemporary characteristics, trends, and outcomes of IVL TAVR in the United States.</div></div><div><h3>Methods</h3><div>The Vizient Clinical Database was queried for patients who underwent percutaneous TAVR between October 1, 2020, and November 30, 2023. Outcomes with IVL TAVR vs non–IVL TAVR were examined after propensity score matching. The primary outcome was a composite of in-hospital death, stroke, vascular complications, surgical vascular intervention, and major bleeding.</div></div><div><h3>Results</h3><div>Over the study period, 129,655 patients (mean age of 78.4 years, 42.2% women, 87.1% White) underwent percutaneous TAVR at 361 hospitals, 1,242 (0.96%) of whom underwent IVL TAVR. There was an uptrend in IVL TAVR, but the frequency remained low. IVL TAVR patients had a higher median Elixhauser comorbidity score (5 [Q1-Q3: 4-7] vs 4 [Q1-Q3: 3-6]) compared to non–IVL TAVR. TAVR was completed via the TF approach in 1,238 (99.7%) IVL TAVR patients. In a 3:1 propensity score matching analysis, IVL TAVR was associated with a higher rate of the primary composite outcome (21.9% vs 13.7%; <em>P</em> < 0.001) driven by higher rates of vascular complications, surgical vascular intervention, and major bleeding. In-hospital death and stroke were similar in both groups.</div></div><div><h3>Conclusions</h3><div>In the United States, IVL is increasingly adopted to facilitate TF TAVR. IVL TAVR patients exhibited a higher burden of comorbidities and experienced more complications compared to non–IVL TAVR patients. Further studies are needed to identify appropriate anatomical and clinical use criteria for IVL TAVR and to compare its outcomes vs alternative non–TF TAVR.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535113","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

Chronic Spontaneous Coronary Artery Dissection 慢性自发性冠状动脉夹层

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.09.008

引用次数: 0

Full Issue PDF 全期 PDF

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/S1936-8798(24)01402-X

引用次数: 0

Stay Calm and Carry On With Intravascular Lithotripsy–Assisted Transfemoral-TAVR in Patients With Calcific-Iliofemoral Artery Disease? 钙化性股动脉疾病患者在血管内碎石辅助经股动脉-TAVR术中保持冷静并继续治疗？

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.09.049

引用次数: 0

Salvage Pulmonary Artery Thrombectomy for High-Risk Pulmonary Embolism Patients Requiring Venoarterial Extracorporeal Membrane Oxygenation Support 为需要静脉体外膜氧合支持的高风险肺栓塞患者实施肺动脉血栓抢救性切除术

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.08.017

引用次数: 0

The Promise and Challenges of Pressure-Guided Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension 压力引导下球囊肺血管成形术治疗慢性血栓栓塞性肺动脉高压的前景与挑战

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.09.013

引用次数: 0

Impact of Severity and Extent of Iliofemoral Atherosclerosis on Clinical Outcomes in Patients Undergoing TAVR 髂股动脉粥样硬化的严重程度和范围对接受 TAVR 患者临床结果的影响

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.07.009

{"title":"Impact of Severity and Extent of Iliofemoral Atherosclerosis on Clinical Outcomes in Patients Undergoing TAVR","authors":"","doi":"10.1016/j.jcin.2024.07.009","DOIUrl":"10.1016/j.jcin.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Vascular complications remain a major concern in transfemoral transcatheter aortic valve replacement (TAVR). The Hostile score has been proposed to stratify risk in TAVR patients with peripheral artery disease.</div></div><div><h3>Objectives</h3><div>The authors aimed to assess the validity of the Hostile score in predicting iliofemoral vascular complications after TAVR.</div></div><div><h3>Methods</h3><div>In a prospective TAVR registry, we validated the Hostile score for the prediction of puncture and non–puncture site vascular complications. This scoring system integrates the extent (number of lesions, lesion length, and minimum lumen diameter) and complexity (tortuosity, calcification, and the presence of obstruction) of iliofemoral atherosclerosis.</div></div><div><h3>Results</h3><div>Of 2,023 patients who underwent transfemoral TAVR with contemporary devices between March 2014 and June 2022, 106 (5.2%) patients experienced puncture site vascular complications and 28 (1.4%) patients experienced non–puncture site vascular complications. The Hostile score was higher in patients with vascular complications than those without complications (1.00 [Q1-Q3: 0-5.00] vs 1.00 [Q1-Q3: 0-4.00]; <em>P</em> < .001). A higher body mass index (OR: 1.23; 95% CI: 1.04-1.50) and the use of Prostar (OR: 6.03; 95% CI: 2.23-16.30) or MANTA (OR: 6.18; 95% CI: 2.67-14.27) compared with ProGlide were independent predictors of puncture site vascular complications, whereas a higher Hostile score (OR: 1.91; 95% CI: 1.55-2.35) and female sex (OR: 2.69; 95% CI: 1.12-6.42) were independent predictors of non–puncture site vascular complications. The area under the receiver-operating characteristic curves for the prediction of puncture site and non–puncture site vascular complications were 0.554 and 0.829, respectively.</div></div><div><h3>Conclusions</h3><div>The Hostile score proved useful in predicting non–puncture site vascular complications after TAVR. (SwissTAVI Registry; <span><span>NCT01368250</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465741","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

Trends, Predictors, and Outcomes of Bleeding Complications After Mitral Transcatheter Edge-to-Edge Repair 二尖瓣经导管边缘到边缘修复术后出血并发症的趋势、预测因素和结果

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.09.035

{"title":"Trends, Predictors, and Outcomes of Bleeding Complications After Mitral Transcatheter Edge-to-Edge Repair","authors":"","doi":"10.1016/j.jcin.2024.09.035","DOIUrl":"10.1016/j.jcin.2024.09.035","url":null,"abstract":"<div><h3>Background</h3><div>Bleeding events after arterial transcatheter procedures are associated with increased morbidity and mortality. The frequency and clinical implications of bleeding after mitral transcatheter edge-to-edge repair (M-TEER) have not been well-studied.</div></div><div><h3>Objectives</h3><div>The authors sought to explore the association of in-hospital bleeding events after M-TEER with patient outcomes.</div></div><div><h3>Methods</h3><div>Patients undergoing M-TEER who were included in the TVT (Transcatheter Valve Therapy) Registry between 2013 and 2022 were included. Rates of the primary endpoint, the composite of death or hospital readmission at 30 days, were compared between patients who experienced in-hospital major or life-threatening bleeding vs those without bleeding. Secondary analyses examined the association between in-hospital bleeding and death or readmission at 1 year, as well as independent predictors of major in-hospital bleeding.</div></div><div><h3>Results</h3><div>Over the study period, in-hospital major bleeding occurred in 1,205 (2.3%) of 51,533 patients. Rates of bleeding decreased over time (from 7.1% in 2013 to 2.0% in 2021; <em>P</em> < 0.001). In-hospital bleeding was associated with increased rates of death or readmission at both 30 days (adjusted OR: 2.15 [95% CI: 1.81-2.54]; <em>P</em> < 0.0001) and 1 year (adjusted HR: 1.43 [95% CI: 1.27-1.60]; <em>P</em> < 0.0001). The strongest correlates of in-hospital bleeding included female sex, prior percutaneous coronary intervention, baseline hemoglobin, greater procedure acuity, and longer procedure duration.</div></div><div><h3>Conclusions</h3><div>Bleeding after M-TEER is associated with increased risk of subsequent death and hospital readmission. Although reductions in bleeding complications over time are encouraging, continued efforts are needed to further mitigate hemorrhagic complications of M-TEER.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":null,"pages":null},"PeriodicalIF":11.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535111","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

Bleeding After Transcatheter Structural Valve Interventions 经导管结构瓣膜介入术后出血

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.09.036

引用次数: 0

Toward Effective EVT for ALI 实现 ALI 的有效 EVT

IF 11.7 1区医学

JACC. Cardiovascular interventions Pub Date : 2024-10-28 DOI: 10.1016/j.jcin.2024.09.037

引用次数: 0