JACC. Cardiovascular interventions最新文献

{"title":"The WOLVERINE Technique: Wire Landmark-Guided Orientation Controlled Leaflet-Resection to Prevent Left-Ventricular Outflow-Tract Obstruction Using Endoscopic-Scissors in TMVR Procedures.","authors":"Leo Kar Lok Lai, Hussayn Alrayes, Georgi Fram, John Dawdy, James C Lee, Brian P O'Neill, Tiberio M Frisoli, Pedro Engel Gonzalez, William W O'Neill, Pedro A Villablanca","doi":"10.1016/j.jcin.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.jcin.2025.06.014","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":" ","pages":""},"PeriodicalIF":11.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698576","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":"Novel Percutaneous Septectomy for Left Atrial Myxoma","authors":"Barbara A. Danek MD , Joseph Park MD , David Elison MD , Christine J. Chung MD , G. Burkhard Mackensen MD, PhD , James M. McCabe MD","doi":"10.1016/j.jcin.2025.04.030","DOIUrl":"10.1016/j.jcin.2025.04.030","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1699-1701"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325739","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":"Vessel Patency After Femoropopliteal Drug-Coated Balloon Therapy in Patients on Hemodialysis","authors":"Yasutaka Yamauchi MD, PhD ,&nbsp;Mitsuyoshi Takahara MD, PhD ,&nbsp;Yoshimitsu Soga MD, PhD ,&nbsp;Osamu Iida MD, PhD ,&nbsp;Akiko Tanaka MD ,&nbsp;Kazuki Tobita MD ,&nbsp;Daizo Kawasaki MD, PhD ,&nbsp;Masahiko Fujihara MD ,&nbsp;Amane Kozuki MD, PhD ,&nbsp;Akira Miyamoto MD, PhD","doi":"10.1016/j.jcin.2025.05.001","DOIUrl":"10.1016/j.jcin.2025.05.001","url":null,"abstract":"<div><h3>Background</h3><div>Drug-coated balloons (DCBs) are widely used as a core treatment for femoropopliteal lesions, but no largescale prospective studies have evaluated DCB in hemodialysis (HD) patients.</div></div><div><h3>Objectives</h3><div>The authors sought to clarify restenosis risk and associated factors after DCB therapy for symptomatic femoropopliteal artery disease in patients on HD.</div></div><div><h3>Methods</h3><div>We analyzed the database of a multicenter prospective study that registered patients undergoing DCB treatment (either Lutonix or IN.PACT Admiral) from March 2018 to December 2019. Of the 3,165 registered lesions, 991 lesions were in patients on HD. The primary outcome was freedom from restenosis.</div></div><div><h3>Results</h3><div>The HD group was younger (72 ± 9 years vs 76 ± 9 years) and had a higher frequency of diabetes (76.5% [557/728 patients]) vs 60.8% [1,081/1,779 patients]). The prevalence of chronic limb-threatening ischemia was 52.2% (444/850 patients) vs 22.1% (437/1,977 patients). Lutonix was used in 30.6% (688/991 lesions) vs 21.3% (462/2,174 lesions), and IN.PACT Admiral was used in 69.4% (303/991 lesions) vs 78.7% (1,712/2,174 lesions). After propensity-score matching, the 1- and 3-year rates of freedom from restenosis in the HD and non-HD groups were 82.2% (95% CI: 79.0%-85.3%) vs 85.8% (83.0%-88.7%) at 1 year and 61.9% (57.7%-66.1%) vs 66.3% (62.2%-70.4%) at 3 years, respectively. In the HD group, restenosis occurred in 363 lesions during a median follow-up of 16.2 months (Q1-Q3: 7.2-35.5 months). Factors independently associated with restenosis risk in the HD group were no below-the-knee runoff, history of endovascular therapy, popliteal lesion, severe calcification, use of Lutonix, and severe dissection.</div></div><div><h3>Conclusions</h3><div>DCB endovascular therapy is a reasonable treatment for femoropopliteal lesions in patients on HD.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1660-1670"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632521","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":"Aortic Tortuosity as a Predictor of Surgical Bailout and Adverse Outcomes in TAVR","authors":"Thomas Lohse MD,&nbsp;Ahmad Hayek MD, MSc,&nbsp;Brahim Harbaoui MD, PhD","doi":"10.1016/j.jcin.2025.01.447","DOIUrl":"10.1016/j.jcin.2025.01.447","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Page 1717"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991044","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 Value of Microvascular Function in Takotsubo Syndrome","authors":"Rob Eerdekens MD, MSc ,&nbsp;Mohamed El Farissi MD, PhD ,&nbsp;Giovanni Luigi De Maria MD, PhD ,&nbsp;Aviel Shetrit MD ,&nbsp;Robert Sykes MBChB, MSc ,&nbsp;Christina Ekenbäck MD, PhD ,&nbsp;Jonas Persson MD, PhD ,&nbsp;Jonas Spaak MD, PhD ,&nbsp;Liam S. Couch MBBS, PhD ,&nbsp;Fernando Alfonso MD, PhD ,&nbsp;Fernando Rivero MD, PhD ,&nbsp;Nieves Gonzalo MD, PhD ,&nbsp;Javier Escaned MD, PhD ,&nbsp;Iván J. Núñez Gil MD, PhD ,&nbsp;Oscar Vedia Cruz MD ,&nbsp;Reut Amar Shamir MD ,&nbsp;Ophir Freund MD ,&nbsp;Marc Vanderheyden MD ,&nbsp;Marta Belmonte MD ,&nbsp;Emanuele Barbato MD, PhD ,&nbsp;Frederik M. Zimmermann MD, PhD","doi":"10.1016/j.jcin.2025.05.028","DOIUrl":"10.1016/j.jcin.2025.05.028","url":null,"abstract":"<div><h3>Background</h3><div>Coronary microvascular dysfunction appears to play a major role in the pathogenesis of Takotsubo syndrome (TTS). However, the prognostic value of microvascular function measured in the acute phase of TTS is unclear.</div></div><div><h3>Objectives</h3><div>This study sought to assess the prognostic value of microvascular function measured invasively in the acute phase of TTS.</div></div><div><h3>Methods</h3><div>In a collaborative, pooled analysis of individual patient data from 9 prospective TTS cohorts, invasive assessment of coronary microvascular function was performed, including the index of microcirculatory resistance (IMR), coronary flow reserve, and microvascular resistance reserve. The primary endpoint was all-cause mortality. Secondary endpoints included major adverse cardiac and cerebrovascular events (MACCE) defined as the composite of all-cause death, recurrence of TTS, stroke, transient ischemic attack, or myocardial infarction.</div></div><div><h3>Results</h3><div>A total of 166 patients with TTS were included, in whom 130 (78%) had the typical (apical) TTS variant and 36 (22%) had an atypical variant. During a median follow-up of 20.6 [4.3-60.0] months, all-cause mortality occurred in 17 patients (10.2%) and MACCE in 29 patients (17.5%). IMR, coronary flow reserve, and microvascular resistance reserve were associated with all-cause mortality. After adjustment for baseline differences, IMR was the only independent predictor of both all-cause mortality (aHR: 3.9; 95% CI: 1.39-10.88; <em>P</em> = 0.010; c-statistic 0.817; 95% CI: 0.711-0.923) and MACCE (aHR: 2.6; 95% CI: 1.17-5.67; <em>P</em> = 0.018; c-statistic 0.719; 95% CI: 0.612-0.826).</div></div><div><h3>Conclusions</h3><div>In this pooled analysis of individual patient data from 9 prospective TTS cohorts, microvascular dysfunction measured in the acute phase was associated with all-cause mortality. In particular, an elevated microvascular resistance, as assessed by IMR, was the only independent predictor of both mortality and MACCE.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1646-1656"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136656","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":"Randomized Comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in Serial Disease","authors":"Matthew E. Li Kam Wa MBBS ,&nbsp;Saad M. Ezad MBBCh ,&nbsp;Bhavik Modi PhD ,&nbsp;Ozan M. Demir PhD ,&nbsp;Jonathan Hinton MD ,&nbsp;Howard Ellis BSc ,&nbsp;Kalpa De Silva PhD ,&nbsp;Ankur Gulati MD ,&nbsp;Ranil De Silva PhD ,&nbsp;Peter O’Kane MD ,&nbsp;Abdel Douiri PhD ,&nbsp;Damien Collison MD ,&nbsp;Nick Curzen PhD ,&nbsp;Carlos Collet PhD ,&nbsp;Divaka Perera MD","doi":"10.1016/j.jcin.2025.05.033","DOIUrl":"10.1016/j.jcin.2025.05.033","url":null,"abstract":"<div><h3>Background</h3><div>Fractional flow reserve (FFR) and the instantaneous wave-free ratio (iFR) identify arteries that benefit from percutaneous coronary intervention (PCI). FFR or iFR gradients on pullback are often used to predict the physiological result (FFR_Δ or iFR_Δ), but this approach is unvalidated.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare the accuracy of FFR_Δ, iFR_Δ and FFR_calc (a mathematical solution incorporating interaction between lesions) for predicting post-PCI physiology in serial or diffuse disease.</div></div><div><h3>Methods</h3><div>Patients with a focal target lesion and either a second focal lesion or a diffusely diseased segment in the same vessel were randomized to FFR- vs iFR-guided PCI (<span><span>ISRCTN18106869</span><svg><path></path></svg></span>). FFR and iFR pullbacks were performed, with operators blinded to one modality. Following target lesion PCI, FFR and iFR were remeasured. The primary outcome was the error in predicted post-PCI physiology compared with actual values.</div></div><div><h3>Results</h3><div>A total of 87 patients were randomized to FFR (n = 45) or iFR (n = 42). Median FFR and iFR were 0.70 (Q1-Q3: 0.62 to 0.78) and 0.81 (Q1-Q3: 0.68 to 0.90) at baseline and 0.82 (Q1-Q3: 0.74 to 0.87) and 0.89 (Q1-Q3: 0.83 to 0.93) after target lesion PCI. The predictive errors were 12% (6% to 17%) for FFR_Δ, 4% (0% to 9%; <em>P</em> &lt; 0.001) for iFR_Δ, and −5% (−18% to 8%; <em>P</em> = 0.427) for FFR_calc. Significant residual disease was missed in 36% of cases with FFR_Δ, 34% with iFR_Δ, and 14% with FFR_calc.</div></div><div><h3>Conclusions</h3><div>FFR and iFR pullback gradients overestimate the benefit of target lesion PCI and can miss residual ischemia in one-third of patients. FFR or iFR should be routinely repeated post-PCI in serial disease.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1617-1627"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632522","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":"Outcomes of Lesions With Discordance Between FFR and Nonhyperemic Pressure Ratios","authors":"Edward T. Ha MD ,&nbsp;Takeshi Nishi MD ,&nbsp;Tatsunori Takahashi MD ,&nbsp;Tatsuro Yamazaki MD ,&nbsp;Yuichi Saito MD ,&nbsp;Shoichi Kuramitsu MD ,&nbsp;Yoshiaki Kawase MD ,&nbsp;Manish A. Parikh MD ,&nbsp;Ron Waksman MD ,&nbsp;Yuhei Kobayashi MD","doi":"10.1016/j.jcin.2025.05.032","DOIUrl":"10.1016/j.jcin.2025.05.032","url":null,"abstract":"<div><h3>Background</h3><div>Discordance between fractional flow reserve (FFR) and nonhyperemic pressure ratios (NHPRs) can occur in about 20% of clinical cases, creating treatment dilemmas in the cardiac catheterization laboratory.</div></div><div><h3>Objectives</h3><div>The authors sought to perform a systematic review and meta-analyses investigating the long-term outcome of deferral strategy in patients found to have discordant physiology.</div></div><div><h3>Methods</h3><div>The primary comparison tested the long-term prognosis of patients who were deferred for discordant physiology vs those deferred for concordant negative results. Various NHPRs were compared with FFR. The primary endpoint was a composite of death (all-cause or cardiac) and myocardial infarction/revascularization with several definitions. Secondary endpoint consisted of death or myocardial infarction. The study is registered with PROSPERO (<span><span>CRD42024628393</span><svg><path></path></svg></span>).</div></div><div><h3>Results</h3><div>Six eligible trials with 9,854 intermediate lesions deferred for PCI were considered in the analysis. Compared with concordant-negative physiology (FFR⁻/NHPRs⁻), deferral of PCI for discordant physiology was associated with an increase in the primary endpoints (FFR⁻/NHPRs⁺: HR: 2.73 [1.95-3.80]; <em>P</em> &lt; 0.00001 and FFR⁺/NHPRs⁻: HR: 3.29[2.33-4.64]; <em>P</em> &lt; 0.00001). Secondary dichotomous analysis showed that deferral of PCI in both discordant groups was associated with an increase in the hard endpoints (death or myocardial infarction) compared with concordant-negative physiology. Exploratory analysis comparing revascularization vs deferral groups within discordant physiology demonstrated reduction in the primary endpoint in the FFR⁺/NHPRs⁻ group, but not in the FFR⁻/NHPRs⁺ group.</div></div><div><h3>Conclusions</h3><div>Deferral of PCI in discordant-physiology was associated with worse long-term outcomes compared with the concordant-negative physiology. There may be a benefit of revascularization in FFR⁺/NHPRs⁻ lesions, which requires further investigation.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1631-1642"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632526","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":"Comparing Coronary Physiology Responses to Adenosine, Dobutamine, and Physical Exercise in Myocardial Bridges","authors":"Aish Sinha PhD,&nbsp;Holly P. Morgan PhD,&nbsp;Matthew Li Kam Wa MBBS,&nbsp;Matthew Ryan PhD,&nbsp;Ozan M. Demir PhD,&nbsp;Saad Ezad MBBS,&nbsp;Kalpa De Silva PhD,&nbsp;Howard Ellis BSc,&nbsp;Divaka Perera MD,&nbsp;Haseeb Rahman PhD","doi":"10.1016/j.jcin.2025.04.023","DOIUrl":"10.1016/j.jcin.2025.04.023","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1706-1708"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234130","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":"Common Femoral Artery Occlusion Secondary to Arterial Telescoping During ProStyle Deployment","authors":"Fidan Damirova MSc ,&nbsp;David N. Hakim MBBCh ,&nbsp;Alexander Tindale PhD ,&nbsp;Nearchos Hadjiloizou PhD ,&nbsp;Sarah Onida PhD ,&nbsp;Adam Hartley PhD","doi":"10.1016/j.jcin.2025.04.021","DOIUrl":"10.1016/j.jcin.2025.04.021","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1691-1693"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325735","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":"Reviving Hope","authors":"Maxime Dubosq-Lebaz MD,&nbsp;Eric A. Secemsky MD","doi":"10.1016/j.jcin.2025.06.006","DOIUrl":"10.1016/j.jcin.2025.06.006","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"18 13","pages":"Pages 1671-1674"},"PeriodicalIF":11.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632520","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}