JACC. Cardiovascular interventions最新文献

{"title":"Side Branch Treatment Dilemma for Coronary Bifurcation Lesion","authors":"Salvatore Brugaletta MD, PhD , Dejan Milasinovic MD, PhD","doi":"10.1016/j.jcin.2026.02.037","DOIUrl":"10.1016/j.jcin.2026.02.037","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 973-975"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753683","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":"Relative Fractional Flow Reserve Increase and Final Fractional Flow Reserve After Percutaneous Coronary Intervention","authors":"Sang Yoon Lee MD ,&nbsp;Seung Hun Lee MD, PhD ,&nbsp;Doosup Shin MD ,&nbsp;Doyeon Hwang MD ,&nbsp;Jaewook Chung MD ,&nbsp;Eun-Seok Shin MD, PhD ,&nbsp;Chang-Wook Nam MD, PhD ,&nbsp;Joon-Hyung Doh MD, PhD ,&nbsp;Hyun-Jong Lee MD, PhD ,&nbsp;Akiko Matsuo MD ,&nbsp;Jun Shiraishi MD, PhD ,&nbsp;Shao-Liang Chen MD, PhD ,&nbsp;Hitoshi Matsuo MD, PhD ,&nbsp;Tsunekazu Kakuta MD, PhD ,&nbsp;Bon-Kwon Koo MD, PhD ,&nbsp;Taek Kyu Park MD, PhD ,&nbsp;Jeong Hoon Yang MD, PhD ,&nbsp;Young Bin Song MD, PhD ,&nbsp;Joo-Yong Hahn MD, PhD ,&nbsp;Seung-Hyuk Choi MD, PhD ,&nbsp;Joo Myung Lee MD, MPH, PhD","doi":"10.1016/j.jcin.2026.02.020","DOIUrl":"10.1016/j.jcin.2026.02.020","url":null,"abstract":"<div><h3>Background</h3><div>Post–percutaneous coronary intervention (PCI) fractional flow reserve (FFR) and relative FFR increase after PCI are determined by the interaction of baseline disease pattern, adequacy of PCI, and residual disease burden in a target vessel. However, the prognostic impact of relative FFR increase after PCI remains uncertain.</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate the prognostic relevance of relative FFR increase in addition to post-PCI FFR in patients undergoing PCI.</div></div><div><h3>Methods</h3><div>From the International Post PCI FFR Extended Registry, 1,497 patients with pre-PCI FFR ≤0.80 were analyzed. The relative FFR increase was expressed as a percentage and calculated as percentage FFR increase (ΔFFR%) with PCI ([post-PCI FFR − pre-PCI FFR]/pre-PCI FFR × 100). The primary endpoint was 5-year target vessel failure (TVF), a composite of cardiac death, target vessel myocardial infarction, or target vessel revascularization (TVR). TVR was further specified as target lesion revascularization (TLR) or non-TLR TVR.</div></div><div><h3>Results</h3><div>Maximally selected log-rank statistics identified 15.0% and 0.80 as the cutoffs to discriminate the occurrence of TVF for ΔFFR% and post-PCI FFR, respectively. Failure to meet either cutoff was associated with increased risk for TVF (ΔFFR%: 10.9% [122 of 1,148] vs 17.6% [59 of 349] [adjusted HR: 1.72; 95% CI: 1.23-2.42; <em>P</em> = 0.002]; post-PCI FFR: 10.9% [136 of 1,279] vs 21.3% [45 of 218] [adjusted HR: 2.08; 95% CI: 1.47-2.94; <em>P</em> &lt; 0.001]). Patients with post-PCI FFR ≤0.80 had increased TVF compared with those with post-PCI FFR &gt;0.80, regardless of sufficient (≥15.0%) or insufficient (&lt;15.0%) relative FFR increase. The higher risk for TVF in patients with post-PCI FFR ≤ 0.80 compared with those with post-PCI FFR &gt;0.80 was driven primarily by non-TLR TVR (2.2% vs 6.0%; <em>P</em> = 0.015) in the sufficient ΔFFR% group (≥15.0%), whereas it was attributable mainly to TLR (6.6% vs 17.0%; <em>P</em> = 0.008) in the insufficient ΔFFR% group (&lt;15.0%).</div></div><div><h3>Conclusions</h3><div>Relative FFR increase after PCI provides prognostic implications comparable with post-PCI FFR. Among patients with insufficient relative FFR increase, post-PCI FFR ≤0.80 was associated with an increased risk for restenosis within stented segments, whereas among those with sufficient relative FFR increase, post-PCI FFR ≤0.80 was associated with risk driven by disease progression in nonstented segments.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 976-987"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753684","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":"Drug-Coated Balloon Angioplasty vs Drug-Eluting Stents in Noncomplex Coronary Bifurcation Lesions","authors":"David Hildick-Smith MD","doi":"10.1016/j.jcin.2026.03.003","DOIUrl":"10.1016/j.jcin.2026.03.003","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 958-960"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753772","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":"Clinical Efficacy of the Cracking Technique for a Microcatheter-Uncrossable Calcified Lesion","authors":"Yuichi Suzuki MD,&nbsp;Kenichiro Suwa MD, PhD,&nbsp;Yuichiro Maekawa MD, PhD","doi":"10.1016/j.jcin.2026.01.295","DOIUrl":"10.1016/j.jcin.2026.01.295","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 1048-1049"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512032","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":"The 10 Commandments of PFO Pathophysiology and Patient Selection","authors":"Ashish H. Shah MD, MD-Research ,&nbsp;John D. Carroll MD","doi":"10.1016/j.jcin.2026.01.296","DOIUrl":"10.1016/j.jcin.2026.01.296","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 1042-1045"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512044","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":"Fully Teleoperated Peripheral Endovascular Interventions With a Novel Robotic System","authors":"Emiel W.M. Huistra MD ,&nbsp;Tomas Baltrunas MD, PhD ,&nbsp;Helmuts Kidikas MD ,&nbsp;Giovanni Federico Torsello MD ,&nbsp;Konstantinos Stavroulakis MD ,&nbsp;Lorenzo Patrone MD ,&nbsp;Vaidas Labunskas MSc ,&nbsp;Vilius Dambrauskas PhD ,&nbsp;Clark J. Zeebregts MD, PhD ,&nbsp;Dainis Krievins MD, PhD","doi":"10.1016/j.jcin.2025.12.021","DOIUrl":"10.1016/j.jcin.2025.12.021","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 1039-1041"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753596","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":"Cold Laser vs Excimer Laser in Lower Limb Atherosclerosis","authors":"Hui Wang MD ,&nbsp;Jinbao Qin MD ,&nbsp;Chao Liu MD ,&nbsp;Xixiang Gao MD ,&nbsp;Lianghua Ma MD ,&nbsp;Shijun Cui MD ,&nbsp;Xinwu Lu MD ,&nbsp;Shaoying Lu MD ,&nbsp;Zhifeng Huang MD ,&nbsp;Zhu Tong MD ,&nbsp;Lianrui Guo MD ,&nbsp;Jianming Guo MD","doi":"10.1016/j.jcin.2026.02.036","DOIUrl":"10.1016/j.jcin.2026.02.036","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral artery disease (PAD) caused by atherosclerotic stenosis or occlusion of the arteries of the lower extremities is a major global health concern. Despite advances in endovascular therapies, treating complex lesions such as heavily calcified segments and chronic total occlusions remains challenging, which limits procedural success and long-term patency. The novel 355-nm cold laser atherectomy (CLA) system offers a photochemical, low-thermal approach to plaque ablation, with potential advantages in safety and efficacy.</div></div><div><h3>Objectives</h3><div>The aim of this study was to evaluate the safety and efficacy of a 355-nm CLA system for treating lower limb atherosclerotic stenosis and occlusion in a prospective, multicenter, randomized controlled trial.</div></div><div><h3>Methods</h3><div>This trial enrolled 110 patients with symptomatic lower extremity PAD (Rutherford classes 2-5) and ≥70% stenosis or occlusion. Patients were randomly assigned to the CLA and excimer laser atherectomy (ELA) groups. The primary endpoint was improvement in vessel diameter stenosis (DS%) prior to any adjunctive therapy. Secondary endpoints included primary patency, target lesion revascularization (TLR), Rutherford classification improvement, and ankle-brachial index values at 30 days and 6 months postoperatively, as well as a device-oriented composite endpoint.</div></div><div><h3>Results</h3><div>A total of 109 patients (CLA, n = 58; ELA, n = 51) were included in the analysis. Baseline demographics and comorbidities were well balanced between the groups. Postprocedural DS% improved significantly in both groups, with no significant intergroup differences (CLA, 59.92% ± 15.02%; ELA, 57.52% ± 17.22%; <em>P</em> = 0.438). The mean improvement in DS% (CLA, 34.28%; ELA, 34.35%) met the noninferiority threshold. At 30 days, the primary patency rates were 85.1% (CLA) and 87.8% (ELA), with TLR rates of 0.0% and 1.9%, respectively. At 6 months, patency decreased to 71.7% (CLA) and 61.5% (ELA), and TLR occurred in 6.5% and 10.2% of patients, respectively (<em>P</em> = 0.698). Ankle-brachial index values and Rutherford classification improved similarly in the 2 groups. Subgroup analyses revealed that for TASC (Trans-Atlantic Inter-Society Consensus) C/D and long lesions (≥10 cm), CLA had lower TLR rates at 6 months (<em>P</em> &lt; 0.05), suggesting potential advantages for complex lesions.</div></div><div><h3>Conclusions</h3><div>The 355-nm CLA system showed similar safety and efficacy to the excimer laser, with a trend toward reducing TLR in complex PAD lesions. These findings highlight its potential as a next-generation endovascular tool that could refine revascularization strategies and improve patient outcomes in clinical practice. (DCB for Dialysis Access Stent Graft Restenosis; <span><span>NCT03360279</span><svg><path></path></svg></span>)</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 1021-1035"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753615","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":"Lighting the Way Forward?","authors":"J. Stephen Jenkins MD","doi":"10.1016/j.jcin.2026.02.034","DOIUrl":"10.1016/j.jcin.2026.02.034","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 1036-1038"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753680","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":"Validation of Wound, Ischemia, and Foot Infection Classification in Infrapopliteal Arterial Disease Undergoing Endovascular Therapy","authors":"Julong Guo MD ,&nbsp;Jianming Guo MD ,&nbsp;Xixiang Gao MD ,&nbsp;Zibo Feng MD ,&nbsp;Ziheng Wu MD ,&nbsp;Chunshui He MD ,&nbsp;Qiang Li MD ,&nbsp;Xin Fang MD ,&nbsp;Hongfei Sang MD ,&nbsp;Zhenyu Shi MD ,&nbsp;Weihao Shi MD ,&nbsp;Hui Zhuang MD ,&nbsp;Wei Zhang PhD ,&nbsp;Zhu Tong MD ,&nbsp;Meng Ye MD ,&nbsp;Lianrui Guo MD","doi":"10.1016/j.jcin.2026.01.311","DOIUrl":"10.1016/j.jcin.2026.01.311","url":null,"abstract":"<div><h3>Background</h3><div>The Wound, Ischemia, and Foot Infection (WIfI) classification system was proposed to improve risk stratification and prognostic prediction in chronic limb-threatening ischemia patients.</div></div><div><h3>Objectives</h3><div>The aim of this prospective, multicenter observational study was to evaluate the prognostic value of the WIfI classification in patients with infrapopliteal arterial occlusive disease undergoing endovascular therapy.</div></div><div><h3>Methods</h3><div>Patients from 10 Chinese centers were enrolled. The primary outcome was 12-month freedom from major adverse events (MAE), which was a composite of major amputation, all-cause death, and clinically driven target limb reintervention. Secondary outcomes included amputation-free survival and the composite components of the primary outcome.</div></div><div><h3>Results</h3><div>This study involved 944 patients (975 limbs). Cox regression analysis identified WIfI stage as an independent predictor of MAE (HR: 1.23; 95% CI: 1.06-1.43; <em>P</em> = 0.007). Additionally, WIfI stage was independently associated with combined major amputation or all-cause death (HR: 1.41; 95% CI: 1.18-1.69; <em>P</em> &lt; 0.001) and with all-cause death alone (HR: 1.38; 95% CI: 1.12-1.70; <em>P</em> = 0.002). WIfI stage 4 carried a consistently higher risk for these 3 endpoints compared with stages 1 to 3. Although WIfI stage was independently linked to major amputation, pairwise comparisons did not show significant differences among stages. No independent association was observed between WIfI stage and clinically driven target lesion reintervention.</div></div><div><h3>Conclusions</h3><div>Although the WIfI classification system shows predictive ability for MAE, amputation-free survival, major amputation, and all-cause death, the prognostic differences are driven primarily by stage 4.</div></div>","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Pages 1004-1017"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753613","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":"Beyond Post-PCI IMR","authors":"Ioannis Skalidis MD, PhD,&nbsp;Giacomo Maria Cioffi MD,&nbsp;Julius Jelisejevas MD,&nbsp;Stephane Cook MD,&nbsp;Mario Togni MD","doi":"10.1016/j.jcin.2026.02.035","DOIUrl":"10.1016/j.jcin.2026.02.035","url":null,"abstract":"","PeriodicalId":14688,"journal":{"name":"JACC. Cardiovascular interventions","volume":"19 8","pages":"Page 1055"},"PeriodicalIF":11.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147753830","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}