Journal of Transcatheter Interventions最新文献

{"title":"Follow-up protocol for patients with delayed skin reactions due to interventional cardiology procedures: follow-up of patients with skin reactions due to radiation","authors":"Patrícia Barbosa, Adriano Barbosa, Pedro Romanini, Heiglon Denti, Marcos Florian, Regina B Medeiros","doi":"10.31160/jotci202331a20230018","DOIUrl":"https://doi.org/10.31160/jotci202331a20230018","url":null,"abstract":"Interventional cardiology procedures can generate high doses of ionizing radiation and delayed skin reactions in patients undergoing complex procedures with a substantial radiation dose level. Since 2014, we have implemented, in the cath lab, the monitoring of patients undergoing procedures with a substantial radiation dose level, to identify these patients and provide patient care support. We present two case reports of such patients, who are undergoing dermatological treatment. The implemented protocol provided specialized treatment for the patients and awareness of radiation safety among health workers.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140266710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two risk models in predicting contrast-induced nephropathy after coronary computed tomography angiography and percutaneous coronary intervention","authors":"Valentin Trevizani Neto, Layla Lott, Davi Rios, Priscila Lima, Mário Bazzarella, Izabela Muniz, Sabrina Pereira, Vitor Rolim, Renato Serpa, O. Calil, Luiz Barbosa, Roberto Babosa","doi":"10.31160/jotci202331a20230011","DOIUrl":"https://doi.org/10.31160/jotci202331a20230011","url":null,"abstract":"Background Contrast-induced nephropathy is one of the main causes of hospital-acquired acute renal failure. The Mehran risk score and the contrast medium volume used/creatinine clearance ratio could help identifying patients at higher risk of developing contrast-induced nephropathy. This study aimed to compare these two scores. Methods A retrospective, single-center observational study including hospitalized patients with baseline creatinine >1.3mg/dL, under observation for at least 48 hours after coronary computed tomography angiography and/or percutaneous coronary intervention. Mehran risk score and contrast medium volume used/creatinine clearance ratio were calculated for all patients, and the incidence of contrast-induced nephropathy was analyzed according to different cutoff points of both scores. Receiver Operating Characteristic curves were plotted to determine the accuracy of the methods in predicting contrast-induced nephropathy. The effectiveness of both methods was analyzed using Pearson’s correlation test. Results We included 102 patients and the incidence of contrast-induced nephropathy was 27.4%. The outcome occurred in 24.7% of patients when Mehran risk score ≥6, in 32.7% when Mehran risk score ≥10, and in 57.8% when Mehran risk score ≥15, in 28.7% of patients with contrast medium volume used/creatinine clearance ratio ≥2, 29.8% with contrast medium volume used/creatinine clearance ratio ≥3, and 34.3% with contrast medium volume used/creatinine clearance ratio ≥5. Receiver Operating Characteristic curves demonstrated area under the curve with moderate predictive capacity for Mehran risk score (0.7), and reduced/borderline for contrast medium volume used/creatinine clearance ratio (0.6). The correlation between the two scores was moderate. Conclusion Mehran risk score demonstrated greater accuracy in predicting contrast-induced nephropathy when compared to contrast medium volume used/creatinine clearance ratio, however both presented similar values. The cutoff points with the closest incidence between the two scores were ≥10 for Mehran risk score (32.7%) and ≥5 for volume used/creatinine clearance ratio (34.3%).","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139264586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous occlusion of sinus venosus atrial septal defect using a covered stent: the importance of imaging methods for printing three-dimensional models and better clinical decision-making","authors":"Pablo Teixerense, Ariane Pacheco, Maximiliano Lacoste, Wilson Guimarães Neto, João Toledo, Luiz Gubolino","doi":"10.31160/jotci202331a20230010","DOIUrl":"https://doi.org/10.31160/jotci202331a20230010","url":null,"abstract":"A superior sinus venosus atrial septal defect is usually accompanied by an anomalous venous connection to a right superior or middle pulmonary vein or veins, draining directly into the superior vena cava or even into the cavoatrial junction. This is a case report of a 62-year-old female patient, diagnosed with a sinus venosus atrial septal defect, with overload of the right chambers, for whom a percutaneous occlusion procedure was planned, using a previous cardiovascular tomography and, sequentially, a three-dimensional anatomical study, with the publicly available software 3D Slicer. In addition, a resin model was printed for inspection and simulation of a stent implantation. The patient was treated percutaneously with a 60-mm covered Chetham-Platinum stent, with total occlusion of the defect, absence of residual shunts, and draining flow from the right superior pulmonary vein to the left atrium, through a posterior communication between the atria, a sine qua non prerequisite to perform this type of procedure. Planning of the percutaneous occlusion procedure of the sinus venosus atrial septal defect involves careful evaluation of imaging tests. The printing of virtual or physical models, derived from computed tomography angiography of the heart, is essential for a detailed study of the defect and associated anatomical structures, minimizing the occurrence of complications.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":" December","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135186393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resolving the conundrum of impediments while navigating from radial path to coronary lumen","authors":"Debabrata Dash, Rohit Mody, Yashas Mylarappa, Ambrose Kibos, Bhavya Mody","doi":"10.31160/jotci202331a202303","DOIUrl":"https://doi.org/10.31160/jotci202331a202303","url":null,"abstract":"Through the efforts of dedicated interventionists, catheterization of the cardiovascular system by transradial method has been recognized as the gold standard due to the several advantages associated with it, such as early ambulation, decline in bleeding and in various other vascular complications. It has successfully turned as an alternative to femoral access. The huge experience of interventionists has helped in understanding the anatomical impediments that can result in many technical issues and complications associated with the transradial approach. A trial-and-error method adopted by the interventionists on their learning curve at the cost of increased procedural failure, complications and patient inconvenience may not be justifiable. The objective of the present manuscript was to review all these difficulties, and understand the treatment method and various preventative strategies that can be used to overcome the complications.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"37 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135414275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience with the Expressman™ guide catheter extension in a high-volume tertiary cardiology center","authors":"Eduardo Silveira, João Slaviero, Alexandre Azmus, Cláudio Moraes, Julio Teixeira, Rogério Leite, André Manica, Henrique Gomes, Claudio Moraes, Eduardo Azevedo, Julia Teixeira, Felipe Fuchs, Pedro Piccaro, Alexandre Quadros","doi":"10.31160/jotci202331a20230009","DOIUrl":"https://doi.org/10.31160/jotci202331a20230009","url":null,"abstract":"Background: Guide catheter extensions provide increased support in complex percutaneous coronary interventions. The ExpressmanTM is a novel guide catheter extension and the objective was to assess the impact of its use on procedural success and complications in a high-volume reference center. Methods: We analyzed data from all consecutive procedures in which the ExpressmanTM guide catheter extension was used. The decision to use a guide catheter extension was at operator’s discretion. Device success was defined as the successful positioning of the guide catheter extension in the coronary vessel and procedural success was defined as <20% residual stenosis and TIMI 3 flow, with no loss of significant side branches. Major adverse cardiac and cerebrovascular events were defined as the composite of all-cause death, myocardial infarction, target vessel revascularization and stroke. Results: From April 2022 to January 2023, 34 procedures were included. The majority of the patients were male (59%) and the mean age was 66.5 years. Guide catheter extension use was not planned pre-procedure in 17 procedures (50%). The most common reasons for guide catheter extension use were target vessel angulation or tortuosity and unfavorable coronary ostium position. Device success was obtained in 88% and revascularization success in 91%. There were three side branch occlusions. During in-hospital clinical follow-up, no major adverse cardiac and cerebrovascular events or major bleeding occurred. Conclusion: The device success and procedural success were high and the rate of complications was low. Guide catheter extension use as bailout technique in complex anatomies allowed procedural success in the vast majority of otherwise untreatable patients.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135900413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to cross the uncrossable lesions in chronic total occlusion","authors":"Rohit Mody, Abha Sheth, Lakshay Rastogi, Debabrata Dash, Bhavya Mody, Inderjeet Monga","doi":"10.31160/jotci202331a20230008","DOIUrl":"https://doi.org/10.31160/jotci202331a20230008","url":null,"abstract":"Coronary chronic total occlusion occurred in approximately 15 to 20% of patients. The most common challenges associated with successful percutaneous coronary intervention in chronic total occlusion are undilatable and uncrossable lesions. Uncrossable lesions are characterized as those lesions in which the balloon cannot cross the lesion. These types of lesions are commonly seen in calcified and tortuous arteries, and in chronic total occlusion. Various techniques, such as side branch anchoring, rotational, orbital, or laser atherectomy can be used to treat these challenging lesions. In this article, we describe the tips and tricks which can be commonly used to cross uncrossable lesions.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"243 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135901615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another failed surgical bioprosthetic valve: a second transcatheter valve-in-valve solution","authors":"T. Pereira, A. Rodrigues, F. Cordeiro, O. Azevedo, F. Ferreira, A. Lourenço","doi":"10.31160/jotci202331a20230006","DOIUrl":"https://doi.org/10.31160/jotci202331a20230006","url":null,"abstract":"Transcatheter mitral valve-in-valve replacement has recently emerged as an increasingly common alternative for high surgical risk patients. We report a case of a successful transseptal transcatheter mitral valve-in-valve replacement for the treatment of a bioprosthetic mitral valve degeneration and severe regurgitation, in an 86-year-old patient who had undergone transcatheter aortic valve-in-valve procedure 6 years ago. This case emphasizes the crucial role of a careful preoperative assessment using multimodality imaging to plan the procedure, in a patient with higher risk of left ventricular outflow obstruction due to the previous transcatheter aortic valve-in- valve procedure.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130150295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left main bifurcation stenting: a 2023 appraisal","authors":"D. Dash, R. Mody, Naveed Ahmed, Yashas Mylarappa, M. Kejariwal, Bhavya Mody","doi":"10.31160/jotci202331a202302","DOIUrl":"https://doi.org/10.31160/jotci202331a202302","url":null,"abstract":"For several decades coronary bypass grafting has been considered the gold standard treatment for unprotected left main coronary artery lesions. However, the anatomic accessibility and the large caliber of the vessel render the percutaneous coronary intervention a very attractive treatment option for left main coronary artery lesions. The use of percutaneous coronary intervention in this subset of lesions has been further expanded as a result of the introduction of newer drug-eluting stents along with rapid advancements in techniques, devices, and adjunctive pharmacotherapies. The current evidence has demonstrated that patients with low or intermediate coronary complexity treated with percutaneous coronary intervention or coronary bypass grafting have comparable outcomes, for up to 10 years. Treatment of left main bifurcation lesions remains technically demanding despite recent developments. The provisional approach is the default strategy in most types of left main bifurcation lesions. However, a few complex left main bifurcation lesions would warrant an elective two-stent technique. An integrated approach incorporating custom- tailored techniques, adjunctive physiological and morphologic evaluation, and pharmacologic agents is critical to tackle this unique challenge and improve clinical outcomes.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128669589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and hemodynamic profile of consecutive patients with aortic valve stenosis studied in the pre-transcatheter aortic valve implantation era at an academic institution. Comparative analysis of invasive evaluation with echocardiography","authors":"Larissa Garcia, F. Campos, J. Marin-Neto, Renata Angelo, Isabela Capodifoglio, H. Moreira, A. Schmidt, M. Romano, A. Badran, M. Lima-Filho, I. Lago, J. Chierice","doi":"10.31160/jotci202331a20230001","DOIUrl":"https://doi.org/10.31160/jotci202331a20230001","url":null,"abstract":"Background: In view of the better understanding of the pathophysiology of aortic valve stenosis, the complexity of assessing its severity has simultaneously grown, with relevant uncertainty persisting as to the applicability of invasive methods by cardiac catheterization and non-invasive methods based on echocardiography. The objective of this study was to analyze the hemodynamic patterns of evaluation with echocardiography compared to the estimation of severity of aortic stenosis with catheterization in consecutive patients referred for diagnostic evaluation by the laboratory of a tertiary academic hospital in the 2016 to 2018 triennium. Methods: An observational, descriptive and retrospective study of clinical characteristics and results of assessments of severity of aortic valve stenosis obtained in 96 consecutive patients, through catheterization and echocardiography. Results: A population sample of 49 men and 47 women, with a median age of 66.5 (56.5 to 72.8) years, degenerative aortic valve stenosis in 49%, and rheumatic aortic stenosis in 40%, in addition to several comorbidities, including coronary disease (37%). Using catheterization, based on the peak gradient of 48 (20 to 68), aortic valve stenosis was assessed as severe in 56%, with ventricular end-diastolic pressure of 20mmHg (16 to 30mmHg). Using echocardiography, the valve area was 0.9cm2 (0.7 to 1.2cm2), indexed valve area was 0.5cm2/m2 (0.43 to 0.5cm2/m2), with peak gradient of 62±26mmHg. Aortic valve stenosis was considered severe in 69.2%. There was disagreement between the methods regarding severity of aortic valve stenosis in 30% of exams, with a Spearman coefficient between the valve area on the echocardiogram and the peak gradient on catheterization of -0.7 (p<0.001). Conclusion: In a representative sample of various hemodynamic patterns, the assessment of severity of aortic valve stenosis, as routinely practiced in an academic laboratory, was limited to measuring the peak transvalvular gradient. The estimation of the valve area using the echocardiographic method was indirect and also subject to criticism, and contributed to the discrepancies found, rendering it justifiable to seek the improvement of both methods, in view of the clinical and hemodynamic complexity detected.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122966160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous treatment of anomalous origin of the right coronary artery with malignant course in a patient with aborted sudden death","authors":"Larissa Oliveira, M. Prudente, Álvaro Moraes Júnior, Paula Chiavenato, Patrícia Demuner, G. Gardenghi","doi":"10.31160/jotci202331a20230003","DOIUrl":"https://doi.org/10.31160/jotci202331a20230003","url":null,"abstract":"Coronary anomalies are less frequent than acquired coronary diseases, such as atherosclerosis, and have been implicated as a cause of cardiovascular events. This case report describes an incidental finding on angiography of an anomalous right coronary artery with origin in the left coronary sinus and an intra-arterial course, after an episode of aborted sudden death. The Heart Team analysis indicated a percutaneous approach with drug-eluting stent implantation at the origin of the right coronary artery as the best treatment, and the procedure was successfully performed. This case report and recent studies have demonstrated percutaneous treatment of coronary anomalies is a safe option for selected patients, considering clinical presentation, anatomy study, and training of the cath lab team.","PeriodicalId":152272,"journal":{"name":"Journal of Transcatheter Interventions","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132149046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}