Journal of interventional cardiology最新文献

{"title":"Declining Trend of Transapical Access for Transcatheter Aortic Valve Replacement in Patients with Aortic Stenosis","authors":"Sumit Sohal,&nbsp;Harsh Mehta,&nbsp;Krishna Kurpad,&nbsp;Sheetal Vasundara Mathai,&nbsp;Rajiv Tayal,&nbsp;Gautam K. Visveswaran,&nbsp;Najam Wasty,&nbsp;Sergio Waxman,&nbsp;Marc Cohen","doi":"10.1155/2022/5688026","DOIUrl":"10.1155/2022/5688026","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. The last decade has witnessed major evolution and shifts in the use of transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Included among the shifts has been the advent of alternative access sites for TAVR. Consequently, transapical access (TA) has become significantly less common. This study analyzes in detail the trend of TA access for TAVR over the course of 7 years. <i>Methods</i>. The national inpatient sample database was reviewed from 2011–2017 and patients with AS were identified by using validated ICD 9-CM and ICD 10-CM codes. Patients who underwent TAVR through TA access were classified as TA-TAVR, and any procedure other than TA access was classified as non-TA-TAVR. We compared the yearly trends of TA-TAVR to those of non-TA-TAVR as the primary outcome. <i>Results</i>. A total of 3,693,231 patients were identified with a diagnosis of AS. 129,821 patients underwent TAVR, of which 10,158 (7.8%) underwent TA-TAVR and 119,663 (92.2%) underwent non-TA-TAVR. After peaking in 2013 at 27.7%, the volume of TA-TAVR declined to 1.92% in 2017 (<i>p</i> &lt; 0.0001). Non-TA-TAVR started in 2013 at 72.2% and consistently increased to 98.1% in 2017. In-patient mortality decreased from a peak of 5.53% in 2014 to 3.18 in 2017 (<i>p</i> = 0.6) in the TA-TAVR group and from a peak of 4.51% in 2013 to 1.24% in 2017 (<i>p</i> = 0.0001) in the non-TA-TAVR group. <i>Conclusion</i>. This study highlights a steady decline in TA access for TAVR, higher inpatient mortality, increased length of stay, and higher costs compared to non-TA-TAVR.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40558167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-Term Outcomes of Elective High-Risk PCI with Extracorporeal Membrane Oxygenation Support: A Single-Centre Registry","authors":"Alexander M. Griffioen,&nbsp;Stijn C. H. Van Den Oord,&nbsp;Marleen H. Van Wely,&nbsp;Gerard C. Swart,&nbsp;Herbert B. Van Wetten,&nbsp;Peter W. Danse,&nbsp;Peter Damman,&nbsp;Niels Van Royen,&nbsp;Robert Jan M. Van Geuns","doi":"10.1155/2022/7245384","DOIUrl":"10.1155/2022/7245384","url":null,"abstract":"<div>\u0000 <p><i>Background.</i> If surgical revascularization is not feasible, high-risk PCI is a viable option for patients with complex coronary artery disease. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) provides hemodynamic support in patients with a high risk for periprocedural cardiogenic shock. <i>Objective.</i> This study aims to provide data about short-term outcomes of elective high-risk PCI with ECMO support. <i>Methods.</i> A retrospective single-center registry was performed on patients with high-risk PCI receiving VA-ECMO support. The short-term outcome was defined as the incidence of major adverse cardiac events (MACE) during the hospital stay and within 60 days after discharge. <i>Results.</i> Between January 2020 and December 2021, 14 patients underwent high-risk PCI with ECMO support. The mean age was 66.5 (±2.5) and the majority was male (71.4%) with a mean left ventricular ejection fraction of 33% (±3.0). Complexity indexes were high (STS-PROM risk score: 2.9 (IQR 1.5–5.8), SYNTAX score I: 35.5 (±2.0), SYNTAX score II (PCI): 49.8 (±3.2)). Femoral artery ECMO cannulation was performed in 13 patients (92.9%) requiring additional antegrade femoral artery cannula in one patient because of periprocedural limb ischemia. The mean duration of the ECMO run was 151 (±32) minutes. One patient required prolonged ECMO support and was weaned after 2 days. Successful revascularization was achieved in 13 patients (92.8%). Procedural success was achieved in 12 patients (85.7%) due to one unsuccessful revascularization and one procedural death. MACE during hospital stay occurred in 4 patients (28.6%) and within 60 days after discharge in 2 patients (16.7%). <i>Conclusion.</i> High-risk PCI with hemodynamic support using VA-ECMO is a feasible treatment option, if surgical revascularization is considered very high risk. Larger and prospective studies are awaited to confirm the benefits of ECMO support in elective high-risk PCI comparing ECMO with other mechanical circulatory support devices, including coaxial left cardiac support devices and IABP. <i>Trial Registration</i>. This trial is registered with NCT05387902.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9507798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40390452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual Antiplatelet Therapy in Patients Aged 75 Years and Older with Coronary Artery Disease: A Meta-Analysis and Systematic Review","authors":"Garly Saint Croix,&nbsp;Spencer C. Lacy,&nbsp;Amre Gazzhal,&nbsp;Michel Ibrahim,&nbsp;Medeona Gjergjindreaj,&nbsp;Jorge Perez,&nbsp;Malik Shehadeh,&nbsp;Karthik Vedantam,&nbsp;Christian Torres,&nbsp;Nirat Beohar,&nbsp;Esteban Escolar","doi":"10.1155/2022/3111840","DOIUrl":"10.1155/2022/3111840","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. This systematic review and meta-analysis evaluates the safety and efficacy of dual antiplatelet therapy (DAPT) in elderly patients with acute coronary syndrome (ACS). <i>Background</i>. The safety and efficacy of DAPT in elderly patients with ACS is not well characterized. <i>Methods</i>. We performed a systematic literature review to identify clinical studies that reported safety and efficacy outcomes after DAPT for ACS in elderly patients. The primary outcomes of primary efficacy endpoint rates and bleeding event rates were reported as random effects risk ratio (RR) with 95% confidence interval. No prior ethical approval was required since all data are public. <i>Results</i>. Our search yielded 660 potential studies. We included 8 studies reporting on 29,217 patients. There was a higher risk of bleeding event rates in elderly patients treated with prasugrel or ticagrelor when compared to clopidogrel with a risk ratio of 1.17 (95% CI 1.08 to 1.27, <i>p</i> &lt; 0.05). There was no difference in primary efficacy endpoint rates between elderly patients treated with prasugrel or ticagrelor when compared to clopidogrel with a risk ratio of 0.85 (95% CI 0.68 to 1.07, <i>p</i> = 0.17). <i>Conclusions</i>. This systematic review and meta-analysis suggests that DAPT with prasugrel or ticagrelor compared to clopidogrel is associated with a higher risk of bleeding events in elderly patients with ACS. There was no difference in the primary efficacy endpoints between the two treatment groups.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40383466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Difference in Coronary Artery Spasm Tested by Intracoronary Acetylcholine Provocation Test in Patients with Nonobstructive Coronary Artery Disease","authors":"Ji Young Park,&nbsp;Se Yeon Choi,&nbsp;Seung-Woon Rha,&nbsp;Byoung Geol Choi,&nbsp;Yung-Kyun Noh,&nbsp;Yong Hoon Kim","doi":"10.1155/2022/5289776","DOIUrl":"10.1155/2022/5289776","url":null,"abstract":"<div>\u0000 <p><i>Introduction</i>. Cardiovascular diseases manifest differently in men and women. The purpose of this study is to compare the sex difference in the characteristics of coronary artery spasm (CAS) in patients with nonobstructive cardiovascular disease (NOCVD) and the clinical outcomes in accordance with sex in CAS patients. <i>Methods</i>. The study analysed 5,491 patients with NOCVD who underwent an acetylcholine provocation test from November 2004 to May 2014 for evaluation of chest pain. CAS was defined as greater than 70% of luminal narrowing of the artery during the acetylcholine provocation test. <i>Results</i>. The patients were divided into men (<i>n</i> = 2,506) and women (<i>n</i> = 2,985). Mean follow-up days were 1,218 ± 577 days. To adjust for confounding factors, the propensity score matching (PSM) analysis was performed in all patients and among the CAS patients. After PSM analysis, a total of 1,201 pairs in all patients and a total of 713 pairs in CAS patients were generated. In all patients, women showed significantly less incidence of CAS compared with men (62.3% vs 50.9%, <i>P</i> &lt; 0.01). Myocardial bridge (MB) and moderate stenosis were less prevalent in women, while transient ST elevation and ischemic chest pain during provocation were more frequent in women. In CAS patients, men had a higher incidence of multivessel spasm than women (35.7% vs. 29.7%, <i>P</i> &lt; 0.01). Old age, dyslipidemia, and MB were independent risk factors of CAS in both men and women. In CAS patients, there was no statistical differences for various individual and composite major outcomes up to five years in either men or women. In men with CAS, old age was a risk factor of a 5-year major adverse cardiac event (MACE), and moderate stenosis was a risk factor of both 5-year MACE and 5-year recurrent angina. In women with CAS, mild stenosis was a risk factor of 5-year MACE, while myocardial bridge was a risk factor of 5-year recurrent angina. <i>Conclusions</i>. In this study, there were sex differences in the angiographic and clinical parameters during the acetylcholine provocation test, incidence of CAS, risk factors of CAS, 5-year MACE, and recurrent angina. Old age, dyslipidemia, and MB were independent risk factors of CAS in both sexes. However, major clinical outcomes up to five years in CAS patients were not different according to sex.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9481410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33466929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial","authors":"Eva M. Zwaan,&nbsp;Elena S. Cheung,&nbsp;Alexander J. J. IJsselmuiden,&nbsp;Carlo A. J. Holtzer,&nbsp;Ton A. R. Schreuders,&nbsp;Marcel J. M Kofflard,&nbsp;J. Henk Coert","doi":"10.1155/2022/6858962","DOIUrl":"10.1155/2022/6858962","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. To determine the incidence of upper extremity dysfunction (UED), after a transradial percutaneous coronary intervention (TR-PCI). <i>Background</i>. Transradial approach (TRA) is the preferred approach for coronary interventions. However, upper extremity complications may be underreported. <i>Methods</i>. The ARCUS was designed as a prospective cohort study, including 502 consecutive patients admitted for PCI. Patients treated with transfemoral PCI (TF-PCI) acted as a control group. A composite score of physical examinations and questionnaires was used for determining UED. Clinical outcomes were monitored during six months of follow-up, with its primary endpoint at two weeks. <i>Results</i>. A total of 440 TR-PCI and 62 control patients were included. Complete case analysis (<i>n</i> = 330) at 2 weeks of follow-up showed that UED in the TR-PCI group was significantly higher than that in the TF-PCI group: 32.7% versus 13.9%, respectively (<i>p</i> = 0.04). The three impaired variables most contributing to UED were impaired elbow extension, wrist flexion, and extension. Multivariate logistic regression showed that smokers were almost three times more likely to develop UED. <i>Conclusions</i>. This study demonstrates that UED seems to occur two times more in TR-PCI than in TF-PCI at 2 weeks of follow-up. However, no significant long-term difference or difference between the intervention arm and the contralateral arm was found at all timepoints.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9470353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40374320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Failed Bioprosthetic Aortic Valves: Mitigating Complications and Optimizing Outcomes","authors":"Elizabeth L. Norton,&nbsp;Alison F. Ward,&nbsp;Adam Greenbaum,&nbsp;Kendra J. Grubb","doi":"10.1155/2022/9737245","DOIUrl":"10.1155/2022/9737245","url":null,"abstract":"<div>\u0000 <p>The use of bioprosthetic prostheses during surgical aortic valve replacements has increased dramatically over the last two decades, accounting for over 85% of surgical implantations. Given limited long-term durability, there has been an increase in aortic valve reoperations and reinterventions. With the advent of new technologies, multiple treatment strategies are available to treat bioprosthetic valve failure, including valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR). However, ViV TAVR has an increased risk of higher gradients and patient prosthesis mismatch (PPM) secondary to placing the new valve within the rigid frame of the prior valve, especially in patients with a small surgical bioprosthesis <i>in situ</i>. Bioprosthetic valve fracture allows for placement of a larger transcatheter valve, as well as a fully expanded transcatheter valve, decreasing postoperative gradients and the risk of PPM.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Predictors of Outcome in the Treatment of In-Stent Restenosis with Drug-Eluting Balloons, a Real-Life Single-Centre Study","authors":"Kyle Murnaghan,&nbsp;Helen Bishop,&nbsp;Navjot Sandila,&nbsp;Bakhtiar Kidwai,&nbsp;Lawrence Title,&nbsp;Ata Ur Rehman Quraishi,&nbsp;Catherine Kells,&nbsp;Hussein Beydoun,&nbsp;Osama Elkhateeb","doi":"10.1155/2022/1395980","DOIUrl":"10.1155/2022/1395980","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. To determine the one-year and five-year occurrence and prognosticators of major adverse cardiac events (MACE: composition of all-cause death, myocardial infarction, target vessel revascularization, and vessel thrombosis), mortality, and target lesion revascularization (TLR) in patients with in-stent restenosis (ISR) treated with drug-eluting balloons (DEBs). <i>Background</i>. DEBs have become an emerging therapeutic option for ISR. We report the results of a single-center retrospective study on the treatment of ISR with DEB. <i>Methods</i>. 94 consecutive patients with ISR treated with the paclitaxel-eluting balloon were retrospectively studied between August 2011 and December 2019. <i>Results</i>. The one-year MACE rate was 11.8%, and the five-year MACE rate was 39.8%. The one-year mortality was 5.3%, and the five-year mortality rate was 21.5%. The one-year TLR rate was 4.3%, and the five-year rate was 18.7%. The univariable-Cox proportional hazard models for TLR showed lesion length, and the number of DEBs per vessel is associated with adverse outcomes with H.R. of 1.038 (1.007–1.069) and 4.7 (1.6–13.8), respectively. <i>Conclusion</i>. Our data indicate that at one year, DEBs provide an effective alternative to stenting for in-stent restenosis. Our five-year data, representing one of the longest-term follow-ups of DEB use, demonstrate high rates of MACE. The high five-year MACE reflects all-cause mortality in a high-risk population. This is offset by a reasonable five-year rate of TLR, indicating that DEB provides both short-term and long-term benefits in ISR.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Artery Disease Intervention: Drug-Coated Balloon vs Drug-Eluting Stent, A Long-Term Comparison","authors":"Nathan Marzlin,&nbsp;M. Fuad Jan,&nbsp;Louie Kostopoulos,&nbsp;Ana Cristina Perez Moreno,&nbsp;Tanvir Bajwa,&nbsp;Suhail Q. Allaqaband","doi":"10.1155/2022/5175607","DOIUrl":"10.1155/2022/5175607","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. The aim of the study is to evaluate current trends and long-term durability of both drug-eluting stents (DES) and drug-coated balloons (DCB) in the treatment of peripheral artery disease (PAD). <i>Background</i>. PAD affects more than 200 million people worldwide. Endovascular treatment of critical PAD has advanced in recent years. DES and DCB have demonstrated superiority compared to balloon angioplasty or bare metal stenting. The current literature lacks any long-term, direct comparison. <i>Methods</i>. A retrospective analysis was completed on patients who had femoral-popliteal interventions from June 2014 to June 2018 with either DCB or DES. Patient medical data and lesion characteristics were retrieved using the Vascular Quality Initiative database. Outcomes were analyzed through December 2019. Primary endpoint of time to clinical event-driven target lesion reintervention (TLR) and secondary endpoint of all-cause mortality were examined. <i>Results</i>. Four hundred eighty-three patients with a total of 563 interventions met the inclusion criteria. Three hundred fifty-nine DCB and 204 DES were performed. Of the DCBs, 132 required bailout stenting at the time of procedure. The mean time for TLR in the DES group was 1,277 days (SD 546), compared to 904 days (SD 330.1) for DCB. For patients requiring TLR, DES remained patent significantly longer (373 days longer on average) (<i>p</i> &lt; 0.001). For all-cause mortality there was no significant difference at 50 months between DCB and DES (<i>p</i> = 0.06). <i>Conclusions</i>. In patients who required TLR, DES had a significantly longer length of time to reintervention vs DCB (average 373 days), although no difference in mortality was observed.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40356316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Coronary Intervention via Distal Transradial Access (dTRA) in Patients with Low Body Mass Index","authors":"La-Mei Li,&nbsp;Liu-Yan Zhang,&nbsp;Hao-Min Huang,&nbsp;Tao Chen,&nbsp;Feng Li,&nbsp;Gan-Wei Shi,&nbsp;Wen-Hua Li,&nbsp;Jian-Qiang Xiao,&nbsp;Chun Gong,&nbsp;She-Liang Xue,&nbsp;Bo Xu,&nbsp;Jun Gu,&nbsp;Yan-Bin Song,&nbsp;Dan-Dan Shen,&nbsp;Rong-Rong Ji,&nbsp;Gao-Jun Cai","doi":"10.1155/2022/1901139","DOIUrl":"10.1155/2022/1901139","url":null,"abstract":"<div>\u0000 <p>The study aimed to investigate the efficacy and safety of coronary intervention via distal transradial access (dTRA) in patients with low body mass index (BMI). A total of 67 patients with low BMI who underwent coronary intervention, comprising 29 patients via dTRA and 38 patients via conventional transradial access (cTRA), were retrospectively included. There was no significant difference in the puncture success rate between the two groups (dTRA 96.6%, cTRA 97.4%, <i>P</i> = 0.846). Compared with the cTRA group, the success rate of one-needle puncture in the dTRA group was lower (51.7% vs. 81.6%, <i>P</i> = 0.020). The compression haemostasis time in the dTRA group was shorter than that in the cTRA group (<i>P</i>  &lt;  0.001). However, the incidence of radial artery occlusion was lower in the dTRA group than in the cTRA group (4.0% <i>vs</i>. 33.3%, <i>P</i> = 0.007). In conclusion, coronary intervention via dTRA was safe and effective in patients with low BMI.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9433246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33455497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Early Efficacy of the Percutaneous Presuture Technique with the Femoral Artery Incision Technique in Endovascular Aortic Repair under Local Anesthesia for Uncomplicated Type B Aortic Dissection","authors":"Qingsong Wu,&nbsp;Debin Jiang,&nbsp;Xiaochai Lv,&nbsp;Jiaxin Zhang,&nbsp;Rongda Huang,&nbsp;Zhihuang Qiu,&nbsp;Liangwan Chen","doi":"10.1155/2022/6550759","DOIUrl":"10.1155/2022/6550759","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To compare the efficacy of the percutaneous presuture technique (PPST) and the femoral artery incision technique (FAIT) under local anesthesia in the treatment of endovascular aortic repair (EVAR) for patients with uncomplicated type B aortic dissection (uTBAD). <i>Method</i>. Two hundred and ninety-five patients diagnosed with uTBAD who underwent EVAR under local anesthesia from June 2017 to December 2021 were consecutively and randomly selected for retrospective analysis. The PPST was performed in 178 cases and the FAIT was performed in 117 cases. The clinical characteristics and surgical and postoperative data from the two groups were analyzed. <i>Results</i>. There were no significant differences in clinical characteristics between the two groups (<i>p</i> &gt; 0.05). The operative time of the PPST group was significantly shorter than that of the FAIT group (46 (33, 58) versus 72 (67.5, 78.0) minutes, <i>p</i> &lt; 0.001), as was the operative approach procedure time (6 (4.5, 9.0) versus 38 (36.5, 43.5) minutes, <i>p</i> &lt; 0.001), and length of postoperative hospital stay (5.19 ± 2.26 versus 8.33 ± 3.76 days, <i>p</i> &lt; 0.001). There were fewer postoperative approach-related procedural complications in the PPST group than in the FAIT group (2 versus 12, <i>p</i> &lt; 0.001); similarly, the average frequency of postoperative wound disinfection was significantly lower in the PPST group (1.08 ± 0.39 versus 3.31 ± 0.91 times, <i>p</i> &lt; 0.05). Obesity was identified as an independent risk factor for postoperative approach-related procedural complications (OR, 22.26; 95% CI, 4.74–104.49; <i>p</i> &lt; 0.001). <i>Conclusions</i>. The PPST has comparable safety and efficacy to the FAIT in EVAR under local anesthesia. It can shorten the length of hospital stay, reduce operation time, lower the risk of wound-related complications, reduce the frequency of postoperative wound disinfection, and hasten postoperative recovery. It can therefore be used as a first-line surgical technique in EVAR of uTBAD under local anesthesia, especially in obese patients.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2022 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2022-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40342207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}