Journal of interventional cardiology最新文献

{"title":"Long-Term Clinical and Angiographic Outcomes With Transcatheter Versus Surgical Aortic Valve Replacement in the Low- and Intermediate-Risk Population: An Updated Meta-Analysis of Randomized Controlled Trials","authors":"Muhammad M. Saleem,&nbsp;Muhammad H. Tariq,&nbsp;Ajit Brar,&nbsp;Aleena Usman,&nbsp;Mahima Upadhyay,&nbsp;Muhammad Mudassar,&nbsp;Saamia Ibrahim,&nbsp;Muhammad Shahzaib Bajwa","doi":"10.1155/joic/3341689","DOIUrl":"https://doi.org/10.1155/joic/3341689","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve replacement (TAVR) is preferred over surgical aortic valve replacement (SAVR) in patients at high risk of morbidity or mortality from surgery. However, surgery is still preferred in younger and healthier patients with symptomatic severe aortic stenosis, although recent trials support comparable efficacy and safety of TAVR even in low-risk patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An intention-to-treat analysis was conducted to construct a forest plot. The primary clinical outcome was the relative risk (RR) of stroke, and the secondary outcomes included the RR of all-cause mortality, cardiovascular mortality, myocardial infarction, new-onset atrial fibrillation, aortic reinterventions, and new permanent pacemaker implantation at the longest available follow-up. Angiographic outcomes were measured in terms of the standardized mean difference (SMD) in effective orifice area (EOA) and the RR of paravalvular leakage (PVL). Subgroup analysis was performed for the clinical outcomes at a 5-year follow-up as well.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No difference was seen between the two groups in terms of the RR of mortality (RR: 0.92, 95% CI: 0.75, 1.12) as well as stroke (RR: 1.05, 95% CI: 0.81, 1.35) in both the low- and intermediate-risk patients and patients &lt; 80 years old. The RR of cardiovascular mortality, disabling stroke, and myocardial infarction was also similar. Five-year follow-up did not show any significant difference in risk of mortality (RR: 0.97, 95% CI: 0.86, 1.11) or stroke (RR: 1.05, 95% CI: 0.89, 1.25). TAVR was associated with a lower risk of new-onset atrial fibrillation (RR: 0.35, 95% CI: 0.25, 0.49, <i>p</i> &lt; 0.00001). TAVR was associated with an increased risk of PVL (RR: 5.21; 95% CI: 2.70–10.07; <i>p</i> &lt; 0.00001), aortic reintervention (RR: 1.95, 95% CI: 1.38, 2.77, <i>p</i> = 0002), and permanent pacemaker implantation (RR: 2.04, 95% CI: 1.55, 2.69, <i>p</i> &lt; 0.00001). No statistically significant difference was found in the EOA; however, sensitivity analysis showed improved EOA with TAVR (SMD: 0.24, 95% CI: 0.12, 0.35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TAVR is angiographically comparable and clinically as safe and effective as SAVR in low-risk patients, even at longer follow-up durations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/3341689","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386438","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":"Left Atrial Strain as a Potential, Promising Tool for Early Detection and Evaluation of Cardiovascular Diseases: A Comprehensive Review","authors":"Antonio Al Hazzouri,&nbsp;Philippe Attieh,&nbsp;Mohamad Al Qassab,&nbsp;Christopher Sleiman,&nbsp;Bassem Derbas,&nbsp;Rose-Mary Daou,&nbsp;Hilda E. Ghadieh,&nbsp;Bernard Harbieh","doi":"10.1155/joic/6034327","DOIUrl":"https://doi.org/10.1155/joic/6034327","url":null,"abstract":"&lt;p&gt;Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide, with cardioembolic events accounting for a substantial proportion of adverse outcomes. Left atrial strain (LAS), particularly left atrial reservoir strain (LASr), has recently been incorporated into contemporary guideline-based assessment of left ventricular diastolic function, representing its only established routine clinical application. Beyond this role, accumulating evidence identifies LAS as a sensitive marker of atrial mechanical dysfunction, capturing early alterations in reservoir, conduit, and contractile function. Reduced LAS is consistently associated with elevated left ventricular filling pressures and with increased risks of ischemic stroke, atrial fibrillation, adverse cardiac remodeling, and heart failure. These observations position LAS as a promising tool for refined risk stratification, early disease detection, and prognostic evaluation across a broad spectrum of cardiovascular conditions. However, outside diastolic function assessment, these applications remain investigational and are not yet validated for routine clinical use. Ongoing advances in speckle-tracking echocardiography, multimodality imaging, and artificial intelligence are expected to enhance the reproducibility and clinical integration of LAS. This paper provides a comprehensive review of the emerging role of LAS as a potential noninvasive sensitive biomarker for the early detection, risk evaluation, prognostic assessment, and therapeutic guidance of major cardiovascular events, specifically cardioembolic strokes, heart failure, cardiomyopathies, and coronary artery diseases.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Abbreviations:&lt;/b&gt; ACM or AtCM, atrial cardiomyopathy; ACS, acute coronary syndrome; AF, atrial fibrillation; AI, artificial intelligence; ARVC, arrhythmogenic right ventricular cardiomyopathy; AUC, area under the curve; BMI, body mass index; CA, cardiac amyloidosis; CAD, coronary artery disease; CCT, cardiac computed tomography; CCTA, cardiac computed tomography angiography; CHF, congestive heart failure; CIS, cryptogenic ischemic stroke; CKD, chronic kidney disease; CMR, cardiac magnetic resonance; CRP, C-reactive protein; CRT, cardiac resynchronization therapy; CS, cryptogenic stroke; DCM, dilated cardiomyopathy; EAT, epicardial adipose tissue; ECG, electrocardiogram; ESE, exercise stress echocardiography; ESUS, embolic strokes of undetermined source; HCM, hypertrophic cardiomyopathy; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HR, heart rate; HTN, hypertension; ILs, interleukins; LA, left atrial; LAA, left atrial appendage; LAA MD, Left atrial appendage mechanical dispersion; LACI, LA coupling index; LACM, left atrial cardiomyopathy; LAEF, LA emptying fraction; LAGLS, reduced left atrial global longitudinal strain; LAS, left atrial strain; LAScd, LA strain conduit; LASct, LA contractile strain; LASr, Left atrial reservoir strain; LASTI, left atrial strain time ","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/6034327","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386891","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":"Impact of Early Versus Delayed Permanent Pacemaker Implantation on Clinical Outcomes in Patients With Third-Degree Atrioventricular Block After Transcatheter Aortic Valve Replacement: A National Inpatient Sample Analysis","authors":"Baotong He,&nbsp;Guangzhi Cong,&nbsp;Congyan Ye,&nbsp;Bo Shi,&nbsp;Rui Yan,&nbsp;Shizhe Fu,&nbsp;Aoqin Gu,&nbsp;Yixuan Xu,&nbsp;Ru Yan,&nbsp;Qing Chen,&nbsp;Ying Cui,&nbsp;Shaobin Jia,&nbsp;Xueping Ma","doi":"10.1155/joic/3309400","DOIUrl":"https://doi.org/10.1155/joic/3309400","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Third-degree atrioventricular (AV) block following transcatheter aortic valve replacement (TAVR) often necessitates permanent pacemaker (PPM) implantation. However, the impact of PPM timing on clinical outcomes remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing the National Inpatient Sample (2016–2021), we identified third-degree AV block patients who received PPM during the same admission period after TAVR. Cohorts were defined as early (≤ 72 h) or delayed (&gt; 72 h) implantation. In-hospital mortality constituted the primary endpoint, while the duration of hospitalization and the costs incurred were designated as secondary endpoints. Multivariable logistic regression was employed to calculate adjusted odds ratios (aOR) or adjusted beta (aβ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In an adjusted analysis of 3385 patients exhibiting third-degree AV block post-TAVR who underwent PPM implantation, no significant variation in in-hospital mortality was detected between the two cohorts (aOR 1.25, 95% CI 0.59–2.66), but the delayed group experienced a 6.30-day longer LOS (aβ: 6.30; 95% CI, 5.96–6.63) and incurred $81,572.80 more in hospitalization costs (aβ: 81,572.8; 95% CI 69,542.5–93,606.1). Delayed PPM implantation was more likely in patients with anemia, coagulation disorders, congestive heart failure, or chronic kidney disease (all <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this national cohort, delayed PPM implantation after TAVR-related AV block was associated with longer stays and higher costs, but not with mortality. This delay was more frequent among patients with baseline hematological and cardiorenal dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/3309400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148386941","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":"Rotational Atherectomy Through Guide Extension Catheters: Indications, Technique, and Limitations","authors":"Evandro Martins Filho,&nbsp;Thomas E. Kaier,&nbsp;M. Bilal Iqbal,&nbsp;Rodrigo Vugman Wainstein,&nbsp;Guilherme Pinheiro Machado,&nbsp;Marco Wainstein,&nbsp;Ricardo F. O. Suruagy Motta,&nbsp;Salman A. Arain,&nbsp;Marielle Rodrigues Martins,&nbsp;Konstantin Schwarz","doi":"10.1155/joic/6627247","DOIUrl":"https://doi.org/10.1155/joic/6627247","url":null,"abstract":"<p>Rotational atherectomy (RA) is an established technique for the treatment of heavily calcified coronary artery disease. Severe coronary calcification remains a frequent cause of procedural difficulty and device delivery failure during complex percutaneous coronary intervention (PCI). Delivery of the atherectomy burr to the target lesion may be particularly challenging in the presence of limited guide support, proximal vessel tortuosity, or unfavorable coronary anatomy that restricts safe access to distal calcified segments. Guide extension catheters (GECs) are widely used to enhance guide support and improve coaxial alignment during complex PCI. However, their use in combination with RA represents an advanced and selectively applied strategy that is not routinely addressed in conventional atherectomy training and is often avoided because of concerns regarding device interaction and difficulties during burr delivery and retrieval. Despite increasing anecdotal use in complex PCI, the technical principles and procedural safety considerations of performing RA through GECs remain insufficiently described in the literature. This review provides a focused technical overview of RA performed through GECs. We summarize the rationale for this approach, describe key technical considerations including device compatibility and burr advancement strategies, and discuss practical measures to minimize procedural complications. In addition, we outline clinical scenarios in which this technique may be beneficial, as well as situations where it should be avoided. Rather than advocating routine use, this review aims to define the role of guide extension–facilitated RA as a selective strategy for highly complex coronary anatomies.</p>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/6627247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324529","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":"Additional Mitral Isthmus Linear Ablation After Roof Linear and Anterior Septal Linear Ablation Is Associated With Improved Sinus Rhythm Maintenance in Patients With Nonparoxysmal Atrial Fibrillation","authors":"Zhe-Ning Wang,&nbsp;Ting Jiang,&nbsp;Yuan-Nan Lin,&nbsp;Sang Qian,&nbsp;Jia-Yang Fu,&nbsp;Ling Li,&nbsp;Tao Yao,&nbsp;Jing-Chen Liu,&nbsp;Yang-Qi Pan,&nbsp;Yue-Chun Li","doi":"10.1155/joic/6881298","DOIUrl":"https://doi.org/10.1155/joic/6881298","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal catheter ablation strategy for non-paroxysmal atrial fibrillation (non-PAF) is controversial. We examined the safety, feasibility, and efficacy of a new treatment strategy for non-PAF, defined as the Pulmonary vein isolation (PVI); left roof linear (RL), Mitral Isthmus linear (MIL), and left anterior SEptal linear (ASL) ablation; and leftatrial appendage (LAA) Device occlusion (PROMISED) procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One-hundred forty-two patients with non-PAF underwent PVI + RL + ASL ablation with/without MIL ablation, combined with LAA occlusion (LAAO). The primary end point was atrial arrhythmia recurrence after a 3-month blanking period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two patients underwent the PROMISED procedure (MIL group) and 60 patients underwent PVI + RL + ASL ablation with LAAO without MIL ablation (Non-MIL group). The baseline characteristics were similar between the two groups. No serious procedure-related complications occurred during the procedure. Twelve months after a single procedure, atrial arrhythmia recurrence was observed in 17/82 patients (20.7%) in the MIL group versus 31/60 patients (51.7%) in the Non-MIL group (hazard ratio [HR]: 0.327 and 95% confidence interval [CI]: 0.181–0.592; <i>p</i> &lt; 0.001). No peridevice leak &gt; 5 mm was observed during the 12-month follow-up. Overall, 85.2% of the patients discontinued oral anticoagulant therapy within 6 months after the procedure. One patient experienced stroke in the MIL group 10 months after the procedure and one experienced stroke in the Non-MIL group 2 months after the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with non-PAF, the MIL group, which underwent the PROMISED procedure, was associated with a lower observed 12-month atrial arrhythmia recurrence rate without an apparent increase in complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/6881298","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324528","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":"Percutaneous Pulmonary Valve Implantation With Balloon-Expandable Valves for Management of Dysfunctional Different Right Ventricular Outflow Tracts","authors":"Fatma Aboalsoud Taha,&nbsp;Mansour Almutairi,&nbsp;Reda Abuelatta","doi":"10.1155/joic/9911295","DOIUrl":"https://doi.org/10.1155/joic/9911295","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Percutaneous pulmonary valve implantation (PPVI) has been approved for the management of the dysfunctional pulmonary valve (PV) and right ventricular outflow tract (RVOT). The study aimed to evaluate the feasibility, safety, and efficacy of the balloon-expandable valves in PPVI for the management of dysfunctional different RVOTs with pulmonary stenosis (PS) and/or pulmonary regurgitation (PR) and to compare PPVI between RV-PA conduits/bioprosthetic PVs and native/patched RVOTs regarding the preprocedure, procedural, postprocedural characteristics, and long-term outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients who underwent PPVI for dysfunctional different RVOTs using balloon-expandable valves, either Melody or Sapien S3 valves, from May 2017 to January 2025 were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-two patients underwent PPVI; 24 (57.1%) had RV-PA conduits/bioprosthetic PVs, and 18 (42.9%) had native/patched RVOTs. The mean age and weight were 29.9 ± 13.7 years and 65.4 ± 23.6 kg, respectively. Cardiac MRI revealed the RVEDVI of 144.9 ± 32.9 mL/m², RVEF of 48.6 ± 7.1%, and PV-Pg of 33.5 ± 20.3 mmHg. Three (7.1%) patients with bioprosthetic PVs underwent direct valve implantation; 21 (50.0%) patients required 1 stent, 15 (35.7%) required 2 stents, and 2 (4.8%) from the native/patched RVOT group required the Russian Doll technique. The Melody valve was implanted in 7 (16.7%) patients, and the Edwards Sapien S3 valve was implanted in 35 (83.3%) patients. Larger balloons, longer and multiple stents, with larger valves were required in native/patched RVOTs (<i>p</i> &lt; 0.001^∗). All patients reported technical success, with mean procedural and fluoroscopy times of 56.7 ± 6.9 and 37.8 ± 7.3 min. No patient suffered coronary impingement with a total in-hospital stay of 2.3 ± 1.0 days, without recorded mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PPVI using balloon-expandable valves is a feasible and safe method for managing dysfunctional RVOTs: RV-PA conduits, bioprosthetic PVs, native, and patched RVOTs. However, preprocedural characteristics, procedural strategies, technical approaches, valve sizing methods, materials used, and outcomes vary according to the RVOT anatomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/9911295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324530","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":"Left Ventricular Guidewire Pacing Is Associated With Lower Pacing Lead-Related Cardiac Tamponade During Transfemoral TAVI: A Systematic Review and Meta-Analysis","authors":"Rafael Ferreira Gomes,&nbsp;Marcela Montenegro,&nbsp;Fabiano Cantarelli,&nbsp;Eduardo Pessoa de Melo,&nbsp;Jorge Guimarães","doi":"10.1155/joic/2519641","DOIUrl":"https://doi.org/10.1155/joic/2519641","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Rapid pacing is required during transcatheter aortic valve implantation (TAVI) to facilitate valve deployment. Conventional right ventricular (RV) temporary pacing requires transvenous lead placement and has been associated with mechanical complications, including cardiac perforation. Left ventricular (LV) guidewire pacing has emerged as an alternative strategy that may avoid lead-related injury. We performed a systematic review and meta-analysis to compare clinical and procedural outcomes between LV guidewire pacing and RV temporary pacing during TAVI.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Web of Science were searched through February 15, 2026. Comparative studies evaluating LV guidewire pacing versus RV temporary pacing during TAVI were included. The primary endpoint was global cardiac tamponade. Prespecified mechanistic analyses evaluated pacing lead-related and annular rupture-related tamponade. Secondary endpoints included all-cause mortality, cardiovascular mortality, major adverse cardiovascular events (MACE), stroke, major vascular complications, bleeding, permanent pacemaker implantation, and procedural metrics. Random-effects meta-analyses were performed using Mantel–Haenszel models.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Five studies (one randomized controlled trial and four observational cohorts) comprising 2840 patients (1910 LV and 930 RV) were included. Global cardiac tamponade occurred in 1.1% of LV patients and 2.5% of RV patients (OR 0.45; 95% CI 0.18–1.16; &lt;i&gt;p&lt;/i&gt; = 0.08). In mechanistic analyses, pacing lead-related tamponade was significantly reduced with LV pacing (OR 0.09; 95% CI 0.02–0.56; &lt;i&gt;p&lt;/i&gt; = 0.03), whereas annular rupture-related tamponade did not differ between strategies. The pooled absolute risk reduction for pacing lead-related cardiac tamponade was approximately 1.2%, corresponding to an estimated number needed to treat of 83. A signal toward lower all-cause mortality was observed in pooled analyses, largely driven by observational cohorts. Major vascular complications and bleeding showed nonsignificant trends favoring LV pacing. Permanent pacemaker implantation did not differ significantly between strategies. LV pacing was associated with shorter procedural duration (mean difference −5.83 min; 95% CI −7.08 to −4.58; &lt;i&gt;p&lt;/i&gt; &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;LV guidewire pacing during transfemoral TAVI was associated with a lower risk of pacing lead-related cardiac ta","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/2519641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324055","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":"Proctorship in Chronic Total Occlusion Percutaneous Coronary Intervention in Low- and Middle-Income Countries: Challenges, Ethics, and Safety Implications—A Perspective From High-Volume CTO PCI Proctors in Latin America","authors":"Evandro Martins Filho,&nbsp;Antônio Carlos Botelho da Silva,&nbsp;João Eduardo Tinoco de Paula,&nbsp;Neisser Morales-Victorino,&nbsp;Franklin Hanna Quesada,&nbsp;Ricardo Santiago,&nbsp;Mauro Echavarría-Pinto,&nbsp;Breno de Alencar Araripe Falcão","doi":"10.1155/joic/2291681","DOIUrl":"https://doi.org/10.1155/joic/2291681","url":null,"abstract":"<p>Chronic total occlusion percutaneous coronary intervention (CTO PCI) has evolved into a safe and effective revascularization strategy when performed by experienced operators in adequately resourced centers. Proctorship has accelerated learning curves, improved procedural success, and reinforced safety during early program development. However, available evidence derives predominantly from high-income countries with relatively uniform infrastructure, device availability, and team expertise.</p><p>In low- and middle-income countries (LMICs), particularly Latin America, CTO PCI proctorship operates within a markedly heterogeneous landscape characterized by variable institutional infrastructure, inconsistent access to safety devices, limited hemodynamic support, and wide disparities in operator experience. Under these conditions, the proctor’s role extends beyond technical mentorship to encompass real-time safety oversight, active procedural participation, ethical stewardship, and mitigation of system-level vulnerabilities.</p><p>This perspective explores the contemporary role of CTO PCI proctorship in LMICs, focusing on structural constraints, operator heterogeneity, recurrent procedural pitfalls, human factors, and ethical considerations. We propose a regionalized, center-focused model as a more sustainable strategy for capacity building, patient safety, and long-term program development. Although grounded in Latin American experience, the structural challenges and proposed solutions are broadly applicable to any setting where procedural complexity outpaces institutional readiness.</p>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/2291681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324131","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":"Three-Year Clinical Outcomes of IVUS-Guided Excimer Laser Coronary Atherectomy for In-Stent Restenosis","authors":"Keisuke Matsuo,&nbsp;Takahide Arai,&nbsp;Mitsunobu Nagai,&nbsp;Hiroki Hoya,&nbsp;Yodo Gatate,&nbsp;Shintaro Nakano","doi":"10.1155/joic/3301068","DOIUrl":"https://doi.org/10.1155/joic/3301068","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In-stent restenosis (ISR) remains challenging after percutaneous coronary intervention (PCI) using drug-eluting stents, often leading to target lesion revascularization (TLR) and major adverse cardiovascular and cerebrovascular events (MACCEs). Excimer laser coronary atherectomy (ELCA) removes neointimal tissue and preserves minimum lumen area (MLA); however, its long-term benefits are unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We assessed the 3-year outcomes of PCI with or without ELCA for ISR and examined prognostic factors and intravascular ultrasound (IVUS) findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed data of 97 patients with ISR among 2083 consecutive patients who underwent PCI between April 2020 and March 2025. Patients were divided into ELCA (<i>n</i> = 44) and non-ELCA (<i>n</i> = 53) groups. Outcomes were analyzed using Kaplan–Meier and log-rank tests. The primary outcome was all-cause mortality. Secondary outcomes included TLR and MACCE rates. IVUS characteristics were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline characteristics were generally similar between groups, although acute coronary syndrome was more frequent in the non-ELCA group. All-cause mortality did not differ significantly between groups (<i>p</i> = 0.699). TLR was numerically lower in the ELCA group (0% vs. 7.5%, <i>p</i> = 0.062). MACCEs were significantly less frequent in the ELCA group (2.3% vs. 18.9%, <i>p</i> = 0.018), and ELCA was independently associated with a lower risk of MACCEs in multivariable Cox analysis. After IPW, ELCA remained significantly associated with a lower risk of MACCEs (odds ratio 0.065, 95% confidence interval 0.006–0.291, <i>p</i> = 0.003). However, event-specific analyses, particularly for TLR, were limited by sparse events and should be interpreted cautiously. IVUS showed significantly greater lumen enlargement in the ELCA group, and the change in MLA correlated with baseline minimum stent area only in the ELCA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this retrospective cohort, ELCA was associated with lower MACCE rates and greater lumen enlargement; however, these findings should be considered hypothesis-generating in light of the nonrandomized design, limited sample size, and imbalance in clinical presentation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/3301068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282229","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":"Neopterin and Copeptin as Biomarkers in the Diagnosis and Prognosis of Acute Coronary Syndrome: A Case-Control Study","authors":"Karamatollah Rahmanian,&nbsp;Mohammad Shojaei,&nbsp;Ali Soofi,&nbsp;Vahid Rahmanian","doi":"10.1155/joic/2332643","DOIUrl":"https://doi.org/10.1155/joic/2332643","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute coronary syndrome (ACS) is a major cause of morbidity and mortality, and early diagnosis remains challenging. Stress- and inflammation-related biomarkers such as copeptin and neopterin may improve diagnostic and prognostic assessment. This study aimed to evaluate serum levels of copeptin and neopterin in patients with ACS compared with controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this case-control investigation, a total of 130 patients diagnosed with ACS were included, comprising 54 individuals with ST-segment elevation myocardial infarction (STEMI), 26 with non-ST-segment elevation myocardial infarction (NSTEMI), and 50 with unstable angina pectoris (UAP). Additionally, 82 control subjects were recruited, consisting of 42 with stable angina pectoris (SAP) and 40 without any cardiac conditions (NCD). Blood samples were obtained alongside demographic information, and serum concentrations of neopterin and copeptin were quantified utilizing the ELISA technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Serum copeptin concentrations were notably greater in the ACS patients (132.73 ± 325.88 ng/mL) in comparison to the control group (87.22 ± 218.36 ng/mL,<i>p</i> &lt; 0.001). Similarly, serum neopterin levels were elevated in ACS patients (5.57 ± 8.92 ng/mL) compared with controls (1.95 ± 6.96 ng/mL, <i>p</i> &lt; 0.001). Among the ACS subgroups, STEMI patients exhibited the highest copeptin (and neopterin) levels, whereas the NCD group had the lowest values (<i>p</i> = 0.001 for copeptin and <i>p</i> = 0.029 for neopterin). The multivariable logistic regression analysis indicated that smoking cigarettes (OR = 4.115, 95%CI: 1.759–9.625), levels of copeptin (OR = 1.013, 95%CI: 1.008–1.018), and neopterin concentrations (OR = 1.316, 95%CI: 1.112–1.558) were notably linked to a heightened risk of ACS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Serum levels of neopterin and copeptin are markers of ACS presence and provide valuable information regarding disease severity and prognosis. These biomarkers may be effectively used alongside conventional markers to improve early diagnosis and guide therapeutic strategies in ACS patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2026 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/joic/2332643","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148237467","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}