Journal of interventional cardiology最新文献

{"title":"SUOH 03 Guidewire for the Management of Coronary Artery Dissection: Insights from a Multicenter Registry","authors":"Gabriele L. Gasparini,&nbsp;Mario Bollati,&nbsp;Mauro Chiarito,&nbsp;Michele Cacia,&nbsp;Fausto Roccasalva,&nbsp;Claudiu Ungureanu,&nbsp;Giuseppe Colletti,&nbsp;Simone Muraglia,&nbsp;Pierluigi Merella,&nbsp;Fabrizio Ugo,&nbsp;Andrea Pacchioni,&nbsp;Salvatore Colangelo,&nbsp;Jorge Sanz Sanchez,&nbsp;Pier Pasquale Leone,&nbsp;Azeem Latib,&nbsp;Pietro Mazzarotto","doi":"10.1155/2023/7958808","DOIUrl":"10.1155/2023/7958808","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. In the setting of coronary artery dissection, both spontaneous and iatrogenic, fixing the intimal tear, usually with stent implantation, can be extremely challenging if the distal wire position has been lost. Common complications are mainly related to the inadvertent subintimal tracking of the guidewire while attempting to gain the distal true lumen. <i>Aims</i>. To report the registry results of using the SUOH 0.3 guidewire for managing coronary artery dissection in a real-world multicenter setting. <i>Methods</i>. The study population in this retrospective, multicenter, international registry included 75 consecutive patients who underwent PCI and required an antegrade wiring of a dissected coronary artery. <i>Results</i>. Successful use of SUOH 0.3 was achieved in 69 (92%) patients. The use of a microcatheter was associated with a significantly higher rate of TIMI 3 flow at the end of the procedure (no microcatheter: <i>n</i> = 17, 81%; microcatheter: <i>n</i> = 52, 96.3%; <i>p</i> = 0.017). The first recanalization attempt was made with the SUOH 03 guidewire in 48 (64%) cases, and it was successful in 42 (87%). The overall PCI success rate was reported in 72 (96%) patients, with no significant differences among patients with different origins, mechanisms, and locations of dissection. <i>Conclusions</i>. In this setting, the SUOH 0.3 guidewire provides high procedural success without additional complex techniques.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10326401","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":"Resting Full-Cycle Ratio versus Fractional Flow Reserve: A SWEDEHEART-Registry-Based Comparison of Two Physiological Indexes for Assessing Coronary Stenosis Severity","authors":"Stephen Malmberg,&nbsp;Jörg Lauermann,&nbsp;Patric Karlström,&nbsp;Dario Gulin,&nbsp;Neshro Barmano","doi":"10.1155/2023/6461691","DOIUrl":"10.1155/2023/6461691","url":null,"abstract":"<div>\u0000 <p>The adenosine-requiring physiological index fractional flow reserve (FFR) is the gold-standard method for determining the significance of intermediate lesions, while the resting full-cycle ratio (RFR) is a novel nonhyperaemic index without the need for adenosine administration. The aim of this study was to investigate the degree of concordance between RFR and FFR in indicating the need for revascularisation in patients with intermediate coronary lesions. This was a retrospective, registry-based study utilising data from the SWEDEHEART registry. Patients treated at Ryhov County Hospital in Jönköping, Sweden, between the 1^st of January 2020 and the 30^th of September 2021, were included. The degree of correlation and concordance between RFR and FFR was determined, both when used with a single cut-off (significant stenosis if RFR ≤0.89) and with a hybrid approach (significant stenosis if RFR ≤0.85, not significant if RFR ≥0.94, and FFR measurement when RFR was in the grey zone 0.86–0.93). The study population consisted of 143 patients with 200 lesions. The overall correlation between FFR and RFR was significant (<i>r</i> = 0.715, <i>R</i>² = 0.511, <i>p</i> ≤ 0.01). A strong correlation was seen for lesions in the left anterior descending artery (LAD) and the left circumflex artery (LCX) (<i>r</i> = 0.748 and 0.742, respectively, both <i>p</i> ≤ 0.01), while the correlation in the right coronary artery (RCA) was moderate (<i>r</i> = 0.524, <i>p</i> ≤ 0.01). The overall concordance between FFR and RFR using a single cut-off was 79.0%. With a hybrid cut-off approach, the degree of concordance was 91%, with no need of adenosine in 50.5% of the lesions. In conclusion, there was a strong correlation and a high degree of concordance between FFR and RFR in determining the significance of a stenosis. The use of a hybrid approach could improve the identification of physiologically significant stenoses while minimising the use of adenosine.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10325873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9801554","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":"The Value of the Cardiac Magnetic Resonance Intravoxel Incoherent Motion Technique in Evaluating Microcirculatory Dysfunction in Hypertrophic Cardiomyopathy","authors":"Alina Abulaiti,&nbsp;Quan Zhang,&nbsp;Haiyan Huang,&nbsp;Shuang Ding,&nbsp;Miriguli Shayiti,&nbsp;Shaoyu Wang,&nbsp;Yunling Wang,&nbsp;Wenxiao Jia","doi":"10.1155/2023/4611602","DOIUrl":"10.1155/2023/4611602","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. To evaluate the value of the cardiac magnetic resonance intravoxel incoherent motion (IVIM) technique in microcirculatory dysfunction in patients with hypertrophic cardiomyopathy (HCM). <i>Methods</i>. The medical records of 19 patients with HCM in our hospital from January 2020 to May 2021 were collected retrospectively, and 23 healthy people with a similar age and gender distribution to the patients with HCM were included as controls. All the included subjects underwent clinical assessment and cardiac magnetic resonance imaging. The original IVIM images were analysed, and the imaging parameters of each segment were measured. The HCM group was divided into non-hypertrophic myocardium and hypertrophic myocardium groups. The differences in imaging parameters between the normal and HCM groups were compared. A Spearman correlation analysis was used to explore the correlation between end-diastolic thickness (EDTH) and each IVIM parameter. <i>Results</i>. The D ^∗ and f values in the HCM group were lower than those in the normal group (<i>p</i> &lt; 0.0001 and <i>p</i> = 0.004, respectively). The f, D, D ^∗, and EDTH values of the hypertrophic segment, non-hypertrophic segment, and normal groups were statistically significant (<i>p</i> &lt; 0.05). The difference in D ^∗ values among the mild, moderate, severe, and very severe HCM groups was statistically significant (<i>p</i> &lt; 0.05). There was a statistically significant difference in EDTH among the mild, moderate, severe, and very severe groups (<i>p</i> &lt; 0.001). There were significant differences in the values of D, D ^∗, and f between the non-delayed enhancement group and the delayed enhancement group (<i>p</i> &lt; 0.05). The EDTH values of 304 segments in the HCM group were negatively correlated with f (<i>r</i> = −0.219, <i>p</i> = 0.028) and D ^∗ values (<i>r</i> = −0.310, <i>p</i> &lt; 0.001). <i>Conclusion</i>. The use of IVIM technology can achieve a non-invasive early quantitative assessment of microvascular disease in HCM without the injection of a contrast agent and provide a reference for the early diagnosis of and intervention in myocardial ischemia in patients with HCM.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10322278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9796628","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":"Drug-Coated Balloon in Primary Percutaneous Coronary Intervention","authors":"Hui Zhao,&nbsp;Runran Miao,&nbsp;Fei Lin,&nbsp;Guoan Zhao","doi":"10.1155/2023/5210808","DOIUrl":"10.1155/2023/5210808","url":null,"abstract":"<div>\u0000 <p>According to the latest coronary interventional guidelines, a drug-eluting stent is the recommended reperfusion therapy in primary percutaneous coronary intervention (pPCI). However, deficiencies and defects, such as in-stent restenosis (ISR), incomplete stent apposition, stent thrombosis, reinfarction after stent implantation, long-term dual antiplatelet drug use, and adverse reactions of metal implants, plague clinicians and patients. Drug-coated balloon (DCB), which delivers antiproliferative agents into the vessel wall without stent implantation and leaves no implants behind after the procedure, is a novel option for percutaneous coronary intervention and has proven to be a promising strategy in cases of ISR, small vessel coronary artery disease, and bifurcation lesions. However, most of the available experience has been gained in elective percutaneous coronary intervention, and experience in pPCI is lacking. The current evidence for the use of DCB-only in pPCI was discussed and analyzed in this review.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10317576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10178187","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 New-Onset Conduction Disturbances following Transcatheter Aortic Valve Replacement on Outcomes: A Single-Center Study","authors":"Claudia See,&nbsp;Yanting Wang,&nbsp;Haocheng Huang,&nbsp;Helen Parise,&nbsp;Yiping Yang,&nbsp;Daniela Tirziu,&nbsp;Dominic P. Francese,&nbsp;Nikolaos Papoutsidakis,&nbsp;Eric Bader,&nbsp;Ryan K. Kaple,&nbsp;Michael Cleman,&nbsp;Alexandra J. Lansky,&nbsp;John K. Forrest","doi":"10.1155/2023/5390338","DOIUrl":"10.1155/2023/5390338","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Transcatheter aortic valve replacement (TAVR) is known to increase the incidence of conduction disturbances compared to surgical aortic valve replacement; however, there are limited data on the impact and duration of these conduction disturbances on longer term outcomes. <i>Objective</i>. To determine the differential impact of persistent versus nonpersistent new-onset conduction disturbances on TAVR-related complications and outcomes. <i>Methods</i>. This is a single-center retrospective analysis of 927 consecutive patients with aortic stenosis who underwent TAVR at Yale New Haven Hospital from July 2012 to August 2019. Patients with new-onset conduction disturbances within 7 days following TAVR were selected for this study. Persistent and nonpersistent disturbances were, respectively, defined as persisting or not persisting on all patient ECGs for up to 1.5 years after TAVR or until death. <i>Results</i>. Within 7 days after TAVR, conduction disturbances occurred in 42.3% (392/927) of the patients. Conduction disturbances persisted in 150 (38%) patients and did not persist in 187 (48%) patients, and 55 (14%) patients were excluded for having mixed (both persistent and nonpersistent) disturbances. Compared with nonpersistent disturbances, patients with persistent disturbances were more likely to receive a PPM within 7 days after the TAVR procedure (46.0% versus 4.3%, <i>p</i> &lt; 0.001) and had a greater unadjusted 1-year cardiac-related and all-cause mortality risk (HR 2.54, <i>p</i> = 0.044 and HR 1.90, <i>p</i> = 0.046, respectively). <i>Conclusion</i>. Persistent conduction disturbances were associated with a greater cardiac and all-cause mortality rate at one year following TAVR. Future research should investigate periprocedural factors to reduce persistent conduction disturbances and outcomes beyond one year follow-up.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9600907","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":"P2Y12 Inhibitors in Acute Coronary Syndromes: A Real-World, Community-Based Comparison of Ischemic and Bleeding Outcomes","authors":"Amit Sachdeva,&nbsp;Ratnabhushan Mutyala,&nbsp;Neha Mantri,&nbsp;Shiyun Zhu,&nbsp;Edward McNulty,&nbsp;Matthew Solomon","doi":"10.1155/2023/1147352","DOIUrl":"10.1155/2023/1147352","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Randomized trials have shown superiority of the novel P2Y12 inhibitors over clopidogrel in patients with acute coronary syndrome (ACS), but clinical benefit in the community remains controversial. Our objective was to compare the safety and efficacy of clopidogrel to ticagrelor and prasugrel in patients with ACS undergoing percutaneous coronary intervention (PCI) in a real-world population. <i>Methods</i>. We conducted a retrospective cohort study of patients with ACS who underwent PCI and were discharged with clopidogrel, ticagrelor, or prasugrel from 2012 to 2018 within Kaiser Permanente Northern California. We used Cox proportional hazard models with propensity-score matching to evaluate the association of the P2Y12 agent with the primary outcomes of all-cause mortality, myocardial infarction (MI), stroke, and bleeding events. <i>Results</i>. The study included 15,476 patients (93.1% on clopidogrel, 3.6% on ticagrelor and 3.2% on prasugrel). Compared to the clopidogrel group, ticagrelorand prasugrel patients were younger with less comorbidities. In multivariable models with propensity-score matching, we found a lower risk of all-cause mortality in the ticagrelor vs the clopidogrel group (HR (95% CI) 0.43 (0.20–0.92)), but no differences in the other endpoints, and no difference between prasugrel and clopidogrel among any endpoints. A larger proportion of patients on ticagrelor or prasugrel switched to an alternative P2Y12 agent vs. clopidogrel (<i>p</i> &lt; 0.01), and a higher level of persistence was seen among patients on clopidogrel vs. ticagrelor (<i>p</i> = 0.03) or prasugrel (<i>p</i> &lt; 0.01). <i>Conclusion</i>. Among patients with ACS who underwent PCI, we observed a lower risk of all-cause mortality in patients treated with ticagrelor vs clopidogrel, but no difference in other clinical endpoints nor any differences in endpoints between prasugrel vs. clopidogrel users. These results suggest that further study is needed to identify an optimal P2Y12 inhibitor in a real-world population.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10224789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9908009","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":"Learning Curve Analyses for Left Bundle Branch Area Pacing with Conventional Stylet-Driven Pacing Leads","authors":"Ga-In Yu,&nbsp;Tae-Hoon Kim,&nbsp;Hee Tae Yu,&nbsp;Boyoung Joung,&nbsp;Hui-Nam Pak,&nbsp;Moon-Hyoung Lee","doi":"10.1155/2023/3632257","DOIUrl":"10.1155/2023/3632257","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. Physiological conduction system pacing has attracted attention to overcome the dyssynchrony problems of conventional right ventricular pacing (RVP). Left bundle branch area pacing (LBBAP), which complements short combing of His bundle pacing (HBP), has emerged and has proven its efficiency and safety. In addition, initial experiences of LBBAP were mainly using lumen-less pacing lead, and the feasibility of stylet-driven pacing lead (SDL) was also established. The purpose of this study is to evaluate the learning curve for LBBAP using SDL. <i>Methods</i>. The study enrolled 265 patients who underwent LBBAP or RVP performed by operators without previous LBBAP experience at Yonsei University Severance Hospital in Korea between December 2020 and October 2021. LBBAP was performed using SDL with an extendable helix. The learning curve was evaluated by analyzing fluoroscopy and procedure times. And, before and after reaching the learning curve, we evaluated how much the time required for the LBBAP differed from the time required for the RVP. <i>Results</i>. LBBAP was successful in 50 of 50 (100.0%) patients left bundle branch pacing was successful in 49 of 50 (98.0%). In 50 patients who underwent LBBAP, mean fluoroscopy and procedural times were 15.1 ± 13.5 minutes and 59.9 ± 24.8 minutes, respectively. The plateau of fluoroscopy time reached in the 25th case and the plateau of procedure time reached in the 24th case. <i>Conclusion</i>. During the initial experience with LBBAP, fluoroscopy and procedural times improved with increasing operator experience. For operators who were experienced in cardiac pacemaker implantation, the steepest part of the learning curve was over the first 24-25 cases. It is shorter than the previously reported learning curves of HBP.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9923753","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":"Application of Nanoliposome Alprostadil in the Perioperative Period of Percutaneous Coronary Intervention to Reduce In-Stent Restenosis: A Systematic Review and Meta-Analysis","authors":"Decai Zhu,&nbsp;Dawei Wang,&nbsp;Zhen Zhao,&nbsp;Qingqing Liu,&nbsp;Rongyuan Yang,&nbsp;Qing Liu","doi":"10.1155/2023/4100197","DOIUrl":"10.1155/2023/4100197","url":null,"abstract":"<div>\u0000 <p><i>Background</i>. In-stent restenosis (ISR) is a common complication after percutaneous coronary intervention (PCI) surgery for patients with coronary atherosclerotic heart disease (CHD). Reports indicate alprostadil may reduce ISR, and this study aimed at reviewing and summarizing the effect of nanoliposome alprostadil on ISR by meta-analysis. <i>Methods</i>. Articles were searched from databases, and meta-analysis was performed in Review Manager software. Funnel plots were performed to evaluate the publication bias, and sensitivity analysis was performed to determine the robustness of the overall treatment effects. <i>Results</i>. Initially, 113 articles were identified, and 5 studies of 463 subjects were included for analysis eventually. The primary endpoint, i.e., the occurrence of ISR after PCI, occurred in 11.91% of the alprostadil treatment group (28 from 235 patients) vs. 21.49% of the conventional treatment group (49 from 228 patients) and showed a statistical significance in our pooled data (<i>χ</i>² = 7.654, <i>P</i> = 0.006), while there was no statistically significant difference in all of the separate studies. We observed no statistical methodological heterogeneity among the studies (<i>P</i> = 0.64, <i>I</i>² ≈ 0%). The pooled odds ratio (OR) of the occurrence of ISR was 49% in a fixed-effect model, and the 95% confidence boundary (95% CI) was 29% to 81%. The funnel plot did not show serious publication bias, and sensitivity analysis showed well robustness of the overall treatment effect. <i>Discussion.</i> In conclusion, the early application of nanoliposome alprostadil after PCI could effectively reduce the occurrence of ISR, and the overall effect of alprostadil treatment in reducing ISR after PCI was relatively stable.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10212678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9923755","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":"Practice Pattern Variation in Adoption of New and Evolving Percutaneous Coronary Intervention Procedures","authors":"Diana Naranjo,&nbsp;Jacob Doll,&nbsp;Charles Maynard,&nbsp;Kristine Beaver,&nbsp;Aasthaa Bansal,&nbsp;Christian D. Helfrich","doi":"10.1155/2023/2488045","DOIUrl":"10.1155/2023/2488045","url":null,"abstract":"<div>\u0000 <p><i>Objective</i>. Assess factors contributing to variation in the use of new and evolving diagnostic and interventional procedures for percutaneous coronary intervention (PCI). <i>Background</i>. Evidence-based practices for PCI have the potential to improve outcomes but are variably adopted. Finding possible drivers of PCI procedure-use variability is key for efforts aimed at establishing more uniform practice. <i>Methods</i>. Veterans Affairs Clinical Assessment, Reporting, and Tracking Program data were used to estimate a proportion of variation attributable to hospital-, operator-, and patient-level factors across (a) radial arterial access, (b) intravascular imaging/optical coherence tomography, and (c) atherectomy for PCI. We used random-effects models with hospital, operator, and patient random effects. Overlap between levels generated cumulative variability estimates greater than 100%. <i>Results</i>. A total of 445 operators performed 95,391 PCI procedures across 73 hospitals from 2011 to 2018. The rates of all procedures increased over this time. 24.45% of variability in the use of radial access was attributable to the hospital, 53.04% to the operator, and 57.83% to patient-level characteristics. 9.06% of the variability in intravascular imaging use was attributable to the hospital, 43.92% to the operator, and 21.20% to the patient. Lastly, 20.16% of the variability in use of atherectomy was attributed to the hospital, 34.63% to the operator, and 57.50% to the patient.<i>Conclusions</i>. The use of radial access, intracoronary imaging, and atherectomy is influenced by patient, operator, and hospital factors, but patient and operator-level effects predominate. Efforts to increase the use of evidence-based practices for PCI should consider interventions at these levels.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10175015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469102","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":"Self-Expanding Versus Balloon Expanding Coronary Stents in Intervention of the Degenerated Saphenous Vein Graft: Memmingen Coronary Artery Bypass Stenosis Trial (MECAST)","authors":"Marcus Siry,&nbsp;Burak Duymaz,&nbsp;Simon Biesenberger,&nbsp;Deborah Siry,&nbsp;Vanessa Kammerer,&nbsp;Andreas E. May","doi":"10.1155/2023/9412132","DOIUrl":"10.1155/2023/9412132","url":null,"abstract":"<div>\u0000 <p><i>Objectives</i>. The aim of this retrospective analysis was to compare the patient outcome after interventional therapy of saphenous vein graft (SVG) stenoses in an all-comers population receiving either self-expanding drug-eluting stents (SExS) or balloon expanding drug-eluting stents (BExS). <i>Background</i>. The interventional therapy of degenerated SVGs remains challenging. Diameter variations of stenotic segments and friable plaques can lead to malapposition and distal embolization with increased major adverse cardiac event (MACE) rates. <i>Methods</i>. 107 patients with a total of 130 SVG interventions were separated into two groups according to either SExS (<i>n</i> = 51) or BExS (<i>n</i> = 56) treatment. Primary endpoint was the MACE rate, which is defined as the composite of cardiac death, myocardial infarction (MI), target vessel (TVR), and target lesion revascularization (TLR) at 30 days and at one-year follow-up. <i>Results</i>. Both patient groups did not differ significantly regarding patient characteristics. The patient outcome was significantly better in the SExS patient group: the MACE rate at 30 days was 1/51 (2.0%) in group SExS vs. 7/56 (12.5%) in group BExS; <i>p</i> &lt; 0.05. At one-year follow-up, the MACE rate remained significantly lower in the SExS group 8/51(15.7%) vs. 20/56 (35.7%) in the BExS group, <i>p</i> &lt; 0.02. Additionally, cardiac death occurred significantly later within the SExS patient group compared to the BExS group (<i>p</i> &lt; 0.05). A better overall outcome of patients with de novo SVG-stenosis compared to patients with previous CABG (coronary artery bypass graft) intervention was noted in both groups. <i>Conclusion</i>. Our findings demonstrate that SVG treatment with SExS is safe and provides clinical benefits by comparatively improving short and especially long-term patient outcomes.</p>\u0000 </div>","PeriodicalId":16329,"journal":{"name":"Journal of interventional cardiology","volume":"2023 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10101740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9310026","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}