Reviews in cardiovascular medicine最新文献

{"title":"Single-Stage Computed Tomography Angiography, Percutaneous Coronary Intervention, and Transcatheter Aortic Valve Replacement in an Octogenarian With Femoral Neck Fracture, Non-ST-Elevation Myocardial Infarction, and Severe Aortic Stenosis: A Case Report and Literature Review of Multidisciplinary Approaches.","authors":"Ming Zhang, Xietian Pan, Lina Yang, Yang Mu, Bo Jiang, Tao Chen, Jing Wang, Lin Wang, Jiayue Li, Jing Liu, Zhuo Zhang, Changfu Liu","doi":"10.31083/RCM50145","DOIUrl":"https://doi.org/10.31083/RCM50145","url":null,"abstract":"<p><p>Geriatric femoral neck fractures are associated with high mortality. Early surgery within 48 hours improves survival, whereas delayed arthroplasty is associated with a 41% increase in mortality. Multimorbidity in this population often prolongs preoperative optimization, thereby exacerbating perioperative risk. Current evidence indicates that 5%-10% of patients with hip fractures have concomitant severe aortic stenosis (AS), which independently increases the risk of anesthesia-related complications. Perioperative acute myocardial infarction further increases mortality risk, making cardiac management a critical challenge. The advent of transcatheter aortic valve replacement (TAVR) has revolutionized care paradigms. Nonetheless, this situation requires multidisciplinary consensus on optimizing the fracture-to-surgery interval, antithrombotic bridging strategies, and concomitant coronary revascularization. Here, we present a case of single-stage aorta-coronary computed tomography angiography (CTA), percutaneous coronary intervention (PCI), and TAVR in an octogenarian with femoral neck fracture, severe AS, and non-ST-elevation myocardial infarction (NSTEMI). This pioneering case is accompanied by a systematic review of contemporary management strategies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50145"},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial Dysfunction and Metabolic Reprogramming in Cardiovascular Diseases.","authors":"Hongyu Chen, Yingliang Zhao, Chengxin Ge, Jianing Wang, Zhihua Wang, Hanzhang Wang, Shaopeng Cheng, Yilin Wang, Jie Yang, Dongjin Wang, Hoshun Chong, Chuiyu Kong","doi":"10.31083/RCM51541","DOIUrl":"https://doi.org/10.31083/RCM51541","url":null,"abstract":"<p><p>Endothelial cells regulate hemodynamics, inflammation, and vascular barrier integrity, thereby playing a central role in vascular homeostasis. Pathological conditions, including hypertension, hyperglycemia, and hyperlipidemia, induce metabolic reprogramming in these cells, altering the balance among glycolysis, fatty acid oxidation, and amino acid metabolism. This reprogramming drives endothelial dysfunction, characterized by reduced nitric oxide (NO) levels, increased inflammation and oxidative stress, and a weakened vascular barrier, thereby accelerating the progression of atherosclerosis, myocardial infarction, calcific aortic valve disease, and aortic aneurysms. Altered metabolites, such as lactate and acetyl-CoA, further exacerbate injury by modulating epigenetic changes and cell signaling. Endothelial metabolism has emerged as a promising therapeutic target for cardiovascular diseases. Natural compounds such as resveratrol, quercetin, and curcumin enhance NO production and reduce oxidative stress. Traditional Chinese medicine formulations (e.g., Qili Qiangxin and Tongxinluo capsules) help regulate glucose and lipid metabolism, thereby mitigating mitochondrial dysfunction and inflammation. Synthetic drugs, including metformin, sodium-glucose transporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor (GLP-1R) agonists, and experimental agents such as I-152, protect vessels by restoring metabolic homeostasis and endothelial function. Future research integrating multi-omics technologies and artificial intelligence is expected to enable real-time metabolic monitoring and precision interventions. Emerging delivery systems, such as exosome-based approaches and stem cell therapies, offer additional therapeutic potential. A deeper understanding of endothelial metabolic reprogramming will provide novel targets for preventing and treating cardiovascular diseases, thereby advancing precision medicine.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"51541"},"PeriodicalIF":2.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exerkines in Cardiovascular-Kidney-Metabolic Syndrome: An Integrative Framework for Mechanisms and Therapeutic Implications-A Narrative Review.","authors":"Hongyan Fan, Changlin Zhai, Chaojie He, Liang Shen, Haihua Pan, Wenwen Zheng","doi":"10.31083/RCM50762","DOIUrl":"https://doi.org/10.31083/RCM50762","url":null,"abstract":"<p><p>Cardiovascular-kidney-metabolic (CKM) syndrome represents a pathophysiological continuum linking metabolic dysfunction, chronic kidney disease (CKD), and cardiovascular disease (CVD) through shared mechanisms, including insulin resistance, chronic inflammation, endothelial dysfunction, mitochondrial impairment, and maladaptive interorgan crosstalk. Although exerkines have emerged as key mediators of exercise-induced benefits, an integrated exerkine-centered framework spanning the CKM spectrum remains lacking. This review synthesizes current evidence on the multiorgan origins and biological roles of major exerkines, including myokines, adipokines, hepatokines, cardiokines, osteokines, lipid mediators, and extracellular vesicle-associated cargos. Moreover, extending beyond reductionist descriptions, we propose a higher-level mechanistic synthesis in which exerkines function as coordinated \"signatures\" across CKM phenotypes, converging on key regulatory hubs, particularly AMP-activated protein kinase (AMPK)-peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α)-mediated metabolic adaptation and the Klotho/fibroblast growth factor (FGF) axis that links renal, metabolic, and cardiovascular regulation. From a translational perspective, adiponectin, FGF21, apelin, and Klotho demonstrate the most consistent associations with cardiometabolic and renal outcomes in humans. However, clinical application remains constrained by uncertain causality, context-dependent resistance, and variability in assay performance. Overall, exerkines are best conceptualized as components of an integrated signaling network rather than isolated therapeutic targets. Meanwhile, future progress will depend on defining disease-stage-specific exerkine signatures and establishing associated causal relevance in humans.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50762"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Anticoagulants in Patients With Atrial Fibrillation and Advanced or End-Stage Renal Disease: A Systematic Review and Meta-Analysis.","authors":"Stylianos Fiflis, Georgios Aletras, Maria Bachlitzanaki, Emmanouil Foukarakis","doi":"10.31083/RCM52237","DOIUrl":"https://doi.org/10.31083/RCM52237","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with atrial fibrillation (AF) and advanced chronic kidney disease (CKD) face a markedly elevated risk of both thromboembolic and bleeding events. While oral anticoagulation is the cornerstone of stroke prevention in AF, the optimal use of this treatment in patients with stage 4-5 CKD and end-stage renal disease (ESRD) undergoing dialysis remains uncertain, as these populations were largely excluded from the landmark trials that established the efficacy of direct oral anticoagulants (DOACs) in the general AF population. This study aimed to systematically evaluate and compare the efficacy and safety of vitamin K antagonists (VKAs) and DOACs, including factor Xa inhibitors, compared with alternative anticoagulation strategies or no anticoagulation in patients with AF and advanced CKD, including both non-dialysis-dependent stage 4-5 CKD and dialysis-dependent ESRD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search of PubMed (MEDLINE), the Cochrane Library, and ClinicalTrials.gov was performed through January 30, 2026. Randomized controlled trials and observational cohort studies evaluating oral anticoagulation in adults with AF and stage 4-5 CKD (estimated glomerular filtration rate (eGFR) &lt;30 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;, not on dialysis) or ESRD on dialysis were included. Outcomes of interest were a composite of stroke, transient ischemic attack or systemic embolism, major bleeding (International Society on Thrombosis and Haemostasis (ISTH) or study-defined), and all-cause mortality. Owing to clinical and methodological heterogeneity, evidence was synthesized narratively for most comparisons; randomized trials comparing factor Xa inhibitors with VKAs in dialysis-dependent patients were pooled in a random-effects meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 20 studies met the inclusion criteria, comprising four randomized trials, one subgroup analysis of an RCT (ARISTOTLE), and fifteen observational cohorts. Four studies evaluated patients with advanced CKD not receiving dialysis, while sixteen focused on dialysis populations. In non-dialysis stage 4-5 CKD, DOAC therapy, particularly apixaban, was generally associated with comparable or reduced thromboembolic risk and lower rates of major bleeding compared with warfarin. Observational data also suggested a potential mortality benefit with DOACs compared with no anticoagulation. In contrast, findings in dialysis-dependent ESRD were heterogeneous. Warfarin was not consistently associated with reduced stroke risk compared with no anticoagulation and was frequently linked to elevated bleeding risk. Observational studies suggest that apixaban may confer a lower risk of major bleeding compared with VKAs while maintaining similar thromboembolic protection; however, randomized evidence has been limited and underpowered to demonstrate a definitive net clinical benefit. In a meta-analysis of the four dialysis randomized trials (n = 486), factor Xa inhibitor","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"52237"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomarkers and Risk Prediction in Cardiovascular-Kidney-Metabolic Syndrome: A Comprehensive Review.","authors":"Yuanyuan Lu, Mingxin Yang, Jinbo Yu, Pan Lin, Jun Ji, Xiaoqiang Ding, Yaqiong Wang, Xialian Xu","doi":"10.31083/RCM50631","DOIUrl":"https://doi.org/10.31083/RCM50631","url":null,"abstract":"<p><p>Cardiovascular-kidney-metabolic (CKM) syndrome represents a complex interplay among cardiovascular disease, chronic kidney disease, and metabolic disorders; meanwhile, CKM syndrome affects a significant proportion of adults and increases the risk of heart failure, end-stage renal disease, and premature death. This review examines traditional and emerging biomarkers in CKM syndrome, focusing on the clinical utility and predictive value of these markers for disease progression and outcomes. Traditional markers include cardiovascular, renal, metabolic and inflammatory biomarkers. Meanwhile, emerging biomarkers include novel lipid biomarkers, epigenetic and microRNA markers, and metabolic and inflammatory markers. Composite tools integrating traditional and emerging biomarkers have shown promise for improving risk stratification and clinical decision-making. Moreover, the Predicting Risk of cardiovascular disease (CVD) Events (PREVENT) and Cardiovascular-Kidney-Metabolic 2-Stage 2-Biomarker Assessment Group (CKM₂S₂-BAG) equations have been developed for CKM syndrome risk stratification. Additionally, machine learning approaches are increasingly being applied in CKM syndrome research. Future research priorities include large-scale validation studies, standardization of biomarker measurement and interpretation, and the development of advanced technologies. The integration and validation of reliable biomarkers for CKM syndrome represent a critical step toward improving risk stratification and enabling personalized management strategies.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"50631"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acetylcholine Provocation Testing for Coronary Vasomotor Disorders.","authors":"Andrea Caffè, Francesco M Animati, Rocco A Montone","doi":"10.31083/RCM52151","DOIUrl":"https://doi.org/10.31083/RCM52151","url":null,"abstract":"<p><p>Vasospastic angina and microvascular angina are increasingly recognized as important causes of myocardial ischemia in patients with angina or myocardial infarction and non-obstructive coronary arteries (ANOCA/MINOCA). Unlike obstructive coronary artery disease, these conditions result from dynamic alterations in epicardial and/or microvascular tone that are not detected by standard coronary angiography. Intracoronary acetylcholine (ACh) provocation testing enables direct assessment of coronary vasomotor function by evaluating both endothelial integrity and smooth muscle reactivity. Moreover, ACh can identify epicardial spasm, microvascular spasm, or impaired endothelium-dependent vasodilation, thereby providing precise characterization of the underlying pathophysiological mechanism. When performed using standardized protocols, ACh testing has shown a high diagnostic yield and a reassuring safety profile. In addition to the associated diagnostic relevance, the ACh response carries prognostic significance, as abnormal findings are associated with a higher risk of recurrent angina and adverse cardiovascular events. Furthermore, randomized data demonstrated that treatment tailored to invasive coronary function testing improves symptoms and quality of life. This review summarizes the pathophysiological background, practical aspects, safety, and clinical value of ACh provocation testing, underscoring its central role in a more personalized approach to patients with ANOCA/MINOCA.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"52151"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome Stratification in Non-ST-Segment Elevation Myocardial Infarction: Standardized Assessment of Left Ventricular Global Longitudinal Strain.","authors":"Yaoyuan Xiao, Xi Li, Qinghua Fu, Yi Tang, Mingxiang Tang","doi":"10.31083/RCM49528","DOIUrl":"https://doi.org/10.31083/RCM49528","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular global longitudinal strain (LVGLS) is a sensitive index of left ventricular systolic function. However, the prognostic value of this metric in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) has not been fully established.</p><p><strong>Methods: </strong>We retrospectively enrolled patients with newly diagnosed NSTEMI at Hunan Provincial People's Hospital between April 2020 and October 2023. All participants underwent transthoracic echocardiography (TTE) within 48 hours before coronary revascularization. Major adverse cardiovascular events (MACEs) were defined as readmission for unstable angina, non-fatal myocardial infarction, readmission for heart failure, or cardiac death.</p><p><strong>Results: </strong>We followed 181 patients with NSTEMI for a median of 599 days (interquartile range (IQR): 297-800). MACEs occurred in 40 patients. Patients who experienced MACEs had significantly worse LVGLS than those without events (-11.00 [-13.70, -7.77] vs. -16.10 [-18.90, -13.50]; <i>p</i> < 0.001). In multivariable Cox regression analysis, LVGLS independently predicted MACEs (hazard ratio (HR) = 1.310, 95% confidence interval (CI): 1.172-1.465; <i>p</i> < 0.001). For 12-month risk prediction, adding LVGLS to the baseline clinical model improved discrimination, increasing the area under the curve (AUC) from 0.668 to 0.835. Kaplan-Meier analysis showed a markedly higher risk of MACEs in patients with LVGLS >-13.75% than in those with LVGLS ≤-13.75% (HR = 7.463; 95% CI, 3.831-14.540; <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>LVGLS is a strong, independent predictor of adverse cardiovascular events and may improve early risk stratification in patients with NSTEMI.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"49528"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Horváth et al. Subacute Reperfusion in Ischemic Hearts: Study of Autophagy and Its Possible Interconnection With Receptor-Interacting Protein Kinase 3. Reviews in Cardiovascular Medicine. 2022; 23(6): 213.","authors":"Csaba Horváth, Tanya Ravingerová, M Saadeh Suleiman, Adriana Adameová","doi":"10.31083/RCM58067","DOIUrl":"https://doi.org/10.31083/RCM58067","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.31083/j.rcm2306213.].</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"58067"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Coronary Artery Bypass Grafting in Patients With Prior Myocardial Infarction: A Propensity Score-Matched Retrospective Study.","authors":"Yanbin Lei, Guang Li, Zhao Yang, Bin You","doi":"10.31083/RCM49786","DOIUrl":"https://doi.org/10.31083/RCM49786","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with prior myocardial infarction (MI) represent a high-risk subgroup for coronary artery bypass grafting (CABG). The primary goal of CABG is durable myocardial revascularization to prevent recurrent ischemic events and improve survival. Minimally invasive CABG (MICS-CABG) may accelerate recovery, but evidence specifically in patients with a history of MI remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We performed a single-center retrospective cohort study of adults with prior MI who underwent isolated CABG from 2017 to 2024. Patients with new or recurrent MI within 3 months were excluded. Patients underwent either MICS-CABG via left mini-thoracotomy or conventional CABG via median sternotomy. Propensity score matching (PSM; 1:1) was used to balance preoperative covariates. The primary outcome was the occurrence of major adverse cardiovascular events (MACEs) during the index hospitalization, reflecting the safety and adequacy of surgical myocardial revascularization. Secondary outcomes included postoperative length of stay (LOS), intensive care unit stay, 24-hour drainage volume, and in-hospital mortality. Univariable and multivariable linear regression analyses were performed to evaluate factors associated with postoperative LOS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The unmatched cohort included 208 patients (sternotomy CABG, n = 142; MICS-CABG, n = 66). After PSM, 106 patients (53 pairs) were included in the analysis. The number of grafts was lower in the MICS-CABG group both before matching (1.71 ± 0.84 vs. 2.08 ± 0.91; &lt;i&gt;p&lt;/i&gt; = 0.004) and after matching (1.79 ± 0.86 vs. 2.17 ± 0.89; &lt;i&gt;p&lt;/i&gt; = 0.029). The number of diseased vessels was also lower in the MICS-CABG group after matching (1.83 ± 0.85 vs. 2.17 ± 0.83; &lt;i&gt;p&lt;/i&gt; = 0.039). The incidence of in-hospital MACEs was low and did not differ between groups, and no MACEs occurred after matching. Postoperative LOS was shorter with the minimally invasive approach before matching (6.06 ± 2.79 vs. 7.20 ± 2.98 days; mean difference, -1.14 days; 95% confidence interval (CI), -1.97 to -0.31; &lt;i&gt;p&lt;/i&gt; = 0.009) and after matching (6.09 ± 2.96 vs. 7.34 ± 2.68 days; mean difference, -1.25 days; 95% CI, -2.32 to -0.18; &lt;i&gt;p&lt;/i&gt; = 0.025). However, this association was attenuated and no longer significant after multivariable adjustment. Early postoperative complications, support therapies, and in-hospital mortality were uncommon and comparable between groups, and no reoperations occurred.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In selected patients with prior MI, MICS-CABG demonstrated comparable early safety and a similar incidence of in-hospital MACEs compared with conventional sternotomy CABG after PSM. Although the diseased/transplanted vessel ratio was similar between groups, this finding should be interpreted cautiously because the metric does not fully capture angiographic complexity or graftability. Although the minimally invasive approach was associated with a sh","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"49786"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Ultrasound-Guided Versus Ultrasound-Guided Femoral Venous Puncture in the Interventional Pulmonary Embolism Era: Does Ultrasound Guidance Improve Safety and Feasibility?","authors":"Abdelrahman Elhakim, Desouki Abdelatti, Mohamed Elhakim, Osama Bisht, Ibrahim Yassin, Mohamed A Mosaad, Ahmad M Hassaan, Peter W Radke, Mohammed Saad","doi":"10.31083/RCM46795","DOIUrl":"https://doi.org/10.31083/RCM46795","url":null,"abstract":"<p><strong>Background: </strong>The use of interventional endovascular therapy for pulmonary embolism (PE) has become increasingly important over the last decade. In contrast to other cardiovascular interventions, these procedures carry a higher risk of access-related bleeding due to the acute clinical setting, elevated body mass index, and the frequent need for high-dose anticoagulation. However, there is still no clear consensus regarding the optimal vascular access site for endovascular PE therapy or the impact of ultrasound (US)-guided puncture on access-related complications.</p><p><strong>Methods: </strong>We treated 89 patients with intermediate- to high-risk PE using the Ekosonic endovascular system (EKOS). Group A (n = 39) underwent femoral venous puncture without US guidance, and Group B (n = 50) underwent US-guided femoral venous puncture.</p><p><strong>Results: </strong>Intraprocedural complications differed significantly between the two groups, with a higher incidence of vascular access complications in the non-US-guided group. Access-site pseudoaneurysms and retroperitoneal bleeding events occurred exclusively in the non-US-guided group (n = 6). Major (n = 3) and moderate (n = 5) bleeding events were also observed only in the non-US-guided group (<i>p</i> < 0.001). However, the total length of stay in the intermediate care unit and in the hospital did not differ between the groups. These findings are consistent with prior reports from other interventional settings that demonstrate fewer bleeding events among patients undergoing US-guided procedures.</p><p><strong>Conclusion: </strong>Widespread adoption of US-guided puncture in interventional PE therapy could reduce access-related complications, increase first-pass success, and reduce the number of puncture attempts, inadvertent arterial punctures, and unsuccessful access-site cannulations, particularly in patients with unfavorable access anatomy, obesity, or anatomical variations. Further education and implementation of US-guided access into training programs could improve the adoption of this technique.</p>","PeriodicalId":20989,"journal":{"name":"Reviews in cardiovascular medicine","volume":"27 9","pages":"46795"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}