REC Interventional Cardiology English Ed最新文献_第4页

Thermodilution assessment of vasoreactivity and microvascular function in the absence of obstructive coronary artery disease 无阻塞性冠状动脉疾病时血管反应性和微血管功能的热稀释评估

REC Interventional Cardiology English Ed Pub Date : 2023-06-07 DOI: 10.24875/recice.m23000376

Pau Federico Zaragoza, T. Castelló Viguer, Luis Martínez Ortiz de Urbina, Ana Planas del Viejo, E. Peris Domingo, F. Pomar Domingo

{"title":"Thermodilution assessment of vasoreactivity and microvascular function in the absence of obstructive coronary artery disease","authors":"Pau Federico Zaragoza, T. Castelló Viguer, Luis Martínez Ortiz de Urbina, Ana Planas del Viejo, E. Peris Domingo, F. Pomar Domingo","doi":"10.24875/recice.m23000376","DOIUrl":"https://doi.org/10.24875/recice.m23000376","url":null,"abstract":"Introduction and objectives: Invasive diagnosis of vasoreactivity and microvascular function may be useful to optimize the management of patients with signs and/or symptoms of myocardial ischemia in the absence of significant coronary stenosis (INOCA). We analyzed the prevalence of the different endotypes, as well as the concordance between 2 diagnostic methods based on ther-modilution assessment. Methods: We prospectively included 60 patients with INOCA who underwent a vasoreactivity test with intracoronary acetylcholine, and measurement of absolute coronary blood flow (Q) and minimum microvascular resistance (R) using continuous thermodilution assessment. Finally, calculations of the coronary flow reserve (CFR) and index of microcirculatory resistance index (IMR) were made using the bolus thermodilution method considering CFR < 2 and MRI ≥ 25 as established pathological cut-off values. Results: The invasive functional diagnostic procedure allowed patients to be categorized into 4 subgroups: microvascular dysfunction (40%), epicardial vasospasm (17%), mixed disorder (20%), and normal study (23%). No correlation was seen between the Q and the CFR. Using ROC curves, an R > 435 UW was estimated as the optimal cut-off value to identify patients with IMR ≥ 25 with an area under the curve of 0.67 (95%CI, 0.51-0.82; P = .04). Conclusions: The invasive study of vasoreactivity and microcirculation was feasible and safe. Prevalence of vasospasm and microvascular dysfunction in patients with INOCA was high. The CFR/MRI/Q combined study allowed us to unmask a subtype of microvascular dysfunction characterized by an abnormally high coronary flow at baseline. The concordance seen between the microvascular resistance obtained by continuous thermodilution measurements and the reference method was low so future studies are justified to determine the usefulness of this technique.","PeriodicalId":34613,"journal":{"name":"REC Interventional Cardiology English Ed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42139422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Drug-eluting balloon angioplasty for bifurcated chronic total coronary occlusion 药物洗脱球囊成形术治疗慢性冠脉分叉性全闭塞

REC Interventional Cardiology English Ed Pub Date : 2023-06-02 DOI: 10.24875/recice.m23000390

Marcel Alméndarez, Rut Álvarez-Velasco, Alberto Alperi Garcia, P. Avanzas, Cesar Morís de la Tassa, and Isaac Pascual

引用次数: 0

Design of the ROLLERCOASTR trial: rotational atherectomy, lithotripsy or laser for the management of calcified coronary stenosis ROLLERCOASTR试验的设计：旋磨、碎石或激光治疗钙化性冠状动脉狭窄

REC Interventional Cardiology English Ed Pub Date : 2023-05-22 DOI: 10.24875/recice.m23000381

A. Jurado-Román, A. Gómez-Menchero, I. Amat-Santos, J. Caballero-Borrego, S. Ojeda, R. Ocaranza-Sanchez, S. Jiménez-Valero, G. Galeote, and Raúl Moreno

{"title":"Design of the ROLLERCOASTR trial: rotational atherectomy, lithotripsy or laser for the management of calcified coronary stenosis","authors":"A. Jurado-Román, A. Gómez-Menchero, I. Amat-Santos, J. Caballero-Borrego, S. Ojeda, R. Ocaranza-Sanchez, S. Jiménez-Valero, G. Galeote, and Raúl Moreno","doi":"10.24875/recice.m23000381","DOIUrl":"https://doi.org/10.24875/recice.m23000381","url":null,"abstract":"Introduction and objectives: Coronary calcification is one of the leading factors that affect negatively the safety and effectiveness of percutaneous coronary intervention. Several calcium modification techniques exist. However, there is a lack of randomized evidence on the therapy of choice in this scenario. Methods: The ROLLERCOASTR is a prospective, multicenter, randomized clinical trial designed to compare the safety and efficacy profile of 3 plaque modification techniques in the moderate-to-severe coronary calcification setting: rotational atherectomy (RA), excimer laser coronary angioplasty (ELCA), and intravascular lithotripsy (IVL). The study primary endpoint is stent expansion evaluated by optical coherence tomography. An intention-to-treat analysis will be conducted with an alpha coefficient of 0.05 between the reference group (RA) and the remaining 2 groups (ELCA and IVL). An analysis of the study primary endpoint per protocol will be conducted for consistency purposes. If the non-inferiority hypothesis is confirmed, a superiority 2-sided analysis will be conducted. Both the clinical events committee and the independent core laboratory will be blinded to the treatment arm. Assuming an α error of 0.05, an β error of 0.2 (80% power), a margin of irrelevance ( ε ) of 7, and losses of 10% due to measurement difficulty or impossibility to complete the intervention, we estimate a sample size of 56 cases per group. The study secondary endpoints are device success, procedural success, crossover rate among the different techniques used, and the occurrence of major adverse cardiovascular events at 1-year follow-up. Conclusions: The ROLLERCOASTR trial will evaluate and compare the safety and effectiveness of 3 plaque modification techniques: RA, ELCA, and IVL in patients with calcified coronary stenosis. This trial was registered at clinicaltrials.gov with identifier NCT04181268.","PeriodicalId":34613,"journal":{"name":"REC Interventional Cardiology English Ed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42839683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The mystery of the Dragon�s tail solved by 3D reconstruction 龙之谜�三维重建求解s尾

REC Interventional Cardiology English Ed Pub Date : 2023-05-22 DOI: 10.24875/recice.m23000385

S. Santos-Martínez, Miguel Leiva-Gordillo, R. García-Belenguer, Paula Tejedor-Viñuela, and Pedro Morillas-Blasco

引用次数: 0

Transcatheter closure of aorto-left atrial fistula 经导管主动脉-左房瘘闭合术

REC Interventional Cardiology English Ed Pub Date : 2023-05-17 DOI: 10.24875/recice.m23000387

M. Tamargo, J. Elízaga, and Francisco Fernández-Avilés

引用次数: 0

Syphilitic aortitis as a rare cause of coronary ostial stenosis 梅毒性大动脉炎是冠状动脉口狭窄的罕见原因

REC Interventional Cardiology English Ed Pub Date : 2023-05-11 DOI: 10.24875/recice.m23000375

Rui Flores, F. Mané, C. Braga, and Cátia Oliveira

引用次数: 0

The MANTA vascular closure device in transfemoral TAVI: a real-world cohort MANTA血管闭合装置在经股TAVI中的应用：一个真实世界的队列

REC Interventional Cardiology English Ed Pub Date : 2023-05-11 DOI: 10.24875/recice.m23000380

Sofia Martinho, E. Jorge, V. Marinho, R. Baptista, Marco Costa, and Lino Gonçalves

{"title":"The MANTA vascular closure device in transfemoral TAVI: a real-world cohort","authors":"Sofia Martinho, E. Jorge, V. Marinho, R. Baptista, Marco Costa, and Lino Gonçalves","doi":"10.24875/recice.m23000380","DOIUrl":"https://doi.org/10.24875/recice.m23000380","url":null,"abstract":"Introduction and objectives: Transcatheter aortic valve implantation (TAVI) is an established treatment option for patients with symptomatic severe aortic stenosis often performed via transfemoral access route (TF-TAVI). Therefore, successful closure of large-bore access sites is essential. This study aims to investigate the safety and effectiveness of the MANTA (Teleflex/Essential Medical, United States) vascular closure device (VCD) in patients undergoing TF-TAVI in an unselected and consecutive cohort of patients. Methods: We conducted a single-center, observational study of 245 consecutive patients undergoing TF-TAVI in whom the arterial large-bore femoral access was closed with a MANTA device from March 2020 through February 2022. The primary efficacy outcome measure was the rate of VCD failure according to the VARC-3 definition. Results: Successful closure of the large-bore access site occurred in 92.2% of the patients (n = 226). According to the VARC-3 definition, no major vascular or bleeding complications related to the plug-based VCD were reported. Patients with failed VCDs (7.8%) had significantly smaller minimal femoral artery diameters (6.6 ± 1.1 mm vs 7.6 ± 1.4 mm; P = .005) and consequently, significant higher sheath-to-femoral artery diameter ratios (0.78 ± 0.16 vs 0.69 ± 0.15; P = .019). No other inter-group differences were found. Conclusions: In this single-center, real-world, unselected large cohort of consecutive patients treated with TF-TAVI, a plug-based VCD for large-bore arteriotomy closure turned out effective and safe, and enabled arterial access-site management with a low rate of complications.","PeriodicalId":34613,"journal":{"name":"REC Interventional Cardiology English Ed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42463556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intracoronary fibrinolysis as a bailout strategy for massive thrombotic catastrophe. Case resolution 冠状动脉内纤溶作为大规模血栓形成灾难的救助策略。案例解析

REC Interventional Cardiology English Ed Pub Date : 2023-05-10 DOI: 10.24875/recice.m22000306

Rui Flores, João Costa, Carlos Braga, Catarina Vieira, and, Catarina Quina-Rodrigues

引用次数: 0

New TAVI technique for difficult valve crossing 新TAVI技术解决阀门交叉困难

REC Interventional Cardiology English Ed Pub Date : 2023-05-04 DOI: 10.24875/recice.m23000379

J. M. T. Torre Hernández, Gabriela Veiga Fernández, S. Barrera, Fermín Sainz Laso, Daehyun Lee, and Tamara García Camarero

引用次数: 0

Dosimetric parameters in congenital cardiac catheterizations in Spain: the GTH-SECPCC Radcong-21 multicenter registry 西班牙先天性心脏导管的剂量参数：GTH-SECPCC Radcong-21多中心注册

REC Interventional Cardiology English Ed Pub Date : 2023-05-04 DOI: 10.24875/recice.m23000372

F. Rueda Núñez, C. Abelleira Pardeiro, B. Insa Albert, M. Álvarez-Fuente, Vanesa Balboa Barreiro, F. Ballesteros Tejerizo, P. Betrián-Blasco, Félix Coserría Sánchez, Juana María Espín López, Luis Fernández González, Dolores Herrera Linde, M. R. Romero Moreno, F. Sarnago Cebada, R. Sanz-Ruiz, and Juan Ignacio Zabala Argüelles

{"title":"Dosimetric parameters in congenital cardiac catheterizations in Spain: the GTH-SECPCC Radcong-21 multicenter registry","authors":"F. Rueda Núñez, C. Abelleira Pardeiro, B. Insa Albert, M. Álvarez-Fuente, Vanesa Balboa Barreiro, F. Ballesteros Tejerizo, P. Betrián-Blasco, Félix Coserría Sánchez, Juana María Espín López, Luis Fernández González, Dolores Herrera Linde, M. R. Romero Moreno, F. Sarnago Cebada, R. Sanz-Ruiz, and Juan Ignacio Zabala Argüelles","doi":"10.24875/recice.m23000372","DOIUrl":"https://doi.org/10.24875/recice.m23000372","url":null,"abstract":"Introduction and objectives: The results of the Radcong-21 Registry of the Spanish Society of Pediatric Cardiology and Congenital Heart Disease Working Group on Hemodynamics are described to analyze data, establish updated reference parameters, and compare them to other registries. Methods: Retrospective, cross-sectional, observational, multicenter registry of patients with congenital heart disease undergoing cardiac catheterization in 2021. Each cath lab sent the last 100 cases performed prior to January 2022. A descriptive analysis was conducted of anthropomorphic variables, procedural (grouped by type and radiation exposure categories [REC]) and technical characteristics, and dosimetric parameters with additional review of all values outside the 95%CI of the median. Results: A total of 1090 procedures performed in 11 cath lab of 10 hospital centers were analyzed. Age distribution: 22.8% < 1 year, 60.7% between 1-18 years, and 16.4% > 18 years. In dose area product (DAP)/Kg and DAP/Kg/fluoroscopy, the distribution was very similar regardless of the type of cath lab as is the case with most pediatric patients in terms of age, weight, and REC group. The DAP/Kg was higher in the REC I and III groups compared to other countries with registries and improvement programs in this area (78% and 8,3%, respectively). Conclusions: Representative data of dosimetric parameters by age and procedures in congenital cardiac catheterizations were obtained in Spain back in 2021. DAP/Kg is the parameter with the lowest dispersion in the sample. There is room for improvement compared to other countries with optimization programs in this area.","PeriodicalId":34613,"journal":{"name":"REC Interventional Cardiology English Ed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47454216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1