Interventional Cardiology Review最新文献

{"title":"Complete Revascularisation in ST-elevation MI: Do We Really Buy It? Challenging the Current Approach to Bystander Percutaneous Coronary Intervention.","authors":"Tevin Browne, Richard J Jabbour, Nick Curzen","doi":"10.15420/icr.2025.57","DOIUrl":"10.15420/icr.2025.57","url":null,"abstract":"<p><p>Complete revascularisation during ST-elevation MI (STEMI) has Class 1A guideline support based on multiple randomised controlled trials showing improved clinical outcomes compared with culprit-only percutaneous coronary intervention. However, the concept that all STEMI patients with bystander disease should undergo complete revascularisation is flawed. The randomised controlled trials have highly variable anatomical and physiological inclusion criteria and drivers for outcome benefit, to the extent that it is hard to pick out a possible mechanism of effect. There is a case to pursue some fundamental questions about how prophylactic stenting may help bystander disease in STEMI patients, as well as to try to establish whether there are high-risk patients/vessels/lesions that derive substantial benefit from stenting and, conversely, others in whom it is futile.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e12"},"PeriodicalIF":2.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13187932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal Fluoroscopic Angles for Percutaneous Coronary Intervention During Mechanical Cardiopulmonary Resuscitation in Cardiac Arrest Patients.","authors":"Uzma Sajjad, Rupert Simpson, Paul Rees, Sooriyamohan Mohanakumar, Klio Konstantinou, Tom Johnson, Nick Curzen, Nilesh Pareek, John R Davies, Thomas R Keeble","doi":"10.15420/icr.2025.54","DOIUrl":"10.15420/icr.2025.54","url":null,"abstract":"","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e10"},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Performance of the DynamX Bioadaptor in Complex Coronary Lesions: An Optical Coherence Tomography-based Evaluation.","authors":"Arif Al Nooryani, Ahmed Khashaba, George Sianos, Nagwa Abdelrahman","doi":"10.15420/icr.2025.48","DOIUrl":"10.15420/icr.2025.48","url":null,"abstract":"<p><strong>Background: </strong>The DynamX Coronary Bioadaptor System incorporates a novel uncaging element that disengages approximately 6 months post-implantation following polymer resorption, while preserving longitudinal structural integrity. This innovative design aims to address the limitations of conventional drug-eluting stents by facilitating restoration of physiological vessel function in the treated segment without compromising radial support.</p><p><strong>Methods: </strong>This retrospective study assessed the acute mechanical performance of the DynamX Bioadaptor in complex coronary lesions, as evaluated by optical coherence tomography (OCT) before and after DynamX implantation, with specific focus on lumen gain, device expansion, and strut apposition.</p><p><strong>Results: </strong>A total of 29 coronary lesions from 24 patients were retrospectively analysed by OCT. Pre-implantation plaque morphology revealed ruptured plaques in 34.5% of lesions and calcified plaques in 55%. An OCT-based calcium score of 3 or 4 was observed in nine lesions. Post-implantation OCT demonstrated an acute lumen gain of 1.37 ± 0.8 mm and a residual area stenosis of 14.7 ± 9%. The incidence of malapposed struts (strut-lumen distance >300 μm) was low (0.64 ± 1.34%). Edge dissections were observed in four lesions, with two (6.9%) requiring bailout stenting.</p><p><strong>Conclusion: </strong>The DynamX Bioadaptor showed favourable acute performance, achieving adequate lumen enlargement and optimal expansion and apposition in calcified and thrombotic lesion subsets, supporting its use in contemporary clinical practice.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e11"},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Hypothermia as Adjunctive Therapy in Percutaneous Coronary Intervention for ST-elevation MI: A Comprehensive Meta-analysis.","authors":"Mohamed Riad Abouzid, Ibrahim Kamel, Karim Ali, Ahmed E Ali, Ahmed Mazen Amin","doi":"10.15420/icr.2024.31","DOIUrl":"10.15420/icr.2024.31","url":null,"abstract":"<p><strong>Aim: </strong>This meta-analysis aims to assess the effectiveness of hypothermia as an adjunctive therapy in percutaneous coronary intervention (PCI) for patients with ST-elevation MI.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using electronic databases to identify relevant studies published up to September 2023. Studies investigating the use of adjunctive hypothermia in ST-elevation MI patients undergoing PCI were included. Data on clinical outcomes, including mortality, infarct size, left ventricular function, major adverse cardiac events and microvascular obstruction, were extracted and analysed. Bleeding and infection events as primary safety endpoints in the safety analysis were also assessed.</p><p><strong>Results: </strong>Eight studies involving 488 patients were included in this meta-analysis. The pooled analysis revealed no significant difference in all-cause mortality between the adjunctive hypothermia group and the control group (OR 0.60; 95% CI [0.24-1.53], p=0.29). There was no significant difference in major adverse cardiac event rates between the two groups (OR 1.59; 95% CI [0.63-4.01]). Additionally, no significant differences were observed in infarct size, left ventricular function or microvascular obstruction. In the safety analysis, hypothermia significantly increased the risk of infection (OR 7.22, 95% CI [2.47-21.10]; p=0.0003; <i>I</i>²=0%) but showed no significant impact on bleeding events (OR 2.27; 95% CI [0.76-6.78]; p=0.14; <i>I</i>²=0%).</p><p><strong>Conclusion: </strong>While previously believed to show promise, hypothermia as adjunctive therapy in PCI fails to achieve any significant superiority over standard interventions according to our analysis. Furthermore, hypothermia was associated with a significantly increased risk of infection without a notable impact on bleeding events, raising concerns about its safety profile. Nevertheless, our findings should be interpreted with caution, considering the limitations of our analysis, such as the small number of studies available in the literature. Continued research efforts on larger sample sizes are essential to either refine or refute the current findings.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e08"},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultimaster TANSEI Stent in Complex Coronary Lesions: The EPIC08 TANSEI COMPLEX Study.","authors":"Ricardo Palma-Carbajal, Yassin Belahnech, José María de la Torre Hernández, Tamara García Camarero, José Miguel Vegas Valle, Juan Rondán Murillo, Antonio-Gómez Menchero, Armando Pérez de Prado, Eduardo Pinar Bermúdez, Pedro Martín Lorenzo, Jesús Jiménez Mazuecos, Koldobika García San Román, Beatriz Vaquerizo, Ramón Calviño Santos, Fernando Lozano Ruiz-Poveda, Soledad Ojeda Pineda, Jorge Perea Armijo, Jeremías Bayón, Javier Goicolea Ruigómez, Juan H Alonso Briales, Juan Sanchis, Bruno García Del Blanco","doi":"10.15420/icr.2025.33","DOIUrl":"10.15420/icr.2025.33","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) for complex anatomy is increasingly common. The third-generation Ultimaster TANSEI drug-eluting stent (DES) was developed to optimise safety and efficacy in challenging lesions.</p><p><strong>Methods: </strong>This was a prospective, single-arm, multicentre registry (August 2020-November 2022) of patients with complex lesions - left main, bifurcations, small vessels and long lesions - treated with Ultimaster TANSEI DES and followed for 1 year. The primary endpoint was the device-oriented composite endpoint (DoCE), including cardiac death, target-vessel MI, target-vessel revascularisation (TVR) and stent thrombosis. The secondary endpoint was the patient-oriented composite endpoint (PoCE), including all-cause death, any MI and any revascularisation.</p><p><strong>Results: </strong>In total, 501 patients with 591 complex lesions (mean age 66.7 years; 79.6% male; 33.4% with diabetes) were treated. Lesion types: left main 11%, bifurcations 43.9%, small vessels 40.7%, long lesions 34.3%. At 1 year, incidence rates were: DoCE 3.23 per 100 person-years (95% CI [1.84-5.24]) and PoCE 5.04 per 100 person-years (95% CI [3.26-7.44]). In subgroup analyses, long lesions (>35 mm) showed consistently higher risk: DoCE RR 4.22 (95% CI [1.49-11.95]; p=0.006), PoCE RR 4.93 ([2.10-11.57]; p<0.001), overall mortality RR 4.79 [1.53-15.06]; p=0.007) and TVR RR 17.60 [2.22-139.51]; p<0.001).</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e09"},"PeriodicalIF":2.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative Management of Coronary Perforation: Lessons from the Oleander Bloom.","authors":"Rithik Mohan Singh Sindhi, Aaron Peace, Jack Andrews","doi":"10.15420/icr.2025.05","DOIUrl":"10.15420/icr.2025.05","url":null,"abstract":"<p><p>This is a case report of a 62-year-old male patient who developed coronary perforation during a percutaneous coronary intervention. He presented with a non-ST-elevation MI and had a history of hypertension and hypercholesterolaemia, with an elevated BMI. Coronary angiography revealed severe calcific coronary disease within an angulated proximal left anterior descending artery. Following a heart team meeting, the consensus was for complex percutaneous coronary intervention to the left anterior descending artery, with or without left main stem involvement. Following initial balloon dilatation within the left anterior descending artery there was a clear coronary perforation. The operators could not advance a balloon past the point of perforation. It was thought that a calcific spur was preventing this. The patient suffered no acute haemodynamic compromise and there was no evidence of pericardial effusion on bedside echocardiography. After a period of observation, the operators made the decision to stop. The patient remained in the cardiac care unit on dual antiplatelet therapy for 2 weeks. The operators then brought the patient back to the laboratory and completed the case with relative ease. This case highlights the potential for conservative, non-surgical management in selected patients with contained coronary perforations, suggesting that appropriate monitoring and pharmacotherapy can mitigate the risks associated with invasive correction.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e07"},"PeriodicalIF":2.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147469485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the Left Main Bifurcation: Which Stenting Strategy Best Minimises Major Adverse Cardiac Events and Target Lesion Revascularisation? A Network Meta-analysis.","authors":"Suryono Suryono, Muhammad Farhan Hibatulloh, Alfiyah Ramadhani, Candra Agung Wibisana, Achmad Ilham Tohari, Muhammad Rijal Fachrudin Hidayat, Muhammad Irsyad Amien, Muhammad Naufal Hibatullah, Hazbina Fauqi Ramadhan","doi":"10.15420/icr.2025.47","DOIUrl":"10.15420/icr.2025.47","url":null,"abstract":"<p><strong>Background: </strong>Left main bifurcation lesions (LMBL) present considerable challenges in percutaneous coronary intervention due to the increased risk of restenosis, thrombosis and major adverse cardiac events (MACE). Determining the optimal stenting technique remains crucial to improving patient outcomes.</p><p><strong>Methods: </strong>This network meta-analysis systematically reviewed 19 eligible studies assessing diverse stenting strategies' effects on MACE and target lesion revascularisation (TLR) at 12-month follow-up. Random effects models were used and studies were selected using the PICO framework - population, intervention, comparison, outcome. Key techniques evaluated included provisional single-stenting, doublestenting (culotte, T-stenting and small protrusion (T/TAP), V-stenting and standard crush) and double kissing (DK) crush. Quality and risk of bias were appraised using appropriate validated instruments.</p><p><strong>Results: </strong>DK crush demonstrated significantly lower TLR (RR 0.58; 95% CI [0.38-0.88]) and MACE (RR 0.51; 95% CI [0.36-0.72]) compared with single-stenting. Pooled double-stenting techniques increased TLR risk (RR 1.29; 95% CI [1.06-1.58]). Detailed ranking models consistently placed DK crush as the most effective, with p-values up to 0.95. Heterogeneity and reporting bias were minimal, supporting the robustness of these findings. Provisional stenting remains suitable for less complex bifurcations, while culotte and T/TAP were associated with higher risks.</p><p><strong>Conclusion: </strong>DK crush is the preferred strategy for complex LMBL as it minimises MACE and TLR. Provisional stenting is reasonable in simpler anatomical scenarios. Clinical decision-making should incorporate lesion complexity, patient characteristics and operator expertise. Further large-scale randomised trials are warranted to validate these results.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e06"},"PeriodicalIF":2.0,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraprocedural Management of Pulmonary Embolism Patients Undergoing Transcatheter Treatment, and Ventilatory and Cardiac Support.","authors":"Sylwia Sławek-Szmyt, Aleksander Araszkiewicz","doi":"10.15420/icr.2024.56","DOIUrl":"10.15420/icr.2024.56","url":null,"abstract":"<p><p>This review critically examines and summarises the current literature on haemodynamic and respiratory support for pulmonary embolism. It addresses oxygen therapy, fluid therapy, pharmacological support (including vasopressors and inotropes), and mechanical circulatory support options, including veno-arterial extracorporeal membrane oxygenation and right ventricular assist devices. Additionally, it provides the practical aspects of each therapy.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e05"},"PeriodicalIF":2.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Imaging for Structural Heart Disease: What is Normal for Women?","authors":"Rowa H Attar","doi":"10.15420/icr.2024.27","DOIUrl":"10.15420/icr.2024.27","url":null,"abstract":"<p><p>The accessibility of advanced imaging techniques has led to the exponential growth of transcatheter valve and structural interventions. The prevalence of valve disease in women is increasing in both developed and developing countries. Despite this increase in disease burden in women, optimal imaging indices for referral are understudied and underused in both research and clinical settings, resulting in later referral for intervention, suboptimal risk prediction and arbitrary procedural and device selection. Available published clinical trials are deficient in adequate sex-specific enrolment, resulting in a paucity of evidence to guide refined valve-related management in female patients. Thus, data referenced in current guidelines scarcely outline sex-specific recommendations with reference to optimal selection criteria, timing for referral and optimal procedural strategy and follow-up for this group of patients. This review summarises the available literature, focusing on disparities in imaging in women with valvular heart disease.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e04"},"PeriodicalIF":2.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workflow-based Framework to Aid with High-Definition Intravascular Ultrasound-Optimised Coronary Stenting: Introducing IVUS 123 Essentials.","authors":"Simon J Walsh, Rafael Cavalcante, Kevin Croce, Colm G Hanratty, Hayder Hashim, Francis Joshi, Sanjog Kalra, Ajay Kirtane, Akiko Maehara, Margaret McEntegart, Robert F Riley, James C Spratt","doi":"10.15420/icr.2025.44","DOIUrl":"10.15420/icr.2025.44","url":null,"abstract":"<p><p>Intravascular ultrasound (IVUS) has been in clinical use for more than three decades. Despite evidence that supports the application of the technology from multiple registries, randomised trials and meta-analyses, adoption remains low. Potential barriers to the adoption of IVUS are a lack of understanding as to how to accurately interpret images and how to incorporate it into clinical workflow. To address this, this paper summarises evidence-based protocols for the application of IVUS during percutaneous coronary intervention (PCI) into an easily understood workflow. Standardisation of approaches and wider adoption of IVUS-optimised PCI should improve patient outcomes and PCI durability.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"21 ","pages":"e03"},"PeriodicalIF":2.8,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}