Interventional Cardiology Review最新文献

{"title":"Left Atrial Appendage Occlusion: British Cardiovascular Intervention Society and British Heart Rhythm Society Position Statement.","authors":"Tim R Betts, Patrick A Calvert, Lee N Graham, Gerald J Clesham, Ashan Gunarathne, Brian Clapp, Dhiraj Gupta, Jan Kovac, James D Newton, David Hildick-Smith","doi":"10.15420/icr.2023.42","DOIUrl":"https://doi.org/10.15420/icr.2023.42","url":null,"abstract":"<p><p>Percutaneous left atrial appendage occlusion aims to reduce the risk of stroke in patients with AF, particularly those who are not good candidates for systemic anticoagulation. The procedure has been studied in large international randomised trials and registries and was approved by the National Institute for Health and Care Excellence in 2014 and by NHS England in 2018. This position statement summarises the evidence for left atrial appendage occlusion and presents the current indications. The options and consensus on best practice for pre-procedure planning, undertaking a safe and effective implant and appropriate post-procedure management and follow-up are described. Standards regarding procedure volume for implant centres and physicians, the role of multidisciplinary teams and audits are highlighted.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e02"},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294862","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":"Foreword.","authors":"","doi":"10.15420/icr.2024.19.S1","DOIUrl":"10.15420/icr.2024.19.S1","url":null,"abstract":"","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294861","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":"Coronary Artery Fistula: A Diagnostic Dilemma.","authors":"Rajesh Kumar, Jathinder Kumar, Cormac O'Connor, Ihsan Ullah, Benjamin Tyrell, Ian Pearson, Sajjad Matiullah, Kevin Bainey","doi":"10.15420/icr.2022.34","DOIUrl":"https://doi.org/10.15420/icr.2022.34","url":null,"abstract":"<p><p>Coronary artery fistula (CAF), although one of the rare coronary anomalies, is becoming increasingly more detectable in the recent years due to advancements in cardiac diagnostic imaging. Its long-term prognostic implications and importance for the cardiovascular system remain a dilemma for cardiologists and patients. Based on a variety of haemodynamic symptoms and complications, cardiologists must be aware of the characteristics of CAF and the diagnostic importance of multi-slice CT in evaluation, pre-procedural management and follow-up. Both surgical and percutaneous options are available for symptomatic patients or those with complications, while management of asymptomatic CAF remains a viable alternative.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138831992","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":"Coronary CT Angiography in the Cath Lab: Leveraging Artificial Intelligence to Plan and Guide Percutaneous Coronary Intervention.","authors":"Hirofumi Ohashi, Frédéric Bouisset, Dimitri Buytaert, Ruiko Seki, Jeroen Sonck, Koshiro Sakai, Marta Belmonte, Pieter Kitslaar, Adam Updegrove, Tetsuya Amano, Daniele Andreini, Bernard De Bruyne, Carlos Collet","doi":"10.15420/icr.2023.12","DOIUrl":"https://doi.org/10.15420/icr.2023.12","url":null,"abstract":"<p><p>The role of coronary CT angiography for the diagnosis and risk stratification of coronary artery disease is well established. However, its potential beyond the diagnostic phase remains to be determined. The current review focuses on the insights that coronary CT angiography can provide when planning and performing percutaneous coronary interventions. We describe a novel approach incorporating anatomical and functional pre-procedural planning enhanced by artificial intelligence, computational physiology and online 3D CT guidance for percutaneous coronary interventions. This strategy allows the individualisation of patient selection, optimisation of the revascularisation strategy and effective use of resources.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138832002","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":"Revascularisation for Ischaemic Cardiomyopathy.","authors":"Matthew E Li Kam Wa, Saba Z Assar, Ajay J Kirtane, Divaka Perera","doi":"10.15420/icr.2023.06","DOIUrl":"10.15420/icr.2023.06","url":null,"abstract":"<p><p>Coronary artery disease is a leading cause of heart failure with reduced ejection fraction. Coronary artery bypass grafting appears to provide clinical benefits such as improvements in quality of life, reductions in readmissions and MI, and favourable effects on long-term mortality; however, there is a significant short-term procedural risk when left ventricular function is severely impaired, which poses a conundrum for many patients. Could percutaneous coronary intervention provide the same benefits without the hazard of surgery? There have been no randomised studies to support this practice until recently. The REVIVED-BCIS2 trial (NCT01920048) assessed the outcomes of percutaneous coronary intervention in addition to optimal medical therapy in patients with ischaemic left ventricular dysfunction and stable coronary artery disease. This review examines the trial results in detail, suggests a pathway for investigation and revascularisation in ischaemic cardiomyopathy, and explores some of the remaining unanswered questions.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e24"},"PeriodicalIF":0.2,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/1e/icr-18-e24.PMC10466461.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10135184","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":"Severe Acute Thrombocytopenia After Treatment with Tirofiban: A Case Series Approach.","authors":"Gian-Manuel Jiménez-Rodríguez, Patricia Carmona-Levario, José-Alberto Ayón-Martínez, Aleksandra Gasecka, Luis Eduardo Juárez-Orozco, Antonio Reyes-Ortega, Patricia Espinosa-González, Gyna Alejandra Altamirano-Solorzano, Guering Eid-Lidt","doi":"10.15420/icr.2022.23","DOIUrl":"10.15420/icr.2022.23","url":null,"abstract":"<p><p>Glycoprotein IIb/IIIa inhibitors are an adjuvant therapy for the treatment of patients with acute coronary syndromes. The main adverse reactions are bleeding and thrombocytopenia in 1-2% of cases. A 66-year-old woman arrived at the emergency department with ST-elevation MI. The catheterisation lab was busy, so she received thrombolytic therapy. Coronary angiography revealed a 90% stenosis in the middle segment of the left anterior descending artery and Thrombolysis in MI 2 flow. Subsequent percutaneous coronary intervention showed abundant thrombus and a coronary dissection and it was necessary to insert five drug-eluting stents. Non-fractionated heparin and a tirofiban infusion were used. After the percutaneous coronary intervention, she developed severe thrombocytopenia, haematuria and gingivorrhagia, for which infusion of tirofiban was suspended. In follow-up, no major bleeding or subsequent haemorrhagic complications were identified. It is crucial to distinguish between heparin-induced thrombocytopenia and thrombocytopenia caused by other drugs. A high level of suspicion should be employed in these cases.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e15"},"PeriodicalIF":0.2,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/8c/icr-18-e15.PMC10311402.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737626","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":"Long-term Outcomes for Drug-eluting Balloons versus Drug-eluting Stents in the Treatment of Small Vessel Coronary Artery Disease: A Systematic Review and Meta-analysis.","authors":"Greg Murphy, Ailish Naughton, Rory Durand, Elizabeth Heron, Conor McCaughey, Ross T Murphy, Ian Pearson","doi":"10.15420/icr.2022.26","DOIUrl":"10.15420/icr.2022.26","url":null,"abstract":"<p><p><b>Background:</b> This systematic review and meta-analysis compares long-term outcomes follow-up data comparing drug-eluting balloons (DEBs) and drug-eluting stents (DESs) in interventional treatment of small coronary artery disease (<3 mm). <b>Methods:</b> A systematic review was undertaken along with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome was 1-3-year performance of DEB versus DES in major adverse cardiac events. Secondary outcomes include all-cause mortality, MI, cardiac death, vessel thrombosis, major bleeding, target vessel revascularisation and target lesion revascularisation. Two independent reviewers extracted data. All outcomes used the Mantel-Haenszel and random effects models. ORs are presented with a 95% CI. <b>Results:</b> Of 4,661 articles, four randomised control trials were included (1,414 patients). DEBs demonstrated reduced rates of non-fatal MI at 1 year (OR 0.44; 95% CI [0.2-0.94]), and BASKET-SMALL 2 reported a significant reduction in 2-year bleeding rates (OR 0.3; 95% CI [0.1-0.91]). There was no significant difference in all other outcomes. <b>Conclusion:</b> Long-term follow-up of DEB and DES use in small coronary arteries demonstrates DEBs be comparable with DESs in all outcomes at 1, 2 and 3 years of follow-up. A significant reduction was found in rates of non-fatal MI at 1 year in the DEB arm, and a reduction in major bleeding episodes at 2 years in the BASKET-SMALL 2 trial. These data highlight the potential long-term utility of novel DEBs in small coronary artery disease revascularisation.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e14"},"PeriodicalIF":0.2,"publicationDate":"2023-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/8c/icr-18-e14.PMC10311399.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9737631","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":"Procedural and Technological Innovations Facilitating Ultra-low Contrast Percutaneous Coronary Interventions.","authors":"Breda Hennessey, Asad Shabbir, Alejandro Travieso, Nieves Gonzalo, Javier Escaned","doi":"10.15420/icr.2022.32","DOIUrl":"10.15420/icr.2022.32","url":null,"abstract":"<p><p>Ultra-low-dose contrast percutaneous coronary intervention (PCI) is a valuable approach in selected complex high-risk patients with renal failure. One of the objectives of ultra-low contrast PCI is to decrease the probability of developing postprocedural contrast-induced nephropathy (CIN), which predominately affects patients with baseline renal dysfunction. CIN is associated with poor clinical outcomes and increased healthcare-related costs. Another two clinical scenarios in which reduced dependence on contrast administration by the operator may contribute to improved safety are PCI in complex, high-risk indicated patients and in shock. In this review, we discuss the procedural techniques and recent technological innovations that enable ultra-low-dose contrast PCI to be performed in the cardiac cath lab.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e09"},"PeriodicalIF":0.2,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/75/ea/icr-18-e09.PMC10301683.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9736983","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":"Invasive Detection of Coronary Microvascular Dysfunction: How It Began, and Where We Are Now.","authors":"Samer Fawaz,&nbsp;Sarosh Khan,&nbsp;Rupert Simpson,&nbsp;Gerald Clesham,&nbsp;Christopher M Cook,&nbsp;John R Davies,&nbsp;Grigoris V Karamasis,&nbsp;Thomas R Keeble","doi":"10.15420/icr.2022.30","DOIUrl":"10.15420/icr.2022.30","url":null,"abstract":"<p><p>The landscape of interventional cardiology is ever evolving. Contemporary practice has shifted from a stenosis-centred approach to the total characterisation of both the epicardial and microcirculatory vessels. Microcirculatory dysfunction plays an important role in the pathophysiology of acute and chronic coronary syndromes, and characterisation of the microcirculation has important clinical consequences. Accordingly, the invasive diagnosis of microcirculatory dysfunction is becoming a key feature of the interventional cardiologist's toolkit. This review focuses on the methodology underpinning the invasive diagnosis of microvascular dysfunction and highlights the indices that have arisen from these methodologies.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e07"},"PeriodicalIF":0.0,"publicationDate":"2023-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/56/icr-18-e07.PMC10433108.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10047176","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":"Angiographic and Procedural Characteristics in Frail Older Patients with Non-ST Elevation Acute Coronary Syndrome.","authors":"Benjamin Beska, Hanna Ratcovich, Alan Bagnall, Amy Burrell, Richard Edwards, Mohaned Egred, Rebecca Jordan, Amina Khan, Greg B Mills, Emma Morrison, Daniell Edward Raharjo, Fateh Singh, Chris Wilkinson, Azfar Zaman, Vijay Kunadian","doi":"10.15420/icr.2022.20","DOIUrl":"10.15420/icr.2022.20","url":null,"abstract":"<p><strong>Background: </strong>Angiographic and procedural characteristics stratified by frailty status are not known in older patients with non-ST elevation acute coronary syndrome (NSTEACS). We evaluated angiographic and procedural characteristics in older adults with NSTEACS by frailty category, as well as associations of baseline and residual SYNTAX scores with long-term outcomes.</p><p><strong>Methods: </strong>In this study, 271 NSTEACS patients aged ≥75 years underwent coronary angiography. Frailty was assessed using the Fried criteria. Angiographic analysis was performed using QAngio® XA Medis in a core laboratory. Major adverse cardiovascular events (MACE) consisted of all-cause mortality, MI, stroke or transient ischaemic attack, repeat unplanned revascularisation and significant bleeding.</p><p><strong>Results: </strong>Mean (±SD) patient age was 80.5 ± 4.9 years. Compared with robust patients, patients with frailty had more severe culprit lesion calcification (OR 5.40; 95% CI [1.75-16.8]; p=0.03). In addition, patients with frailty had a smaller mean improvement in culprit lesion stenosis after percutaneous coronary intervention (50.6%; 95% CI [45.7-55.6]) than robust patients (58.6%; 95% CI [53.5-63.7]; p=0.042). There was no association between frailty phenotype and completeness of revascularisation (OR 0.83; 95% CI [0.36-1.93]; p=0.67). A high baseline SYNTAX score (≥33) was associated with adjusted (age and sex) 5-year MACE (HR 1.40; 95% CI [1.08-1.81]; p=0.01), as was a high residual SYNTAX score (≥8; adjusted HR 1.22; 95% CI [1.00-1.49]; p=0.047).</p><p><strong>Conclusion: </strong>Frail adults presenting with NSTEACS have more severe culprit lesion calcification. Frail adults were just as likely as robust patients to receive complete revascularisation. Baseline and residual SYNTAX score were associated with MACE at 5 years.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"18 ","pages":"e04"},"PeriodicalIF":0.2,"publicationDate":"2023-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/d2/icr-18-e04.PMC10442670.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10067478","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}