{"title":"Combination Tools for Calcium Modification from RASER to Orbitalshock.","authors":"Jonathan Hinton, Peter O'Kane","doi":"10.15420/icr.2024.24","DOIUrl":"https://doi.org/10.15420/icr.2024.24","url":null,"abstract":"<p><p>Coronary artery calcification is frequently encountered during percutaneous coronary intervention and its presence is associated with a higher risk of stent under-expansion which has been associated with long-term risk of stent failure. There are several different calcium modification strategies available, whether they be balloon-based devices (cutting/scoring and intravascular lithotripsy) or atherectomy devices (orbital atherectomy, rotational atherectomy, excimer laser coronary atherectomy) that are established for the modification of coronary calcification. Each strategy applies a different mechanism of action for calcium modulation and consequently the potential to combine modifying tools may offer synergistic advantages over device monotherapy. This article will focus on reviewing the evidence for the use of multiple calcium modification techniques and examine whether there really is any such synergistic effect of combining these tools.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e18"},"PeriodicalIF":0.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509859","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":"Endovascular Intervention for Acute Superior Mesenteric Artery Occlusion Following COVID-19 Pneumonia: Two Case Reports.","authors":"Duy Cao Phuong Le, Hoa The Bui, Quan Duy Vo","doi":"10.15420/icr.2024.09","DOIUrl":"10.15420/icr.2024.09","url":null,"abstract":"<p><p>COVID-19 patients may experience acute mesenteric ischaemia. Identifying acute mesenteric ischaemia is challenging, particularly as initial symptoms are often vague and easily overlooked. Early detection and immediate intervention to restore blood flow can prevent these severe consequences. Presented in this report are two cases of superior mesenteric artery (SMA) thrombosis following severe acute respiratory syndrome coronavirus 2 infection. CT scans demonstrated SMA thrombosis in both patients, with no evidence of bowel necrosis. Endovascular intervention with self-expanding stent placement was performed after angiographic confirmation of the diagnosis. At 6-month follow-up, both patients remained asymptomatic on dual antiplatelet therapy. Atypical gastrointestinal manifestations in COVID-19 patients should raise suspicion for uncommon complications, such as SMA thrombosis. For SMA occlusion without associated bowel necrosis, endovascular therapy represents a viable treatment approach.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e17"},"PeriodicalIF":0.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297578","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}
Reza Masoomi, Marouane Boukhris, Silvia Moscardelli, Lorenzo Azzalini
{"title":"Dissection and Re-entry Techniques for Chronic Total Occlusion Percutaneous Coronary Intervention.","authors":"Reza Masoomi, Marouane Boukhris, Silvia Moscardelli, Lorenzo Azzalini","doi":"10.15420/icr.2024.04","DOIUrl":"10.15420/icr.2024.04","url":null,"abstract":"<p><p>Despite early stagnation in success rates for percutaneous coronary intervention for chronic total occlusion with the traditional antegrade wiring approach, the introduction of dissection/re-entry techniques and the retrograde approach opened new avenues for operators to tackle more complex occlusions. Dissection/re-entry techniques (both antegrade and retrograde) are commonly used in angiographic scenarios characterised by long, tortuous and calcified occlusions, as well as in those with proximal cap ambiguity. Familiarity and comfort using the extraplaque space (with either an antegrade or retrograde approach) have become fundamental to achieving safe and effective recanalisation of complex chronic total occlusions. This review provides an overview of different contemporary antegrade and retrograde dissection re-entry techniques and their acute and longer-term outcomes.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e16"},"PeriodicalIF":0.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297577","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}
Khaled A Shams, Hossameldin Hussein, Soha Romeih, Ahmed M Elguindy
{"title":"Percutaneous Coronary Intervention for Atherosclerotic Coronary Artery Disease After Arterial Switch Operation: A Case Report.","authors":"Khaled A Shams, Hossameldin Hussein, Soha Romeih, Ahmed M Elguindy","doi":"10.15420/icr.2023.28","DOIUrl":"10.15420/icr.2023.28","url":null,"abstract":"<p><p>Late coronary complications after an arterial switch operation (ASO) may occur due to vessel kinking, compression resulting from growth of the great vessels, ostial fibro-intimal thickening after reimplantation or possibly secondary to accelerated atherosclerosis. Given that many of these patients are asymptomatic, adult ASO survivors require special attention and an individualised approach to the early detection of coronary artery disease. Most previously reported cases of coronary artery disease after an ASO have been managed surgically. Owing to the complex anatomy of the aortic sinuses and abnormal coronary origin, percutaneous coronary intervention may be challenging with difficult catheter engagement and/or support. Pre-procedural multi-slice CT coronary angiography can be used for proper planning and guidance. A case is described here for percutaneous coronary intervention in an adult patient who presented with coronary artery disease 33 years after an ASO.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e14"},"PeriodicalIF":0.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583915","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}
Suleman Aktaa, Noman Ali, Peter F Ludman, Nick Curzen, Andrew T Goodwin, David Hildick-Smith, Rajesh K Kharbanda, Peter D Jones, Sue Manuel, Satya Phanthala, Daniel J Blackman
{"title":"Geographical Inequality in Access to Aortic Valve Intervention in England: A Report from the UK Transcatheter Aortic Valve Implantation Registry and National Adult Cardiac Surgery Audit.","authors":"Suleman Aktaa, Noman Ali, Peter F Ludman, Nick Curzen, Andrew T Goodwin, David Hildick-Smith, Rajesh K Kharbanda, Peter D Jones, Sue Manuel, Satya Phanthala, Daniel J Blackman","doi":"10.15420/icr.2024.19","DOIUrl":"10.15420/icr.2024.19","url":null,"abstract":"<p><strong>Background: </strong>For patients with severe aortic stenosis, transcatheter aortic valve implantation (TAVI) is a less invasive but equally effective treatment option compared with surgical aortic valve replacement (SAVR). In 2019, we reported low rates of TAVI in the UK compared with other countries in western Europe and highlighted profound geographical variation in TAVI care. Here, we provide contemporary data on access to aortic valve replacement by either TAVI or SAVR across clinical commissioning groups in England.</p><p><strong>Methods: </strong>We obtained aggregated data from the UK TAVI registry and the National Adult Cardiac Surgery Audit between 2019 and 2023. Rates of TAVI and SAVR procedures per million population were reported by clinical commissioning groups. The relationship between TAVI and SAVR rates was determined using Pearson correlation coefficients.</p><p><strong>Results: </strong>In 2022/23, the rates of TAVI and SAVR in England were 136 per million population and 60 per million population, respectively. The observed increase in TAVI rates since 2019/20 corresponded with a decline in SAVR rates. There remains substantial variation in access to both procedures, with an over tenfold variation in TAVI rates, and an over fourfold variation in SAVR rates across clinical commissioning groups in England. No relationship was identified between the rates of TAVI and those for SAVR (correlation coefficient 0.06).</p><p><strong>Conclusion: </strong>Geographical heterogeneity in access to TAVI persists over time, with the low rates of TAVI in many areas not compensated for by higher rates of SAVR, indicating an overall inequality in the treatment of severe aortic stenosis.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e15"},"PeriodicalIF":0.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11413983/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297579","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":"Dedicated Balloon Techniques for Coronary Calcium Modification.","authors":"Max W Maffey, Rodrigo Bagur","doi":"10.15420/icr.2024.06","DOIUrl":"10.15420/icr.2024.06","url":null,"abstract":"<p><p>Coronary calcification represents a significant technical challenge in percutaneous coronary intervention and is associated with worse clinical outcomes. Fortunately, a number of balloon-assisted technologies are available to aid in the management of coronary calcification before stenting. Adequate lesion preparation is crucial in the successful management of calcified coronary lesions. Balloon-based techniques can be a safe and effective method of lesion preparation and, as such, are an integral part of an interventionalist's armamentarium. In this mini-review, we focus on the use of non-compliant balloons, super high-pressure non-compliant balloons, cutting balloons, scoring balloons and intravascular lithotripsy.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e13"},"PeriodicalIF":0.2,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113029","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}
Rutger-Jan Nuis, Mark van den Dorpel, Rik Adrichem, Joost Daemen, Nicolas Van Mieghem
{"title":"Conduction Abnormalities after Transcatheter Aortic Valve Implantation: Incidence, Impact and Management Using CT Data Interpretation.","authors":"Rutger-Jan Nuis, Mark van den Dorpel, Rik Adrichem, Joost Daemen, Nicolas Van Mieghem","doi":"10.15420/icr.2024.11","DOIUrl":"10.15420/icr.2024.11","url":null,"abstract":"<p><p>The demonstrated safety and effectiveness of transcatheter aortic valve implantation (TAVI) among low surgical risk patients opened the road to its application in younger low-risk patients. However, the occurrence of conduction abnormalities and need for permanent pacemaker implantation remains a frequent problem associated with adverse outcomes. The clinical implications may become greater when TAVI shifts towards younger populations, highlighting the need for comprehensive strategies to address this issue. Beyond currently available clinical and electrocardiographic predictors, patient-specific anatomical assessment of the aortic root using multi-sliced CT (MSCT) imaging can refine risk stratification. Moreover, leveraging MSCT data for computational 3D simulations to predict device-anatomy interactions may help guide procedural strategy to mitigate conduction abnormalities. The aims of this review are to summarise the incidence and clinical impact of new left bundle branch block and permanent pacemaker implantation post-TAVI using contemporary transcatheter heart valves; and highlight the value of MSCT data interpretation to improve the management of this complication.</p>","PeriodicalId":38586,"journal":{"name":"Interventional Cardiology Review","volume":"19 ","pages":"e12"},"PeriodicalIF":0.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113028","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}
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
{"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}
Rajesh Kumar, Jathinder Kumar, Cormac O'Connor, Ihsan Ullah, Benjamin Tyrell, Ian Pearson, Sajjad Matiullah, Kevin Bainey
{"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}