Cardiovascular Revascularization Medicine最新文献

{"title":"Serial quantitative optical coherence tomography for luminal volume changes following either paclitaxel or sirolimus coated balloon in de novo small coronary artery lesions.","authors":"Akihiro Tobe, Patrick Serruys, Kotaro Miyashita, Asahi Oshima, Pruthvi Chenniganahosahalli Revaiah, Tsung-Ying Tsai, Dijkstra Jouke, Scot Garg, Angela McInerney, Yoshinobu Onuma, Faisal Sharif","doi":"10.1016/j.carrev.2025.03.025","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.025","url":null,"abstract":"<p><strong>Background: </strong>Drug coated balloons (DCB) are a treatment option for lesions in small coronary arteries, with treatment using paclitaxel coated balloons (PCB) associated with less angiographic late lumen loss than sirolimus coated balloons (SCB).</p><p><strong>Methods: </strong>This single-center sub-study of the TRANSFORM-I study compared quantitative optical coherence tomography (OCT) data in patients with de novo lesions in small coronary arteries treated with the MagicTouch (SCB) or SeQuent Please Neo (PCB). The relationship between the lumen volume of the treated segment immediately post procedure and at 6-month follow-up was evaluated. Late lumen volume loss (LLVL, mm³) was defined as the post-procedural lumen volume - lumen volume at 6 months.</p><p><strong>Results: </strong>Serial OCT analysis was performed in 19 patients with 21 lesions (SCB: 9 patients/11 lesions; PCB: 10 patients/10 lesions). There was a significant decrease in lumen volume between post-procedure and 6 months in the SCB group (97.35 ± 71.09 mm³ vs 87.96 ± 61.48 mm³, p = 0.03), but not in the PCB group (69.67 ± 38.24 mm3 vs 71.64 ± 42.22 mm3, p = 0.64). The LLVL was 9.39 ± 12.76 mm³ and - 1.97 ± 12.90 mm³ in the SCB and PCB group, respectively (SCB vs PCB, p = 0.06). A trend for interaction between SCB and PCB was observed in the relationship between dissection volume and LLVL (SCB: LLVL = 1.28 ∗ dissection volume + 7.42, p = 0.37; PCB: LLVL = -2.84 ∗ dissection volume + 4.51, p = 0.12; p for interaction = 0.07).</p><p><strong>Conclusion: </strong>In de novo lesions of small coronary arteries, treatment with an SCB lead to a significant decrease in lumen volume at 6-months compared to post-procedure, with no significant change observed after treatment with a PCB.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812736","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}

{"title":"Comparison of drug-coated versus conventional balloons for the side branch of the bifurcation lesion - multicenter randomized controlled study - (OCVC-BIF): Design and rationale.","authors":"Tomoharu Dohi, Takayuki Ishihara, Hirota Kida, Daisuke Nakamura, Atsushi Kikuchi, Tsutomu Kawai, Naoki Mori, Naotaka Okamoto, Yasunori Ueda, Ryu Shutta, Minoru Ichikawa, Toshiaki Mano, Tetsuya Watanabe, Yoshiharu Higuchi, Masami Nishino, Eisuke Hida, Tomoharu Sato, Shungo Hikoso, Daisaku Nakatani, Yohei Sotomi, Yasushi Sakata","doi":"10.1016/j.carrev.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.024","url":null,"abstract":"<p><strong>Background: </strong>Although several clinical trials have suggested the usefulness of drug-coated balloons (DCB) for side-branch lesions, their efficacy and safety have not yet been established.</p><p><strong>Methods and study design: </strong>The Osaka Cardiovascular Conference (OCVC) will conduct a multicenter, randomized, open-label, controlled trial aiming to examine whether additional DCB treatment for the side branch after main vessel stenting followed by kissing balloon inflation (KBI) is superior to only KBI by conventional balloons in PCI patients with coronary bifurcation lesions. The primary endpoint is restenosis of side branches documented by scheduled or symptom-driven coronary angiography during 9-month follow-up period after the index PCI. The key secondary endpoints include major adverse cardiac event which consists of cardiac death, myocardial infarction, target lesion revascularization, and stent thrombosis, and optical coherence tomography findings. A total of 300 patients will be enrolled and followed up to 1 year.</p><p><strong>Summary: </strong>The OCVC-BIF trial is a randomized controlled trial designed to assess whether additional DCB treatment for side branch is superior to only KBI by conventional balloons in patients with coronary bifurcation lesions undergoing PCI with main vessel stenting.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788932","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}

{"title":"Impact of pre-procedural red cell distribution width on one-year all-cause mortality following transcatheter aortic valve replacement: A systematic review and meta-analysis.","authors":"Adhvithi Pingili, Lakshmi Sai Meghana Kodali, Mounika Reddy Vadiyala, Lida Koskina, Bhavin A Patel, Koushik Sanku, Rupak Desai, Meera Kondapaneni","doi":"10.1016/j.carrev.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.019","url":null,"abstract":"<p><strong>Background: </strong>Red cell distribution width (RDW) has emerged as a novel biomarker associated with adverse outcomes in patients with cardiovascular disease (CVD). We aimed to determine the prognostic significance of pre-procedural RDW levels on one-year all-cause mortality (ACM) following transcatheter aortic valve replacement (TAVR) by conducting a systematic review and meta-analysis due to limited evidence on the impact of RDW levels in TAVR patients.</p><p><strong>Methods: </strong>We systematically reviewed articles on pre-procedural RDW and one-year ACM post-TAVR until February 2024 using PubMed and Google Scholar. Binary random effects model was used for pooled adjusted odds ratio (aOR), with 95 % confidence intervals (CI) and I2 statistics for heterogeneity.</p><p><strong>Results: </strong>A total of 7 studies with 3273 patients aged between 70-90 years and 45 % males were analyzed. High pre-procedural RDW was an independent predictor of one-year ACM (aOR 1.60, 95%CI 1.13-2.27, p < 0.01). This association is even more prominent when aged > 80 years vs. <80 years (aOR 1.64, 95 % CI 1.17-2.31, p < 0.01 vs. aOR 1.46, 95 % CI 0.49-4.32, p < 0.01). Leave-one-out sensitivity analysis validated the robustness of our meta-analysis.</p><p><strong>Conclusions: </strong>Our study indicated that elevated baseline RDW is an independent predictor of one-year ACM post-TAVR. Further studies are needed to validate the importance of RDW as a marker of post-TAVR outcomes.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774474","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}

{"title":"Left atrial appendage occlusion optimized with artificial intelligence-guided CT pre-planning and intra-procedural intracardiac echocardiographic guidance.","authors":"Sant Kumar, Mustafa Suppah, Osama Niazi, Ashish Pershad","doi":"10.1016/j.carrev.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.021","url":null,"abstract":"<p><strong>Background: </strong>Left atrial appendage occlusion (LAAO) offers a safe alternative to oral anticoagulants for stroke prevention in patients with atrial fibrillation. This study compares the integration of preprocedural cardiac computed tomography (CT), artificial intelligence (AI) modeling, and intracardiac echocardiography (ICE) to standard transesophageal echocardiography (TEE)-guided LAAO.</p><p><strong>Methods: </strong>This single-center retrospective cohort study from 2021 to 2024 compared TEE-guided LAAO to a method combining artificial intelligence-augmented CT preplanning and ICE. The primary outcome of the study was a composite of procedural success, incidence of device-related thrombus, and peri-device leaks ≥5 mm at 45 days. Secondary outcomes included procedural duration, contrast volume, device recaptures, and resizing.</p><p><strong>Results: </strong>The study included 143 patients: 46 in the CT/ICE arm and 97 in the TEE arm. Baseline characteristics were similar in the two groups. The number of males was statistically higher in the CT/ICE arm (76.1 % vs. 58.8 % p = 0.043). Procedural success was similar between groups (97.8 % vs. 95.9 %, p = 0.899). At 45 days, device-related thrombus (2.2 % vs. 0 %, p = 0.145) and peri-device leaks were similar (8.7 % vs. 4.1 %, p = 0.266) in both groups. The CT/ICE group had significantly fewer device recaptures (0.0 ± 0.1 vs. 0.2 ± 0.4, p = 0.001) and devices attempted (1.0 ± 0.2 vs. 1.2 ± 0.4, p = 0.002).</p><p><strong>Conclusion: </strong>AI-augmented preprocedural cardiac CT planning combined with ICE has similar efficacy to TEE-guided LAAO. Due to the need for significantly fewer LAA devices and recaptures of these devices, there is the potential that AI augmented CT planning combined with ICE can reduce adverse events. The use of ICE and eliminating the need for general anesthesia and preprocedural TEE planning has the potential to improve procedural efficiency.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796635","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}

{"title":"Final 5-year outcomes of the Epic02 - RANGO study: A real-world registry of the durable fluoroacrylate polymer-based sirolimus-eluting Angiolite® stent.","authors":"Armando Pérez de Prado, Jeremías Bayón, Ignacio Sánchez Pérez, José Moreu Burgos, Pablo Aguar Carrascosa, Alberto Rodrigues, Luis Fernández González, Elena Sánchez Lacuesta, Eduardo Pinar, Vicente Peral, Fermín Sainz Laso, José Ramón Rumoroso, Alfonso Torres, Manel Sabaté, Bruno García Del Blanco, Ramiro Trillo Nouche","doi":"10.1016/j.carrev.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.015","url":null,"abstract":"<p><strong>Background: </strong>Clinical results at mid-term of Angiolite, a cobalt-chromium sirolimus-eluting stent, in a non-selected, real-world population were demonstrated to be excellent. 5-year follow-up was planned to exclude late complications.</p><p><strong>Methods: </strong>We conducted an observational, prospective, multicenter study (RANGO) in different clinical indications with independent event adjudication and data monitoring. All consecutive patients with at least 1 Angiolite stent implanted who gave their informed consent were included. The primary endpoint was the occurrence of target lesion failure (TLF). The secondary endpoints were the individual components of the primary endpoint, Patient-oriented Composite Endpoint (PoCE), and stent thrombosis. We present the 5-year clinical results in the entire population and in 2 predefined subgroups: diabetics and small-vessel disease (≤2.5 mm).</p><p><strong>Results: </strong>646 patients with high-risk features (previous MI 18.4 %, previous coronary revascularization 23.4 %, ST-elevation MI 23.1 %, and multivessel disease 47.8 %) were included. Only 18 patients (2.8 %) were lost at 5-years follow-up. The final outcomes were: TLF 8.7 %, PoCE 21.8 %, and stent thrombosis 1.2 %. The small-vessel subgroup showed slightly worse results (TLF, 10.3 %; PoCE, 24.1 %; thrombosis, 0 %), as diabetic subgroup also did (TLF, 11.1 %; PoCE, 29.1 %; thrombosis, 1.0 %). Multivariable analysis showed variables significantly associated with TLF: chronic kidney disease, prior PCI or CABG and lesion calcification; and those associated with PoCE were age, atrial fibrillation, prior PCI, lesion calcification and chronic kidney disease.</p><p><strong>Conclusions: </strong>The 5-years results of this observational study of Angiolite stent in a real-world population corroborate the outstanding results observed in the mid-term. No signals of late complications were detected.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744200","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}

{"title":"Flow characteristics of reperfusion sheaths when utilizing large bore mechanical circulatory support devices.","authors":"Imran Naeem Aziz, Ahmad Jabri, Ying Xu, Seth Bilazarian, Dana Bentley, Amir Kaki, Allison Dupont, William O'Neill, Herbert D Aronow, Alejandro Lemor, Hady Lichaa, Alexander G Truesdell, Mir B Basir","doi":"10.1016/j.carrev.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.017","url":null,"abstract":"<p><strong>Background: </strong>Reperfusion sheaths are commonly utilized to prevent acute limb ischemia (ALI) when using large bore mechanical circulatory support devices, though little is known about flow characteristics of these sheaths.</p><p><strong>Methods: </strong>The purpose of this assessment was to characterize the flow rates of various femoral to femoral (fem-fem) bypass circuits. We devised a test setup that maintains a preset input pressure for test devices to enable an accurate comparison of bypass techniques.</p><p><strong>Results: </strong>Negligible flow rate increases were observed in active or passive ipsilateral and contralateral circuits when donor or receiver sheaths were sequentially increased in size. When using a contralateral fem-fem bypass circuit, the use of a Merit Prelude Pro 8F sheath paired with a 5F Arrow reperfusion sheath provided 167 ml/min of flow. If the reperfusion sheath was exchanged to a 6F sheath the flow rate was 169 ml/min, 175 ml/min with a 7F sheath and 179 ml/min with an 8F sheath, a total difference of 7 %. When maintaining a 6F reperfusion sheath as a constant, the use an ipsilateral fem-fem bypass circuit using an Abiomed 14F Low profile sheath provided 215 ml/min of flow, a 27 % higher flow than a contralateral 8F circuit. The use of an active pressure bypass system using an 18F ECMO cannula provided 356 ml/min, a 66 % higher flow than a 14F ipsilateral fem-fem bypass and 110 % higher flow than an 8F contralateral fem-fem bypass.</p><p><strong>Conclusion: </strong>Flow rate through a fem-fem bypass circuit is contingent upon the smallest diameter along the pathway which is typically the side port of the sheath. There are negligible changes in flow rate based on increasing donor or receiver sheath sizes. Novel, purpose-built reperfusion sheath taking these flow characteristics into account are needed to improve such systems.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755183","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}

{"title":"Outcomes of percutaneous coronary intervention for myocardial infarction in adults with congenital heart disease.","authors":"Taha Mansoor, Maninder Randhawa, Mahmoud Ismayl, Austin Brubaker, Santhosh K G Koshy","doi":"10.1016/j.carrev.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.014","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721952","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}

{"title":"Angina in stable coronary artery disease: Data from ORBITA and ORBITA-2.","authors":"Shayna Chotai, Ahmed Salih, Fiyyaz Ahmed-Jushuf, Michael Foley, Rasha K Al-Lamee","doi":"10.1016/j.carrev.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.018","url":null,"abstract":"<p><p>It is now widely accepted that in the setting of stable angina, the primary remit of percutaneous coronary intervention (PCI) is for symptom relief. However, prior to the Objective Randomised Blinded Investigation with optimal medical Therapy of Angioplasty in stable angina (ORBITA) trial, there had been no placebo-controlled trial to assess the efficacy of this common procedure to improve angina. ORBITA randomised 200 patients with significant single-vessel coronary artery disease on maximal anti-anginal medications to either PCI or a placebo procedure. The results were striking and unexpected: after 6 weeks, there was no significant difference in the primary endpoint of treadmill exercise time between groups. Questions arose; how could PCI fail to outperform a placebo procedure, despite resolving significant epicardial stenosis and ischaemia? Clearly the relationship between symptoms, ischaemia and stenosis was more complex than previously understood. ORBITA-2 was designed to assess the effect of PCI compared to placebo in patients with single or multivessel disease, without the possible attenuation of anti-anginal medication, at 12 weeks. In this setting, PCI convincingly improved symptoms, with a significant increment over placebo as assessed by the angina symptom score, a patient-orientated primary endpoint. Taken together, these trials highlight a key insight: when offered first without anti-anginal medications, PCI offers meaningful symptom benefit. When offered after anti-anginal medications, as is recommended by international guidelines, it's added benefit is much smaller. This suggests the sequence of treatment matters, with the first therapy, whether PCI or medications, yielding the most demonstrable benefit, with subsequent interventions then offering little added value. As clinicians, the decision to advocate for PCI or anti-anginal medications first, will depend on many factors including individual patient characteristics and preferences. Importantly, in the absence of a head-to-head placebo-controlled trial of PCI alone versus medication alone, the question of which approach offers the greatest symptomatic benefit remains unresolved.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765395","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}

{"title":"Are polymer-coated non-drug-eluting stents threatening the kingdom of drug-eluting stents?","authors":"Fernando Alfonso, Lidia Vilches, Fernando Rivero","doi":"10.1016/j.carrev.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.016","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774473","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}

{"title":"Observational data on timing of invasive angiography in NSTEMI.","authors":"William S Weintraub","doi":"10.1016/j.carrev.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.03.013","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721944","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}