Cardiovascular Revascularization Medicine最新文献

{"title":"Evaluation of the REDUCtion of thrombus burdEn with Core Lab OcT assessmenT (REDUCE-CLOTT) study.","authors":"Jason Galo, Abhishek Chaturvedi, Evan Shlofmitz, Pablo M Rubio, Gebremedhin Melaku, Susan V Thomas, Jordan Busch, Fernando Sosa, Doosup Shin, Ziad A Ali, Allen Jeremias, Richard Shlofmitz, Ron Waksman, Hector M Garcia-Garcia","doi":"10.1016/j.carrev.2025.04.031","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.031","url":null,"abstract":"<p><strong>Background: </strong>Optical coherence tomography (OCT) allows for quantitative analysis of thrombus in coronary vessels. High post-percutaneous coronary intervention (PCI) thrombotic burden as identified by OCT, correlates with adverse angiographic and periprocedural clinical outcomes.</p><p><strong>Objective: </strong>To assess by OCT the amount of residual thrombus post-PCI without the use of cangrelor, representing the standard of care and the control group of the REDUCE-CLOTT (The REDUCtion of thrombus burdEn with cangreLor by OcT assessmenT) study.</p><p><strong>Methods: </strong>This was a single-arm observational study of patients who presented with acute coronary syndrome or stable angina with evidence of acute thrombus on baseline OCT evaluation of the target lesion. All patients received treatment with PCI plus standard of care medications, with repeat OCT assessment peri-procedurally after PCI. The primary endpoint was the assessment of residual thrombus on post-PCI OCT, quantified as the total thrombus area (TTA) - calculated by measuring the total prolapsed thrombus area (TPTA), defined as the difference between the outer and lumen contours, and adding any free-floating thrombus.</p><p><strong>Results: </strong>A total of 17 patients and 18 lesions were included. Most were male (70.9 %), hypertensive (58.8 %), and smokers (64.7 %). Unfractionated heparin was used in 94.1 % and bivalirudin in 5.8 % of cases. TTA was numerically reduced by 35.4 % (relative difference), from 0.48 mm² to 0.31 mm² (p = 0.17). TPTA numerically reduced by 37.5 % (relative difference), from 0.48 mm² to 0.31 mm² (p = 0.15).</p><p><strong>Conclusions: </strong>PCI plus standard-of-care medications was associated with numerically lower, but not statistically significant, acute reduction of thrombus burden as assessed by OCT post-PCI.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034571","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":"Editorial: Catheter-based therapy for intermediate risk pulmonary embolism: are we moving in the right direction?","authors":"George Chrysant","doi":"10.1016/j.carrev.2025.04.032","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.032","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053480","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":"Editorial: prophylactic intra-aortic balloon pump before left ventricular assist device implantation.","authors":"Niku Thapa, Nauman Khalid, Sarah Aftab Ahmad","doi":"10.1016/j.carrev.2025.04.030","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.030","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056807","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":"Editorial: Do less, do better? Challenging the concomitant PCI paradigm in TAVR.","authors":"A Pieter Kappetein, Kendra Grubb","doi":"10.1016/j.carrev.2025.04.022","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.022","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989709","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":"Supravalvular aortic stenosis - Novel pathogenic ELN variant in siblings with a wide spectrum of clinical cardiovascular features and a long follow-up from infancy to adulthood.","authors":"Sini Keskinen, Jussi Niemelä, Hannele Koillinen, Talvikki Boldt, Anita Arola","doi":"10.1016/j.carrev.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.027","url":null,"abstract":"<p><strong>Background: </strong>Supravalvular aortic stenosis (SVAS) is an autosomal dominantly inherited congenital cardiovascular disease caused by disruption of elastin gene (ELN), encoding elastin, an essential component of elastic arteries. It usually affects the middle layer of the wall of the aorta but also the pulmonary and coronary arteries may be affected.</p><p><strong>Methods: </strong>We report a family with six affected siblings who were closely followed up from infancy to early adulthood at a pediatric cardiology outpatient clinic. Whole-exome sequencing was performed using DNA of the index patient. Targeted variant testing was performed for other family members.</p><p><strong>Results: </strong>The affected siblings presented with a wide spectrum of clinical features of SVAS, ranging from mild pulmonary artery stenosis with or without pulmonary artery branch stenoses to severe supravalvular aortic obstruction and coronary artery stenosis with fatal outcome. Genetic analysis identified a novel pathogenic 1-bp deletion c.1983delG, p. (Pro662Leufs*13) in the ELN gene. Males tended to have a more severe cardiac disease than females. However, if interventions were successful during infancy or early childhood, the outcome was fairly favorable. Moreover, supravalvular pulmonary stenosis, even when combined with a stenotic pulmonary valve and severe pulmonary artery branch stenoses, tended to resolve during follow-up.</p><p><strong>Conclusions: </strong>We describe a family with six siblings showing elastin arteriopathy with variable disease severity and outcome. A novel pathogenic ELN gene variant was detected in five of them, indicating that there are obviously yet unknown genetic and environmental modifying factors that affect the severity and outcome in individual patients.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062818","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":"The impact of the RADPAD in reducing radiation exposure in a contemporary cardiac Cath Lab: Rationale and design of the ATTENUATE trial.","authors":"Giorgio A Medranda, Brian C Case, Dimitrios Bliagos","doi":"10.1016/j.carrev.2025.04.023","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.023","url":null,"abstract":"<p><strong>Background: </strong>Despite recent improvements in radiation safety, interventionalists are increasingly exposed to radiation during cardiac catheterization laboratory (CCL) procedures. The RADPAD was designed as a protective scatter-radiation absorbing shield with the goal of reducing scatter radiation. Early studies demonstrated between a 20 and 62 % relative reduction in scatter radiation. The purpose of this study was to examine the impact of the RADPAD through a randomized controlled trial in a large contemporary CCL.</p><p><strong>Design: </strong>The ATTENUATE (v) Trial is an investigator-initiated, prospective, randomized controlled trial which will randomize 1000 CCL procedures 1:1 to use of the RADPAD vs. no use of the RADPAD. The primary outcome of interest is the most proximal operator's dose-area product (DAP)-normalized operator dose (E) defined as E divided by DAP. Additional subgroup analysis comparing types of procedure will also be performed. Every case will utilize contemporary radiation safety equipment.</p><p><strong>Summary: </strong>The ATTENUATE Trial is the largest randomized controlled trial to evaluate the utility of the RADPAD in reducing relative operator exposure in a contemporary CCL including coronary and structural interventions.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024932","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":"Challenges in diagnosing coronary microvascular dysfunction and coronary vasospasm.","authors":"Sonya Burgess, F Aaysha Cader, Martha Gulati, Nadia R Sutton, Yolande Appelman, Shrilla Banerjee","doi":"10.1016/j.carrev.2025.04.025","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.025","url":null,"abstract":"<p><p>Chronic coronary syndromes (CCS) include 2 overlapping subgroups of patients - those with angina with nonobstructive coronary arteries (ANOCA), or ischaemia with non-obstructive coronary arteries (INOCA). A diagnosis of ANOCA-INOCA, is common and should be considered where angina is present and/or ischaemia is found on functional imaging in the absence of obstructive coronary artery disease (CAD) on coronary computed tomography angiography (CCTA) or invasive coronary angiography (ICA) (Ford and Berry, 2019). This review aims to provide an overview of contemporary challenges in the diagnosis of coronary microvascular dysfunction (CMD) and vasospastic disease, with a focus on recent guideline changes and current controversies. CMD and vasospastic angina (VSA) are increasingly acknowledged as an important and frequently overlooked, under investigated, and undertreated entities that contribute to ANOCA-INOCA (Samuels et al., 2023; Kunadian et al., 2020; Ford and Berry, 2019; Burgess and Mamas, 2024).</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990602","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":"Editorial: Will covered stents improve arterial side-branch injury repair?","authors":"Oleksandr Strelko, Nicholas Olivieri, Robert S Dieter","doi":"10.1016/j.carrev.2025.04.026","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.026","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024778","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":"Editorial: Left atrial appendage occlusion, atrial fibrillation, and the anticoagulation conundrum.","authors":"Subrata Kar","doi":"10.1016/j.carrev.2025.04.021","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.021","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024724","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":"Editorial: Optimal lesion preparation: to cut or not to cut.","authors":"Manel Sabaté","doi":"10.1016/j.carrev.2025.04.024","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.04.024","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034950","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}