Zachary L Steinberg, Lauren N Carlozzi, Brian H Morray
{"title":"Intravascular lithotripsy-assisted intervention in patients with congenital heart disease.","authors":"Zachary L Steinberg, Lauren N Carlozzi, Brian H Morray","doi":"10.25270/jic/24.00272","DOIUrl":"10.25270/jic/24.00272","url":null,"abstract":"<p><strong>Objectives: </strong>The use of intravascular lithotripsy (IVL) in patients with calcified coronary and peripheral arterial disease is now commonplace; however, its use in procedures specific to congenital heart disease is rare, with a very limited published case-based experience to date. The authors report the outcomes of 4 patients with congenital heart disease who underwent IVL-assisted transcatheter procedures in the effort to inform future operators as to the potential benefits and risks of this technology in this patient population.</p><p><strong>Methods and results: </strong>Four patients underwent IVL-assisted transcatheter procedures including branch pulmonary artery stenting, aortic coarctation stenting, and transcatheter pulmonary valve replacement. All 4 patients underwent successful IVL-assisted implantation of large stents in highly calcified native or surgically implanted biological conduits without significant complications.</p><p><strong>Conclusions: </strong>The use of IVL-assisted interventions in patients with severe native or surgical calcified vascular conduits is feasible and may be a useful adjunct in conduit stent implantation and dilation. Vascular injury during angioplasty of calcified vessels and conduits remains a concern despite the use of lithotripsy, and covered stent implantation should be considered prior to aggressive dilation in order to reduce the risk of catastrophic rupture.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michaella Alexandrou, Pedro E P Carvalho, Dimitrios Strepkos, Deniz Mutlu, Athanasios Rempakos, Olga Mastrodemos, Bavana V Rangan, Sandeep Jalli, Mario Goessl, Ahmed Al Ogaili, Konstantinos Vourdris, Özgür Selim Ser, Muhammad Hamza Saad Shaukat, Gauravpal Singh Gill, Joe Jensen, Jaskanwal Deep Singh Sara, Maksymilian P Opolski, Yader Sandoval, M Nicholas Burke, Mark Linzer, Emmanouil S Brilakis
{"title":"Heart rate variability of interventional cardiology fellows and attendings and changes over time.","authors":"Michaella Alexandrou, Pedro E P Carvalho, Dimitrios Strepkos, Deniz Mutlu, Athanasios Rempakos, Olga Mastrodemos, Bavana V Rangan, Sandeep Jalli, Mario Goessl, Ahmed Al Ogaili, Konstantinos Vourdris, Özgür Selim Ser, Muhammad Hamza Saad Shaukat, Gauravpal Singh Gill, Joe Jensen, Jaskanwal Deep Singh Sara, Maksymilian P Opolski, Yader Sandoval, M Nicholas Burke, Mark Linzer, Emmanouil S Brilakis","doi":"10.25270/jic/25.00011","DOIUrl":"10.25270/jic/25.00011","url":null,"abstract":"<p><strong>Objectives: </strong>The levels of stress experienced by interventional cardiologists (IC) while performing procedures are not well known. The study examined the IC fellow and attending stress levels using both objective (heart rate variability [HRV]) and subjective (State Trait Anxiety Inventory [STAI]) metrics across the IC fellowship.</p><p><strong>Methods: </strong>Six ICs participated in a study conducted over 2 periods, each lasting 10 to 14 days. Participants recorded their HRV using a Polar H10 chest strap (Polar Electro, Inc.) and a WHOOP 4.0 wrist band (WHOOP). The low frequency/high frequency (LF/HF) ratio, biomarker of sympathetic system activation, and related metrics were calculated using Kubios HRV Scientific software (Kubios Oy).</p><p><strong>Results: </strong>A total of 217 procedures were analyzed. The median LF/HF ratio during procedures was significantly higher than at baseline (6.2 vs 4.1, P less than .001). Complex procedures had higher LF/HF ratio difference (procedural minus baseline LH/HF ratio) compared with non-complex procedures (2.55 vs 1.73, P less than .001), as did procedures with complications compared with uncomplicated procedures (3.01 vs 1.82, P less than .001) and emergent compared with non-emergent (3.51 vs 1.84, P less than .001) procedures. Procedures performed during period 2 (end of IC fellowship) had a lower LF/HF ratio difference (2.96 vs 1.10, P less than .001) but higher daily resting HRV (52 vs 46, P less than .001) compared with period 1 (beginning of IC fellowship). No correlation was detected between the pre- and post-procedural LF/HF ratio difference and the STAI score difference.</p><p><strong>Conclusions: </strong>Interventional cardiologists experience significant stress, as measured by the LF/HF ratio, during complex, emergency, and complicated procedures; however, stress levels decrease later in the IC fellowship.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Deniz Mutlu, Zafer Akman, Mehmet Semih Belpinar, Cezar A Iliescu, Konstantinos Marmagkiolis, Mehmet Cilingiroglu
{"title":"Uncommon etiology of ST-elevation myocardial infarction: Behçet's disease-induced coronary aneurysm.","authors":"Deniz Mutlu, Zafer Akman, Mehmet Semih Belpinar, Cezar A Iliescu, Konstantinos Marmagkiolis, Mehmet Cilingiroglu","doi":"10.25270/jic/24.00352","DOIUrl":"10.25270/jic/24.00352","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicolas Majunke, Hamza El Hadi, Steffen Desch, Tobias Kister, Maria Buske, Natalie Fischer, Katharina Kirsch, Janine Pöss, Holger Thiele, Marcus Sandri
{"title":"Procedural and long-term thromboembolic outcomes after left atrial appendage closure: comparison of patients with reduced and preserved left ventricular ejection fraction.","authors":"Nicolas Majunke, Hamza El Hadi, Steffen Desch, Tobias Kister, Maria Buske, Natalie Fischer, Katharina Kirsch, Janine Pöss, Holger Thiele, Marcus Sandri","doi":"10.25270/jic/24.00347","DOIUrl":"https://doi.org/10.25270/jic/24.00347","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of left ventricular ejection fraction (LVEF) on periprocedural complications and long-term thromboembolic events in patients with non-valvular atrial fibrillation (NVAF) treated with interventional left atrial appendage closure (LAAC).</p><p><strong>Methods: </strong>In a retrospective single-center study, a total of 612 patients who underwent successful interventional LAAC were divided into 2 groups: 139 patients with reduced LVEF (less than 50%) and 473 patients with preserved LVEF (≥ 50%). Baseline characteristics, in-hospital procedural complications, and long-term thromboembolic events were compared between the 2 groups.</p><p><strong>Results: </strong>Patients with reduced LVEF were more likely to be female with a higher CHA2DS2-VA-Score (median 5 vs 4; P less than .0001) and had higher rates of diabetes mellitus (54% vs. 40%; P = .003) and coronary/peripheral artery disease (68% vs 41%; P less than .0001). There was no significant difference in procedure-related complications (major or minor bleeding [2.1% vs 4.2%; P = .44], access site complications [0% vs 4.2%; P = .08], cardiac tamponade [0.7% vs. 0.6%; P = .91], transient ischemic attack (TIA) [1.4% vs. 0.4%; P = .19], stroke [0% vs 0%], and in-hospital death [0% vs 0%]) between the 2 groups. Both groups had a similar median duration of long-term follow-up (20 vs 19 months, respectively; P = .15). During follow-up, there was no significant difference in the rates of TIA (2.2% vs 1.1%; P = .32), stroke (0.7% vs 1.9%; P = .33), or systemic thromboembolic events (0.7% vs 0.4%; P = .66) between the 2 groups.</p><p><strong>Conclusions: </strong>In patients with reduced LVEF, the procedural safety of LAAC and the long-term rate of thromboembolic events were consistently low and comparable to patients with preserved LVEF.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing productivity: how AI chatbots can benefit cardiologists.","authors":"Michaella Alexandrou, Dimitrios Strepkos, Arun Mahtani, Yader Sandoval, Emmanouil S Brilakis","doi":"10.25270/jic/25.00052","DOIUrl":"10.25270/jic/25.00052","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saif Zako, David Naguib, Kathrin Klein, Asena Öz, Carolin Helten, Philipp Mourikis, Daniel Metzen, Malte Kelm, Tobias Zeus, Amin Polzin
{"title":"Closure devices versus manual compression to achieve hemostasis post-patent foramen ovale closure.","authors":"Saif Zako, David Naguib, Kathrin Klein, Asena Öz, Carolin Helten, Philipp Mourikis, Daniel Metzen, Malte Kelm, Tobias Zeus, Amin Polzin","doi":"10.25270/jic/25.00021","DOIUrl":"https://doi.org/10.25270/jic/25.00021","url":null,"abstract":"<p><strong>Objectives: </strong>Venous access plays a crucial role in various interventional cardiology procedures, including percutaneous patent foramen ovale (PFO) closure. Traditionally, manual compression has been the standard method for achieving hemostasis following venous access. However, this approach may be associated with potential complications such as puncture site bleedings. The aim of the study was to compare the safety and efficacy of different venous closure techniques.</p><p><strong>Methods: </strong>The authors conducted a single-center observational study of 220 patients undergoing PFO closure. The study quasi-randomized participants to 1 of 3 methods: Z-suture closure, Perclose ProGlide suture-mediated closure (Abbott), and manual compression. The primary outcome was the occurrence of bleeding events, classified according to the standardized Bleeding Academic Research Consortium (BARC) classification system.</p><p><strong>Results: </strong>Bleeding events were not significantly different between the closure groups. Of the patients who received manual compression, 14.2% (n = 17) experienced BARC bleeding events of 2 or higher. In the Z-suture group, 14.5% (n = 7) of patients had BARC bleeding events of 2 or higher. In the ProGlide group, 15% (n = 8) of patients experienced such events (P = .9). Only 1 patient in the manual compression group experienced a severe bleeding event (BARC 3). However, no cases of BARC 4 or 5 occurred in any of the closure groups.</p><p><strong>Conclusions: </strong>The Z-suture and ProGlide methods are safe and efficient for venous occlusion after percutaneous PFO closure compared with manual compression.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neil Zhang, Kyla Sherwood, Brian Claggett, Sanket Dhruva, Ashishdeep Sandhu, Susan Cheng, Joseph Ebinger
{"title":"Sex differences and the role of anemia in contrast-associated acute kidney injury after percutaneous coronary intervention.","authors":"Neil Zhang, Kyla Sherwood, Brian Claggett, Sanket Dhruva, Ashishdeep Sandhu, Susan Cheng, Joseph Ebinger","doi":"10.25270/jic/24.00353","DOIUrl":"10.25270/jic/24.00353","url":null,"abstract":"<p><p>Many, though not all, studies suggest that contrast-associated acute kidney injury (CA-AKI) after percutaneous coronary intervention (PCI) rates are higher in women. The authors sought to clarify the presence of and factors contributing to possible sex differences. Among 2971 consecutive patients undergoing PCI, women experienced higher crude rates of CA-AKI. However, this association was significantly attenuated after adjusting for demographic and comorbid conditions, particularly pre-procedural anemia, which accounted for a substantial proportion of the excess risk. The study offers clarification regarding the higher post-PCI risks among women and underscores the role of anemia as a prevalent contributor to CA-AKI.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Atul D Bali, Sadrine Lebrun, Abduljabar Adi, Varinder Singh, Michael C Kim, Arber Kodra
{"title":"Intravascular brachytherapy for the management of drug-eluting in-stent restenosis.","authors":"Atul D Bali, Sadrine Lebrun, Abduljabar Adi, Varinder Singh, Michael C Kim, Arber Kodra","doi":"10.25270/jic/24.00341","DOIUrl":"https://doi.org/10.25270/jic/24.00341","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the utilization and clinical outcomes of coronary intravascular brachytherapy (IVBT) as a treatment modality for multilayer in-stent restenosis (ISR).</p><p><strong>Methods: </strong>This multicenter study retrospectively analyzed 101 patients who presented for percutaneous intervention of recurrent drug-eluting stent ISR using IVBT from 2019 to 2023. The primary outcome assessed was target lesion revascularization (TLR) at 1 year. Secondary endpoints were aimed to establish procedural safety. All lesions had evaluation by either angiography, intravascular ultrasound, or both.</p><p><strong>Results: </strong>The majority of ISR was related to neointimal hyperplasia (61.4%), with stent underexpansion (11.9%) being the second most common cause. The average layer of stents in the sample was 1.90 layers. Prior to delivery of IVBT, lesions were prepared with balloon angioplasty, laser atherectomy, intravascular lithotripsy, or a combination of pretreatment strategies. The average time of the IVBT dwell period was 11 minutes, with an average dose of 21.76 Gy. Of the 101 patients evaluated, TLR occurred in 10.9% of patients at 1 year. Readmission at 30 days was 4.9% and vascular complications occurred in 3.9% of the patients. Major adverse cardiac events were limited to 0.9% of the patients, and no peri-procedural myocardial infarctions, urgent need for revascularization within 24 hours, need for mechanical support, nor cardiac arrest were observed.</p><p><strong>Conclusions: </strong>In this study, IVBT proved to be a safe and effective treatment modality for multilayer ISR. The study generates the hypothesis for the routine use of IVBT in this commonly encountered clinical scenario. Larger and prospective randomized studies are needed.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Percutaneous coronary intervention of chronic total occlusion in patients with prior coronary artery bypass graft: the current situation.","authors":"Soichiro Ebisawa, Etsuo Tsuchikane, Koichi Kishi, Yoshiaki Ito, Hisayuki Okada, Satoru Sumitsuji, Yuji Oikawa, Ryohei Yoshikawa, Hiroyuki Tanaka","doi":"10.25270/jic/24.00301","DOIUrl":"https://doi.org/10.25270/jic/24.00301","url":null,"abstract":"<p><strong>Objectives: </strong>The equipment and strategies used for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) have been improved. However, CTO-PCI for patients with prior coronary artery bypass graft (CABG) remains challenging. This study aimed to compare the strategies and initial success rates of CTO-PCI in patients with and without prior CABG.</p><p><strong>Methods: </strong>The authors extracted data from the Japanese CTO-PCI expert registry for this study. They enrolled 11 605 patients who underwent CTO-PCI by Japanese operators from 2014 to 2022. The cohort was divided into 2 groups: post-CABG (n = 830) and no-CABG patients (n = 10775).</p><p><strong>Results: </strong>The post-CABG patients were older than the no-CABG patients (70.3 ± 9.2 vs 67.5 ± 11.1 years, P less than .01). The post-CABG group exhibited more prevalent long, tortuous, and calcified lesions, as well as higher Japanese Multicenter CTO Registry scores than the no-CABG group (1.8 ± 1.1 vs 1.4 ± 1.1, P less than .01). The post-CABG patients opted for the primary and rescue retrograde approaches more frequently than the no-CABG patients (52.4% vs 40.7%, P less than .02), and the post-CABG patients exhibited a lower success rate than the no-CABG patients (82.2% vs 90.2%, P less than .01). However, an improvement in success rates was observed in the post-CABG patients compared with that of Japanese data from 1999 to 2011 (71%-82.2%). Additionally, the procedure time decreased from 210 to 191 minutes.</p><p><strong>Conclusions: </strong>Compared with no-CABG patients, the initial success rate of CTO-PCI for post-CABG patients remains low, and the retrograde approach is more commonly chosen. However, the success rate has improved over previous data.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}