Journal of Invasive Cardiology最新文献

{"title":"Chronic total occlusion percutaneous coronary intervention: 2026 update.","authors":"Semih Ceylan, Deniz Mutlu, Eleni Kladou, Nick Williford, Sandeep Jalli, Ahmed Al-Ogaili, Masahisa Yamane, Khaldoon Alaswad, Allison Hall, Rhian Davies, James W Choi, Andrea Gagnor, Roberto Garbo, Omer Goktekin, Sevket Gorgulu, Jaikirshan J Khatri, William Nicholson, Stephane Rinfret, Wissam Jaber, Mohaned Egred, Anastasios Milkas, Niccolò Ciardetti, Carlo Di Mario, Kambis Mashayekhi, Alexandre Avran, Gregor Leibundgut, Yiannis S Chatzizisis, Gerald S Werner, Claudiu Ungureanu, Yader Sandoval, Emmanouil S Brilakis","doi":"10.25270/jic/25.00301","DOIUrl":"10.25270/jic/25.00301","url":null,"abstract":"<p><p>Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) is continually evolving through improvements in strategy, imaging, and equipment. This review provides a summary of the published literature in CTO PCI between September 2023 and April 2025, categorized by procedural outcomes, techniques, complications, and ongoing studies. Recent multicenter analyses report technical success rates exceeding 90% in expert centers, accompanied by significant reductions in angina and dyspnea at long-term follow-up. Despite higher complexity, radiation exposure has significantly decreased during the past decade as a result of equipment upgrades and operator awareness. Procedural refinements such as the use of coronary computed tomography for guidance, intravascular ultrasound guided re-entry, hydrodynamic contrast recanalization, novel retrograde techniques, and artificial intelligence-based tools are improving success and safety. Ongoing randomized trials and large-scale registries will continue to shape practice patterns and refine strategy selection in CTO PCI.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229536","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":"The impact of clinical presentation on one-year major adverse cardiac events in patients with angiographically defined moderate to severe calcified coronary artery disease.","authors":"Argisjt Mkrtchjan, Eleni Ntantou, Alexandros A Siskos, Jacob J Elscot, Jeroen M Wilschut, Rutger-Jan Nuis, Roberto Diletti, Joost Daemen, Isabella Kardys, Nicolas M Van Mieghem, Wijnand K den Dekker","doi":"10.25270/jic/26.00022","DOIUrl":"10.25270/jic/26.00022","url":null,"abstract":"<p><strong>Objectives: </strong>The authors aimed to investigate the impact of clinical presentation on 1-year major adverse cardiac events (MACE) in patients with angiographically defined moderate or severe calcified coronary artery disease.</p><p><strong>Methods: </strong>The authors conducted a retrospective, single-center cohort study in patients with moderate to severe coronary calcification who underwent percutaneous coronary intervention (PCI) between June 2020 and July 2021 with either chronic coronary syndrome (CCS) or acute coronary syndrome (ACS). The primary endpoint was 1-year MACE, a composite of all-cause mortality, myocardial infarction (MI), and ischemia-driven revascularization. Cox proportional hazards regression was used.</p><p><strong>Results: </strong>Seven hundred twenty-four patients were included: 420 patients with ACS and 304 patients with CCS. The median age was 72.0 years. There were relatively more men in the CCS cohort (76.0% vs 66.2%, P = .005). Procedure time was longer in the context of CCS (88 minutes [25th-75th percentile: 56-104] vs 78 minutes [66-121], P < .001). Application of atherectomy and lithotripsy was similar in both cohorts. No significant difference was observed in the cumulative incidence of MACE between the ACS (15.0%) and CCS (16.4%) groups (HR, 0.94; 95% CI, 0.65-1.36; P = .74). Secondary outcomes, such as all-cause mortality, MI, and ischemia-driven revascularization, did not result in statistical significance between the groups.</p><p><strong>Conclusions: </strong>The cumulative incidence of 1-year MACE and its composites did not show statistically significant difference between patients with moderate or severe calcification in the context of CCS or ACS. This suggests that the clinical presentation of patients with calcified coronary arteries does not significantly affect their outcomes.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693261","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":"Drug-eluting stent, drug-coated balloon, or conventional angioplasty for in-stent coronary restenosis: an updated meta-analysis of randomized trials.","authors":"M Haisum Maqsood, Robert S Zhang, Sripal Bangalore","doi":"10.25270/jic/26.00028","DOIUrl":"10.25270/jic/26.00028","url":null,"abstract":"<p><strong>Objectives: </strong>The SELUTION SLR 014 In-stent Restenosis (SELUTION4ISR) trial showed noninferiority of DCB for the outcome of target lesion failure (TLF) when compared with standard of care (80% DES and 20% POBA). It was notable that in the DCB vs DES subgroup analysis there was a numerically higher rate of TLF with DCB (15.3% vs 7.1%). The authors aimed to re-evaluate the outcomes of drug-eluting stent (DES), drug-coated balloon (DCB), or plain old balloon angioplasty (POBA) in patients with coronary in-stent restenosis (ISR).</p><p><strong>Methods: </strong>The authors searched PubMed and EMBASE databases for randomized clinical trials (RCTs) that compared these 3 percutaneous revascularization strategies for ISR until March 15, 2026. Outcomes included major adverse cardiovascular events (MACE), target lesion revascularization, all-cause mortality, cardiovascular mortality, and stent thrombosis.</p><p><strong>Results: </strong>From 19 RCTs that randomized 4238 patients with ISR at mean follow-up of 19.6 months, there was a significant reduction in MACE and TLR with both DCB (OR, 0.35; 95% CI, 0.24-0.52 and OR, 0.28; 95% CI, 0.16-0.49, respectively) and DES (OR, 0.35; 95% CI, 0.24-0.52 and OR, 0.22; 95% CI, 0.12-0.42, respectively) when compared with POBA. There were no significant differences in clinical outcomes between DCB and DES.</p><p><strong>Conclusions: </strong>In patients with ISR, DCB reduced MACE/TLR when compared with POBA. There were no clinical differences between DCB and DES even after inclusion of the SELUTION4ISR trial, thus suggesting that DCB are reasonable alternative to repeat stenting in patients presenting with ISR.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787239","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":"Inadvertent hepatic vein puncture during emergent pericardiocentesis.","authors":"Neha Chopra, Sourabh Agstam, Devesh Kumar, Surbhit Bhadauria, Anwar Hussain Ansari","doi":"10.25270/jic/25.00391","DOIUrl":"10.25270/jic/25.00391","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918789","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":"Off-label use of a ventricular septal defect occluder for large mitral paravalvular leak in the early postoperative period: a case report.","authors":"Leire Unzué, Lorena Martín-Polo, Ángel González-Pinto","doi":"10.25270/jic/25.00347","DOIUrl":"10.25270/jic/25.00347","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918907","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":"Ventricular fibrillation as a manifestation of delayed distal coronary perforation induced by high blood pressure.","authors":"Kwok-Ho Yau, Tin Wah Christopher Lau, Justin Ka-Ho Wong, Kin-Lam Tsui","doi":"10.25270/jic/25.00384","DOIUrl":"10.25270/jic/25.00384","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858851","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":"Cardiopulmonary bypass is safe and effective support for concomitant high-risk percutaneous coronary intervention and transcatheter aortic valve replacement.","authors":"Axel Gomez, Madison E Matthews, Aaron Grober, Ryan Ferreira, Kendrick A Shunk, Jeffrey Zimmet, Elaine E Tseng, Marko T Boskovski","doi":"10.25270/jic/25.00352","DOIUrl":"10.25270/jic/25.00352","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with coexisting severe aortic stenosis (AS) and critical coronary artery disease (CAD) face high procedural risk when treated percutaneously. Although mechanical circulatory support (MCS) can mitigate hemodynamic instability, evidence guiding the use of cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO) during concomitant transcatheter aortic valve replacement (TAVR) and percutaneous coronary intervention (PCI) is lacking.</p><p><strong>Methods: </strong>The authors retrospectively reviewed 6 high-risk patients who underwent concomitant TAVR and PCI with planned MCS using CPB or venoarterial (VA)-ECMO between 2015 and 2023. Outcomes were classified according to VARC-3 criteria.</p><p><strong>Results: </strong>Six male patients (mean age 77.3 ± 8.3 years) underwent concomitant TAVR and PCI with planned MCS using CPB (n = 4, 2015-2020) or VA-ECMO (n = 2, 2022-2023). Complete coronary revascularization was achieved in 4 cases (66.7%). Implanted valves included 2 self-expanding and 4 balloon-expandable prostheses. The mean catheter-measured transaortic gradient decreased from 37.2 ± 17.6 mm Hg to 3.9 ± 2.1 mm Hg (P = .006). Trace (1+) paravalvular leak occurred in 4 patients (66.7%), with none 2+ or higher. There were no intraprocedural complications, neurologic events, major bleeding, vascular complications, or 30-day deaths. Three patients (50%) developed new conduction abnormalities, all without pacemaker requirement. Acute kidney injury occurred in 3 (Stage I, 50%). The mean intensive care and total hospital stays were 5.5 ± 3.5 and 8.3 ± 6.0 days, respectively.</p><p><strong>Conclusions: </strong>Planned CPB or VA-ECMO support enabled safe performance of concomitant TAVR and PCI in non-surgical, high-risk patients, representing a feasible approach for selected complex cases.</p>","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291581","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":"Finding the optimal pacing threshold and avoiding multiple deployments of the Micra device using temporary venous pacing mapping.","authors":"Kwok-Ho Yau, Tin-Yau Chan, Kwok-Keung Chan","doi":"10.25270/jic/25.00381","DOIUrl":"10.25270/jic/25.00381","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858688","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":"Adaptive use of a large-bore sheath to access the right ventricular outflow tract in a pediatric patient.","authors":"Guste Cesnaite, Ugne Stulpinaite, Sigitas Cesna","doi":"10.25270/jic/25.00393","DOIUrl":"10.25270/jic/25.00393","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918833","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":"Very late thrombosis of a hemi-Cabrol coronary graft: a rare cause of cardiogenic shock.","authors":"Miguel A Martín-Arena, Joaquín Vila-García, Clara Ugueto-Rodrigo, Cristina Contreras-Lorenzo, Ricardo Martínez-González, Carmen Labarta-Bello, Guadalupe Buitrago Weiland, Sandra Rosillo-Rodríguez, Santiago Jiménez-Valero, Raúl Moreno","doi":"10.25270/jic/25.00390","DOIUrl":"10.25270/jic/25.00390","url":null,"abstract":"","PeriodicalId":49261,"journal":{"name":"Journal of Invasive Cardiology","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145985529","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}