Journal of Transcatheter Interventions最新文献

{"title":"Evaluation of the effects of compressive dressing after interventional procedures via radial approach","authors":"Fernando Canedo, Larissa Oliveira, M. Prudente, Patrícia Demuner, Débora Rodrigues, Guiulliano Gardenghi, A. Souza, Adriano Araújo","doi":"10.31160/jotci202331a20230014","DOIUrl":"https://doi.org/10.31160/jotci202331a20230014","url":null,"abstract":"Background External compressive devices after radial puncture for cardiac catheterization and percutaneous coronary intervention aim at hemostasis, patient comfort, and safety. The objective of the study was to evaluate patients undergoing invasive coronary procedures by radial approach, in which a low-cost compressive dressing developed at the service was used, assessing its safety and the occurrence of complications. Methods Patients undergoing coronary angiography and percutaneous coronary intervention, evaluated at the time of removal of compressive dressing and after 7 days, by means of a questionnaire addressing comorbidities, clinical picture, procedure and compression time, physical assessment of hematoma and pain, and a vascular Doppler ultrasound to evaluate radial artery occlusion. Results A total of 144 patients were evaluated, 138 of whom were followed up within 7 days. Events did not differ among diagnostic and therapeutic procedures. In the immediate evaluation after removal of dressing, an incidence of 4.2% of radial artery occlusion was observed, with pain reported by 23.6% of patients, graded at 2.9±1.7 points in the Visual Analogue Scale (intensity of zero to ten), and no major bleeding. Hematoma occurred in one patient (0.9%), classified as type III according to the EASY criteria. In the 7-day evaluation, the incidence of radial artery occlusion was 2.2%, pain was reported in 11.1% of sample (intensity 1.8±0.8), and hematoma was evident in 3.5%. Conclusion The compressive dressing proved to be a safe procedure, with a low rate of complications and a low rate of local pain in patients undergoing invasive coronary procedures via radial approach.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"62 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140080265","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":"Percutaneous coronary intervention with the staged mini culotte technique for ostial restenosis of the large side branch","authors":"P. Jariwala, Gururaj Kulkarni","doi":"10.31160/jotci202331a20230016","DOIUrl":"https://doi.org/10.31160/jotci202331a20230016","url":null,"abstract":"Understanding the anatomy and physiology of a bifurcation is crucial in today’s interventional field. The bifurcation lesion is one of the most challenging coronary conditions to treat percutaneously. Numerous interventional strategies have been investigated because of the high level of interest in these lesions, but the relatively poor procedural and long-term results. Improvements in stenting and other interventional procedures have reduced the likelihood of adverse clinical outcomes, by creating the most favorable environment for stents to do their work. Provisional stenting has been widely accepted as the initial interventional technique for coronary bifurcation lesions by the medical community for over 15 years. Restenosis of a major branch is possible after angioplasty of the main vessel using a provisional one-stent approach. Although side branch restenosis following bifurcation angioplasty is less common with modern bifurcation procedures, it still occurs in 5% of cases during angiographic follow-up for symptoms. In our case series of five patients, severe side-branch restenosis presented with recuring anginal symptoms, which required target vessel revascularization. By applying bifurcation principles, we improved the “staged mini culotte” part of the culotte bifurcation stent technique, making it more user-friendly, and reducing exposure to radiation and operating time.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"50 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140431443","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":"Coronary heart disease in young individuals: novel ways to detect, prevent and treat","authors":"R. Mody, Debarabrata Dash, Bhavya Mody, Umanshi Dash","doi":"10.31160/jotci202331a20230015","DOIUrl":"https://doi.org/10.31160/jotci202331a20230015","url":null,"abstract":"In spite of major advancements in the management and prevention strategies of atherosclerosis, the prevalence of coronary artery disease has risen worldwide, and might start at an early age. Cardiovascular diseases among young adults are characterized as a heterogeneous group of disorders due to congenital or acquired causes. Multiple risk factors, such as dyslipidemia, premature coronary heart disease, diabetes mellitus and cigarette smoking potentiate the patient’s risk for early coronary heart disease. Early assessment of patients with coronary artery disease can be performed using various non-invasive imaging methods, which facilitate early selection of effective and preventative therapies for coronary artery disease management; however, it is associated with several challenges due to limitations in risk calculators, and limited sensitivity of various screening methods. In this manuscript, we will discuss about pathophysiology, risk factors, invasive and non- invasive imaging methods, and various management strategies for the early prevention of coronary heart disease in young adults and, importantly, the future directions and preventing disease and sudden cardiac death.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"29 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429972","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":"Prognostic value of residual SYNTAX score on in-hospital and follow-up clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing pharmacoinvasive strategy","authors":"Raphael Rossi Ferreira, Tania Falcão, Fernando Atik","doi":"10.31160/jotci202331a20230017","DOIUrl":"https://doi.org/10.31160/jotci202331a20230017","url":null,"abstract":"Background Multivessel coronary artery disease is a challenge in clinical practice. An individualized approach should consider not only the patient characteristics, but also a multidisciplinary approach, together with the Heart Team. Multiple angiographic scores have been proposed with the aim of quantifying the risk associated with multivessel coronary artery disease. Residual SYNTAX score has been proposed as a method to systematically characterize and quantify residual coronary disease after percutaneous coronary intervention. There are few data in the literature correlating the residual SYNTAX score in patients with ST-segment elevation myocardial infarction undergoing pharmacoinvasive strategy. The objective of this study was to evaluate the SYNTAX score and residual SYNTAX score as predictors of in-hospital and medium-term outcomes (180 to 380 days) in patients with multivessel coronary artery disease in the setting of ST-segment elevation myocardial infarction, after successful fibrinolytic therapy. Methods In a cross-sectional, analytical, and prospective study, we evaluated residual SYNTAX score as predictor of in-hospital and medium-term outcomes (6 months to 1 year), in patients with multivessel coronary artery disease, in the setting of ST-segment elevation myocardial infarction after pharmacoinvasive strategy. Results Between August 2019 and December 2020, 108 patients with ST-segment elevation myocardial infarction after fibrinolysis, with reperfusion criteria, were analyzed. The mean SYNTAX score was 13.98 (±4.87) and the mean residual SYNTAX score was 7.56 (±4.47). High residual SYNTAX score was associated with contrast-induced nephropathy and major adverse cardiac event. It was also an independent predictor of major adverse cardiac event with a 9.69-fold increased risk (p=0.0274). Conclusion High residual SYNTAX score confers worse prognosis in patients with ST-segment elevation myocardial infarction after pharmacoinvasive strategy.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"131 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140449217","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 antegrade dissection and re-entry technique on coronary percutaneous interventions for chronic total occlusion: the LATAM Chronic Total Occlusion registry","authors":"Sebastián Peralta, M. Bettinotti, Ezequiel Zaidel, Guillermo Jubany, Luis Murillo, Andres Mazuquin, Francisco Goldaracena, Luis Sztejfman, Lucio Padilla, João Tinoco, Pedro Oliveira, Alexandre Quadros","doi":"10.31160/jotci202331a20230012","DOIUrl":"https://doi.org/10.31160/jotci202331a20230012","url":null,"abstract":"Background The newest techniques of percutaneous coronary interventions for chronic total occlusion may improve technical success. The objectives were to describe safety and efficacy of antegrade dissection and reentry technique as initial revascularization strategy. Methods A multicenter registry from Latin American countries (LATAM Chronic Total Occlusion). Baseline characteristics and outcomes of cases using antegrade dissection and reentry as primary strategy or bailout of antegrade wire escalation were analyzed. Retrograde approach cases were excluded. Physicians used conventional antegrade dissection and reentry technique. Results Out of 1,875 patients analyzed, 50 were planned primary antegrade dissection and reentry and 1,825 planned primary antegrade wire escalation. Primary antegrade dissection and reentry was preferred in older patients, with a history of revascularization (coronary artery bypass graft: primary antegrade dissection and reentry in 33.3% and primary antegrade wire escalation in 13.4%; p<0.001; percutaneous coronary interventions in 66.6% and 48.8%, respectively; p=0.012). Longer chronic total occlusions (30mm [22-41] and 21mm [15-30]; p<0.001), moderate or severe calcification (62% and 42.6%; p=0.008) were associated with the selection of primary antegrade dissection and reentry, instead of primary antegrade wire escalation. There was a significant correlation between increasing J-CTO score (X2=37, df=5; p<0.001), and use of primary antegrade dissection and reentry. Primary antegrade wire escalation had a success rate of 88.4%, and primary antegrade dissection and reentry of 76.7%. For primary antegrade wire escalation and bailout antegrade dissection and reentry, the use of the CrossBoss® device was related to the highest rates of success (92.3% and 82.7%, respectively). Short-term outcomes were similar in both groups. Conclusion In Latin America, antegrade dissection and reentry was safe and effective, both as primary or bailout strategy, even when used for higher complexity lesions. The use of dedicated devices was related to a higher success rate.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"116 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138958569","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":"Aspirin versus P2Y12 inhibitors for secondary prevention after percutaneous coronary intervention","authors":"Luiz Tanajura, Áurea Chaves, Rafaela Freitas, Ana Barbosa, Kelvyn Vital, José Delamain","doi":"10.31160/jotci202331a202304","DOIUrl":"https://doi.org/10.31160/jotci202331a202304","url":null,"abstract":"Currently, percutaneous coronary intervention with a drug-eluting stent implantation is the main method of myocardial revascularization in tertiary care hospitals, regardless of the clinical presentation of coronary artery disease. It is well known that to be effective, it requires the use of a dual antiplatelet therapy, which is a combination of acetylsalicylic acid and a P2Y12 platelet receptor inhibitor, which plays a key role in preventing thromboses after endoprosthesis implantation and is also indicated to prevent atherothrombotic events in the late clinical course, regardless of the stent model used. After a variable period of time, depending on some factors, such as the clinical presentation of coronary artery disease and the type of stent implanted, this therapy is discontinued, and the main current guidelines recommend interrupting the P2Y12 receptor inhibitor and maintaining acetylsalicylic acid in the long term, as one of the main pharmacological measures for secondary prevention of atherosclerosis. However, recently, due to their greater antiplatelet potency and probable lower potential for significant bleeding, especially in the digestive tract, P2Y12 inhibitors have been considered a valid and attractive option as an antiplatelet agent for long-term use; but this alternative has not been endorsed by guidelines yet. This review discusses the details related to this important decision that must be made by cardiologists when discontinuing the different antithrombotic therapies initially used after percutaneous coronary intervention. In principle, the scarcity of conclusive and normative clinical studies, especially in the population treated by percutaneous intervention, means that acetylsalicylic acid is the only antiplatelet agent with class I indication for secondary prevention of atherosclerosis.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139001423","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":"Percutaneous edge-to-edge mitral regurgitation valve repair after transcatheter aortic valve implantation","authors":"Júlio Schulz, Felipe Amaral, Paloma Lima, Marcelo Dreckmann, Edson Tafner, Guiulliano Gardenghi","doi":"10.31160/jotci202331a20230013","DOIUrl":"https://doi.org/10.31160/jotci202331a20230013","url":null,"abstract":"Moderate to severe mitral regurgitation is observed in 17 to 35% of patients undergoing transcatheter aortic valve implantation. A study reporting mitral regurgitation after transcatheter aortic valve implantation due to aortic stenosis demontrated 50% of patients with moderate to severe reflux showed improvement in regurgitation, and 8.7% showed worsening of the condition, which led to increased mortality. This progression suggested conventional management, based on medication optimization, may not be able to prevent poor outcomes. We report a case on the clinical course of a patient with mitral regurgitation after transcatheter aortic valve implantation, and the use of MitraClip® as an alternative treatment and its benefits.","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"10 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139001373","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":"Comment on: Initial Invasive or Conservative Strategy for Stable Coronary Disease (ISCHEMIA) clinical trial","authors":"F. Sant'Anna, L. Sant'Anna, S. Couceiro","doi":"10.31160/jotci202028a202005","DOIUrl":"https://doi.org/10.31160/jotci202028a202005","url":null,"abstract":"Muito se tem pesquisado sobre o tratamento da doenca arterial coronariana (DAC) cronica.– O estudo ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) foi muito aguardado, na esperanca de que respondesse a muitas duvidas ainda existentes. Nossa intencao e elaborar uma leitura critica desse documento, analisando sua metodologia, seus resultados e o quanto ele pode produzir de impacto na pratica clinica dos cardiologistas. Inicialmente, ao examinarmos a metodologia do estudo, nota-se uma diferenca entre o que [...]","PeriodicalId":494091,"journal":{"name":"Journal of Transcatheter Interventions","volume":"88 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141203793","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}