Postepy W Kardiologii Interwencyjnej最新文献

{"title":"Circumstances and clinical significance of cardiac troponin T elevation following transvenous lead extraction.","authors":"Jarosław Kosior, Dorota Nowosielecka, Wojciech Jacheć, Anna Polewczyk, Andrzej W Kutarski","doi":"10.5114/aic.2026.160051","DOIUrl":"https://doi.org/10.5114/aic.2026.160051","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about cardiac troponin T (cTnT) release during transvenous lead extraction (TLE).</p><p><strong>Aim: </strong>The aim of the study was to identify factors influencing the intensity of cTnT release during TLE and to investigate whether the increase in cTnT levels after TLE has any prognostic significance for medium-term survival.</p><p><strong>Material and methods: </strong>Retrospective analysis of a TLE database.</p><p><strong>Results: </strong>In 166 consecutive patients who underwent the TLE procedure, an elevated <i>hs</i> cTnT level > 0.014 µg/l was present in almost 100%. The increase in troponin level 8 h after TLE (DcTnT₈) was 900% of average and 400% of the median initial concentration. The factors most strongly associated with cTnT release during TLE were the age of the oldest extracted leads and the number of points on the Complex Indicator of Difficulty (CID) score. Additional procedural factors included the occurrence of technical problems, the need for second-line tools, hypotension > 1 min appearance, and traction on cardiac structures visible on transoesophageal echocardiography.</p><p><strong>Conclusions: </strong>Elevated cTnT levels are observed following nearly all TLE procedures; however, they do not impact the incidence of major complications, perioperative mortality, or long-term survival rates. Longer dwelling time of the extracted leads and the procedural complexity of TLE are the primary determinants of the magnitude of cardiac troponin release.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"103-113"},"PeriodicalIF":1.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular revascularization for treatment of acute mesenteric ischemia: a single-center experience.","authors":"Paweł Latacz, Wirginia Krzyściak, Marian Simka","doi":"10.5114/aic.2026.160099","DOIUrl":"https://doi.org/10.5114/aic.2026.160099","url":null,"abstract":"<p><strong>Introduction: </strong>Acute mesenteric ischemia (AMI), primarily from superior mesenteric artery (SMA) occlusion, is a life-threatening condition with high mortality. While open surgery has been the standard, endovascular techniques are emerging as a less invasive alternative.</p><p><strong>Aim: </strong>This study evaluated the outcomes of an endovascular-first strategy for AMI.</p><p><strong>Material and methods: </strong>A single-center, retrospective analysis was conducted on 25 consecutive patients (median age 74) with AMI due to SMA occlusion (23 thrombotic, 2 embolic) treated between 2022 and 2025. All patients underwent endovascular recanalization via antegrade or retrograde techniques, using stents, aspiration thrombectomy, or hybrid procedures as needed. The primary endpoint was a composite of mortality or irreversible bowel ischemia requiring resection.</p><p><strong>Results: </strong>Technical success was achieved in 24 (96%) patients. The in-hospital mortality rate was 16%. The cumulative 30-day rate of major adverse events was 24%. Serum lactate proved to be a sensitive marker for bowel viability, normalizing only in patients without necrosis. No recurrent stenosis was observed at 3- and 6-month follow-up.</p><p><strong>Conclusions: </strong>An endovascular-first approach for AMI is feasible, safe, and effective, with high technical success and acceptable mortality. It is applicable to both thrombotic and embolic occlusions. Success requires a multidisciplinary strategy, advanced endovascular tools, and the capability to convert to open surgery. The prognosis ultimately depends on the extent of bowel necrosis, underscoring the critical need for rapid diagnosis and intervention.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"121-129"},"PeriodicalIF":1.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute lower limb ischemia due to embolism in a patient with severe aortic stenosis and thrombus in the left ventricle.","authors":"Ewa Kwiatkowska, Karolina Niedbał, Michał Okarski, Jacek Legutko, Paweł Kleczyński","doi":"10.5114/aic.2026.160009","DOIUrl":"https://doi.org/10.5114/aic.2026.160009","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"159-160"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete versus culprit only revascularization in young STEMI patients with multivessel disease.","authors":"Ozlem Ozbek, Erdal Belen","doi":"10.5114/aic.2026.160032","DOIUrl":"https://doi.org/10.5114/aic.2026.160032","url":null,"abstract":"<p><strong>Introduction: </strong>There are still uncertainties regarding revascularization strategies in younger ST segment elevation myocardial infarction (STEMI) patients, largely due to limited data in this specific population.</p><p><strong>Aim: </strong>To determine whether complete revascularization reduces major adverse cardiovascular events (MACEs) and all cause mortality compared to culprit only percutaneous coronary intervention (PCI) in cases of STEMI among patients with multivessel disease.</p><p><strong>Material and methods: </strong>In this single center retrospective cohort study, we examined 431 STEMI patients treated between January 2022 and December 2023. Among these, 219 had undergone culprit only while 212 had received complete revascularization. Baseline demographics, angiographic and procedural variables, pharmacotherapy, laboratory, and echocardiographic data were collected. The primary endpoint was incidence of MACE, and the secondary endpoint was all cause mortality. Independent predictors of MACE and death were determined.</p><p><strong>Results: </strong>The median age was 49 years (IQR 46-50), and 89.1% were male. MACE occurred in 135 (31.3%) patients, with higher incidence in the culprit only group (<i>p</i> < 0.001). Complete revascularization was associated with a 61% reduction in MACE risk (<i>p</i> < 0.001) and significantly lower urgent CABG requirements (<i>p</i> = 0.020). Elevated postoperative creatinine (<i>p</i> < 0.001 for MACE; <i>p</i> = 0.002 for mortality) and reduced postoperative left ventricular ejection fraction (<i>p</i> < 0.001 for MACE; <i>p</i> < 0.001 for mortality) were independent adverse predictors. b-blocker use (<i>p</i> = 0.028), antilipemic therapy (<i>p</i> < 0.001), and a history of hyperlipidemia (<i>p</i> < 0.001) were independently associated with reduced mortality.</p><p><strong>Conclusions: </strong>In young STEMI patients with multivessel disease, complete revascularization significantly reduces MACE compared to culprit-only PCI. Renal dysfunction and impaired left ventricular ejection fraction independently predict adverse outcomes, while b-blocker and antilipemic therapy are associated with improved survival.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"29-40"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ST-elevation myocardial infarction in a patient with coronary artery ectasia: an enduring challenge for the interventional cardiologist.","authors":"Konstantinos C Theodoropoulos, Aikaterini Chasiou, Alexandra Liakopoulou, George Kassimis, Antonios Ziakas","doi":"10.5114/aic.2026.160004","DOIUrl":"https://doi.org/10.5114/aic.2026.160004","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"146-148"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female sex as a possible factor associated with favorable long-term outcomes in off-pump coronary artery bypass surgery.","authors":"Tomasz K Urbanowicz, Michał Michalak, Antoni F Araszkiewicz, Paweł Wójcik, Krzysztof Jańczak, Szymon Kubiak, Marek Jemielity","doi":"10.5114/aic.2026.160035","DOIUrl":"https://doi.org/10.5114/aic.2026.160035","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical revascularization, alongside percutaneous intervention, is a viable therapeutic option with satisfactory long-term results. Accumulating evidence indicates that biological sex modulates the predisposition to coronary artery disease and perioperative risk.</p><p><strong>Aim: </strong>The study aimed to identify potential long-term prognostic factors after surgical revascularization in patients undergoing off-pump coronary artery bypass (OPCAB) using bilateral mammary arteries.</p><p><strong>Material and methods: </strong>In total, 276 consecutive patients were operated on due to complex stable coronary disease with off-pump surgical revascularization using bilateral mammary arteries. The long-term survival rates, including the Kaplan-Meier survival curve, were compared based on all-cause mortality risk between the female and male populations.</p><p><strong>Results: </strong>Among the 276 analyzed participants, 64 (23%) were deceased, with a median follow-up time of 3,307 days (range: 1,703-5,414 days). The 5-, 10-, and 15-year survival rates in the male and female populations were 90.5% vs. 96.5%, 78.1% vs. 91.4%, and 62.9% vs. 81.3%, respectively.</p><p><strong>Conclusions: </strong>Female sex may be related to superior long-term survival in off-pump revascularization with bilateral mammary artery grafts. While early perioperative risks may be higher in women due to anatomical and referral delay factors, the long-term survival in women may surpass that of men once the immediate postoperative period is successfully navigated. Large-scale studies are required to confirm the suggested association.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"97-102"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of major adverse cardiac events, high radiation exposure, and contrast use in percutaneous coronary interventions for calcified lesions.","authors":"Christos N Bousis, Evaggelia Kalampoki, Anna Kotsia, Pavlos Karanikis, Athanasios Kosovitsas, Eleni Tzima, Vasiliki Beli, Evgenia Pappa","doi":"10.5114/aic.2026.160014","DOIUrl":"https://doi.org/10.5114/aic.2026.160014","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous coronary intervention (PCI) for calcified lesions poses risks of major adverse cardiac events (MACE), increased radiation exposure, and contrast use for patients.</p><p><strong>Aim: </strong>To analyze radiation exposure and contrast use during PCI for calcified lesions and identify key predictors of MACE.</p><p><strong>Material and methods: </strong>A cohort of 281 patients undergoing PCI for calcified lesions between March 2018 and April 2025 was studied. Multiple linear regression was used to analyze dose-area product (DAP) and contrast, while binary logistic regression identified factors associated with high DAP (≥ 500 Gy·cm²) or low DAP (< 500 Gy·cm²) and MACE.</p><p><strong>Results: </strong>DAP was primarily affected by operator (fold change = 0.55; 95% CI: 0.49-0.62; <i>p</i> < 0.001). Male sex and ad-hoc (vs. elective) PCI resulted in elevated DAP (fold change = 1.22; 95% CI: 1.10-1.35; <i>p</i> < 0.001 and fold change = 1.14; 95% CI: 1.03-1.26; <i>p</i> = 0.01, respectively). Higher contrast use correlated with more balloons deployed (fold change = 1.1; 95% CI: 1.0-1.2; <i>p</i> ≤ 0.03) and longer irradiation time (fold change = 1.02; 95% CI: 1.01-1.03; <i>p</i> < 0.001). High DAP was mainly predicted by procedures on chronic total occlusions (OR = 14.61; 95% CI: 4.21-50.60; <i>p</i> < 0.001) and by a greater number of PCIs (OR = 12.47; 95% CI: 5.35-29.06; <i>p</i> < 0.001). MACE risk increased with the presence of chronic kidney disease (OR = 5.89; 95% CI: 2.09-16.62; <i>p</i> < 0.001 at 6 months and OR = 7.22; 95% CI: 2.80-18.62; <i>p</i> < 0.001 at 1 year); severe (vs. mild or moderate) calcifications further amplified 1-year MACE risk (OR = 2.55; 95% CI: 1.01-6.43; <i>p</i> = 0.046).</p><p><strong>Conclusions: </strong>Managing factors related to operator, procedural complexity, calcification severity, and patient comorbidities is essential to reduce radiation and contrast exposure, as well as MACE, during interventions on calcified lesions.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"8-20"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful double-step percutaneous repair of aortic atresia.","authors":"Paulina Figarska, Robert Sabiniewicz, Anna Sabiniewicz","doi":"10.5114/aic.2026.160011","DOIUrl":"https://doi.org/10.5114/aic.2026.160011","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"141-143"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter closure of interatrial communication using the Cocoon occluder in patients with confirmed nickel hypersensitivity: a long-term observational study.","authors":"Danuta Sorysz, Kinga Glądys, Michał Węgiel, Stanisław Bartuś","doi":"10.5114/aic.2026.160010","DOIUrl":"https://doi.org/10.5114/aic.2026.160010","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"137-140"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter aortic valve implantation in centers without a cardiac surgery department: a meta-analysis of contemporary evidence.","authors":"Antonio Rocha de Almeida, Rafael Viana, Renato Fernandes, Ângela Bento, Diogo Brás, Kisa Congo, Lino Patrício","doi":"10.5114/aic.2026.160041","DOIUrl":"https://doi.org/10.5114/aic.2026.160041","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of aortic stenosis (AS) is increasing, resulting in a growing demand for aortic valve interventions. Current guidelines recommend transcatheter aortic valve implantation (TAVI) only in centers with on-site cardiac surgery (CS) backup. However, procedural advancements have reduced the need for emergent cardiac surgery (ECS), prompting a debate about the necessity of backup for this procedure. This meta-analysis evaluated the safety of TAVI performed in centers without CS backup.</p><p><strong>Material and methods: </strong>The study was conducted in accordance with the MOOSE guidelines. The protocol was registered at PROSPERO (CRD420251044095). PubMed, CENTRAL, and Scopus were systematically searched up to November 2025. Studies comparing outcomes of TAVI performed with and without on-site CS or reporting outcomes of TAVI in non-CS centers were included. The outcomes were in-hospital mortality, 30-day death, need for ECS, and stroke. Meta-analyses of comparative studies and pooled proportions were performed using random-effects models. Risk of bias was evaluated using the ROBINS-I tool.</p><p><strong>Results: </strong>Eight observational studies were analyzed, including 22,203 patients (19,373 with and 2830 without on-site CS). No significant difference in in-hospital mortality was observed between groups (relative risk [RR] = 1.1, 95% CI: 0.6-1.9, <i>p</i> = 0.8). Thirty-day mortality was also similar (RR = 1.2, 95% CI: 0.5-2.6, <i>p</i> = 0.72). ECS did not occur (0%; 95% CI: 0-1), with an RR of 0.8 (95% CI: 0.2-2.4, <i>p</i> = 0.7). Stroke rates did not differ (RR = 1.1, 95% CI: 0.8-1.5). Pooled in-hospital mortality in non-surgical centers was 3% (95% CI: 1-4%), and 30-day mortality was 4% (95% CI: 2-6%). Sensitivity analyses in propensity score-matched populations confirmed findings with reduced heterogeneity and consistent results.</p><p><strong>Conclusions: </strong>TAVI performed in centers without on-site cardiac surgery demonstrated comparable outcomes to those with surgical backup, suggesting that selected programs may safely operate under this model. These findings support reconsidering current guideline restrictions to enhance access and equity in TAVI delivery.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"58-69"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}