Postepy W Kardiologii Interwencyjnej最新文献

{"title":"Intravascular lithotripsy of the femoropopliteal arteries: analysis of a prospective two-center pilot study.","authors":"Frantisek Stanek, David Prochazka, Oleksandr Zubkovskyy, Boris Koznar, Marian Rybar","doi":"10.5114/aic.2026.160002","DOIUrl":"https://doi.org/10.5114/aic.2026.160002","url":null,"abstract":"<p><strong>Introduction: </strong>Intravascular lithotripsy (IVL) is an emerging option for endovascular treatment of calcified lesions of the peripheral arteries. However, its clinical significance has not yet been firmly established. It is also hypothesized that IVL may improve long-term outcomes of drug-coated balloon (DCB) angioplasty by disrupting calcified barriers, thereby enabling improved drug penetration.</p><p><strong>Aim: </strong>The aim of this pilot study was to clarify the feasibility and safety of IVL in calcified femoropopliteal stenoses. Another objective was to determine whether IVL can potentiate the long-term effect of DCB angioplasty in calcified femoropopliteal lesions.</p><p><strong>Material and methods: </strong>Patients with significant calcified stenoses of the femoral and/or popliteal arteries were enrolled and assigned to two groups. The DCB plus group (DCB+) received IVL and subsequent DCB angioplasty, while the DCB minus group (DCB-) underwent IVL and, if necessary, plain balloon angioplasty.</p><p><strong>Results: </strong>A total of 45 procedures were performed: 22 in the DCB+, 23 in the DCB- group. Angiographic success rates were 90.9% in the DCB+ group and 87.0% in the DCB- group. At the 24-month follow-up, cumulative patency did not differ significantly between the groups (65.22% for DCB-, 58.85% for DCB+). No amputations were required during follow-up.</p><p><strong>Conclusions: </strong>IVL has proven to be a safe approach, yielding favorable immediate results. Regarding long-term patency, our study found no significant differences between the DCB+ and DCB- groups. However, the smaller number of patients in each group may have limited the ability to draw definitive conclusions.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"114-120"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845246","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":"Guideline-directed medical therapy in Polish patients with chronic coronary syndrome and advanced chronic kidney disease: insights from the ISCHEMIA-CKD trial.","authors":"Radosław Pracoń, Rebecca Anthopolos, Ying Lu, Marcin Demkow, Tomasz Mazurek, Jarosław Drożdż, Piotr Pruszczyk, Marek Roik, Karolina Kryczka, Jan Henzel, Edyta Kaczmarska-Dyrda, Robert Małecki, Anna Teresińska, Hanna Szwed, Witold Rużyłło","doi":"10.5114/aic.2026.160027","DOIUrl":"https://doi.org/10.5114/aic.2026.160027","url":null,"abstract":"<p><strong>Introduction: </strong>The ISCHEMIA-CKD trial showed similar outcomes with an initial conservative vs invasive approach to chronic coronary syndrome in patients with advanced chronic kidney disease. Guideline-directed medical therapy (GDMT) was recommended regardless of the randomized strategy assignment.</p><p><strong>Aim: </strong>To describe GDMT attainment in ISCHEMIA-CKD participants in Poland compared to other world regions.</p><p><strong>Material and methods: </strong>Among 777 trial participants, 105 were randomized in Poland. Patients were followed for a median of 2.2 years with the following GDMT recommendations: not smoking, systolic blood pressure (SBP) < 140/ diastolic blood pressure (DBP) < 90 mm Hg, high/moderate-intensity statin, antiplatelet/anticoagulant, angiotensin-converting-enzyme inhibitors (ACE-I)/angiotensin receptor blockers (ARB) and b-blocker therapy, glycated hemoglobin (HbA1c) < 8% when indicated.</p><p><strong>Results: </strong>Participants in Poland vs other regions of the world (age 67 [60, 76] vs. 63 [55, 70] years, <i>p</i> < 0.001, 32% vs. 31% females, <i>p</i> = 0.86) had higher incidence of prior myocardial infarction (25% vs. 16%, <i>p</i> = 0.04), peripheral vascular disease (12% vs. 5%, <i>p</i> = 0.009), atrial fibrillation (23% vs. 7%, <i>p</i> < 0.001), and less frequently diabetes (44% vs. 59%, <i>p</i> = 0.004). At baseline, Polish participants were more often on antiplatelets/anticoagulants (91% vs. 83%, <i>p</i> = 0.04), b-blockers (95% vs. 72%, <i>p</i> < 0.001), and ACE-I/ARBs (62% vs. 45%, <i>p</i> = 0.002), with better attainment of SBP < 140 (73% vs. 53%, <i>p</i> < 0.001), and HbA1c < 8% (86% vs. 56%, <i>p</i> = 0.003) and similar smoking and high-/moderate-intensity statin treatment frequencies. This degree of GDMT goal attainment was maintained at the last follow-up visit.</p><p><strong>Conclusions: </strong>In Polish patients with advanced kidney disease, high GDMT goal attainment was observed and maintained until the last follow-up visit under trial-specific, strict medical surveillance. The impact of GDMT on long-term outcomes remains to be studied in this patient population.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844934","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":"Spontaneous isolated common hepatic artery dissection during conservative management of superior mesenteric artery dissection.","authors":"Keisuke Yamamoto, Yuichi Ozaki, Kazuya Mori, Hironori Kitabata, Atsushi Tanaka","doi":"10.5114/aic.2026.160018","DOIUrl":"https://doi.org/10.5114/aic.2026.160018","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"161-162"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845178","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":"Percutaneous closure of acquired Gerbode type I defect in adults: summary of a consecutive series of 7 cases.","authors":"Ewa Peszek-Przybyła, Marek Jędrzejek, Piotr Pysz, Tomasz Gallina, Wojciech Wojakowski, Grzegorz Smolka","doi":"10.5114/aic.2026.160024","DOIUrl":"https://doi.org/10.5114/aic.2026.160024","url":null,"abstract":"<p><strong>Introduction: </strong>Gerbode defect (GD) is a rare anomaly: a left ventricle-to-right atrium shunt. Due to its infrequency, there are no treatment standards.</p><p><strong>Aim: </strong>We aimed to assess the feasibility, efficacy, and complications of transcatheter closure of acquired Gerbode defects in a consecutive series of adult patients.</p><p><strong>Material and methods: </strong>The single-center, prospective registry included all consecutive patients with iatrogenic GD treated via a transvenous approach using a steerable sheath and a telescopic system under 3D-RT TEE guidance between 2003 and 2025. Baseline, procedural, and follow-up data were analyzed.</p><p><strong>Results: </strong>We included 7 patients (3/7, 43% male) with a median age of 54.7 years (30-85 years). All patients presented with symptomatic right-sided heart failure (NYHA III, <i>n</i> = 6; NYHA IV, <i>n</i> = 1) and right ventricular dilatation on echocardiography. Devices used were the Amplatzer Membranous VSD, with a median central diameter of 6 mm (range: 6-8), and the ADO II device. Procedural success (device deployment and effective occlusion) was achieved in 5/7 patients (57%). Median pulmonary pressure fell from a baseline of 41 mm Hg (34-70 mm Hg) to 27 mm Hg (23-39 mm Hg) post-procedurally (<i>p</i> = 0.002).</p><p><strong>Conclusions: </strong>In this small series, transvenous closure of an acquired Gerbode defect using a steerable sheath and telescopic system under 3D-RT transesophageal echocardiography (TEE) was feasible in 5/7 patients. Larger studies with longer follow-up are needed to confirm the safety and efficacy of this approach.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"80-85"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845183","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":"Radial artery pseudoaneurysm: the unexpected face of the \"safest\" access.","authors":"Wojciech Kula, Jakub Drozd, Mateusz Drozd","doi":"10.5114/aic.2026.160005","DOIUrl":"https://doi.org/10.5114/aic.2026.160005","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"157-158"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845195","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":"A patient-tailored percutaneous coronary intervention of calcified lesions using different intravascular lithotripsy modalities in a multimorbid nonagenarian patient presenting with non-ST elevation myocardial infarction.","authors":"Michał Stachura, Michał Kuzemczak, Marek Roik, Michał Machowski, Piotr Pruszczyk","doi":"10.5114/aic.2026.160016","DOIUrl":"https://doi.org/10.5114/aic.2026.160016","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"149-151"},"PeriodicalIF":1.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845209","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":"Results from an international multi-center prospective registry of cardiac catheterizations and percutaneous cardiac interventions guided with three-dimensional imaging.","authors":"Sebastian Góreczny, Gareth J Morgan, Seong-Ho Kim, Juan Pablo Sandoval, Paweł Dryżek, Tomasz Moszura, Jenny E Zablah, Michael Ross, José García-Montes, Carlos Zabal, Felix Berger, Titus Kuehne, So-Ick Jang, Jung Yoon Kim, Stephan Schubert","doi":"10.5114/aic.2025.158239","DOIUrl":"https://doi.org/10.5114/aic.2025.158239","url":null,"abstract":"<p><strong>Introduction: </strong>Developments in fusion imaging (FI) software have facilitated easy use of three-dimensional (3D) roadmaps based on preregistered computed tomography (CT) or magnetic resonance imaging (MRI) datasets for guidance of cardiac catheterizations.</p><p><strong>Aim: </strong>The aim of this study was to report the initial results from the first international prospective registry of cardiac catheterizations guided with fusion of CT and MRI datasets.</p><p><strong>Material and methods: </strong>A multi-center prospective registry was set up to evaluate fusion of fluoroscopic two-dimensional (2D) images and the CT- or MRI-derived 3D roadmaps for guidance of cardiac catheterizations in congenital heart disease.</p><p><strong>Results: </strong>Fusion imaging was applied in 205 patients for guidance (<i>n</i> = 182) or planning (<i>n</i> = 23) of cardiac catheterization. Successful fusion of CT or MRI images was achieved in all cases. In 176 (96.7%) patients, 2D-3D registration was performed. In the remaining 6 patients, 3D-3D registration was utilized. Accurate initial 3D roadmap alignment was achieved in 142 (78%) patients. Seventeen (9.3%) patients required intra-procedural readjustment of the 3D roadmap due to distortion of the anatomy. Interventional procedures were performed in 137 (75.3%) patients. In 37 (20.3%) patients, catheterization was performed using only 3D guidance without additional angiography. Overall, 3D guidance with FI was deemed at least useful in 98.3% of patients and not useful or misleading in 3 (1.7%) patients.</p><p><strong>Conclusions: </strong>Direct 2D-3D registration of pre-catheterization CT or MRI is a safe and effective method of guidance of cardiac catheterization in selected congenital heart disease cases. In selected patients, FI facilitates percutaneous interventions without contrast angiography.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"22 1","pages":"86-96"},"PeriodicalIF":1.4,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845151","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":"Troponin elevation in sepsis: when numbers mislead and clinical context matters.","authors":"Wojciech Szczeklik, Wojciech Skupnik","doi":"10.5114/aic.2025.158113","DOIUrl":"https://doi.org/10.5114/aic.2025.158113","url":null,"abstract":"","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"21 4","pages":"473-474"},"PeriodicalIF":1.4,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312278","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":"Radial artery access in interventional cardiology: a review of current practices.","authors":"Ameen Nasser, Alexandra Malkowski, Anna Żądło, Mateusz Michalczak, Artur Dziewierz, Tomasz Tokarek","doi":"10.5114/aic.2025.158053","DOIUrl":"https://doi.org/10.5114/aic.2025.158053","url":null,"abstract":"<p><p>Transradial access (TRA) has evolved from an alternative technique to the guideline-recommended default strategy for coronary angiography and percutaneous coronary intervention. This shift is driven by TRA's association with improved clinical outcomes, fewer complications, and enhanced patient comfort compared with transfemoral access (TFA). The evolution of transradial techniques, including distal radial access (DRA), reflects a broader move towards minimally invasive, patient-centered interventional cardiology. This narrative review synthesizes data from 50 peer-reviewed articles retrieved from PubMed, Scopus, and Web of Science, including randomized controlled trials, meta-analyses, observational studies, and expert consensus statements. Key topics examined include anatomical considerations, comparisons between left and right radial access, comparisons between TRA and TFA, the emerging role of DRA, special considerations in certain populations, procedural complications, and cost analysis. TRA represents a major advancement in interventional cardiology, enhancing safety, efficiency, and patient satisfaction. Its incorporation into routine practice improves outcomes and procedural ergonomics. Despite certain anatomical and technical challenges, robust evidence supports TRA as the default strategy for coronary interventions across most patient populations. Ongoing investigations and trials continue to define optimal procedural techniques and patient selection criteria. These data are expected to further standardize clinical practice and support more consistent, high-quality outcomes across centers.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"21 4","pages":"475-486"},"PeriodicalIF":1.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312097","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: latest evidence, gaps in knowledge, and future directions.","authors":"Dario Mafrica, Artur Dziewierz, Dobromir Dobrev, Francesco Pelliccia","doi":"10.5114/aic.2025.158101","DOIUrl":"https://doi.org/10.5114/aic.2025.158101","url":null,"abstract":"<p><p>Aortic stenosis (AS) remains the most prevalent valvular heart disease worldwide and is increasingly managed through transcatheter aortic valve implantation (TAVI). With the 2025 ESC/EACTS Guidelines lowering the age threshold for TAVI to 70 years, the focus has shifted from short-term survival to lifetime management, necessitating rigorous evaluation of device durability, coronary access, and biological valve degeneration. This review synthesizes the latest evidence-based strategies for TAVI, contrasting randomized trial data with long-term registry findings. We critically analyze the hemodynamic trade-offs between self-expandable valves and balloon-expandable valves, particularly in patients with small aortic annuli, where SEVs demonstrate superior indexed effective orifice areas and reduced rates of patient-prosthesis mismatch (SMALL-TAVI registry). We further examine the expansion of indications into complex anatomical subsets, including bicuspid aortic valves (BIVOLUTX, STABILITY) and pure aortic regurgitation, where dedicated anchoring mechanisms are required to mitigate the risk of valve migration. Procedural optimization is addressed through the \"minimalist\" TAVI pathway (BENCHMARK registry), which emphasizes conscious sedation and ultrasound-guided vascular access to reduce length of stay without compromising safety. Finally, we discuss emerging biomarkers (MMP-3, osteopontin) and the role of epicardial adipose tissue as novel predictors of structural valve deterioration, signaling a potential shift toward biological modulation of valvular disease.</p>","PeriodicalId":49678,"journal":{"name":"Postepy W Kardiologii Interwencyjnej","volume":"21 4","pages":"487-495"},"PeriodicalIF":1.4,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291747","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}