Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions最新文献

{"title":"Comparative Visual Analysis of Coronary Slow Flow and Myocardial Blush Grade in Relation to Invasive Testing for Coronary Microvascular Dysfunction.","authors":"Andrew P Hill, Ryan L Wallace, Abhishek Chaturvedi, Flavia Tejada Frisancho, Matteo Cellamare, Vaishnavi Sawant, Sevket Ozturk, Vijoli Cermak, Cheng Zhang, Ron Waksman, Hayder D Hashim, Brian C Case","doi":"10.1002/ccd.70246","DOIUrl":"https://doi.org/10.1002/ccd.70246","url":null,"abstract":"<p><strong>Background: </strong>Angiographic coronary slow flow (CSF) has been correlated with coronary microvascular dysfunction (CMD) and abnormal myocardial blush grade (MBG) has been associated with worse outcomes in acute myocardial infarction. Their validity has not been compared with newer invasive forms of coronary functional CMD testing. Therefore, we aimed to investigate whether angiographic assessment of CSF and MBG correlate with gold-standard invasive assessments of CMD.</p><p><strong>Methods: </strong>Using the Coronary Microvascular Disease Registry (NCT05960474), we identified patients with angina and non-obstructive coronary arteries (ANOCA) who underwent invasive coronary functional testing (CFT) between August 2021 and August 2024. CMD was defined as coronary flow reserve (CFR) < 2.5 with an index of microcirculatory resistance (IMR) > 25 using invasive bolus thermodilution technique. CSF was defined as > 3 cardiac cycles for distal opacification of vessels with contrast. Slow Thrombolysis in Myocardial Infarction frame count (TFC) was defined as a corrected frame count of > 25. MBG was categorized as abnormal (Grade 0 or 1). Rates of abnormal CSF and MBG were compared between the CMD-positive and negative groups.</p><p><strong>Results: </strong>A total of 304 patients were included, of whom 81 (26.6%) were CMD positive. Patients were predominantly female (67.9 vs. 63.7%, p = 0.50) and slightly older (64.0 ± 11.3 vs. 60.6 ± 10.8 years, p = 0.02) with a lower BMI (28.5 ± 5.7 vs. 31.6 ± 6.9; p < 0.001) in the CMD positive group. Common comorbidities included hypertension, hyperlipidemia, and diabetes with a similar prevalence in both groups. There was no difference between CMD-positive and negative groups for CSF, (8.6% vs. 4.9%, p = 0.23) or slow cTFC (14.8% vs. 15.7%, p = 0.85). Additionally, the rate of abnormal MBG was similar in both groups (1.3% vs. 3.1%; p = 0.37).</p><p><strong>Conclusion: </strong>Our findings suggest that, while readily available and previously used for diagnosis, the angiographic findings of CSF and MBG do not reliably indicate the presence of CMD in ANOCA patients. Therefore, dedicated CFT should be pursued if there is clinical suspicion of CMD.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350984","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":"Reply to Letter to the Editor for Case Series Entitled \"Optimizing Stent Expansion in Calcified Coronary Lesions: A Case Series on the Efficacy of Scoring Balloons for Acute Underexpansion\".","authors":"Aslan Erdoğan, Muhammet Mert Göksu, Gamze Acar, Yeliz Güler","doi":"10.1002/ccd.70235","DOIUrl":"https://doi.org/10.1002/ccd.70235","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351315","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":"\"Letter to Editor: Percutaneous Coronary Intervention Outcomes for Chronic Total Occlusion in Patients on Dialysis: Analysis of the Japanese CTO-PCI Expert Registry\".","authors":"Muhammad Ahmad, Meer Hassan Khalid, Syed Ali Raza Zaidi, Taha Yahya, Suleman Arshad","doi":"10.1002/ccd.70280","DOIUrl":"https://doi.org/10.1002/ccd.70280","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350937","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":"\"Letter to the Editor: Comparison of Procedural and Clinical Outcomes of Angiography- Versus Imaging-Guided Percutaneous Coronary Intervention With Intravascular Lithotripsy\".","authors":"Muhammad Ahmad, Mian Zain Hayat, Taha Yahya, Mohsin Tariq","doi":"10.1002/ccd.70279","DOIUrl":"https://doi.org/10.1002/ccd.70279","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351009","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 Role of the Precise DAPT Score on Long-Term Outcomes After Carotid Artery Stenting: A Retrospective Cohort Study.","authors":"Altuğ Ösken, Evliya Akdeniz, Ahmet Öz, Ercan Aydın, Sinan Şahin","doi":"10.1002/ccd.70272","DOIUrl":"https://doi.org/10.1002/ccd.70272","url":null,"abstract":"<p><strong>Background: </strong>Carotid artery stenosis is a major contributor to stroke, a leading cause of mortality and disability worldwide. Carotid artery stenting (CAS) is commonly performed to reduce the risk of stroke in affected individuals. The Precise DAPT score, originally designed to predict bleeding risk in percutaneous coronary intervention (PCI) patients, has shown potential in predicting adverse outcomes in other vascular interventions.</p><p><strong>Aim: </strong>This study investigates the role of the Precise DAPT score associated with short- and long-term clinical outcomes in patients undergoing CAS.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from 376 patients who underwent CAS at Health Sciences University Siyami Ersek Thoracic and Cardiovascular Surgery Center between December 2012 and January 2018. The study analyzed the relationship between the Precise DAPT score and short- and long-term outcomes, including peri-procedural complications, recurrent stroke, and mortality. Statistical analyses included Cox regression, survival analysis, and receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Patients were stratified into two groups based on their Precise DAPT score: high score (≥ 25) and low score (< 25). After a mean follow-up of 54.3 months, those in the high-score group exhibited significantly higher long-term all-cause mortality (36.3% vs. 6.1%, p < 0.001) and major stroke events (18.6% vs. 9.1%, p = 0.01). The high-score group also had worse renal function and were older. A multivariable Cox regression model demonstrated that the Precise DAPT score ≥ 25 was associated with long-term mortality (adjusted HR 4.82, 95% CI 2.75-8.45, p < 0.001) and major stroke (adjusted HR 2.11, 95% CI 1.14-3.92, p = 0.018).</p><p><strong>Conclusions: </strong>The Precise DAPT score, despite being designed for PCI patients, is a valuable prognostic tool in patients undergoing CAS. It is independently associated with both long-term mortality and major stroke, highlighting its potential to guide personalized therapeutic strategies. These findings suggest that integrating the Precise DAPT score into clinical practice may enhance the management of patients undergoing carotid interventions, particularly in risk stratification for bleeding and ischemic events.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351282","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":"Contemporary Use of Coils During Percutaneous Coronary Intervention: Insights From the Multicenter COILSEAL Registry.","authors":"Enrico Cerrato, Giulio Piedimonte, Marco Franzino, Giorgio Marengo, Mario Bollati, Simone Zecchino, David Rutigliano, Francesco Soriano, Massimo Leoncini, Riccardo Mangione, Emanuele Sagazio, Francesco Maiellaro, Francesco Jeva, Gian Paolo Ussia, Fernando Scudiero, Alfonso Franzè, Umberto Barbero, Dario Calderone, Annamaria Nicolino, Fabrizio Ugo, Alessio La Manna, Francesco Costa, Pietro Mazzarotto, Ignacio Jt's Amat-Santos, Ferdinando Varbella","doi":"10.1002/ccd.70233","DOIUrl":"https://doi.org/10.1002/ccd.70233","url":null,"abstract":"<p><strong>Background: </strong>Use of coils during percutaneous coronary interventions (PCI) is often life-saving and useful, although their off-label use according to the instructions for use.</p><p><strong>Aims: </strong>Evaluation of in-hospital and long-term outcomes of patients undergoing PCI with coil implantation for treating coronary perforation or closing coronary artery aneurysms/fistulas.</p><p><strong>Methods: </strong>Among 245,652 PCIs performed in 17 high-volume European centers, 143 patients (0.06%) undergoing coil implantation during PCI were finally included in the analysis. PCI strategy (coiling performed during coronary perforation vs. closing aneurysm/fistulas) and procedural devices used were collected. The primary outcome was technical success, defined as the successful sealing of coronary perforation or aneurysm/fistulas, and procedural success defined as technical success without in-hospital major cardiovascular events (MACE). Long-term MACE and mortality were also reported.</p><p><strong>Results: </strong>The primary outcome occurred in 95.7% of cases, with no significant differences observed between the perforation and aneurysm/fistulas groups (94.5% vs. 100%, p = 0.19). Patients in the perforation group had a significantly lower rate of procedural success (83.5% vs. 96.6%, p = 0.01). Target lesion failure occurred in 11.4% of cases without differences between groups at a median follow-up of 2 years.</p><p><strong>Conclusions: </strong>Coils implantation during PCI is safe and feasible among patients treated for coronary perforations or closing aneurysms/fistulas.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350952","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":"Mid-Term Clinical Outcomes and Predictors of Mortality and Major Adverse Cardiovascular Events Following Cardiac Valve Replacement Surgery: A Retrospective Cohort Study From a Tertiary Center in Iran.","authors":"Homina Saffar, Nadia Rajablou, Abbasali Karimi, Shahrzad Salehbeygi, Soheil Mansourian, Hamidreza Pourhosseini, Arezou Zoroufian, Mohammad Sahebjam, Reza Mohseni-Badalabadi, Reza Hali, Ali Hosseinsabet, Zohreh Lesani, Hamidreza Hekmat, Samad Azari, Negar Omidi","doi":"10.1002/ccd.70276","DOIUrl":"https://doi.org/10.1002/ccd.70276","url":null,"abstract":"<p><strong>Objectives: </strong>Valvular heart disease (VHD) is a growing global health concern with increasing prevalence, particularly in aging populations. While surgical valve replacement (VRS) remains a definitive treatment, limited data exists from developing countries regarding postoperative outcomes. This study aimed to evaluate mid-term clinical outcomes, specifically survival and major adverse cardiovascular events (MACE), in patients undergoing isolated mitral and aortic valve replacement surgery, and to identify factors associated with mortality.</p><p><strong>Methods: </strong>In this retrospective cohort study, 1044 patients who underwent isolated mitral or aortic VRS at Tehran Heart Center between 2003 and 2023 were analyzed. Demographic, clinical, and echocardiographic data were collected. The primary outcome was all-cause mortality; the secondary outcome was MACE. Statistical analyses included univariate and multivariate Cox regression, ROC curve analysis, and log-rank tests.</p><p><strong>Results: </strong>The mean age of patients was 55 years, and 52% were male. Over a mean follow-up of 23.9 months, the overall mortality rate was 4.3%, and 8.4% experienced MACE. Multivariate analysis identified older age (p = 0.002) and female gender (p = 0.006) as independent predictors of mortality. Age > 50 years had a sensitivity of 85.5% and specificity of 34% for predicting mortality (AUC = 0.639, p = 0.001). No significant predictors of MACE were identified.</p><p><strong>Conclusion: </strong>Advanced age and female gender were associated with increased mortality following isolated VRS. These findings underscore the importance of tailored preoperative risk assessment to optimize surgical outcomes, particularly in developing healthcare settings.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351007","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":"Can Eptifibatide Rewrite the NSTEMI Story? (Eptifibatide vs. Standard Care for NSTEMI: A 5-Year Analysis of Major Adverse Cardiovascular Events).","authors":"Parvin Kalhor, Pargol Nowrouzi, Parichehr Ghahari, Mehdi Mehrani","doi":"10.1002/ccd.70242","DOIUrl":"https://doi.org/10.1002/ccd.70242","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is a leading cause of death worldwide. Among acute coronary syndromes, non-ST-elevation myocardial infarction (NSTEMI) poses a higher long-term risk than ST-elevation myocardial infarction (STEMI). Eptifibatide, a glycoprotein IIb/IIIa inhibitor, is used during percutaneous coronary intervention (PCI) to prevent clots, but its long-term effects in NSTEMI patients remain unclear.</p><p><strong>Aims: </strong>This study assesses the impact of Eptifibatide on major adverse cardiac events (MACE) and survival in NSTEMI patients undergoing PCI.</p><p><strong>Methods: </strong>A retrospective cohort study of NSTEMI patients treated between 2015 and 2022 at Tehran Heart Center. Patients were grouped based on whether they received Eptifibatide. MACE outcomes were tracked during hospitalization and 1 year later. Statistical adjustments were made for baseline differences.</p><p><strong>Results: </strong>Among 5309 patients, 12% received Eptifibatide. There were no significant differences between groups in MACE (17.2% vs. 15.6%) or survival (HR 0.97, p = 0.901).</p><p><strong>Conclusion: </strong>Eptifibatide showed no significant effect on MACE or survival in NSTEMI patients undergoing PCI. Further research is needed to explore its role in high-risk subgroups.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351015","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":"MINOCA and SCAD in Young Adults: Diagnostic-Prevention Gaps and the Case for Community CPR Preparedness.","authors":"Fasih Mehmood, Maheen Afaq, Nayab Magsi, Khushbakht Baloch, Rabia Ramzan, Muhammad Maaz Hassan","doi":"10.1002/ccd.70249","DOIUrl":"https://doi.org/10.1002/ccd.70249","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351232","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":"Sentinel Cerebral Protection System in TAVI: An Updated Meta-Analysis of Randomized and Propensity-Matched Studies.","authors":"Márcio Braite, Natanael de Paula Portilho, Lara Barbosa de Souza Moura Canas Lara, Deivyd Vieira Silva Cavalcante, Enzo Crema Scheffer, Marina Ferreira Machado, Ivo Queiroz Costa Neto, Eline Rozaria Ferreira Barbosa, Giuseppe Tarantini","doi":"10.1002/ccd.70236","DOIUrl":"https://doi.org/10.1002/ccd.70236","url":null,"abstract":"<p><strong>Backgrounds: </strong>Stroke remains a serious complication of transcatheter aortic valve implantation (TAVI). The Sentinel cerebral embolic protection (CEP) system is designed to mitigate this risk by capturing embolic debris, but its clinical benefit remains uncertain.</p><p><strong>Aims: </strong>This meta-analysis evaluated the impact of Sentinel CEP on stroke and related outcomes in TAVI.</p><p><strong>Methods: </strong>PubMed, Embase, and Cochrane were searched for randomized controlled trials (RCTs) and propensity score-matched (PSM) studies comparing TAVI with and without Sentinel CEP. The outcomes were periprocedural ischemic stroke, total stroke, disabling stroke, 30-day mortality, in-hospital mortality, composite death or stroke, acute kidney injury (AKI), and major vascular complications. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model.</p><p><strong>Results: </strong>Eight studies (five RCTs, three PSM studies) encompassing 33,111 patients were analyzed, with 50.1% receiving Sentinel. In pooled analysis, Sentinel CEP significantly reduced 30-day mortality (RR 0.75, 95% CI 0.58-0.97; p = 0.03) and AKI (RR 0.90, 95% CI 0.82-0.98; p = 0.01). No significant effect was observed for periprocedural ischemic stroke (RR 0.92, CI 0.79-1.07; p = 0.28), total stroke (RR 0.79, CI 0.59-1.05; p = 0.10), in-hospital mortality (RR 0.86, CI 0.57-1.31; p = 0.47), composite death or stroke, or major vascular complications. RCT-only analyses confirmed no significant effect on any outcome.</p><p><strong>Conclusions: </strong>Sentinel CEP was associated with lower 30-day mortality and AKI in pooled cohorts, but did not reduce stroke. The absence of benefit in RCTs underscores the need for further studies in high-risk TAVI populations.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145351227","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}