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

{"title":"Trans-Patch Retrograde Re-Entry During Hybrid Revascularization of an External Iliac Artery Chronic Total Occlusion: A Technical Note and Review of Re-Entry Strategies.","authors":"Bibhas Amatya, Dipankar Mukherjee","doi":"10.1002/ccd.70937","DOIUrl":"https://doi.org/10.1002/ccd.70937","url":null,"abstract":"<p><p>Failure of true-lumen re-entry after subintimal wire passage is a well-recognized limitation of endovascular treatment for external iliac artery (EIA) chronic total occlusions (CTO). We report a 73-year-old woman with severe limb ischemia and a prior failed endovascular attempt who underwent hybrid left common femoral artery (CFA) endarterectomy with patch angioplasty, followed by trans-patch retrograde access and dedicated device-assisted re-entry (Outback Elite) after antegrade and retrograde wires repeatedly tracked subintimally without reaching the true lumen. Controlled re-entry preserved hypogastric artery flow and allowed drug-eluting stent reconstruction of the EIA. At 12-month follow-up, ABI improved from 0.36 to 0.50, and TBI improved to 0.37. Duplex ultrasound at 6-month follow-up confirmed patency of the reconstructed segment without evidence of hemodynamically significant restenosis. This technical report illustrates the use of an endarterectomized CFA as a retrograde re-entry platform and reviews contemporary strategies for managing subintimal crossing failure in iliac CTOs.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221298","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":"Additive Value of Acetylcholine Testing in ANOCA: A US-Based Multicenter FlowLab Study.","authors":"Edward T Ha, Samit M Shah, Olga Toleva, Krystyna Bronchard, Kathleen E Kearney, Akl C Fahed, Farouc Jaffer, John E A Blair, Allen Jeremias, Joia Spinelli, Brian A Bergmark, Yuhei Kobayashi","doi":"10.1002/ccd.70947","DOIUrl":"https://doi.org/10.1002/ccd.70947","url":null,"abstract":"<p><strong>Background: </strong>Angina with non-obstructive coronary arteries (ANOCA) is an underrecognized cause of angina with non-universal diagnostic techniques and patient management strategies. Among ANOCA testing, vasospasm provocation is not always performed mainly due to differences in institutional availability.</p><p><strong>Aims: </strong>Using the FlowLab Study, we quantified vasospasm prevalence among patients with ANOCA at US centers and compared physician decision-making, endotype distribution, and management between sites that did and did not include vasospasm testing in their workup.</p><p><strong>Methods: </strong>The FlowLab Study was a prospective, multicenter, US-based study of patients who were referred for coronary angiography and underwent ANOCA testing using the bolus thermodilution method. Presumed diagnosis before cardiac catheterization and final diagnosis after ANOCA testing were compared between participating sites with or without acetylcholine testing availability.</p><p><strong>Results: </strong>A total of 253 procedures at 14 US sites were included in this study. There were 155 procedures among sites performing spasm provocation testing and 98 procedures among sites not performing spasm provocation testing. Prior to cardiac catheterization, sites with spasm provocation testing were less likely to suspect epicardial coronary artery disease as the cause of angina compared to sites without (27% vs. 59.2%, p < 0.0001). A diagnosis of CMD was made more frequently at sites performing spasm testing compared to sites not performing spasm testing (68% vs. 29.6%, p < 0.0001). Similarly, among 125 patients who underwent spasm provocation testing, diagnostic yield increased from 34.4% with bolus thermodilution alone to 84.8% after the addition of spasm provocation testing (p < 0.001). In these patients, intensification involving calcium channel blockers was more frequent with epicardial (67%) and microvascular spasm (41%) than without spasm (24%, p = 0.001).</p><p><strong>Conclusions: </strong>In contemporary US practice, adding spasm provocation testing to bolus thermodilution more than doubled diagnostic yield and was followed by medication changes directed toward the diagnosed endotype. Differences between sites with and without spasm testing also reflected variation in procedural practice.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221291","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":"Anatomy-Driven Transcatheter Edge-to-Edge Repair of the Systemic Atrioventricular Valve in Complex Transposition Anatomy.","authors":"Georgios E Papadopoulos, Ilias Ninios, Alexandra Frogoudaki, George Giannakoulas, Vlasis Ninios, Grigorios Giamouzis","doi":"10.1002/ccd.70953","DOIUrl":"https://doi.org/10.1002/ccd.70953","url":null,"abstract":"<p><p>Systemic atrioventricular valve (SAVV) regurgitation contributes importantly to systemic right ventricular deterioration in adults with congenitally corrected transposition of the great arteries (ccTGA) and dextro-transposition of the great arteries (d-TGA) after atrial-switch repair. Transcatheter edge-to-edge repair (TEER) has emerged as an option for selected patients at high or prohibitive surgical risk, and prior congenital series have established the feasibility of transseptal, transbaffle, and alternative access strategies. However, procedural execution remains highly anatomy-dependent because systemic venous pathways, atrial baffles, ventricular topology, cardiac orientation, and access-to-valve geometry can substantially alter guide-catheter support and device coaxiality. We report a single-center Interventional Rounds experience of four consecutive high-risk adults undergoing SAVV-TEER across four distinct transposition anatomies: ccTGA with dextrocardia, d-TGA after Mustard atrial-switch repair, Mustard anatomy with severe iliofemoral tortuosity, and ccTGA with interrupted inferior vena cava and azygos continuation. Transfemoral access was used in two patients, and right internal jugular access in two. Three procedures were performed with PASCAL ACE and one with MitraClip. Device implantation was successful in all four patients, with SAVV regurgitation reduced from severe (3+) to mild (1+). Final mean SAVV gradients were 1.5, 2.1, 1.9, and 1.8 mmHg, respectively, and no major acute procedural complications occurred. The principal technical message is that access selection should be guided not only by anatomic patency but by the anticipated mechanical trajectory of the delivery system. Right internal jugular access may be selected prospectively as the preferred primary route when inferior venous anatomy is absent or expected to provide unfavorable curvature, support, or device alignment. Dextrocardia and atrial-switch baffle anatomy may additionally require specific steering and traversal adaptations. These observations represent focused procedural refinements within the evolving congenital TEER experience rather than evidence of comparative efficacy or safety.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221275","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":"Real-World Invasive Evaluation of Myocardial Bridging: A Multicenter Italian Survey of Interventional Cardiologists' Practices.","authors":"Stefano Elia, Gaetano Rizzo, Renzo Laborante, Donato Antonio Paglianiti, Stefano Righetti, Cristina Aurigemma, Daniela Trabattoni, Daniele Andreini, Arturo Cesaro, Andrea Rognoni, Gioel G Secco, Fabrizio D'Ascenzo, Gianluca Massaro, Roberto Scarsini, Paolo Canova, Rocco Vergallo, Mattia Galli, Giuseppe Musumeci, Giuseppe Patti, Domenico D'Amario","doi":"10.1002/ccd.70943","DOIUrl":"https://doi.org/10.1002/ccd.70943","url":null,"abstract":"<p><strong>Background: </strong>Myocardial bridging (MB) is increasingly recognized as a potential cause of ischemia through heterogeneous mechanisms, yet real-world management remains heterogeneous. We surveyed interventional cardiologists to describe contemporary MB practice, focusing on functional assessments, perceived value, and barriers to the \"full-physiology\" approach, and priorities for standardization and research.</p><p><strong>Aims: </strong>To characterize contemporary MB management among interventional cardiologists, focusing on physiology approaches, imaging strategies, and perceived barriers to implementation and treatment.</p><p><strong>Methods: </strong>An anonymized online survey was conducted among interventional cardiologists from 28 Italian centers. Items covered MB-specific functional assessment strategies, therapies, implementation barriers, operational infrastructure, and research interest.</p><p><strong>Results: </strong>Ninety-three cardiologists responded (mean age 38.8 ± 8.6 years; 82.8% male). Pressure-based indices were widely used for epicardial CAD, but phenotyping in MB was uncommon: 57.0% performed physiology in < 10% of MB cases, and 19.4% never did. Epicardial MB assessment relied mainly on adenosine-FFR (33.3%) or iFR (31.2%), whereas stress-enhanced protocols were rarely used. Although intracoronary acetylcholine testing was commonly used in general practice (79.6%), only 49.5% of respondents reported using it to assess MB-related coronary spasm, and most did so in only a small proportion of cases. CMD testing in MB was rare (< 10% in 66.7%). Despite this, most respondents (87.1%) endorsed \"full-physiology\" as useful for mechanism identification and personalized therapy, but cited evidence uncertainty, procedural time, and limited experience as key barriers. Operational readiness was low (dedicated protocols: 26.9%; registries: 39.8%; routine capture: 34.4%). Willingness to join a randomized trial was high (93.5%).</p><p><strong>Conclusions: </strong>Despite the widespread availability of invasive functional assessment tools and operators' recognition of their relevance, their use in MB remains limited and heterogeneous, reflecting the lack of evidence-based guidance and underscoring the need for dedicated mechanistic studies and standardized invasive workflows.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198826","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":"Mitral Transcatheter Edge-to-Edge Repair at Centers With and Without On-Site Cardiac Surgery: A Comparative Registry With a Shared Interventional Team.","authors":"Giulia Marchisio, Elisa Pelloni, Francesco Pisano, Lorenzo Zaccaro, Laura Contu, Maurizio Tusa, Nedy Brambilla, Marco Guerrini, Francesco Bedogni, Paolo Scacciatella","doi":"10.1002/ccd.70874","DOIUrl":"https://doi.org/10.1002/ccd.70874","url":null,"abstract":"<p><strong>Background: </strong>Comparative evidence for M-TEER performed at centers with versus without on-site cardiac surgery is lacking. We compared early outcomes at two centers that shared the same interventional operator team but differed in the availability of on-site cardiac surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed prospectively collected registry data from 64 consecutive patients with severe (4+) MR treated at a center without on-site cardiac surgery (no-CCH, n = 21) and a center with on-site cardiac surgery (CCH, n = 43). The same interventional operator team performed every procedure. At the no-CCH center, surgical expertise was provided through a shared Heart Team and a formal emergency transfer pathway. The cohorts were treated in sequential calendar periods. Principal comparative endpoints were MVARC device and procedural success at 30 days. Exploratory non-inferiority analyses used margins of -12.5% and -10%.</p><p><strong>Results: </strong>MVARC technical success was 100% versus 97.7%. Device and procedural success were each 81.0% versus 72.1% (risk difference [RD] +8.9%, 95% CI -14.9 to +27.5; p = 0.547). Freedom from major MVARC serious adverse events was 95.2% versus 95.3%. Twelve of 16 device-success failures involved a mean transmitral gradient ≥ 5 mmHg. Surgical conversion and in-hospital death were 0% in both centers.</p><p><strong>Conclusions: </strong>In this preliminary same-team comparison, 30-day MVARC device and procedural success rates were 81.0% at the no-CCH center and 72.1% at the CCH center. Confidence intervals were wide and non-inferiority was not established. These findings support prospective evaluation of network-based M-TEER programs with shared interventional expertise and formal surgical backup.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186774","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 Renal Denervation for Resistant Hypertension in a High-Risk Real-World Population: Preliminary Results From a Prospective Single-Center Experience.","authors":"Saverio Danilo Vetrano, Dario Formigli, Luciano Umberto Rossi, Giovanni Marco Esposito, Simona Covino, Francesco Moscato, Vitangelo Franco, Marino Scherillo","doi":"10.1002/ccd.70920","DOIUrl":"https://doi.org/10.1002/ccd.70920","url":null,"abstract":"<p><p>Renal denervation (RDN) is an adjunctive treatment for selected patients with resistant hypertension. We report the preliminary effectiveness and safety of radiofrequency RDN in a high-risk real-world population. This prospective, observational, single-center study enrolled 18 patients who underwent bilateral RDN using the Symplicity Spyral system. All had baseline office systolic BP (SBP) > 155 mmHg and diastolic BP > 90 mmHg despite at least three antihypertensive drugs at the maximum tolerated doses. Clinical response required both an office SBP reduction ≥ 10 mm Hg and a mean 24-h ambulatory SBP reduction ≥ 5 mm Hg. Outcomes were assessed within 72 h and at 1 month. All procedures were technically successful. At 72 h, 15 patients (83.3%) met both response criteria; all had an office SBP reduction ≥ 20 mm Hg. At 1 month, 16 (88.9%) were responders and 2 (11.1%) were nonresponders. Among responders, five discontinued one drug and continued dual therapy, whereas 11 continued three drugs at reduced doses. Procedural events included one iatrogenic renal artery dissection, one femoral artery dissection with perforation, one guidewire fracture successfully retrieved with an endovascular snare, and two femoral hematomas. Renal function did not deteriorate. In conclusion, radiofrequency RDN was technically feasible and was followed by an early clinical response in most patients. The small sample, short follow-up, and absence of a control group preclude definitive efficacy conclusions.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186830","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":"Impaired Flow and Physiology in Coronaries With Anomalous Origin From the Opposite Sinus of Valsalva.","authors":"Mauro Lo Rito, Mattia Squillace, Mauro Luca Agnifili, Antonio Rosato, Serena Anglese, Adele Chiavetta, Camilla Muritti, Miriam Deamici, Jessica Negri, Andrea Attanasio, Gianluigi Guida, Giandomenico Disabato, Francesco Secchi, Michele Conti, Alessandro Frigiola, Massimo Chessa, Alessandro Giamberti, Francesco Bedogni","doi":"10.1002/ccd.70891","DOIUrl":"https://doi.org/10.1002/ccd.70891","url":null,"abstract":"<p><strong>Background: </strong>Anomalous Aortic Origin of a Coronary Artery (AAOCA) high-risk anatomical features (intramural segment, acute take-off angle, slit-like ostium) cause coronary stenosis leading to myocardial infarction. How these features alter coronary physiology remains unclear.</p><p><strong>Aims: </strong>We aimed to evaluate their impact on coronary blood supply using continuous thermodilution.</p><p><strong>Methods: </strong>We prospectively enrolled 51 AAOCA patients undergoing continuous thermodilution. Subjects were classified into an ischemic risk (IR) group (intramural segment, acute angle, oval or slit ostium) or non-ischemic risk (no-IR) group. Non-anomalous coronary arteries served as controls. We measured absolute coronary blood flow (CBF) and microvascular resistance.</p><p><strong>Results: </strong>Subjects (median age 48.4 years) presented mostly with angina, syncope, and arrhythmia. Final analysis included 48 AAOCA cases (31 IR, 17 no-IR) and 45 controls. The IR group had a median IM length of 9 mm, take-off angle of 31.9°, and a slit-like or oval ostium. The no-IR group had a median angle of 51.5° and an oval or round ostium. At rest, absolute CBF and microvascular resistance showed no significant differences among groups. However, during hyperemia, the IR group had significantly reduced CBF compared to controls (179 vs. 290 mL/min, p = 0.015). The IR group demonstrated higher microvascular resistance at rest (1473 vs. 1150, p = 0.024) and during hyperemia (433 vs. 305, p = 0.012), indicating persistently increased coronary vascular tone.</p><p><strong>Conclusions: </strong>High-risk anatomical features of AAOCA are associated with altered coronary physiology. An intramural segment, acute take-off angle, and slit-like or oval ostium are linked to reduced hyperemic coronary blood flow due to increased microvascular resistance.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187515","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":"Pre-Procedural Prediction of Left Ventricular Ejection Fraction Normalization After Transcatheter Aortic Valve Implantation.","authors":"Yuki Hida, Teruhiko Imamura, Hiroshi Ueno, Koichiro Kinugawa, Masanori Yamamoto, Takahiro Tokuda, Tetsuro Shimura, Shinichi Shirai, Kenichi Ishizu, Yohei Ohno, Fumiaki Yashima, Toru Naganuma, Yusuke Watanabe, Futoshi Yamanaka, Gaku Nakazawa, Masahiko Noguchi, Masaki Izumo, Masahiko Asami, Hidetaka Nishina, Hiroto Suzuyama, Kazumasa Yamasaki, Kenji Nishioka, Daisuke Hachinohe, Yasushi Fuku, Toshiaki Otsuka, Kentaro Hayashida","doi":"10.1002/ccd.70941","DOIUrl":"https://doi.org/10.1002/ccd.70941","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) is an established therapy for severe aortic stenosis. Among patients with left ventricular (LV) systolic dysfunction, recovery of LV function after TAVI is heterogeneous, and reliable tools for pre-procedural risk stratification and patient counseling remain limited.</p><p><strong>Aims: </strong>We sought to identify simple pre-procedural predictors of complete LV functional recovery after TAVI and to develop a clinically applicable risk score to support patient counseling and post-procedural management.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with severe aortic stenosis and baseline LV ejection fraction (LVEF) < 40% enrolled in a large multicenter registry in Japan. The primary outcome was complete LVEF normalization (LVEF > 50%) at 1 year after TAVI. Independent predictors were identified using multivariable logistic regression in a derivation cohort, and an exploratory weighted score was constructed. The score was preliminarily assessed in a separate single-center cohort.</p><p><strong>Results: </strong>The derivation cohort comprised 177 patients (median age 84 years; 44% women), of whom 94 (53%) achieved LVEF normalization. Lower body mass index (odds ratio [OR] 0.86, 95% confidence interval [CI] 0.77-0.95; p = 0.004), higher aortic valve peak velocity (OR 2.45, 95% CI 1.40-4.29; p = 0.002), and smaller LV end-diastolic diameter (OR 0.93, 95% CI 0.88-0.98; p = 0.020) were independently associated with LVEF normalization. The derived score stratified patients into low-, intermediate-, and high-probability groups (15%, 45%, and 71%, respectively; p < 0.001), with consistent discrimination in the validation cohort.</p><p><strong>Conclusions: </strong>A simple exploratory score incorporating body mass index, transvalvular peak velocity, and LV size was associated with the probability of complete LV functional recovery after TAVI. This pre-procedural tool may facilitate patient counseling, expectation-setting, and identification of patients who may require closer heart failure follow-up after TAVI. It should not be used to determine eligibility for TAVI.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187309","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":"The Impact of Dual Antiplatelet Therapy on Bleeding and Thrombotic Risks in Diabetic Patients Following Coronary Stent Implantation: A Prospective Study.","authors":"Rui Fan, Yulong Ma","doi":"10.1002/ccd.70940","DOIUrl":"https://doi.org/10.1002/ccd.70940","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the 12-month clinical outcomes of short-term versus extended dual antiplatelet therapy (DAPT) in diabetic patients following drug-eluting stent (DES) implantation.</p><p><strong>Methods: </strong>In this single-center prospective cohort study, 536 diabetic patients undergoing DES implantation were categorized into short-term (< 6 months, n = 312) or extended (≥ 6 months, n = 224) DAPT groups based on actual treatment duration. Primary endpoints were major adverse cardiovascular events (MACE: cardiac death, myocardial infarction, and target vessel revascularization) and BARC type 2, 3, or 5 bleeding events at 12 months.</p><p><strong>Results: </strong>Extended DAPT significantly reduced the incidence of MACE compared to short-term therapy (7.8% vs. 10.5%; HR = 0.72, 95% CI: 0.53-0.98, p = 0.033), primarily driven by lower rates of target vessel revascularization (3.1% vs. 5.1%; p = 0.030). While overall bleeding rates did not differ significantly between groups (8.1% vs. 6.2%; p = 0.192), extended DAPT was associated with a significantly higher risk of recurrent bleeding in patients with a prior bleeding history (HR = 2.10, 95% CI: 1.20-3.60, p = 0.011).</p><p><strong>Conclusion: </strong>Extended DAPT effectively mitigates ischemic risks in diabetic patients following stent implantation without significantly increasing overall clinically significant bleeding. However, clinicians should prioritize individualized DAPT durations, specifically avoiding extended regimens in patients with a history of bleeding to minimize the risk of hemorrhage recurrence.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187311","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":"Short-Term Complications of Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis (PROLONG-TAVR).","authors":"Mauricio Castillo-Perez, Humberto De León-Gutiérrez, Carlos Jerjes-Sánchez, Lillian Royzman-Rivera, Jose Gildardo Paredes-Vazquez, Vicente Jimenez-Franco, Paola Gutiérrez-Gallegos, Maria J Cabada-Garcia, Jahir Rodriguez-Rivera, Enrique Paredes-Gutierrez, Renata Quevedo-Salazar, Juan F Sanchez-Avila","doi":"10.1002/ccd.70944","DOIUrl":"https://doi.org/10.1002/ccd.70944","url":null,"abstract":"<p><p>To estimate the cumulative incidence of short-term complications across different transcatheter heart valve (THV) prostheses used for transcatheter aortic valve replacement (TAVR). We performed a systematic review and meta-analysis in accordance with PRISMA and a prospectively registered PROSPERO protocol. Observational studies published from 2002 through May 2024 that included patients with severe aortic stenosis undergoing predominantly transfemoral TAVR and reported prosthesis-specific complications were eligible. Although the original protocol intended to evaluate both short- and long-term complications, long-term outcomes were too sparse and inconsistently reported for robust pooled analyses; therefore, the present analysis focuses on short-term complications. Pooled cumulative incidences were calculated using random-effects models. We included 242 studies comprising 181,187 patients. SAPIEN 3 had the lowest incidence of moderate-to-severe paravalvular leak (PVL) (1.04%, 95% CI 0.69-1.55) and stroke (1.87%, 95% CI 1.64-2.14), whereas ACURATE neo2 had the lowest incidence of permanent pacemaker implantation (PPI) (7.7%, 95% CI 5.82-10.11). Evolut PRO and SAPIEN 3 showed among the lowest rates of major vascular complications (3.56%, 95% CI 2.77-4.57 and 3.87%, 95% CI 3.22-4.66, respectively) and major or life-threatening bleeding (2.96%, 95% CI 2.09-4.17 and 4.8%, 95% CI 4.04-5.69, respectively). Short-term complications have decreased with newer-generation THV prostheses. PVL remains more frequent with self-expanding valves, whereas PPI is the most frequent complication and is generally less frequent with balloon-expandable valves and ACURATE neo2. Stroke rates have changed little across newer generations, and annular rupture, coronary artery obstruction, and valve embolization remain rare (< 1%).</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187231","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}