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

{"title":"Impact of 5- and 6-Fr Sheaths on Hemostasis Duration and Access Site Complications in Distal Transradial Approach.","authors":"Adem Aktan, Raif Kılıç, Tuncay Güzel, Ali Evsen, Barış Acun, Muhammed Raşit Tanırcan, Mehmet Zülküf Karahan","doi":"10.1002/ccd.70187","DOIUrl":"https://doi.org/10.1002/ccd.70187","url":null,"abstract":"<p><strong>Background: </strong>The distal transradial approach (dTRA) is increasingly preferred for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) because of its advantages in patient comfort and vascular access. However, the effect of sheath size on these outcomes remains unclear.</p><p><strong>Aim: </strong>To compare the effects of 5-French (Fr) and 6-Fr sheaths in dTRA on vascular complications, hemostasis duration, and patient comfort.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent dTRA for CAG between January 2020 and October 2023. Participants were categorized into two groups based on sheath size (5- vs. 6-Fr). Data on procedural details, complications, hemostasis duration, and patient discomfort were collected.</p><p><strong>Result: </strong>A total of 228 patients were included, with 72 in the 5-Fr group and 156 in the 6-Fr group. The study found no significant difference in vascular complications between the two groups (p = 0.18). However, hemostasis duration was significantly shorter in the 5-Fr group compared to the 6-Fr group (97.8 ± 27.6 vs. 122.0 ± 24.9 min; p < 0.001). Severe pain was more frequent in the 6-Fr group (p = 0.036). Regression analysis showed that severe pain, puncture time, and the use of P2Y12 receptor antagonists (P2Y12 inhibitors) were significantly associated with vascular complications (p < 0.05).</p><p><strong>Conclusion: </strong>In our study, sheath size-specifically the comparison between 5- and 6-Fr-did not significantly affect vascular complications in the dTRA. However, using a 5-Fr sheath may reduce hemostasis time and patient discomfort compared to a 6-Fr sheath. Procedural factors such as puncture time and severe pain, as well as P2Y12 inhibitor use, should be carefully considered to minimize complications. These findings support the safe application of the dTRA with sheath size tailored to individual patient characteristics.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071508","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 Significance of Endogenous-Type Coronary Microvascular Dysfunction in the Left Anterior Descending Artery After Elective Percutaneous Coronary Intervention.","authors":"Takahiro Watanabe, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Tatsuhiro Nagamine, Hiroki Ueno, Mirei Setoguchi, Kodai Sayama, Hikaru Shimosato, Takashi Mineo, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1002/ccd.70182","DOIUrl":"https://doi.org/10.1002/ccd.70182","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular dysfunction (CMD) can be phenotyped as endogenous or classical.</p><p><strong>Aims: </strong>This study investigated the prognostic significance of these CMD endotypes in patients with chronic coronary syndrome after elective percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>This retrospective study included 205 patients who underwent elective PCI in the left anterior descending artery (LAD). Post-PCI, coronary flow was assessed using stress transthoracic Doppler echocardiography to measure diastolic peak flow velocity (DPV) and calculate coronary flow velocity reserve (CFVR). CMD was defined as CFVR ≤ 2.0 and further classified as endogenous (resting DPV > 33 cm/s) or classical (resting DPV ≤ 33 cm/s). This cutoff was determined by the 34.6th percentile of sorted DPV values, corresponding to reduced CFVR distribution. The primary endpoint was major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction, heart failure hospitalization, and target vessel revascularization.</p><p><strong>Results: </strong>Over a median follow-up of 2.3 years, 30 patients (14.6%) experienced MACE. The cumulative incidence of MACE was significantly higher in patients with endogenous-type CMD compared to those with classical-type CMD or without CMD (p < 0.001). In multivariate Cox proportional hazard analysis, endogenous-type CMD remained an independent predictor of MACE (hazard ratio: 3.28; 95% confidence interval: 1.53-7.04; p = 0.002).</p><p><strong>Conclusions: </strong>Endogenous-type CMD in the LAD territory following elective PCI is an independent predictor of MACE. Noninvasive phenotyping of CMD post-PCI using stress echocardiography may improve risk stratification and guide personalized management strategies for these high-risk patients.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077179","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":"Noncoronary Sinus Pivot Implantation (NCPI) Strategy for Transcatheter Aortic Valve Replacement With Self-Expanding Valve in Pure Native Aortic Regurgitation: A Multicenter, Registry Study From the CCA Database-NTCVR.","authors":"Feng Xia, XinJing Chen, ZiLong Weng, Xin Pan, JinJun Liu, Hao Zhou, LianPin Wu, YanSong Guo, LongYan Zhang, WenZhi Pan, DaXin Zhou, JunBo Ge","doi":"10.1002/ccd.70183","DOIUrl":"https://doi.org/10.1002/ccd.70183","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) for pure native aortic regurgitation (PNAR) remains challenging. While the noncoronary sinus pivot implantation (NCPI) strategy showed promise with VitaFlow valve, its efficacy with other valves needs validation.</p><p><strong>Aims: </strong>This study aims to evaluate the real-world efficacy of the TaurusElite valve in patients with PNAR and to assess the impact of the NCPI strategy on procedural outcomes.</p><p><strong>Methods: </strong>This registry-based analysis included 121 PNAR patients from the prospective CCA Database-NTCVR who underwent transfemoral TAVR with TaurusElite valve at seven Chinese centers (April 2022 to October 2024). A core laboratory assessed procedural imaging to classify patients into NCPI (n = 81) and non-NCPI (n = 37) groups. Outcomes were evaluated per VARC-3 criteria.</p><p><strong>Results: </strong>The TaurusElite valve demonstrated good effectiveness (overall device success 90.9%). NCPI strategy showed superior outcomes: higher success rate (98.8% vs. 81.1%, p < 0.001), no valve-in-valve implantation (0% vs. 16.2%, p < 0.001), and lower permanent pacemaker requirement (3.7% vs. 18.9%, p = 0.006). NCPI (OR:6.08, 95% CI: 3.27-28.68) independently predicted success.</p><p><strong>Conclusions: </strong>The TaurusElite valve is an effective treatment for PNAR, and the NCPI strategy provides significant additional benefits in improving procedural success and reducing complications compared to conventional approaches.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071535","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":"Clinical Outcomes of Intravascular Brachytherapy for Recurrent In-Stent Restenosis: Is Treatment Failure Predictable?","authors":"Gal Sella, Chloe Kharsa, Mangesh Kritya, Devin Olek, Bin S Teh, Yueh-Yun Lin, Anshuj Deva, Muhammad Faraz Anwaar, Joseph Elias, Elia El Hajj, Albert E Raizner, Andrew Farach, Neal S Kleiman, Alpesh Shah","doi":"10.1002/ccd.70139","DOIUrl":"https://doi.org/10.1002/ccd.70139","url":null,"abstract":"<p><strong>Background: </strong>In-stent restenosis (ISR) remains a significant challenge in interventional cardiology, with limited long-term effective treatment options. Intravascular brachytherapy (IVB) has reemerged as a viable treatment modality for ISR, yet predictors of treatment failure remain poorly characterized. This study evaluates the clinical outcomes and identifies predictors of failure following IVB in patients with coronary ISR.</p><p><strong>Aims: </strong>To evaluate the clinical outcomes of intravascular brachytherapy for in-stent restenosis and to identify predictors of treatment response. We hypothesized that specific baseline patient characteristics and procedural factors would be associated with clinical response to IVB at one- and three-year follow-up.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 199 patients (226 lesions) who underwent IVB for coronary ISR between June 2016 and January 2024 at our institution. Patients were stratified based on clinical response at 1 year: responders (absence of target lesion revascularization [TLR]) and nonresponders (presence of TLR). The primary endpoint was TLR at 1 year. Secondary endpoints included major adverse cardiovascular events (MACE), net adverse cardiovascular events (NACE), thrombosis, bleeding complications, and mortality.</p><p><strong>Results: </strong>At 1-year follow-up, 186 lesions (82.3%) were classified as responders and 40 (17.7%) as nonresponders. Baseline demographic characteristics were similar between groups. Angiographic and procedural characteristics were not significantly different between groups. Nonresponders experienced significantly higher rates of thrombosis (7.5% vs. 0%, p = 0.01), cardiac hospitalization (82.5% vs. 21.5%, p < 0.01), myocardial infarction (37.5% vs. 2.15%, p < 0.01), all-cause mortality (12.5% vs. 3.23%, p = 0.03), and cardiac death (12.5% vs. 1.09%, p < 0.01). Stent implantation was comparable (15% vs. 18.28%, p = 0.62). In multivariate analysis, no baseline or procedural characteristics were significant predictors of TLR. However, stent implantation was associated with increased 3-year all-cause mortality (OR 3.81, 95% CI 1.04-13.99).</p><p><strong>Conclusions: </strong>Our analysis demonstrates that the majority of patients treated with IVB for ISR derive sustained clinical benefit at 1 year. The association between stent implantation and long-term mortality warrants further investigation. These findings highlight the importance of identifying novel predictors of treatment response to optimize patient selection for IVB.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071582","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":"Limitations of Scoring Balloons for Acute Stent Underexpansion: The Need for Imaging and Calcium Modification.","authors":"Rajesh Vijayvergiya, Tirumalai N C Pranav, Anirudh Mukherjee","doi":"10.1002/ccd.70200","DOIUrl":"https://doi.org/10.1002/ccd.70200","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":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071523","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 Endocardial Septal Ablation for Hypertrophic Obstructive Cardiomyopathy: Promising Results Require Broader Validation.","authors":"Bisma Tariq","doi":"10.1002/ccd.70193","DOIUrl":"https://doi.org/10.1002/ccd.70193","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":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071569","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":"Selective Intracoronary Hypothermia in Percutaneous Coronary Intervention: Current Evidence, Challenges, and Future Directions.","authors":"Harsh Kumar, Maha Zehra, Tehreem Fatima, Amna Shakeel, Areeba Hanif, Omama Asim, Syed Irtiza Imam, Abdullah Nadeem","doi":"10.1002/ccd.70138","DOIUrl":"https://doi.org/10.1002/ccd.70138","url":null,"abstract":"<p><strong>Background: </strong>Selective intracoronary hypothermia (SICH) is a promising therapeutic approach aimed at mitigating ischemia-reperfusion injury (IRI) in patients undergoing percutaneous coronary intervention (PCI), a procedure used to address blocked or narrowed coronary arteries. This technique involves the infusion of cooled saline or cardioplegic solutions directly into the coronary arteries near the lesion, inducing localized cooling of myocardial tissue to protect against damage caused by the restoration of blood flow.</p><p><strong>Objective: </strong>Early studies indicate that SICH is a safe and feasible method that may potentially reduce infarct size and enhance myocardial recovery.</p><p><strong>Current challenges: </strong>However, the clinical implementation of SICH is currently limited due to certain challenges including the need for specialized equipment, the risk of cooling-related complications such as arrhythmias, and the requirement for precise temperature control. Furthermore, the ideal temperature and duration for effective cooling remain unclear.</p><p><strong>Future directions: </strong>Addressing these challenges, future investigations should prioritize large-scale, long-term trials focusing on the long-term effects of SICH on patient outcomes such as infarct size, cardiac function, and survival to confirm the efficacy and safety of this therapy. Additionally, comparative studies with other established reperfusion strategies are also required to evaluate the relative effectiveness of SICH and optimize its use during PCI.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067645","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: Balloon-Expandable Versus Self-Expanding Valves in Bicuspid Aortic Stenosis: Insights From the SWEDEHEART Registry.","authors":"Garzeen Ghaffar","doi":"10.1002/ccd.70192","DOIUrl":"https://doi.org/10.1002/ccd.70192","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":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071572","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":"Are Women at Higher Risk for Isolated Surgical Aortic Valve Replacement? Results From 178,000 STS Adult Cardiac Surgery Database Patients.","authors":"Takuya Ogami, Irsa Hasan, Julie A Phillippi, Derek Serna-Gallegos, Carlos E Diaz-Castrillon, Ibrahim Sultan","doi":"10.1002/ccd.70188","DOIUrl":"https://doi.org/10.1002/ccd.70188","url":null,"abstract":"<p><strong>Background: </strong>Female sex is a well-established risk factor for morbidity and mortality in cardiac surgery.</p><p><strong>Aims: </strong>This study aimed to assess the characteristics and contemporary outcomes of surgical aortic valve replacement (SAVR) in women compared to men.</p><p><strong>Methods: </strong>All patients who underwent isolated SAVR from 2014 through 2022 were identified using the Society of Thoracic Surgery national database. Patient characteristics were compared between women and men. The primary interest of outcomes was operative mortality.</p><p><strong>Results: </strong>A total of 178,014 patients undergoing isolated SAVR were identified, including 64,684 36.3%) women and 113,330 (63.7%) men. Women were older (66.1 years vs. 63.6 years in men, SMD = 0.21) and had a smaller body surface area (1.84 vs. 2.09 m² in men, SMD = 1.15). A history of infective endocarditis was more common in men (10.5% vs. 5.4% in women, SMD = 0.19), while women were more likely to undergo annular enlargement (8.4% vs. 2.9% in men, SMD = 0.24). Propensity score matching yielded 33,228 pairs in each sex category. After matching, operative mortality was comparable (2.2% in women vs. 1.7% in men, SMD = 0.04). Likewise, postoperative complications were similarly observed.</p><p><strong>Conclusion: </strong>Women undergoing isolated SAVR demonstrated similar morbidity and mortality compared to men despite having smaller body surface area and higher frequency of annular enlargement. Given the improved outcomes with contemporary practice in SAVR, sex may no longer be a risk factor for worse outcomes in isolated SAVR.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071563","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":"Increasing Acute Coronary Syndrome Mortality in Cirrhosis After a Period of Decline: A National Analysis of Temporal and Demographic Disparities.","authors":"Abdalhakim Shubietah, Ameer Awashra, Fathi Milhem, Mohammed AbuBaha, Maisam Tobeh, Abubakar Nazir, Mohamed S Elgendy, Mohammad Bdair, Jehad Zeidalkilani, Hosam I Taha, Anwar Zahran, Ahmed Emara, Suleiman Khreshi, Islam Rajab","doi":"10.1002/ccd.70169","DOIUrl":"https://doi.org/10.1002/ccd.70169","url":null,"abstract":"<p><strong>Background: </strong>How acute coronary syndrome (ACS) mortality has evolved among people with cirrhosis at the national level is unclear, and the clinical implications for cardio-hepatic care are underdefined.</p><p><strong>Methods: </strong>Using CDC WONDER mortality files (1999-2020), we identified deaths with ACS as the underlying cause and cirrhosis listed among multiple causes, computed age-adjusted mortality rates (AAMRs; per 100,000), and modeled trends with Joinpoint regression. Subgroups included sex, race/ethnicity, urbanization, and place of death.</p><p><strong>Results: </strong>We identified 10,319 cirrhosis-associated ACS deaths; the overall AAMR was 0.22. Rates were higher in men than women (0.33 vs. 0.12) and higher in Hispanic than non-Hispanic individuals (0.31 vs. 0.20). American Indian/Alaska Native had the highest AAMR (0.34). Rural noncore counties had the highest AAMR (0.28). Joinpoint detected a national inflection in 2014: AAMR declined from 1999 to 2014 (APC - 3.49%) and increased thereafter (APC + 5.38%), with an overall AAPC of -1.03%.</p><p><strong>Conclusions: </strong>After years of decline, cirrhosis-associated ACS mortality has risen since 2014, with persistent disparities by sex, race/ethnicity, and rurality. These data support integrated cardio-hepatic pathways, targeted outreach to rural and historically underserved groups, and system-level quality improvement focused on time-sensitive ACS care in cirrhosis.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067582","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}