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

{"title":"Validation of the V-RESOLVE Score for Side Branch Occlusion in the PROGRESS-BIFURCATION Registry.","authors":"Dimitrios Strepkos, Michaella Alexandrou, Deniz Mutlu, Pedro E P Carvalho, Ozgur S Ser, Oleg Krestyaninov, Dimitri Khelimskii, Barkin Kultursay, Ali Karagoz, Ufuk Yildirim, Korhan Soylu, Mahmut Uluganyan, Olga Mastrodemos, Bavana V Rangan, Sandeep Jalli, Konstantinos Voudris, M Nicholas Burke, Yader Sandoval, Emmanouil S Brilakis","doi":"10.1002/ccd.70023","DOIUrl":"https://doi.org/10.1002/ccd.70023","url":null,"abstract":"<p><strong>Background: </strong>We validated the Visual estimation for Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion (V-RESOLVE) score for predicting side branch occlusion (SBO) in an independent registry.</p><p><strong>Aims: </strong>We sought to evaluate the predictive performance of the V-RESOLVE score.</p><p><strong>Methods: </strong>We compared the characteristics, V-RESOLVE scores, and outcomes of 791 patients (937 bifurcation PCIs) who underwent provisional bifurcation PCI performed at five centers between 2014 and 2024 from the PROGRESS-BIFURCATION registry.</p><p><strong>Results: </strong>The incidence of SBO was 13% (n = 124). SBO patients had lower rates of hypertension, diabetes, prior coronary artery bypass graft surgery (CABG), and prior PCI but higher angiographic complexity, with higher left anterior descending artery stenoses, lower side branch diameter, higher side branch diameter stenoses, and lower rates of ostial lesions. SBO patients had higher median V-RESOLVE scores (16 vs. 12, p < 0.001) and were more likely to convert from provisional to two-stent strategies (21.0% vs. 5.8%, p < 0.001) and to require plaque modification (37.9% vs. 18.9%, p < 0.001). SBO patients had lower technical (76.6% vs. 95.9%, p < 0.001) and procedural (72.8% vs. 92.6%, p < 0.001) success and similar in-hospital major adverse cardiovascular events (MACE) (6.1% vs. 3.8%, p = 0.306). The quartile cutoffs for V-RESOLVE scores were 9 for the first quartile of patients, 12 for the second, and 18 for the third with a maximum of 43. SBO rates were 7.5%, 9.8%, 17.5%, and 15.3% for each quartile (p < 0.001). Using the cutoff values used to develop the score (0-3, 4-7, 8-11, 12-43), the SBO rates were 7.0%, 7.0%, 8.6%, 15.7%, respectively (p < 0.001). The area under the curve (AUC) of the V-RESOLVE score for predicting SBO was 0.61 (95% confidence intervals 0.56-0.66).</p><p><strong>Conclusions: </strong>The predictive value of the V-RESOLVE score for SBO in the PROGRESS-BIFURCATION registry was modest.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693059","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":"Navigating the Uncertainties of Antithrombotic Therapy After Transcatheter Patent Foramen Ovale Closure: A Comprehensive Review.","authors":"Eirini Beneki, Kyriakos Dimitriadis, Nikolaos Pyrpyris, Georgios Tzimas, Ioannis Skalidis, David Meier, Panagiotis Antiochos, Panagiotis Kostakis, Efthymia Pavlou, Francesco Perone, Georgios Tsivgoulis, Constantina Aggeli, Ole de Backer, Konstantinos Tsioufis","doi":"10.1002/ccd.70049","DOIUrl":"https://doi.org/10.1002/ccd.70049","url":null,"abstract":"<p><p>The patent foramen ovale (PFO), present in 25% of the population, can cause paradoxical embolism and stroke. Transcatheter PFO closure is the gold standard for recurrent embolism with significant inter-atrial shunting, with recent trials confirming its superiority in reducing ischemic stroke recurrence over medical therapy. However, device-related thrombosis remains a concern, posing risks of systemic embolism and neurological events. Optimal post-closure antithrombotic management, including the choice and duration of therapy, remains unclear. Recommendations suggest transient dual antiplatelet therapy followed by long-term single therapy, but robust evidence is lacking, especially regarding device neo-endothelization timelines. Current studies often lack long-term follow-up, leaving gaps in understanding the incidence and prevention of thrombosis. Future research is crucial to provide evidence-based guidance and refine personalized treatment strategies for better outcomes.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700915","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":"Serial Changes in Right Ventricular Outflow Tract Gradient and Endocarditis Risk After Transcatheter Pulmonary Valve Replacement.","authors":"Juan C Samayoa, Lauren Carlozzi, Connie Choi, William Tressel, Jack M Wolf, Benjamin Langworthy, Agustin Rubio, Troy Johnston, Zachary L Steinberg, Thomas Jones, Brian Morray","doi":"10.1002/ccd.70027","DOIUrl":"https://doi.org/10.1002/ccd.70027","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis (IE) after transcatheter pulmonary valve replacement (TPVR) remains a significant concern. Although there are overall good short-term and long-term hemodynamic outcomes, limited data exist comparing postimplantation echocardiographic findings leading to IE.</p><p><strong>Objectives: </strong>To compare the progressive echocardiographic performance of percutaneous implanted pulmonary valves before the development of IE.</p><p><strong>Methods: </strong>This is a single-center retrospective cohort study of all patients who underwent successful TPVR using either Medtronic Melody or Edwards Sapien valves from 2009 to 2021. Patient demographics, procedural details, and yearly echocardiographic findings were collected and compared as appropriate. The risk of IE was compared between groups defined by baseline characteristics using time-to-event methods. Joint modeling was used to evaluate the association between peak-to-peak gradient trajectories over time and the risk of IE. The predictive performance of using peak-to-peak gradient thresholds to predict IE was evaluated using receiver operating characteristic (ROC) analyses.</p><p><strong>Result: </strong>A total of 226 patients underwent successful TPVR of which 26 patients developed IE. The annualized incidence of IE was 2.96 per 100 patient years. Patients with and without IE had similar ages, weights, and diagnoses. All IE cases were with the Melody valves. Patients who had higher postimplantation echo-derived peak instantaneous gradients (PGs) were significantly more likely to develop IE. Patients with immediate postimplant invasive peak to peak gradient ≥ 15 mmHg were more likely to develop IE. Higher PGs over time were significantly associated with a higher risk of IE (HR 1.04 per mmHg; 95% CI: 1.00-1.07, p = 0.03). ROC analyses indicate that PGs over time have poor predictive performance of IE.</p><p><strong>Conclusion: </strong>Echocardiographic performance following TPVR was generally acceptable and similar to other studies. Patients who ultimately developed IE trended to have higher PPG post-TPVR and higher gradients over time before the development of IE. The rate of change of echo-derived gradients in patients with lower initial invasive gradients was more pronounced. These findings suggest that longitudinal monitoring of echocardiographic gradient could provide targeted surveillance in those identified at higher risk for IE.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700918","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 Predictive Value of Quantitative Flow Ratio and Its Derived Angiographic Microvascular Resistance for Restenosis Following Drug-Coated Balloon Angioplasty.","authors":"Chenhang Wang, Li Chen, Xiaoyong Xu","doi":"10.1002/ccd.70028","DOIUrl":"https://doi.org/10.1002/ccd.70028","url":null,"abstract":"<p><strong>Background: </strong>Initially, drug-coated balloon (DCB) angioplasty was primarily employed for in-stent restenosis (ISR) treatment. Over time, its indications have broadened to include de novo small-vessel lesions and bifurcation lesions. However, there is a lack of effective strategies to reduce restenosis rates post-DCB angioplasty.</p><p><strong>Aims: </strong>Exploring the predictive value of quantitative flow ratio (QFR) and its derived angiographic microvascular resistance (AMR) for vascular restenosis following DCB angioplasty.</p><p><strong>Methods: </strong>This study enrolled 108 patients who received DCB angioplasty during the period between February 2021 and October 2024. All patients underwent follow-up coronary angiography at 1 year post-procedure. Based on angiographic findings, patients were divided into a restenosis group (n = 38) and a non-restenosis group (n = 70). The study compared preoperative parameters, surgical data, and postoperative variables.</p><p><strong>Results: </strong>The restenosis group demonstrated a significantly higher prevalence of diabetes (p < 0.05), greater history of smoking (p < 0.05), lower postoperative QFR values (p < 0.05), and a higher proportion of patients with AMR values exceeding 2.5 (p < 0.05) compared to the non-restenosis group. Multivariate logistic regression analysis identified postoperative QFR and high AMR values as independent predictors of restenosis after DCB therapy. ROC curve analysis demonstrated that the AUC for postoperative QFR in predicting restenosis was 0.727 (95% CI: 0.518-0.936, p < 0.05), which improved to 0.903 (95% CI: 0.782-1, p < 0.01) when combined with high AMR values.</p><p><strong>Conclusions: </strong>Coronary angiography-derived QFR and AMR are closely associated with vascular restenosis in patients treated with DCB. Routine postoperative measurement of QFR and AMR may enhance risk prediction for restenosis following DCB angioplasty.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693057","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":"Echocardiography-Guided Percutaneous Patent Ductus Arteriosus Closure: A Prospective Trial at High Altitude.","authors":"Hongliang Wei, Luxi Guan, Dong Luo, Zhengwei Li, Ping Ni, Zhuoga Danzeng, Zheng Ban, Xiangbin Pan, Luobu Gesang, Haibo Hu","doi":"10.1002/ccd.70044","DOIUrl":"https://doi.org/10.1002/ccd.70044","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical efficacy and safety of interventional closure of patent ductus arteriosus (PDA) via femoral venous puncture under echocardiography guidance at high altitude.</p><p><strong>Methods: </strong>From December 2022 to July 2023, 36 patients with PDA at high altitude were prospectively enrolled and underwent closure either under echocardiography guidance or fluoroscopy guidance. Baseline, procedural, and outcome characteristics were compared in intention-to-treat analysis.</p><p><strong>Results: </strong>The characteristics of patients and PDA were comparable between the two groups. The success rate of occlusion was 100% in both groups. Compared with the traditional fluoroscopy group, the echocardiography group showed a significant reduction in Air Kerma (112.13 ± 77.51 Gy vs. 247.27 ± 123.81 Gy, p = 0.001), Dose Area Product (24.3 [13.6-31.3] Gy·cm² vs. 41.5 [26.9-63.5] Gy·cm², p = 0.015) and intraoperative contrast dose (0 vs. 1.74 ± 1.02 mL/kg, p < 0.001). In the fluoroscopy group, a significant rise in creatinine (60.47 ± 14.02 umol/L vs. 40.93 ± 14.94 umol/L, p < 0.001) and urea nitrogen levels (6.03 ± 1.12 mmol/L vs. 4.80 ± 0.81 mmol/L, p < 0.001) at 24 h postoperatively were detected compared to preoperative levels, whereas no such changes were detected in the echocardiography group. Except for one patient in the fluoroscopy group lost to 1-year follow-up, no adverse events were reported in either group.</p><p><strong>Conclusion: </strong>At high altitude, echocardiography-guided percutaneous PDA closure offers comparable efficacy to traditional methods, with minimal X-ray exposure and no contrast-induced kidney injury.</p><p><strong>Clinical trial registration: </strong>The trial is registered at http://www.chictr.org.cn (ChiCTR2400090901).</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693055","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":"Comparison of Self-Expandable Acurate Neo-2 and Balloon-Expandable Myval Transcatheter Heart Valves at 4-Year Follow-Up.","authors":"Akash Jain, John Jose, Matteo Montorfano, Henrik Nissen, Pedro Martin, Ashok Seth, Kresimir Stambuk, Sengottuvelu Gunasekaran, Mussayev Abdurashid, Mario García-Gómez, Clara Fernandez-Cordón, Alberto Campo, Marcelo Rodriguez, Mathias D Jorgensen, Sofía Campillo, Manuel Carrasco-Moraleja, Alberto San Román, Ignacio J Amat-Santos","doi":"10.1002/ccd.70034","DOIUrl":"https://doi.org/10.1002/ccd.70034","url":null,"abstract":"<p><strong>Background: </strong>Recently, Acurate neo2 (ACN2; Boston Scientific, US) and Sapien-3 series (Edwards Lifesciences, US) were compared in the IDE trial failing to demonstrate non-inferiority of ACN2. The Myval series (MyV), an alternative balloon-expandable device, demonstrated non-inferiority compared to Sapien-3 and Evolut (Medtronic, US) in the LANDMARK trial. However, no direct comparison exists between ACN2 and MyV.</p><p><strong>Aims: </strong>We aimed to compare mid-term clinical and hemodynamic outcomes of the ACN2 and MyV transcatheter heart valves.</p><p><strong>Methods: </strong>This multicenter retrospective analysis included patients implanted with ACN2 and MyV series devices. The primary objective was to assess 1-year mortality and stroke rates. Secondary outcomes included technical success, mortality, stroke, residual aortic regurgitation (AR), mean aortic gradients, and new permanent pacemaker implantation (PPI) rates up to 4 years. A matched comparison adjusting for clinical and anatomical characteristics was performed and echocardiograms were centrally analyzed.</p><p><strong>Results: </strong>A total of 545 patients (ACN2: 144; MyV: 401) from nine institutions were included. Matched technical success rates were 87.6% and 94.4%, p = 0.180 (90.3% for ACN2 and 97% for MyV; p < 0.001 in unmatched). In-hospital matched PPI rates were 10.1% for ACN2 and 9% for MyV. At 4 years, matched residual ≥ moderate AR rates were similar (ACN2: 15.8% vs. MyV: 21.1%, p = 0.706), though ACN2 showed better mean aortic gradients (9.2 ± 4.2 vs. 13.1 ± 5.4, p = 0.001) and effective orifice area. Unmatched mortality + stroke rates were comparable but lower for ACN2 after matching (3.4% vs. 15.7%, p = 0.005). Importantly, cardiovascular mortality (3.4% for ACN2 and 5.6% for MyV, p = 0.720) and valve-related deaths were comparable.</p><p><strong>Conclusion: </strong>ACN2 showed superior long-term hemodynamics and lower matched 4-year mortality and stroke rates, though cardiovascular mortality and valve-related deaths were comparable.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700913","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":"Bioprosthetic Valve Fracturing or Standard Postdilatation? A Clinical Perspective on ViV-TAVI Optimization.","authors":"Javed Iqbal, Brijesh Sathian, Syed Muhammad Ali, Ramya Kundayi Ravi, Mian Zahid Jan Kakakhel","doi":"10.1002/ccd.70053","DOIUrl":"https://doi.org/10.1002/ccd.70053","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":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700912","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":"Triglyceride-Glucose Index Is Associated With Restenosis After Percutaneous Coronary Intervention With Drug-Coated Balloons in Patients With Coronary Artery Disease.","authors":"Hui Zhao, Yutao Sun, Bao Fu, Yupeng Hou, Ting Wang","doi":"10.1002/ccd.70025","DOIUrl":"https://doi.org/10.1002/ccd.70025","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloon (DCB) has become a common treatment, but restenosis may still occur after DCB. The association of the triglyceride-glucose (TyG) index with coronary atherosclerotic heart disease prognosis has been demonstrated. However, the relationship between the TyG index and restenosis after DCB-only remains unknown.</p><p><strong>Aims: </strong>This study aimed to investigate the relationship between the TyG index and restenosis after DCB-only.</p><p><strong>Methods: </strong>The present study retrospectively recruited patients who underwent coronary angiography at 6-36 months after successful based DCB-only percutaneous coronary intervention. Subgroup analyses, correlation analyses, and, most importantly, a multivariate logistic regression analysis model were also constructed to assess the association between TyG index and restenosis after DCB treatment.</p><p><strong>Results: </strong>A total of 173 patients received DCB-only therapy (58.22 ± 11.16 years of age, 74.6% male) were included in this study (mean follow-up time of 13.0 ± 7.7 months). The TyG index was higher in the restenosis group than in the non-restenosis group at both baseline (9.24 ± 0.73 vs. 8.65 ± 0.60, p < 0.001) and follow-up (9.00 ± 0.77 vs. 8.54 ± 0.55, p < 0.001). The positive association between the TyG index and the restenosis after DCB was also determined in the fully adjusted model. The association was also reflected in all subgroups. Moreover, AUC of ROC showed that TyG index could provide predictive value for DCB‑Restenosisat baseline, both at baseline (AUC: 0.756, 95% CI 0.678 to 0.833, p < 0.001) and follow-up (AUC: 0.679, 95% CI 0.594 to 0.765, p < 0.001).</p><p><strong>Conclusion: </strong>An elevated TyG index was independently and positively correlated with the risk of restenosis in patients treated with DCB-only. The TyG index obtained both at baseline and at follow-up was predictive of restenosis after DCB, but the exact mechanism is unclear and requires further study.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684022","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":"Breaking the Barrier: Unraveling the No-Reflow Phenomenon in Cardiovascular Medicine.","authors":"Stephanie Howes, Osamah Altaee, Ariana Ramirez, Loreto Calaquian, Anum Asif, Collin Stone, Muhammad Hammadah, Debanshu Roy, Bryan Ramsey, Robert Chilton","doi":"10.1002/ccd.70017","DOIUrl":"https://doi.org/10.1002/ccd.70017","url":null,"abstract":"<p><p>The no-reflow phenomenon is a stubborn and often devastating complication in cardiovascular medicine, where blood flow is restored to an artery, yet the microvasculature remains unresponsive. First identified in 1967, this phenomenon has haunted clinicians and researchers alike, particularly in the context of acute myocardial infarction (AMI). With incidence rates reaching 11.5% in AMI-related percutaneous coronary interventions (PCI), no-reflow is a major contributor to poor cardiac outcomes, including heart failure and increased mortality. At its core, no-reflow stems from microvascular obstruction (MVO), driven by endothelial dysfunction, distal embolization, and reperfusion-related injury. Capillaries become clogged, inflammation surges, and oxidative stress wreaks havoc, leading to irreversible tissue damage. Advanced imaging techniques like cardiac magnetic resonance (CMR) and myocardial contrast echocardiography (MCE) now allow for more precise detection, offering hope for earlier intervention. Despite decades of research, effective treatments remain elusive. Conventional strategies, from vasodilators to mechanical interventions, often fall short. However, emerging therapies like Nicorandil, a potassium-channel activator with nitrate properties, show promise in improving microvascular perfusion and reducing inflammation. To break the barrier of no-reflow, a paradigm shift is needed: one that integrates cutting-edge diagnostics, personalized medicine, and innovative pharmacological and mechanical interventions. As we unravel the complexities of this phenomenon, the future holds the potential to transform outcomes for patients battling myocardial ischemia-reperfusion injury.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684012","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":"Evaluating the New Watchman FLX Pro 40 mm Device: A Case Study Series.","authors":"Philippe Taieb, Marco Frazzetto, Pedro Soares Teixeira, Steven J Filby","doi":"10.1002/ccd.70036","DOIUrl":"https://doi.org/10.1002/ccd.70036","url":null,"abstract":"<p><strong>Background: </strong>Left atrial appendage closure (LAAC) is a well-established alternative for stroke prevention in patients with atrial fibrillation (AF) who are not suitable for long-term anticoagulation. The WATCHMAN FLX Pro 40 mm device is a novel advancement featuring a fluoropolymer coating to enhance thromboresistance and a size expansion to accommodate larger left atrial appendages (LAA). However, clinical data on this new device remains limited.</p><p><strong>Objective: </strong>This study presents the first case series evaluating the procedural success, safety, and early outcomes of the 40 mm WATCHMAN FLX Pro device.</p><p><strong>Methods: </strong>A total of nine patients underwent LAAC with the 40 mm WATCHMAN FLX Pro between July and November 2024. Pre-procedural imaging, intraoperative guidance, procedural outcomes, and follow-up imaging were analyzed. Procedural success was defined by the successful deployment of the device meeting \"PASS\" criteria, with no major complications.</p><p><strong>Results: </strong>The study demonstrated a 100% procedural success rate, with all patients undergoing same-day discharge. No procedural or periprocedural complications were observed. Follow-up imaging at 4 months (available for 88.9% of patients) revealed no high-grade device-related thrombus (DRT), though some cases exhibited peridevice leaks, predominantly minor subfabric leaks.</p><p><strong>Conclusion: </strong>The 40 mm WATCHMAN FLX Pro expands LAAC treatment options for patients with larger LAA anatomy, demonstrating a favorable safety and efficacy profile in this early experience. Larger studies with long-term follow-up are needed to validate these findings.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693056","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}