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

{"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":"Percutaneous Transapical Bioprosthetic Leaflet Modification Facilitated Transfemoral Valve-in-Surgical Bioprosthetic Transcatheter Aortic Valve Replacement: Undermining Iatrogenic Coronary Obstruction With Radiofrequency Needle (UNICORN).","authors":"Mina Iskander, Saif Anwaruddin, Paul Pearson, Peter J Mason","doi":"10.1002/ccd.70037","DOIUrl":"https://doi.org/10.1002/ccd.70037","url":null,"abstract":"<p><p>An 81-year-old male presented with severe, symptomatic bioprosthetic surgical aortic valve dysfunction. He was considered high-risk for reoperation and cardiovascular imaging determined him to be a very high-risk for coronary occlusion with valve-in-valve TAVR. This is the first reported case of valve-in-valve TAVR facilitated by percutaneous transapical UNICORN procedure.</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":"144684019","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}

{"title":"Reassessing Long-Term Valve Durability in Small Annuli: A Critical Look at SEV Versus BEV Outcomes.","authors":"Ibrahim Nagmeldin Hassan","doi":"10.1002/ccd.70024","DOIUrl":"https://doi.org/10.1002/ccd.70024","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":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684020","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":"Expanding Predictive Models of Microvascular Obstruction in ST-Elevation Myocardial Infarction.","authors":"Areeba Abid","doi":"10.1002/ccd.70045","DOIUrl":"https://doi.org/10.1002/ccd.70045","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":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144684016","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":"External Validation of the PRECISE-DAPT Cancer Score in Patients With Acute Myocardial Infarction.","authors":"Mohamed Dafaalla, Francesco Costa, Evangelos Kontopantelis, Rodrigo Bagur, Mario Iannaccone, Paolo Bironzo, Sergio Raposeiras Roubí, Ovidio De Filippo, Fabrizio D'Ascenzo, Mamas A Mamas","doi":"10.1002/ccd.70040","DOIUrl":"https://doi.org/10.1002/ccd.70040","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to externally validate the PRECISE-DAPT cancer score which showed better accuracy in predicting bleeding events in patients with cancer than the original PRECISE-DAPT score.</p><p><strong>Methods: </strong>We used data from the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged after an Acute Coronary Syndrome) project. We compared the performance and clinical usefulness of the original score and the cancer score by calculating the C-statistic, the net reclassification index (NRI), and decision curve analysis.</p><p><strong>Results: </strong>A total of 13,932 patients were included, of which 864 patients had a diagnosis of cancer at the time of presentation with an AMI. According to the original PRECISE DAPT score, 63.3% of patients with cancer were classified as HBR, whereas 94.9% of patients with cancer were classified as HBR according to the cancer score. Cox-regression models showed that patients classified as HBR by the updated cancer score have higher odds of bleeding (HR 2.6, 95% CI 2.1-3.1) events than patients classified as HBR by the original score (HR 2.2, 95% CI 1.8-2.7). The cancer score showed higher discrimination ability (C-statistic 0.66) than the original score (C-statistic 0.64). The overall NRI of the cancer score was 2.7%. The decision curves analysis showed that the cancer score use is roughly identical to the original score in patients without cancer but superior to the original score in patients with cancer.</p><p><strong>Conclusion: </strong>The PRECISE-DAPT cancer score is a valid and useful tool for the prediction of bleeding risk in patients with cancer and presenting with AMI.</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":"144684017","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}