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

{"title":"Limited Iatrogenic Dissection of the Aortic Root: To Treat or Not to Treat?","authors":"Valeria Cosco, Giuseppe Grenci, Alessandro Fiorentino, Giuseppe Santarpino","doi":"10.1002/ccd.70262","DOIUrl":"https://doi.org/10.1002/ccd.70262","url":null,"abstract":"<p><p>The treatment of aortic dissections of iatrogenic etiology still requires evaluation on a case-by-case basis, as the prevalence of these problems in the past was low, but has grown in recent years due to the exponential increase in hemodynamic procedures. Patients undergoing percutaneous hemodynamic procedures today are often elderly and also frail. Proposing \"conventional\" surgery to treat an acute aortic dissection may represent a request for \"surgical stress\" that is too high for their \"biological reserves.\" In addition to this, we assume that the physio-pathological mechanism that creates this type of dissection with a flap in the intima, compared to that of classic noniatrogenic dissections, is different in the angle of entry of the flap with formation of the false lumen, which has a consequent greater tendency to spontaneous \"self-resolution\" favored by physiological blood flow. In this paper, we present two cases of patients who underwent hemodynamic procedures (coronary angiography with angioplasty and transcatheter aortic valve implantation) both with limited iatrogenic dissection of the ascending aorta treated in a conservative nonsurgical manner. This approach resulted in the closure of the dissection line in both cases, demonstrating in one case the disappearance of the flap even at a 6-month follow-up.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282592","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":"Prognosis of Calcified Lesions Treated With PCI in Patients With Chronic Coronary Artery Disease.","authors":"Julie Juul Siig, Marc Meller Søndergaard, Laust Dupont Rasmussen, Evald Høj Christiansen, Lars Jakobsen, Lisette Okkels Jensen, Jens Flensted Lassen, Niels Thue Olsen, Ole Ahlehoff, Kristian Hay Kragholm, Ashkan Eftekhari","doi":"10.1002/ccd.70245","DOIUrl":"https://doi.org/10.1002/ccd.70245","url":null,"abstract":"<p><strong>Background: </strong>Calcified coronary lesions are frequently seen in patients with comorbidities and pose a higher risk of complications during percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>To evaluate the 5-year risk of acute myocardial infarction (MI) and all-cause mortality in patients with and without calcified lesions in patients with chronic coronary artery disease.</p><p><strong>Methods: </strong>Demographic, clinical, and procedural data were extracted from the Western Denmark Heart Registry (WDHR) for individuals with chronic coronary artery disease undergoing PCI from January 2000 to January 2021. Major exclusion criteria were prior MI and PCI. Patients were categorized according to presence of calcified lesions defined as visible calcium on angiography during the index procedure. The endpoint was MI and all-cause mortality.</p><p><strong>Results: </strong>In total, 16,757 patients underwent PCI due to chronic coronary artery disease of whom 5302 (32.6%) patients had calcified lesions and 11,455 (68.4%) patients had lesions without calcium. Patients with calcified lesions had significantly higher absolute 5-year risk of MI (15.6% (n = 826)) compared to patients without calcified lesions (12.8% (n = 1469)) (p < 0.0005). Patients with calcified lesions had significantly higher absolute 5-year risk for all-cause mortality (13.6% (n = 720)) compared to patients without calcified lesions (8.6% (n = 984)) (p < 0.0005).</p><p><strong>Conclusion: </strong>PCI of calcified lesions was associated with higher 5-year risk of MI and all-cause mortality.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282588","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":"Left Ventricular Apical Thrombus in Apical Hypertrophic Cardiomyopathy Without Aneurysm or Arrhythmia: A Case Report.","authors":"Ibrahim Antoun, Jeffrey Khoo, Sanjay S Bhandari","doi":"10.1002/ccd.70265","DOIUrl":"https://doi.org/10.1002/ccd.70265","url":null,"abstract":"<p><p>Apical hypertrophic cardiomyopathy (ApHCM) is a rare variant of hypertrophic cardiomyopathy, typically associated with a benign course. However, complications such as ventricular arrhythmias, apical aneurysms, and thrombus formation may occur. Left ventricular (LV) thrombus is an unusual finding in ApHCM, especially in patients with preserved systolic function and normal sinus rhythm. A 54-year-old male with a history of pulmonary embolism and ApHCM was under routine surveillance. He remained asymptomatic with a normal sinus rhythm. Transthoracic echocardiography (TTE) identified an echogenic mass in the LV apex. Cardiac magnetic resonance imaging (CMR) confirmed severe apical hypertrophy, preserved LV systolic function, and a large apical mass measuring 24 × 19 mm. The mass showed no contrast uptake on early or late gadolinium enhancement sequences, consistent with thrombus. Native T1 mapping was mildly elevated, suggesting diffuse interstitial fibrosis, and focal non-ischaemic replacement fibrosis was noted. There was no evidence of apical aneurysm or mid-ventricular obstruction. The patient was anticoagulated with warfarin and remains under close follow-up. This case represents a rare occurrence of a large LV thrombus in ApHCM without associated apical aneurysm or impaired LV function. The findings suggest that regional fibrosis and altered apical flow dynamics may contribute to thrombus formation even in hypercontractile ventricles. Multimodal imaging, particularly CMR, is essential for accurate diagnosis and risk assessment. Clinicians should maintain vigilance for thrombotic complications in ApHCM, even in the absence of classical risk factors, as subtle fibrosis or flow abnormalities may predispose to thrombus formation.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288101","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":"Implantation of Leadless Pacemaker in a Patient With Chronic Type A Aortic Dissection-A Case Report.","authors":"Xuehui Liu, Yue Luo, Xin Zhang, Xingbin Liu","doi":"10.1002/ccd.70222","DOIUrl":"https://doi.org/10.1002/ccd.70222","url":null,"abstract":"<p><p>When implanted into a structurally normal heart, leadless pacemakers are more effective and safer than traditional pacemakers. However, clinical experience with leadless pacemaker implantation in patients with severe right heart deformity remains limited. We present a rare case of an 87-year-old woman with right heart deformity (secondary to chronic Stanford type A aortic dissection) who successfully underwent implantation of a Micra leadless pacemaker. Preoperative computed tomography (CT) revealed compression of the right atrium by an ascending aortic root dissection aneurysm (maximum diameter: 7.2 cm) and clockwise rotation of the right heart. The delivery system was adjusted repeatedly during the operation, and angiography confirmed that the delivery system was in the right ventricle before releasing the pacemaker. Preoperative familiarity with distorted cardiac anatomy (via CT) and intraoperative angiographic verification of delivery system location are critical for safe leadless pacemaker implantation in patients with right heart deformity. These measures can effectively prevent complications such as cardiac perforation.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282567","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":"Effect of Position Change After Coronary Angiography on Pain, Vital Signs, Comfort, and Vascular Complications: A Randomized Controlled Trial.","authors":"Necibe Dagcan Sahin, Burcu Nal, Mehmet Ali Astarcioglu","doi":"10.1002/ccd.70259","DOIUrl":"https://doi.org/10.1002/ccd.70259","url":null,"abstract":"<p><strong>Background: </strong>The supine position given to patients after femoral angiography causes pain. Pain causes changes in vital signs, impaired comfort, and vascular complications.</p><p><strong>Aims: </strong>To investigate the effect of position change on pain, vital signs, comfort, and vascular complications after femoral angiography was the aim of this study.</p><p><strong>Methods: </strong>This is a double-blind randomized controlled trial. The study included 60 volunteer patients undergoing femoral angiography. Data were collected using the Patient Information Form, the Visual Analog Scale, the Immobilization Comfort Scale, and a Vascular Complications Form. Experimental group patients were given supine position with 15° head angle, semi-fowler position with 30° head angle, and right or left lateral position with 15° head angle every 2 h after sheath removal. Control group patients were given supine position for 6 h as a routine practice of the clinic.</p><p><strong>Results: </strong>Following the position change, the mean visual analog scale pain score and systolic and diastolic blood pressure scores decreased significantly in the experimental group, and the Immobilization Comfort Scale score increased. In the control group, the mean visual analog scale pain score increased significantly, and the Immobilization Comfort Scale score decreased. No significant difference was found between the experimental and control groups in terms of bleeding/leakage and ecchymosis/hematoma.</p><p><strong>Conclusions: </strong>This study revealed that position changes after femoral angiography had positive effects on pain, vital signs, and comfort. However, no significant difference was observed in vascular complications. Future studies should evaluate different position change protocols and their long-term effects on larger groups.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282521","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":"All Roads Lead to Rome: Let's Choose the Safest One!","authors":"Francesco Catania, Salvatore Notaristefano, Alberto Barengo, Francesco Notaristefano","doi":"10.1002/ccd.70256","DOIUrl":"https://doi.org/10.1002/ccd.70256","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: \"Safety and Efficacy of a Plug-Based Vascular Closure Device After Percutaneous Microaxial Flow Pump in the Treatment of Complex and High-Risk Indicated Patients\".","authors":"Taha Yahya, Ahmad Furqan Anjum, Suleman Arshad, Syed Ali Raza Zaidi","doi":"10.1002/ccd.70260","DOIUrl":"https://doi.org/10.1002/ccd.70260","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282556","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":"Off Label Use of EndoAnchors for the Treatment of Abdominal Aortic Aneurysm With Large-Barrel Neck.","authors":"Suko Adiarto, Ayers Gilberth Ivano Kalaij, Suci Indriani, Taofan","doi":"10.1002/ccd.70251","DOIUrl":"https://doi.org/10.1002/ccd.70251","url":null,"abstract":"<p><p>EVAR has replaced open surgical repair as the most commonly preferred definitive therapy for abdominal aortic aneurysm (AAA)s with suitable anatomy. However, the hostile neck has its own challenges in terms of treatment. Several endovascular techniques have been applied successfully to some of these hostile necks; however, none of these techniques are known to be used for large barrel necks. We presented a 73-year-old male with a large barrel neck AAA that was successfully treated with EVAR with EndoAnchors. Final procedural angiogram showed that the use of EndoAnchors were successful to completely exclude the aneurysms without evidence of endoleak. One-year follow-up CT revealed complete thrombosis of the aneurysmal sac and freedom from endoleak. EndoAnchors might be used to treat some large barrel neck AAAs. Through this case, we propose that the suitable anatomy would be: Diameter of \"secondary neck\" of less than 32 mm, absence of circumferential calcification and thrombus > 2 mm, the length of the \"secondary neck\" of at least 4 mm, and position of the secondary neck within 40-50 mm below the lowest renal artery.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282578","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 Thigh Saphenous Vein Versus the Calf Saphenous Vein: Searching for the Optimal Conduit for Coronary Artery Bypass Grafting.","authors":"Aidong Chen, Ke Pan","doi":"10.1002/ccd.70270","DOIUrl":"https://doi.org/10.1002/ccd.70270","url":null,"abstract":"<p><strong>Background: </strong>The quality of saphenous vein (SV) grafts can vary depending on the site from which they are harvested. However, few studies have compared SV grafts harvested from the thigh with those harvested from the calf to explore which is more appropriate for use in coronary artery bypass grafting (CABG). In this study, we evaluated the graft patency rates of thigh and calf SV grafts over 5 years. We also assessed the functional and structural viability of SV endothelial and smooth muscle cells.</p><p><strong>Methods: </strong>This retrospective observational study included 265 patients who underwent CABG performed by the same surgical team between 2015 and 2019. Each patient received one SV graft from either the thigh or the calf to the right coronary territory. The 1-, 3-, and 5-year postoperative coronary computed tomography (CT) angiography results were compared between patients who received the thigh and calf SV grafts. Surgical specimens were collected from 2015, which were evaluated by western blotting and immunohistochemistry to evaluate the expression, stability, morphology, and localization of von Willebrand factor (vWF), matrix metalloproteinase (MMP)-2, MMP-9, vimentin, and caveolin-1 (CAV-1).</p><p><strong>Results: </strong>The 5-year coronary CT angiography results demonstrated a significantly higher patency rate for thigh SV grafts than for calf SV grafts (69.2% vs. 51.7%, p = 0.030). The protein expression of vWF, MMP-2, MMP-9, vimentin, and CAV-1 was significantly higher in calf SV grafts than in thigh SV grafts (all p ＜ 0.05).</p><p><strong>Conclusions: </strong>In this study, thigh SV grafts had significantly higher patency than calf SV grafts at 5 years after CABG. Moreover, the functional and structural viability of SV endothelial and smooth muscle cells in the thigh SV grafts were better preserved than those in the calf SV grafts. These findings suggest that thigh SV grafts appear to be more appropriate conduits than calf SV grafts for CABG.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282586","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":"A Multicentre Propensity Matched Analysis of Clinical Outcomes With the ACURATE Neo2 Transcatheter Aortic Valve.","authors":"Christopher J Broyd, Timothy J Bagnall, Aayush Singal, Samer Fawaz, Adeogo Olusan, Siu-Fong Wong, Moiz Artani, Ashni Chani, Mohamed Eltayeb, Mohamed Abouelasaad, Jan Kovac, Rohan Jagathesan, Rodney Stables, Kully Sandhu, James Cockburn, Raj Rajendra, Christopher Cook, Clare Appleby, David Hildick-Smith","doi":"10.1002/ccd.70234","DOIUrl":"https://doi.org/10.1002/ccd.70234","url":null,"abstract":"<p><strong>Introduction: </strong>Recent data from a large randomized trial suggested less advantageous outcomes following TAVI with the ACURATE Neo2 valve. However, this valve was more appropriately used selectively in patients with smaller annuli and lesser degrees of aortic valve calcification.</p><p><strong>Methods: </strong>Data from the four highest-volume ACURATE Neo2 implanting sites in the UK were analyzed to compare outcomes between patients treated with the ACURATE Neo2 valve and the Edwards Sapien or Evolut Pro valves. Baseline data was collected at the time of TAVI and outcome obtained from individual patient records. 1-to-1 logit propensity matching with replacement was performed and outcome and survival rates compared. The primary outcome was a composite of death, stroke or cardiac readmission at 1-year.</p><p><strong>Results: </strong>A total of 1277 patients were included for analysis, 500 of whom received the ACURATE Neo2. Median follow-up was 859 days (95% CI: 441-1062). The ACURATE Neo2 valve was not associated with the composite event (p = 0.56) or its subcomponents. Propensity score matching generated 481 matched pairs which did not differ in terms of the composite end point (15.6% vs. 17.9%, p = 0.34) or the individual subcomponents at 1 year. No difference was seen in survival curves (p = 0.81 for composite end point).</p><p><strong>Conclusion: </strong>The ACURATE Neo2 valve was a good valve choice for selected patients with severe aortic stenosis. With appropriate patient selection and experienced implanting teams, the ACURATE Neo2 valve led to outcomes equivalent to the other major valve platforms in use today.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282473","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}