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

{"title":"Successful Revascularization Using Intravascular Ultrasound-Guided Wiring in Severe Digital Ischemia With Occluded Radial and Ulnar Arteries: A Case Report.","authors":"Yasuyuki Tsuchida, Naoki Hayakawa, Toshiki Tsurumaki, Hiromi Miwa, Masaomi Inoue, Shinya Ichihara, Shunichi Kushida","doi":"10.1002/ccd.70231","DOIUrl":"https://doi.org/10.1002/ccd.70231","url":null,"abstract":"<p><p>With recent advances in endovascular therapy (EVT), treatment of complex peripheral artery disease, especially below-the-knee lesions, has become increasingly feasible using intravascular ultrasound (IVUS)-guided techniques. However, reports on EVT for critical digital ischemia remain scarce because of its rarity. We report a case of successful distal digital revascularization using IVUS-guided wiring. The patient was a 62-year-old man with untreated diabetes who presented with progressive non-healing ulcers on the right second to fourth fingers. Angiography revealed chronic total occlusions of the right radial and ulnar arteries. IVUS-guided parallel wiring enabled guidewire passage from the ulnar artery to the common palmar digital arteries of the second and fourth digits. Balloon angioplasty resulted in adequate distal flow and clinical improvement. This case demonstrates the potential of IVUS-guided EVT in managing complex upper extremity ischemia.</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":"145282558","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":"When a Patient Dies During a Procedure: Navigating Operator Grief in Interventional Cardiology.","authors":"George Touma, Sarah Fairley, William Lombardi, Cuneyt Ada, Bernard Wong, Bharat Khialani","doi":"10.1002/ccd.70254","DOIUrl":"https://doi.org/10.1002/ccd.70254","url":null,"abstract":"<p><p>Procedural mortality, though uncommon, remains a profound emotional challenge in interventional cardiology. The death of a patient during a procedure is not merely a technical outcome-it deeply affects the operator, triggering grief, self-doubt, and psychological trauma. This review explores the multifaceted emotional toll of intra-procedural death, examining how operator grief intersects with moral injury, burnout, and threats to professional identity. We identify cognitive and cultural barriers to recovery-such as outcome bias, replay loops, and compartmentalization-that impede emotional healing. The immediacy of procedural trauma, compounded by systemic silence and lack of institutional support, often prolongs distress and suppresses vulnerability. Importantly, we outline evidence-informed strategies for sustainable recovery at both individual and institutional levels. These include reflective practice, reconnecting with patient families, peer dialogue, structured debriefing, and culturally attuned support models. Redefining vulnerability as professionalism and embedding psychological safety within organizational culture are essential for meaningful reform. Recognizing and addressing operator grief is crucial not only for clinician well-being but also for preserving the empathy and decision-making clarity that underpin high-quality cardiovascular care.</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":"145282582","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":"Modification Procedures for Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry.","authors":"Eleni Kladou, Dimitrios Strepkos, Michaella Alexandrou, Deniz Mutlu, Pedro E P Carvalho, Jaskanwal Deep Singh Sara, Ozgur Selim Ser, Khaldoon Alaswad, Mir B Basir, Dmitrii Khelimskii, Farouc A Jaffer, Nidal Abi Rafeh, Raj Chandwaney, Cihan Cevik, Yousif Ahmad, Olga Mastrodemos, Bavana V Rangan, Sandeep Jalli, Konstantinos Voudris, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis","doi":"10.1002/ccd.70228","DOIUrl":"https://doi.org/10.1002/ccd.70228","url":null,"abstract":"<p><strong>Background: </strong>CTO-ARC (Chronic Total Occlusion Academic Research Consortium) defines CTO modification procedures (previously called investment procedures) as intentional balloon dilatation (diameter ≥ 2.0 mm) of the entire CTO, including the proximal and distal caps and the CTO body.</p><p><strong>Aims: </strong>The aim of this study is to compare the outcomes of repeat CTO PCI between patients who underwent lesion modification during the initial failed procedure and those who did not.</p><p><strong>Methods: </strong>We analyzed the association of CTO modification with the baseline clinical and angiographic characteristics and outcomes of 2829 patients, with a total of 2869 CTOs who underwent CTO percutaneous coronary intervention (PCI) after a previously failed attempt.</p><p><strong>Results: </strong>CTO modification was performed in 600 of 2869 CTOs (20.9%) that underwent a repeat PCI attempt. CTOs that underwent modification had a higher prevalence of blunt/no stump (63.9% vs. 54.5%, p < 0.001), moderate/severe calcification (59.4% vs. 48.5%, p < 0.001), and moderate/severe proximal tortuosity (43.6% vs. 30.4%, p < 0.001). They also had longer length (38 vs. 31 mm, p < 0.001) and higher J-CTO (3.69 vs. 3.21, p < 0.001) score. There was no statistically significant difference in technical (84.1% vs. 85.4%, p = 0.478) or procedural (82.7% vs. 84.2%, p = 0.403) success or major adverse cardiac events (MACE, 1.7% vs. 1.8%, p = 1.0) between the modification and no modification groups. Similarly, among patients who underwent CTO modification, there were no significant differences in outcomes between early ( < 60 days) and late ( ≥ 60 days) reattempts after the initial failure. Technical success was significantly higher after subintimal tracking and re-entry (STAR) than subintimal plaque modification (SPM) (82.5% vs. 60.0%, p = 0.028).</p><p><strong>Conclusions: </strong>CTO modification procedures were performed in approximately one of five CTO PCIs during the initial failed procedure. During reattempt CTO PCI, despite higher lesion complexity, CTO modification was associated with similar technical and procedural success and MACE compared to patients undergoing reattempt CTO PCI without prior CTO modification. Among modification techniques, STAR was associated with higher technical and procedural success than SPM.</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":"145282575","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":"Applying DanGer Shock Eligibility Criteria to a Real-World Cohort of Cardiogenic Shock Patients.","authors":"Raffaela Miriam Planka, Lukas Herold, Theresa Glantschnig, Gudrun Sommer, Jonathan Pavek, Stefan Hatzl, Nicolas Verheyen, Christoph Strohhofer, Johannes Gollmer, Ewald Kolesnik, Martin Benedikt, Markus Wallner, Andreas Zirlik, Gabor Toth-Gayor, Dirk von Lewinski","doi":"10.1002/ccd.70239","DOIUrl":"https://doi.org/10.1002/ccd.70239","url":null,"abstract":"<p><strong>Background: </strong>The DanGer Shock trial investigated the effects of adding a microaxial flow pump to guideline-recommended therapy in patients with ST-elevation myocardial infarction (STEMI)-related cardiogenic shock (CS), finding a lower all-cause mortality at 180 days in the intervention group.</p><p><strong>Methods: </strong>DanGer Shock eligibility criteria were applied to the prospective single-center PREPARE CardShock registry, which consecutively enrolled 721 patients between April 2019 and August 2024 with advanced CS-classified as stages C to E according to the SCAI shock classification-who were on vasoactive medication and underwent cardiac catheterization.</p><p><strong>Results: </strong>Among 721 patients in the registry, 384 (53.3%) had STEMI-related CS. Of those, 117 (30.5%) met DanGer Shock trial eligibility criteria, accounting for 16.2% of the registry cohort. Median age of the eligible patients was 68 years (interquartile range [IQR]: 58-78), and 62.4% were male, compared to 68 years (IQR: 60-76) and 79.2% in DanGer Shock. PREPRARE-CS DanGer Shock eligible patients had a higher median systolic blood pressure (SBP) (92 mmHG [78-107] vs. 83 mmHG, [72-91]) and higher median lactate levels (5.2 mmol/L [3.6-7.6] vs. 4.6 mmol/L [3.3-7.0]) at baseline, and were more frequently resuscitated (56.4% vs. 20.3%). Device use was 42.7% in eligible patients. Renal replacement therapy (RRT) was more frequent among trial participants (34.4% vs. 17.1%). The 180-day mortality rate among eligible patients was 71.8%, compared to 52.1% in trial participants.</p><p><strong>Conclusions: </strong>Among STEMI-related CS patients in our cohort, only one-third met the DanGer Shock eligibility criteria. Consequently, trial outcomes may not be broadly applicable.</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":"145282538","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":"Emergency Leaflet Perforation: A Provocative Concept Requiring Further Study.","authors":"Bisma Tariq, Maheen Rizwan, Mariam Mustafa","doi":"10.1002/ccd.70255","DOIUrl":"https://doi.org/10.1002/ccd.70255","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":"145282548","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":"Predictive Value of the Academic Research Consortium High Bleeding Risk Criteria in Self-Identified Black Individuals Undergoing Percutaneous Coronary Intervention.","authors":"Rebecca M Cohen, Francesca Maria Di Muro, Samantha Sartori, Birgit Vogel, Sydney E Lupo, Kenneth F Smith, Amit Hooda, Samin K Sharma, Annapoorna Kini, Roxana Mehran","doi":"10.1002/ccd.70203","DOIUrl":"https://doi.org/10.1002/ccd.70203","url":null,"abstract":"<p><strong>Background: </strong>Whether the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria are a valuable tool for risk stratification in self-identified Black patients undergoing percutaneous coronary intervention (PCI) remains uncertain.</p><p><strong>Aims: </strong>This study aims to assess the predictive ability of the ARC-HBR criteria in patients who identify as Black and White.</p><p><strong>Methods: </strong>Consecutive patients undergoing PCI at a large tertiary-care center from 2012 to 2019, and self-reporting as Black or White, were included in the current retrospective observational analysis and stratified into HBR and non-HBR based on the ARC-HBR definition. The primary outcome was all-bleeding, defined as a composite of peri-procedural in-hospital and post-discharge bleeding at 1-year follow-up. Secondary outcomes included post-discharge bleeding, major adverse cardiovascular events (MACE)-a composite of all-cause death, myocardial infarction, or stroke- and its individual components. The discriminative ability of the ARC-HBR criteria to predict outcomes was computed using Harrell's C-index.</p><p><strong>Results: </strong>Among 9462 patients included, 1881 (19.9%) identified as Black and 7581 (80.1%) as White. In these two groups, 50.8% of Black and 45.6% of White patients were classified as HBR, and a different distribution of the individual major and minor criteria was observed. Within the Black cohort, HBR was associated with a significantly higher risk of the primary bleeding endpoint, MACE, and all-cause mortality, with only a trend toward a higher rate of post-discharge bleeding and MI. Conversely, among White patients, HBR was associated with a significantly higher risk of the primary bleeding endpoint, as well as all secondary endpoints. These findings were confirmed after multivariable adjustment, with no significant interaction between race and HBR status with regard to outcomes.</p><p><strong>Conclusions: </strong>In this contemporary PCI registry, the ARC-HBR criteria showed a good ability in identifying patients at increased risk of bleeding and thrombotic events, irrespective of self-reported Black or White race.</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":"145282579","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":"Efficacy and Safety of Colchicine for Secondary Prevention of Cardiovascular Disease: A Systematic Review and Meta-Analysis.","authors":"Muhammad Ahmed, Muhammad Ahmed Ali Fahim, Mahnoor Humayun, Barka Sajid, Siraj Ahmad, Muhammad Sohaib Asghar","doi":"10.1002/ccd.70238","DOIUrl":"https://doi.org/10.1002/ccd.70238","url":null,"abstract":"<p><p>Colchicine may reduce cardiovascular events in coronary artery disease (CAD) through its anti-inflammatory effects. PubMed, Scopus, and Cochrane Library were searched from inception to May 10, 2025, for randomized controlled trials (RCTs) comparing colchicine with placebo or usual care in patients with CAD. Eligible trials had ≥ 30 days of colchicine use and reported cardiovascular outcomes. The primary outcome was major adverse cardiovascular events (MACE). Secondary outcomes included extended MACE (eMACE), myocardial infarction (MI), stroke, all-cause mortality, cardiovascular mortality, coronary revascularization, gastrointestinal events, infection, myalgia, arrhythmia, cancer, alopecia, and treatment discontinuation. Random-effects models were used to calculate risk ratios with 95% CIs. Heterogeneity was assessed using the I² statistic, and meta-regression analysis was conducted to explore heterogeneity and potential effect modifiers. Eleven studies included 19,618 patients with 9814 and 9804 patients in the colchicine and control groups, respectively. The colchicine group was significantly associated with a lower rate of MACE compared to the control group (RR = 0.73, 95% CI = 0.59-0.92, p = 0.006; I² = 44%). From the secondary outcomes, eMACE (RR = 0.66, 95% CI = 0.52-0.85; p = 0.001; I² = 73%), MI (RR = 0.82, 95% CI = 0.70-0.96, p = 0.01), and coronary revascularization (RR = 0.60, 95% CI = 0.41-0.87, p = 0.007) were found to be significantly lower in the colchicine group. All the other secondary outcomes did not reach statistical significance. Meta-regression analysis for MACE showed a statistically significant association with diabetes (coefficient: -0.0778, p = 0.0013), indicating a potential modifying effect. Other covariates, including mean age, hypertension, smoking, and prior revascularization, did not demonstrate statistically significant associations. Colchicine reduces MACE, MI, and revascularization in CAD patients, supporting its use for secondary prevention.</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":"145282566","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":"Recurrent Chest Pain Due to Spontaneous Coronary Artery Dissection Diagnosed by Optical Coherence Tomography.","authors":"Weimin Wang, Baotao Huang","doi":"10.1002/ccd.70253","DOIUrl":"https://doi.org/10.1002/ccd.70253","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a common cause of acute coronary syndrome, with a higher incidence in women than in men. We report a case of SCAD in a middle-aged male involving the right coronary artery (RCA), presenting as ST-segment elevation myocardial infarction (STEMI) in the inferior leads. Coronary angiography (CAG) performed at our hospital revealed only moderate stenosis of the RCA. Optical coherence tomography (OCT) was ultimately used to confirm the diagnosis of SCAD-induced myocardial infarction.</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":"145282549","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":"Safety and Efficacy of Intravascular Lithotripsy System: A Prospective, Multicenter Clinical Trial (The VIGOUR Study).","authors":"Tao Chen, Jiawei Zhao, Yong He, Chao Fang, Xuebin Han, Bo Luan, Yan Wang, Manhua Chen, Zuyi Yuan, Qian Tong, Yuping Gao, Guoqiang Gu, Xiaodong Li, Yining Yang, Huai Yu, Lijia Ma, Huimin Liu, Maoen Xu, Donghui Zhang, Guang Yang, Shuangyin Zhang, Jincheng Han, Maomao Zhang, Haibo Jia, Jingbo Hou, Bo Yu","doi":"10.1002/ccd.70248","DOIUrl":"https://doi.org/10.1002/ccd.70248","url":null,"abstract":"<p><strong>Background: </strong>Optimal plaque preparation in calcified coronary lesions is essential to prevent stent failure. Intravascular lithotripsy (IVL) has shown safety and efficacy in treating severe coronary calcification in prior studies. This study aimed to assess the safety and effectiveness of IVL using domestically produced balloons for the treatment of calcified de novo coronary lesions in Chinese patients.</p><p><strong>Methods: </strong>The VIGOUR trial (NCT05818098) was a prospective, multicenter, single-arm study designed to obtain approval for coronary IVL in patients with severe coronary calcification. The primary endpoint was procedural success. Secondary endpoints included device success, angiographic success, 30-day major adverse cardiovascular events (MACE) incidence, and procedure-related serious complications. An optical coherence tomography (OCT) sub-study was conducted to assess the mechanisms and predictors of calcium modification.</p><p><strong>Results: </strong>A total of 189 patients were enrolled. The primary endpoint was achieved in 93.7% of cases, exceeding the performance goal of 87.0% (p < 0.001). At the secondary endpoints, device success was achieved in 98.9% of patients, and angiographic success in 98.4%. The 30-day MACE incidence was 5.3%, and procedure-related serious complication was 0.5%. 81.9% (59/72) of lesions exhibited OCT-identified multi-plane and longitudinal calcium fractures after IVL. Multivariable analysis revealed that calcium angle was associated with OCT-identified calcium fractures.</p><p><strong>Conclusions: </strong>IVL using domestically produced balloons significantly improves vessel compliance, facilitating successful stent delivery and deployment. This approach proves to be both effective and safe in the Chinese population with severely calcified coronary arteries. OCT-identified calcium fractures post-IVL are more likely in calcified lesions with a larger calcium angle.</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":"145282563","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: Prevalence and Prognostic Impact of Coronary Total Occlusions in Patients With Cardiogenic Shock.","authors":"Rameen Qadeer Malik, Ahmad Furqan Anjum","doi":"10.1002/ccd.70227","DOIUrl":"https://doi.org/10.1002/ccd.70227","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":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246241","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}