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

{"title":"Neointimal Healing Score After Contemporary Extraplaque Compared to Intraplaque Recanalization of Chronic Total Occlusion: A 6-Month Follow-Up Optical Coherence Tomography Observational Study.","authors":"Peter Philip Shaker Selwanos, Ahmad Samir, Sameh Bakhoum, Magdy Abdelhamid, Ahmed ElGuindy","doi":"10.1002/ccd.70820","DOIUrl":"10.1002/ccd.70820","url":null,"abstract":"<p><strong>Background: </strong>The expanding utilization of extraplaque (EP) strategies has led to increasing success rates in coronary chronic total occlusion (CTO) recanalization. The contemporary EP techniques have shown mid-term outcomes comparable to intraplaque (IP) recanalization approaches. Differential neointimal healing after CTO recanalization by various approaches remains to be identified.</p><p><strong>Aim: </strong>This study aimed to assess the vascular healing response across different CTO recanalization techniques using optical coherence tomography (OCT)-derived Neointimal Healing Score (NIHS).</p><p><strong>Methods: </strong>This was a prospective, observational, analytic, single-center study recruiting 50 consecutive patients who underwent successful recanalization of 51 coronary CTOs. The recanalization technique (EP vs. IP) was according to the operator's discretion based on the CTO anatomical characteristics. The study aimed to compare the impact of the EP versus IP recanalization technique on the vascular healing assessed by OCT-derived NIHS (evaluating the presence of uncovered and/or malapposed stent struts and intraluminal filling defects), 6 months after the index procedure.</p><p><strong>Results: </strong>The mean age was 58 ± 8 years, and 35 (70%) were males. EP and IP techniques were used in 15 and 36 of the recanalized CTOs, respectively. At 6 months, clinical and angiographic follow-ups were completed for all patients, while interpretable OCT imaging was available for 39 patients (77%). The mean NIHS for all patients was 14.3 ± 9.7. The NIHS was comparable between EP and IP techniques (18 ± 7.4 vs. 14.1 ± 8.4; p = 0.51). Target vessel failure (TVF) occurred in 23.5% of all patients with a numerically nonsignificant higher rate in the EP compared to the IP technique (27% vs. 22%; p = 0.73).</p><p><strong>Conclusion: </strong>CTO recanalization using EP techniques is associated with a nonsignificant numerical increase in NIHS without leading to a significant difference in TVF compared to IP techniques at mid-term follow-up.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1762-1772"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868619","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":"Use of Intracoronary Pressure Wire Assessment and Association With Outcomes: Insights From the British Cardiovascular Intervention Society National Database.","authors":"Hussein Bashar, Muhammad Rashid, Mamas A Mamas, Nick Curzen","doi":"10.1002/ccd.70835","DOIUrl":"10.1002/ccd.70835","url":null,"abstract":"<p><strong>Background: </strong>Despite recommendations in international guidelines, Intracoronary pressure wire assessment (PWA) utilization remains limited in clinical practice. This study aims to describe (i) trends of PWA during Percutaneous coronary interventional (PCI), (ii) factors that predict its application, and (iii) association with in-hospital outcomes.</p><p><strong>Methods: </strong>Adults with PCI for chronic coronary syndrome or Non-ST-elevation acute coronary syndrome in the British Cardiovascular Intervention Society (BCIS) database from January 2012 to March 2020 were included. Adjusted odds ratios (aOR) of PWA predictors and its association with in-hospital major adverse cardiovascular and cerebrovascular events (MACCE; a composite of total mortality, stroke/transient ischaemic attack, and new/reinfarction) were assessed using logistic regression models.</p><p><strong>Results: </strong>303,453 records identified of which 10.74% had PWA. There was a modest rise in the use of PWA from 9.1% in 2012 to peak just over 13% in 2018. Intracoronary imaging (aOR: 1.23, 95% CI: 1.18-1.27, p < 0.001), and previous PCI (aOR: 1.30, 95% CI: 1.26-1.34, p < 0.001) were positive predictors of PWA. MACCE was lower with PWA (aOR: 0.73, 95% CI: 0.62-0.87, p < 0.001) in the overall population. PWA was associated with lower procedural complications (aOR: 0.90, 95% CI: 0.84-0.96, P: 0.001).</p><p><strong>Conclusion: </strong>PWA remains underutilized in UK real world practice. Among patients undergoing PCI, PWA was associated with lower in-hospital procedural complications and MACCE. It's association with in-hospital MACCE should be viewed as a hypothesis-generating for future studies. Using pressure wire as a performance and a quality metric for PCI might help improve adoption in the future.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1743-1753"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous Coronary Stentectomy: Redefining Stent Failure Management in the Modern Era.","authors":"Evandro Martins Filho, Raghav Gattani, Tim A Fischell, Ricardo Fonseca Oliveira Suruagy Motta, Marielle Rodrigues Martins, Tarana Zaman, Briana Kulisch, Lindsey A Cilia, Emmanouil S Brilakis, Alexander G Truesdell","doi":"10.1002/ccd.70815","DOIUrl":"10.1002/ccd.70815","url":null,"abstract":"<p><p>Percutaneous coronary stentectomy, intentional retrieval of a fully deployed coronary stent, has evolved from anecdotal salvage to a structured interventional strategy. It addresses scenarios where a deployed stent causes ongoing complications: malapposition, longitudinal deformation, or excessive aorto-ostial protrusion leading to restenosis, thrombosis, or interference with structural heart interventions. We performed a narrative review of the published literature on intentional percutaneous coronary stent retrieval, supplemented by five illustrative cases from three academic centers representing acute, subacute, and late retrieval scenarios. Stentectomy was feasible across acute and late settings. Snare-based retrieval through guide extension catheters was the predominant approach; stents with three or fewer inter-ring connectors allowed more predictable extraction. Intravascular ultrasound was essential for procedural planning, confirmation of complete removal, and post-extraction management. Drug-coated balloons enabled metal-free revascularization after stent removal. A novel reverse hairpin-assisted snare extraction technique facilitated pre-TAVR stent retrieval in one case. The Side Flap technique and stentectomy emerged as complementary strategies for managing excessive aorto-ostial protrusion. Percutaneous coronary stentectomy is a feasible strategy for selected clinical scenarios, with intravascular imaging central to procedural planning and assessment. When performed with appropriate technique and Heart Team evaluation, it can address stent complications, restore coronary access, and enable metal-free revascularization.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1572-1588"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Drug-Eluting Stents and Drug-Coated Balloons in Tortuous Small Coronary Lesions.","authors":"Shunichiro Ishio, Takashi Nagasaka, Ryota Taniuchi, Shiro Amanai, Yohei Ishibashi, Noriaki Takama, Hideki Ishii","doi":"10.1002/ccd.70814","DOIUrl":"10.1002/ccd.70814","url":null,"abstract":"<p><strong>Background: </strong>In small, tortuous coronary lesions, the long-term comparative performance of drug-coated balloon (DCB) angioplasty versus drug-eluting stent (DES) treatment remains uncertain, despite both strategies being widely used in contemporary percutaneous coronary intervention (PCI) practice.</p><p><strong>Aims: </strong>This study aimed to compare 3-year clinical outcomes between DES and DCB in patients undergoing PCI for small, tortuous coronary lesions.</p><p><strong>Methods: </strong>This retrospective, single-center study included 366 patients treated with either DES (n = 226) or DCB (n = 140) for lesions with at least one angulation ≥ 45°. The primary endpoint was major adverse cardiac events (MACE). Time-to-event outcomes were assessed using Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>Procedural success rates were high and comparable between groups. At 3 years, MACE occurred more frequently in the DCB group than in the DES group (log-rank p = 0.013). In multivariable analysis, DCB use remained associated with higher risks of MACE (hazard ratio [HR] 1.88; 95% confidence interval [CI] 1.12-3.16; p = 0.017) and target vessel revascularization (TVR) (HR 1.84; 95% CI 1.01-3.21; p = 0.045). Subgroup analysis showed that DES had significantly better outcomes than DCB in lesions with mild-to-moderate tortuosity, whereas event rates were similar between groups in severely tortuous segments.</p><p><strong>Conclusion: </strong>In small, tortuous coronary lesions, DES use was associated with lower rates of MACE and TVR at 3 years than DCB use. The advantage of DES was most apparent in mild-to-moderate tortuosity, whereas it was not statistically significant in severely tortuous vessels. These findings highlight the importance of anatomic complexity when selecting a treatment strategy for tortuous coronary lesions.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1680-1689"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13667340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Subclavian Pseudoaneurysm Treated With Thrombin Injection.","authors":"S Erdal Sayın, M Kahyaoglu, M Ildızlı Demirbas, A Karagoz, Y Kaynar Topal, C Gecmen","doi":"10.1002/ccd.70809","DOIUrl":"10.1002/ccd.70809","url":null,"abstract":"<p><p>Central venous catheterization for hemodialysis carries the risk of vascular complications, including pseudoaneurysm formation. Traditional management includes manual compression, endovascular intervention, or surgery. A 19-year-old female with a kidney transplant history developed a large subclavian pseudoaneurysm (55 × 32 mm) following an internal jugular vein catheterization attempt for temporary hemodialysis. Manual compression failed to resolve the lesion. CT angiography confirmed a multilobulated pseudoaneurysm with active bleeding. Due to multiple comorbidities and the patient's refusal of surgery, balloon-assisted percutaneous thrombin injection was performed under ultrasound guidance. Complete pseudoaneurysm obliteration was achieved without complications. Follow-up ultrasound at 72 h showed complete thrombosis. Balloon-assisted percutaneous thrombin injection represents an effective, minimally invasive alternative to surgery for complex subclavian pseudoaneurysms, particularly suitable for high-risk patients with multiple comorbidities.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1707-1711"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809751","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":"Multimodality Intravascular Imaging Guidance (NIRS-IVUS-OCT) Compared to Angiography-Guided Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction: The NIRVUS Trial.","authors":"Manijeh Noori, Mikkel Hougaard, Akiko Maehara, Jens Trøan, Kirstine Nørregaard Hansen, Anders Junker, Henrik Steen Hansen, Karsten Veien, Julia Ellert, Jens Flensted Lassen, Lisette Okkels Jensen","doi":"10.1002/ccd.70765","DOIUrl":"10.1002/ccd.70765","url":null,"abstract":"<p><strong>Background: </strong>Imaging-guided percutaneous coronary intervention (PCI) improves outcomes, but the clinical utility of near-infrared spectroscopy (NIRS) remains unclear.</p><p><strong>Aims: </strong>The aim of the study was to evaluate whether multimodality imaging with NIRS, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) would improve stent strut coverage compared with angiography-guided PCI in patients with acute myocardial infarction (MI) and further to assess the impact of lipid-rich plaque (LRP) on vascular healing.</p><p><strong>Methods: </strong>A total of 104 patients with MI were randomized to imaging- or angiography-guided PCI. NIRS-IVUS imaging was performed pre- and post-PCI, and OCT post-PCI and at 6-month follow-up. Maximum lipid core burden index in a 4-mm segment (maxLCBI_4 mm) was measured. The primary endpoint was percentage of covered stent struts (OCT) at 6-month follow-up.</p><p><strong>Results: </strong>Pre-PCI maxLCBI_4 mm was similar in the two groups (441 [239, 565] vs. 333 [242, 517], p = 0.19). Imaging guidance resulted in a larger minimal stent area (7.3 ± 2.4 mm² vs. 6.5 ± 1.7 mm², p = 0.04). At 6-month follow-up, stent strut coverage was higher in the imaging group (86.9% [77.7, 93.7] vs. 74.4% [53.8, 81.8], p < 0.001). Segment-level analyses showed that LRP without superficial attenuation and suboptimal stent expansion was associated with higher percentage of intima hyperplasia (23.4% [20.5, 25.9] vs. 13.9% [10.6, 16.0], p < 0.001) compared to optimal stent expansion, whereas LRP with attenuation and suboptimal stent expansion was associated with higher rates of late-acquired stent malapposition (81.8% vs. 30.0%, p = 0.02) compared to optimal stent expansion.</p><p><strong>Conclusion: </strong>Imaging-guided PCI improved stent strut coverage. LRP phenotypes were associated with different healing patterns.</p><p><strong>Clinical trial registration information: </strong>Clinical Trial Registration Information: URL: https://www.</p><p><strong>Clinicaltrials: </strong>gov; Unique identifier: NCT04460482.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1322-1336"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612258","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":"Methodological Considerations Regarding Hospital Volume and Outcomes in Pulmonary Embolism.","authors":"Muhammad Adil Choudhry","doi":"10.1002/ccd.70823","DOIUrl":"10.1002/ccd.70823","url":null,"abstract":"","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1600-1601"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764724","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":"Long-Term Cardiovascular Outcomes Following Percutaneous Coronary Intervention of Diffuse Coronary Artery Lesions With Overlapping Homogeneous Versus Heterogeneous Second-Generation Drug-Eluting Stents.","authors":"Nagendra Boopathy Senguttuvan, Salman Salahuddin, Rizwan Suliankatchi Abdulkader, Swetharajan Gunasekar, Dharaneswari Hari Narayanan, Pavitraa Saravana Kumar, Sandeep Mohanan, Keerthana Vaishnavi Mahesh, Monisha Ganesh, Kavitha Prabhakaran, Mohan Kumar Thota, Gautam Ganesan Karthikeyan, Aravind Ramesh, Pavithra Ramachandran, Benasir Begam, Gokulalakshmi Lakshmanan, Thrisha Ravi, Yogapriya Chidambaram, Madhesh Kasi, Asuwin Anandaram, Akshay Prashanth, Judah Nijas Arul, Preetam Krishnamurthy, Jayanty Venkata Balasubramaniyan, Vinod Kumar Balakrishnan, Sadhanandham Shanmugasundaram, Sankaran Ramesh, Manokar Panchanatham, Meena Iyer, Jayanty Satyanarayana Murthy, Thoddi Ramamurthy Muralidharan, Sadagopan Thanikachalam","doi":"10.1002/ccd.70781","DOIUrl":"10.1002/ccd.70781","url":null,"abstract":"<p><strong>Background and aims: </strong>The growing prevalence and severity of diffuse coronary artery disease (dCAD) necessitate the utilization of appropriate stenting techniques to ensure complete target lesion coverage. In clinical settings where overlapping stents are the norm, there is inconclusive evidence to determine whether using stents of the same identity produces better outcomes compared to stents that differ in material characteristics.</p><p><strong>Methods and results: </strong>We conducted a retrospective observational cohort study at two high-volume, tertiary cardiac care centers in India to determine the safety and efficacy of homogeneous overlapping stents (HOSTs) and heterogeneous overlapping stents (HESTs) in patients with dCAD undergoing percutaneous coronary intervention (PCI). Patients were stratified into complex and non-complex subgroups based on pre-specified clinical and angiographic criteria. Out of 12,920 interventions that were performed during the study period (January 2016 to December 2023), 972 procedures utilized overlapping stent strategies, of which 935 cases met the inclusion and exclusion criteria. HOSTs were used in 795 patients, while HESTs were used in 140 patients. To account for imbalances in the study population, inverse probability of treatment weighting (IPTW) was applied following propensity score adjustment via logistic regression modeling. During a mean follow-up of 2.5 years, occurrence of major adverse cardiovascular events (MACE) was comparable between HOST and HEST groups in the unadjusted (odds ratio [OR] 0.91, 95% confidence interval [CI]: 0.59-1.42, p = 0.67), as well as adjusted population (OR 1.05, 95% CI: 0.69-1.61, p = 0.81). Similar trends were observed in the complexity-stratified populations, with no evidence of benefit or harm associated with either stenting strategy.</p><p><strong>Conclusion: </strong>Overlapping heterogeneous stents yield similar clinical outcomes as homogeneous stents, regardless of procedural complexity, suggesting that operators may use a \"mix-and-match\" strategy when ideal stent pairings are not feasible.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1366-1376"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650540","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":"Double Transeptal Puncture for SAPIEN M3 Transcatheter Mitral Valve Replacement: Initial Experience, Indications, and Technique.","authors":"Clara Fernandez-Cordon, David Hoare, Aayush Singal, Sanjeev Bhattacharyya, Suneil K Aggarwal, Michael J Mullen","doi":"10.1002/ccd.70935","DOIUrl":"https://doi.org/10.1002/ccd.70935","url":null,"abstract":"<p><p>The SAPIEN M3 system has been recently approved for transcatheter mitral valve replacement (TMVR). The transeptal guide sheath is used to deploy the dock, which is completely released before inserting and deploying the M3 valve using the same femoral access, transeptal puncture (TSP) and guide sheath. However, clinical scenarios such us low dock position or small left ventricular outflow tract (LVOT) may require to deploy the M3 valve with a second guide sheath while the dock is still attached to the first. In this article, we describe our initial experience with the \"double transeptal technique\" in two patients, focusing on indications and key technical points.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122467","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":"Endovascular Bailout Using Covered-Stent Fenestration After Misdeployment of a Balloon-Expandable Covered Stent From the Common Iliac Artery Into the Internal Iliac Artery.","authors":"Akinori Satake, Takahiro Tokuda, Akio Kodama, Tetsuya Amano","doi":"10.1002/ccd.70796","DOIUrl":"10.1002/ccd.70796","url":null,"abstract":"<p><p>Misdeployment of balloon-expandable covered stents extending from the common iliac artery (CIA) to the internal iliac artery (IIA) is a rare but serious complication. Optimal bailout strategies remain limited. Herein, we report a case of endovascular bailout for inadvertent stent deployment from the CIA to the IIA. A 68-year-old man presented with severe claudication of both legs. The bilateral ankle-brachial index was low, and computed tomography showed chronic total occlusion of the left CIA. During revascularization, a balloon-expandable covered stent was inadvertently deployed from the CIA into the IIA. To salvage the external iliac artery (EIA), a modified-tip 0.035-inch guidewire was used to perforate the stent graft, creating a fenestration. A 0.014-inch guidewire was advanced through the newly created opening, followed by deployment of a self-expanding bare-nitinol stent across the fenestration to reconstruct the EIA flow. The final angiography indicated successful revascularization without complications. Therefore, percutaneous fenestration of a balloon-expandable covered stent is a potential therapeutic option for the treatment of aortoiliac lesions.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":"1377-1379"},"PeriodicalIF":0.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665427","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}