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

{"title":"Optimizing MANTA Closure and Bailout in Large-Bore Femoral Access: Computed Tomography Angiography-Derived Measurements and Rescue Strategies.","authors":"Lior Lupu, Andrew P Hill, Dan Haberman, Kalyan R Chitturi, Matteo Cellamare, Cheng Zhang, Vaishnavi Sawant, Waiel Abusnina, Abhishek Chaturvedi, Lowell F Satler, Toby Rogers, Ron Waksman, Itsik Ben-Dor","doi":"10.1002/ccd.31661","DOIUrl":"https://doi.org/10.1002/ccd.31661","url":null,"abstract":"<p><strong>Background: </strong>The MANTA (Teleflex, Wayne, PA, USA) facilitates hemostasis in large-bore femoral access. However, precise measurement of the common femoral artery depth is required before arteriotomy upsizing. This measurement may be unavailable in emergencies or bailout scenarios for suture-based closures.</p><p><strong>Aims: </strong>This study aimed to evaluate computed tomography (CT) angiography-derived common femoral artery depth measurement as an alternative to the MANTA Depth Locator.</p><p><strong>Methods: </strong>This retrospective study at MedStar Washington Hospital Center included all patients with available preprocedural ilio-femoral CT angiography undergoing transfemoral aortic valve reintervention from March 13, 2023, to September 4, 2024. CT measurements of skin-to-artery depth at a designated puncture site, based on the MANTA Instructions for Use 45-degree approach, were compared with intraprocedural MANTA Depth Locator measurements. The acceptable threshold for agreement was defined as ±2 cm to ensure safe in-vessel deployment.</p><p><strong>Results: </strong>Among 289 patients (mean age 78.2 years, 43.6% female), 91% of CT-derived measurements fell within the 2 cm threshold, demonstrating strong agreement. Logistic regression showed that a higher BMI reduced accuracy, with each unit increase in BMI decreasing the odds of meeting the threshold by 11% (OR 0.89; p < 0.001). For patients with BMI ≤ 30 kg/m² (n = 189), the agreement increased to 96%.</p><p><strong>Conclusions: </strong>CT angiography-derived measurements align well with MANTA Depth Locator measurements, although accuracy declines with increasing BMI. These findings support CT imaging as a reliable alternative to MANTA bailout in large-bore access procedures. A practical algorithm for MANTA bailout techniques is proposed to guide clinical practice.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510298","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":"Multivessel Spontaneous Coronary Artery Dissection or a Recanalized Thrombus-Reconsidering the Diagnosis!","authors":"Rajesh Vijayvergiya, Anirudh Mukherjee","doi":"10.1002/ccd.31728","DOIUrl":"https://doi.org/10.1002/ccd.31728","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":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500255","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 Impact of Target Vessel Diameter on the Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry.","authors":"Ozgur Selim Ser, Deniz Mutlu, Michaella Alexandrou, Pedro E P Carvalho, Dimitrios Strepkos, James W Choi, Paul Poommipanit, Khaldoon Alaswad, Mir Babar Basir, Rhian Davies, Farouc A Jaffer, Phil Dattilo, Anthony H Doing, Lorenzo Azzalini, Nazif Aygul, Raj H Chandwaney, Brian K Jefferson, Sevket Gorgulu, Cuneyt Kocas, Jaikirshan J Khatri, Laura D Young, Oleg Krestyaninov, Dmitrii Khelimski, Jarrod Frizzell, Omer Goktekin, James D Flaherty, Daniel R Schimmel, Keith H Benzuly, Mahmut Uluganyan, Ramazan Ozdemir, Yousif Ahmad, Sant Kumar, Bavana V Rangan, Olga C Mastrodemos, M Nicholas Burke, Jaskanwal Deep Singh Sara, Sandeep Jalli, Konstantinos Voudris, Yader Sandoval, Emmanouil S Brilakis","doi":"10.1002/ccd.31709","DOIUrl":"https://doi.org/10.1002/ccd.31709","url":null,"abstract":"<p><strong>Background: </strong>The impact of target vessel diameter on outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study.</p><p><strong>Aim: </strong>To compare the impact of target vessel diameter on CTO PCI outcomes.</p><p><strong>Methods: </strong>We examined the association of vessel diameter with clinical, angiographic characteristics, and procedural outcomes of CTO-PCI in a large multicenter registry. The CTO vessels were classified as small (≤ 2.75 mm), medium (2.76-3.00 mm), and large (> 3.00 mm) diameter.</p><p><strong>Results: </strong>Among 13,423 patients who underwent CTO-PCI at 47 centers between 2012 and 2024, the target CTO vessel was small in 4858 (36%), medium in 5393 (40%), and large in 3172 (24%). Compared with patients who had medium and large CTO target vessels, those who had small vessels were older and had a higher prevalence of diabetes, hypertension, dyslipidemia, and peripheral arterial disease. Large target vessel diameter CTOs had more complex angiographic characteristics such as higher J-CTO scores, longer lesion length, and more complex angiographic characteristics. Compared with CTO PCI of small and large vessel patients, medium vessel patients had higher technical (p = 0.008) and procedural (p = 0.010) success. The incidence of perforation was higher in large-diameter vessels. In multivariable logistic regression using restricted cubic spline analysis, a vessel diameter of 2.75-3.00 mm was associated with higher technical (OR 2.05 95% CI 1.12-3.76; p < 0.001) and procedural (OR 2.48 95% CI 1.49-4.13; p < 0.001) success compared with a vessel diameter of less than 2.75 or greater than 3.00 mm.</p><p><strong>Conclusions: </strong>Large and small CTO target vessels were associated with lower technical and procedural success compared with medium-sized vessels.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500256","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 Clinical Impact of Successful Vessel Preparation in Femoropopliteal Drug-Coated Balloon Angioplasty.","authors":"Yusuke Tomoi, Yoshimitsu Soga, Taichi Hirano, Kazuki Tsunoda, Kenji Ando","doi":"10.1002/ccd.31705","DOIUrl":"https://doi.org/10.1002/ccd.31705","url":null,"abstract":"<p><strong>Background: </strong>Although successful vessel preparation (VP) before drug-coated balloon (DCB) treatment has been found to improve primary patency, its long-term clinical impact remains uncertain.</p><p><strong>Aims: </strong>The present study sought to assess the long-term clinical efficacy of of of successful VP before DCB treatment for de novo femoropopliteal (FP) lesions in patients with symptomatic lower extremity artery disease.</p><p><strong>Methods: </strong>This retrospective study analyzed 268 patients (308 limbs) who underwent successful FP endovascular therapy (EVT) for symptomatic lower extremity artery disease between March 2018 and December 2019. Successful VP was defined as < 50% residual stenosis and a dissection grade below grade D before DCB treatment. The primary endpoint was limb salvage (LS) rate, whereas the secondary endpoints included overall survival rate, primary patency, and freedom from clinically driven target lesion revascularization (CD-TLR).</p><p><strong>Results: </strong>The median follow-up period was 4.4 (interquartile range, 1.6-5.4) years. At 5 years, the LS rate was significantly higher in the successful VP group than in the nonsuccessful VP group (94.4% vs. 87.9%, p = 0.03), but no significant difference in the overall survival rate was observed between both groups (65.6% vs. 68.7%, p = 0.82). At 5 years, the primary patency and freedom from CD-TLR were significantly higher in the successful VP group than in the nonsuccessful VP group (51.2% vs. 31.5%, p < 0.001; 65.0% vs. 51.6%, p = 0.01). Hemodialysis, chronic limb-threatening ischemia, heart failure, and successful VP before DCB treatment were identified as independent predictors of LS.</p><p><strong>Conclusions: </strong>Successful VP before DCB treatment was independently associated with LS by improving long-term patency in FP-EVT.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500254","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":"Blood Draws, Fluid Input, and Bleeding Events After Percutaneous Coronary Intervention.","authors":"Meghana Iyer, Ankur Kalra, Khaled Ziada, Jacqueline Tamis-Holland, Leslie Cho, Rishi Puri, Stephen G Ellis, Umesh N Khot, Amar Krishnaswamy, Samir Kapadia, Grant W Reed","doi":"10.1002/ccd.31712","DOIUrl":"https://doi.org/10.1002/ccd.31712","url":null,"abstract":"<p><strong>Background: </strong>The American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) CathPCI Registry reports bleeding events within 72-h of percutaneous coronary intervention (PCI) as a quality metric. It is plausible that NCDR post-PCI bleeding events may be influenced by markers of intensity of patient care not related to PCI quality. The relationship between iatrogenic phlebotomy, intravenous fluid input, and post-PCI bleeding events is unknown.</p><p><strong>Methods: </strong>This is a patient-level, observational study of 13,553 PCI procedures at a single center between 6/11/2009 and 6/14/2017. Multivariable logistic regression determined associations between NCDR bleeding events, total oral and intravenous fluid volume input, and number of lab tubes drawn on day of PCI up to 72-h post PCI. Improvement in discriminatory ability of adding these variables to a bleeding risk model was assessed with C-statistic.</p><p><strong>Results: </strong>There were 767 (5.7%) bleeding events. Every 100 mL input was independently associated with 2.0% increased odds of bleeding (odds ratio [OR] 1.01-1.03, p < 0.001). Every 3 mL lab tube drawn was independently associated with 8.1% increased odds (OR 1.07-1.09, p < 0.001). A multivariable model including baseline patient characteristics and PCI variables achieved good discriminatory ability (C-statistic 0.858), but with addition of input, number of lab draws, and length of stay (LOS) achieved an excellent discriminatory ability (C-statistic 0.927, p < 0.001 comparing C-statistics).</p><p><strong>Conclusions: </strong>Variables reflecting intensity of patient illness including frequency of lab draws and fluid intake within 72-h of PCI significantly improve the ability of models to predict NCDR post-PCI bleeding events. Consideration should be given to risk-adjusting for lab draws and fluid administration when nationally reporting bleeding event rates.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487663","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":"Management of Acurate Neo 2 Valve Protrusion Into the Left Ventricle.","authors":"Giorgio Quadri, Innocenzo Scrocca, Gianmarco Annibali, Giuseppe Musumeci","doi":"10.1002/ccd.31708","DOIUrl":"https://doi.org/10.1002/ccd.31708","url":null,"abstract":"<p><p>We report the case of an 81-year-old woman with severe aortic stenosis and moderate aortic regurgitation who underwent transcatheter aortic valve implantation (TAVR) with an Acurate Neo 2 valve. During the procedure, the valve protruded into the left ventricle, rendering simple retrieval impossible. A novel \"balloon-assisted\" technique was successfully employed to centralize and retract the valve into the ascending aorta, allowing for proper deployment without complications. This case highlights a unique complication and its innovative management strategy.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487665","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 Flow Dynamics After Left Atrial Appendage Occlusion With the Watchman FLX Versus Amulet Devices: Implications for Device-Related Thrombosis.","authors":"Ahmad Bshennaty, Brennan J Vogl, Ghasaq Saleh, Alessandra Maria Bavo, Agata Sularz, Karam Ghazal-Aswad, Anders Dahl Kramer, Yuheng Jia, Matthieu De Beule, Jens Erik Nielsen-Kudsk, Ole De Backer, Mohamad Alkhouli, Hoda Hatoum","doi":"10.1002/ccd.31710","DOIUrl":"https://doi.org/10.1002/ccd.31710","url":null,"abstract":"<p><strong>Background: </strong>This study aims to assess how Watchman FLX (Boston Scientific) and Amplatzer Amulet (Abbott) devices for left atrial appendage occlusion (LAAO) impact the flow dynamics in the LA and the risk of device-related thrombosis (DRT).</p><p><strong>Methods: </strong>Flow simulations were carried out for 12 AF patients before and after undergoing LAAO. Six patients had Watchman FLX while the other six had Amulet devices, of which three in each group had DRT. The flow parameters investigated included the LA velocities, pressure, time averaged wall shear stress (TAWSS), oscillatory shear index (OSI), and relative residence time (RRT). Low TAWSS and high OSI and RRT are generally associated with flow stasis and thrombosis.</p><p><strong>Results: </strong>LA flow dynamics differed significantly between the two groups. On average, after LAAO, the Amulet patients exhibited a 25% increase in TAWSS and 24% decrease in RRT while the Watchman FLX patients exhibited, on average, a 24% decrease in TAWSS and a 23% increase in RRT. Both populations experienced an increase in LA pressure (~10% for Amulet patients and 16% for Watchman FLX patients). Increased DRT volume seems to be correlated with low TAWSS and elevated RRT.</p><p><strong>Conclusion: </strong>This preliminary study suggests that the Amulet device might be associated with improved LA flow dynamics and a potentially lower incidence of DRT compared with the Watchman. However, a larger clinical study is needed to confirm 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":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487664","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":"Cardiovascular and Non-Cardiovascular Complications of Transcatheter Aortic Valve Implantation.","authors":"Antonio Padilla-Serrano, José Ignacio Galvañ Pozo, Encarnación Castillo Lorente, Antonio Cárdenas Cruz","doi":"10.1002/ccd.31702","DOIUrl":"10.1002/ccd.31702","url":null,"abstract":"<p><p>Degenerative aortic valve stenosis is becoming a more prevalent disease, and transcatheter aortic valve implantation (TAVI) offers a treatment option for patients who are at high surgical risk. This manuscript reviews cardiovascular and non-cardiovascular complications associated with TAVI. A search was conducted in PubMed, Scopus, and Web of Science using the terms \"transcatheter aortic valve implantation\" and each keyword referring to potential complications, with the Boolean operator \"AND\" used to allow us to obtain documents containing two or more keywords simultaneously. The most frequent cardiovascular complications were hemorrhage and vascular access-related complications (2.93%-24%), new-onset left bundle branch block (13.3%-37%), and myocardial injury (95%-100%). Among non-cardiovascular complications, stroke and subclinical brain injury occurred in 1.6%-5% of cases; acute kidney injury, in 11.7%; and delirium, in 17.8%-23.7%. Described mortality ranges from 1.1% to 4.2%. This narrative review provides a multidimensional perspective of TAVI complications by addressing both cardiovascular and non-cardiovascular complications. Non-cardiovascular complications, such as delirium, negatively influence 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":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144370055","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 Guide for Successful Transcatheter Tricuspid Valve Repair With the Triclip.","authors":"Craig Basman, Polydoros Kampkatsis, Sung-Han Yoon, Perry Wengrofsky, Jessica Willert, Ryan Kaple","doi":"10.1002/ccd.31693","DOIUrl":"https://doi.org/10.1002/ccd.31693","url":null,"abstract":"<p><p>The use of transcatheter edge-to-edge repair (t-TEER) for tricuspid regurgitation (TR) continues to grow due to its proven clinical results and high safety profile. Yet, because the tricuspid valve is a complex and heterogenous valve, the results of recent landmark t-TEER trials may be difficult to replicate in daily practice as the use of t-TEER expands. Hence, this review is design to review optimal steps and advanced maneuvers for the Triclip (Abbott, MN, Minneapolis), which is the first United States regulatory approved device for t-TEER.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478536","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":"Silent Danger: Coexistence of Late-Onset External Iliac Artery Pseudoaneurysm and Deep Vein Thrombosis.","authors":"Sefa Tatar, Oznur Keskin, Abdullah Enes Atas, Abdullah Icli","doi":"10.1002/ccd.31715","DOIUrl":"https://doi.org/10.1002/ccd.31715","url":null,"abstract":"<p><p>Pseudoaneurysm (PA) is a well-known vascular complication following percutaneous interventions, typically occurring in the early post-procedural period. However, delayed-onset PA associated with deep vein thrombosis (DVT) is an uncommon presentation. This case highlights a late external iliac artery (EIA) PA diagnosed in a patient who initially underwent coronary angiography. A 65-year-old male underwent a routine coronary angiography via the femoral artery and was discharged without complications. Twenty days later, he presented with unilateral lower limb swelling and pain. Doppler ultrasonography revealed extensive external iliac DVT, and contrast-enhanced computed tomography (CT) angiography confirmed a PA of the EIA. Endovascular stent graft placement was performed successfully. The patient was followed for 1 week, during which the limb swelling and pain resolved completely, and he was discharged without complications. This case underscores the importance of considering delayed PA formation in patients with unexplained limb swelling after arterial access procedures. Early diagnosis and intervention are crucial in preventing complications and ensuring favorable outcomes.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478540","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}