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

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Long-Term Outcomes of Jetstream Atherectomy Combined With Ranger Drug-Coated Balloon in Calcified Femoropopliteal Lesions: A Three-Year Single-Center Experience. 射流动脉粥样硬化切除术联合Ranger药物包覆球囊治疗钙化股腘动脉病变的长期结果:一项为期三年的单中心研究。
Jérôme Brunet, Yann Gouëffic, Jean-Pascal Peyre, Gilles Bayet, Maxime Dubosq-Lebaz
{"title":"Long-Term Outcomes of Jetstream Atherectomy Combined With Ranger Drug-Coated Balloon in Calcified Femoropopliteal Lesions: A Three-Year Single-Center Experience.","authors":"Jérôme Brunet, Yann Gouëffic, Jean-Pascal Peyre, Gilles Bayet, Maxime Dubosq-Lebaz","doi":"10.1002/ccd.70204","DOIUrl":"https://doi.org/10.1002/ccd.70204","url":null,"abstract":"<p><strong>Background: </strong>Calcified femoropopliteal lesions remain a major challenge in peripheral endovascular interventions. Vessel preparation with atherectomy before drug-coated balloon (DCB) angioplasty has been proposed to improve long-term outcomes, but evidence remains limited.</p><p><strong>Aims: </strong>To evaluate the 3-year clinical outcomes of Jetstream atherectomy combined with Ranger DCB angioplasty in patients with calcified femoropoplite.</p><p><strong>Methods: </strong>This retrospective, single-center study included 50 patients (74% male, mean age 72.7 ± 9.8 years) treated between 2016 and 2020 for 63 femoropopliteal lesions. Lesions were classified as severely calcified in 56% of cases and TASC C-D in 54%. Jetstream atherectomy was performed before Ranger DCB angioplasty. The primary endpoint was primary patency at 36 months, defined as freedom from restenosis or target lesion revascularization (TLR). Secondary endpoints included freedom from TLR and target vessel revascularization (TVR), Rutherford category and ankle-brachial index (ABI) improvement, limb salvage, and all-cause mortality.</p><p><strong>Results: </strong>TThe mean lesion length was 122.8 ± 78.9 mm. Bailout stenting was required in 6.3% of cases. Primary patency was 91.7% at 12 months and 69.2% at 36 months. Freedom from TLR was 98.4% at 12 months and 92.0% at 36 months. TVR freedom at 36 months was 82.0%. Rutherford improvement was observed in 92.0% of patients at 1 month and sustained in 84.0% at 36 months. ABI ≥ 0.9 was achieved in 69.4% at 1 month and 68.6% at 36 months. No major amputations or cardiovascular deaths occurred during follow-up.</p><p><strong>Conclusion: </strong>Jetstream atherectomy combined with Ranger DCB angioplasty provided sustained long-term patency, low reintervention rates, and durable clinical benefit in patients with calcified femoropopliteal lesions. Further prospective trials are needed to validate these findings.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133412","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}
引用次数: 0
Complete Revascularization Versus Culprit-Only PCI in Acute Coronary Syndrome and Multivessel Coronary Artery Disease: An Updated Systematic Review and Meta-Analysis of 10,150 Subjects From 11 Randomized Studies. 急性冠状动脉综合征和多支冠状动脉疾病的完全血运重建术与单纯罪魁祸首PCI:来自11项随机研究的10,150名受试者的最新系统综述和荟萃分析
Dario Calderone, Giuseppe Verolino, Alessandro Cianca, Giuseppe Migliario, Davide Sala, Paolo Ghiso Basile, Roberto Adriano Latini, Paolo Sganzerla, Gianfranco Parati
{"title":"Complete Revascularization Versus Culprit-Only PCI in Acute Coronary Syndrome and Multivessel Coronary Artery Disease: An Updated Systematic Review and Meta-Analysis of 10,150 Subjects From 11 Randomized Studies.","authors":"Dario Calderone, Giuseppe Verolino, Alessandro Cianca, Giuseppe Migliario, Davide Sala, Paolo Ghiso Basile, Roberto Adriano Latini, Paolo Sganzerla, Gianfranco Parati","doi":"10.1002/ccd.70185","DOIUrl":"https://doi.org/10.1002/ccd.70185","url":null,"abstract":"<p><strong>Background: </strong>Approximately half of individuals with acute coronary syndrome (ACS) are affected by multivessel coronary artery disease (CAD), and recent studies in the field have presented conflicting data on effective benefit of complete revascularization. The aim of this study was to investigate the efficacy and safety of multivessel percutaneous coronary intervention (PCI) versus culprit-only PCI in individuals presenting with acute coronary syndrome and multivessel CAD.</p><p><strong>Methods and results: </strong>Randomized trials on ACS comparing multivessel PCI versus culprit-only PCI were included. The primary efficacy outcome was all-cause death. The primary safety outcomes were major bleeding and contrast induced nephropathy. Secondary ischemic and safety outcomes were also investigated. Subgroup analyses were conducted to investigate the consistency of the effect sizes as a function of age (younger vs older individuals, using a cut-off of 65 years) and of a higher or lower prevalence of diabetic patients (using a cut-off of 20% for each study). A total of 11 randomized trials including 10,150 individuals with a mean follow-up of 21.7 months were included. Compared with cluprit-only PCI, multivessel PCI significantly reduced the risk of all-cause death (risk ratio 0.86, [0.74-1.00], p = 0.047), mainly due to a significant reduction in cardiovascular mortality by 26%. Similarly, the rates of new myocardial infarction and unplanned revascularization were significantly reduced. No increases in major bleeding, contrast induced nephropathy or stroke were observed, with a significantly higher rate of stent thrombosis in complete revascularization group, even if with a low absolute risk (risk ratio 1.69 [1.10, 2.59], p = 0.027). Subgroup analyses revealed a significant interaction for death in studies with higher prevalence of diabetics (p for interaction = 0.029), but no interaction for death with regards of age.</p><p><strong>Conclusion: </strong>In individuals presenting with ACS and multivessel CAD, complete revascularization was associated with a significant reduction in all-cause mortality, with a lower rate of major ischemic events and no significant increase in major complications. The benefit was particularly evident in diabetic patients.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088799","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}
引用次数: 0
Outcomes for Patients Undergoing Revascularization for Multivessel Acute Coronary Syndrome at High-Volume and Non-High-Volume Hospitals. 在大容量和非大容量医院接受多血管急性冠状动脉综合征患者血运重建术的结果
Jacob Powel, Kendall Hammonds, Jose E Exaire, Timothy A Mixon, Christopher D Chiles, Molly I Szerlip, Srini Potluri, Javed Butler, J Michael DiMaio, R Jay Widmer
{"title":"Outcomes for Patients Undergoing Revascularization for Multivessel Acute Coronary Syndrome at High-Volume and Non-High-Volume Hospitals.","authors":"Jacob Powel, Kendall Hammonds, Jose E Exaire, Timothy A Mixon, Christopher D Chiles, Molly I Szerlip, Srini Potluri, Javed Butler, J Michael DiMaio, R Jay Widmer","doi":"10.1002/ccd.70184","DOIUrl":"https://doi.org/10.1002/ccd.70184","url":null,"abstract":"<p><strong>Objective: </strong>To investigate outcomes in high-volume hospitals (HVH) versus non-HVH (NHVH), regardless of revascularization strategy.</p><p><strong>Patients and methods: </strong>This is a sub-analysis of a multi-centered, retrospective, observational study assessing outcomes in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in HVH versus NHVH hospitals. The primary endpoint was 1-year mortality, and secondary endpoints were death, MI, and stroke or transient ischemic attack (TIA) during admission, at 30 days, and at 1 year, 1-year readmission, and index length of stay.</p><p><strong>Results: </strong>Seven hundred thirty-eight patients from NHVHs and 1116 patients from HVHs were included in this study. Baseline demographics showed a higher proportion of males in the NHVH versus HVH group (73% vs. 67%) and a lower proportion of CABG (9% vs. 20%). The primary endpoint (death) was similar comparing NHVH to HVH hospitals (HR = 0.98 [95% CI 0.75-1.27], p = 0.85) as was MI (HR = 0.87 [95% CI 0.52-1.44] p = 0.58) and stroke or TIA (HR 1.28 [95% CI 0.18-6.98], p = 0.90). Readmission rates were numerically lower but not statistically significant between NHVH centers (HR = 0.85 [95% CI 0.69-1.04] p = 0.11), as was the median length of stay (3 days vs. 5 days, p < 0.001).</p><p><strong>Conclusion: </strong>Patients with ACS found to have multivessel disease had similar 1-year mortality and repeat ACS whether they received care at an HVH or an NHVH. Yet, HVH patients had increased readmission rates, perhaps underscoring their complexity and comorbidities. This study demonstrates that certain patient populations without serious comorbidities may be managed at NHVH hospitals.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088853","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}
引用次数: 0
A Novel Classification Proposal for Iatrogenic Arteriovenous Fistulas and Pseudoaneurysms After Transfemoral Cardiovascular Interventions-An Analysis of a Single-Center Database of 5941 Punctures. 经股动脉心血管介入后医源性动静脉瘘和假性动脉瘤的新分类建议——对5941例穿刺单中心数据库的分析。
Jacek Kurzawski, Łukasz Zandecki, Marianna Janion, Łukasz Turek, Agnieszka Walczyk, Aleksandra Kwapiszewska-Szybalska, Agata Kundera-Mądro, Magdalena Chrapek, Edyta Barańska, Marcin Sadowski
{"title":"A Novel Classification Proposal for Iatrogenic Arteriovenous Fistulas and Pseudoaneurysms After Transfemoral Cardiovascular Interventions-An Analysis of a Single-Center Database of 5941 Punctures.","authors":"Jacek Kurzawski, Łukasz Zandecki, Marianna Janion, Łukasz Turek, Agnieszka Walczyk, Aleksandra Kwapiszewska-Szybalska, Agata Kundera-Mądro, Magdalena Chrapek, Edyta Barańska, Marcin Sadowski","doi":"10.1002/ccd.70195","DOIUrl":"https://doi.org/10.1002/ccd.70195","url":null,"abstract":"<p><strong>Background: </strong>Pseudoaneurysms (psA) and arteriovenous fistulas (AVF) may complicate transfemoral cardiovascular interventions. This study aimed to determine their incidence, propose a morphological classification system, and evaluate associations with procedures and treatment options.</p><p><strong>Methods: </strong>A prospective single-center study was conducted from 2012 to 2024 including 5941 femoral vessel cannulations in 4700 patients screened using Doppler ultrasound for post-intervention complications. PsA and AVF were categorized into morphological types, and their frequencies and associations with different medical interventions were analyzed.</p><p><strong>Results: </strong>A total of 280 vascular complications (4.78%) were identified: 146 (2.5%) isolated psA, 109 (1.8%) isolated AVF, and 25 (0.4%) combined psA and AVF. A detailed analysis defined two morphological variants: Type I, without measurable communicating channel between the sac and the artery (psA), or the artery and the vein (AVF), and Type II, defined by its presence. A rare variant, Type III AVF, featured a sac-like dilation along the fistulous channel. AVF types were further subtyped as A (isolated AVF) or B (coexisting with psA). There was no significant difference in the occurrence of morphological Type I psA compared to Type II (p = 0.146), while Type I AVF was more frequent than Type II (p < 0.001). Electrophysiological interventions resulted in fewer psA (p < 0.001) and AVF (p = 0.001) than coronary interventions. There was no significant relationship between the morphological variants and procedure category (p = 0.08). Right-sided cannulations were associated with higher risks of psA (p < 0.001) and AVF (p = 0.034).</p><p><strong>Conclusion: </strong>This study introduces a novel classification system for psA and AVF, supporting standardized reporting and treatment planning.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088834","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}
引用次数: 0
Improving CTEPH Detection: The Role of Expertise, Comorbidities, and Structured Follow-Up. 改进CTEPH检测:专业知识、合并症和结构化随访的作用。
Gialuca Pagnoni, Aurora Vicenzi, Francesca Coppi
{"title":"Improving CTEPH Detection: The Role of Expertise, Comorbidities, and Structured Follow-Up.","authors":"Gialuca Pagnoni, Aurora Vicenzi, Francesca Coppi","doi":"10.1002/ccd.70194","DOIUrl":"https://doi.org/10.1002/ccd.70194","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":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088818","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}
引用次数: 0
The NavigIIster: Transcatheter Aortic Valve Implantation With the Navitor Platform in Bicuspid Anatomy. 导航器:经导管主动脉瓣植入与导航平台在双尖解剖。
Omar A Oliva, Enrico Criscione, Matteo Casenghi, Davorka Lulic, Andrea Zuffi, Federico De Marco, Emanuele Barbato, Luca Testa, Francesco Bedogni, Ole De Backer, Nicolas Dumonteil, Didier Tchétché, Chiara De Biase
{"title":"The NavigIIster: Transcatheter Aortic Valve Implantation With the Navitor Platform in Bicuspid Anatomy.","authors":"Omar A Oliva, Enrico Criscione, Matteo Casenghi, Davorka Lulic, Andrea Zuffi, Federico De Marco, Emanuele Barbato, Luca Testa, Francesco Bedogni, Ole De Backer, Nicolas Dumonteil, Didier Tchétché, Chiara De Biase","doi":"10.1002/ccd.70186","DOIUrl":"https://doi.org/10.1002/ccd.70186","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve implantation (TAVI) for the treatment of bicuspid aortic valve (BAV) is still debated. Although several registries reported favorable outcomes with various transcatheter heart valves (THV) in BAV, there is no published data on the Navitor platform.</p><p><strong>Aims: </strong>To provide preliminary data on the efficacy and the safety of the Navitor valve in BAV.</p><p><strong>Methods: </strong>We retrospectively included patients who underwent TAVI using the Navitor valve (Abbott, Minneapolis, Minnesota, USA) for severe aortic stenosis in BAV anatomies, from October 2021 until August 2024. Patients were enrolled at six high TAVI volume centers. The endpoints were procedural device success and early safety, according to the VARC-3 criteria.</p><p><strong>Results: </strong>A total of 47 patients were included in this registry. The mean age was 83.7 ± 7.9, and 66% of the patients were women. Bicuspid type 1 L-R fusion (72.3%) was the dominant anatomical subtype. A high device success rate was achieved: 91.5% in-hospital and 91.1% at 30-day follow-up, while early safety was 70.2% in-hospital and 66.7% at 30 days. No 30-day prosthesis-patient mismatch (PPM) and no ≥moderate paravalvular regurgitation (PVR) were observed at 30 days; meanwhile, rates of permanent pacemaker implantation (PPI) were not negligible (23.4% in-hospital and 26.7% at 30-day follow-up).</p><p><strong>Conclusions: </strong>The Navitor THV appears to be a safe and effective treatment option for patients with severe bicuspid aortic stenosis. Larger registries and comparison with different platforms are required to validate these 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":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083129","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}
引用次数: 0
One-Year Outcomes of Short-Term Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention With Drug-Eluting Stents: A Meta-Analysis of Randomized Clinical Trials. 药物洗脱支架经皮冠状动脉介入治疗后短期双重抗血小板治疗的一年结果:随机临床试验的荟萃分析。
Thomas Fretz, Srikiran Dasari, John Sakaleros, Abdul Mueez Alam Kayani, Nathaniel Bluckner, Kristina Pond, Nathan Markus, Alejandra Cardona-Perez, Alan Garcia, Ricky Lemus-Zamora, Jeffrey Breall
{"title":"One-Year Outcomes of Short-Term Dual Antiplatelet Therapy Following Percutaneous Coronary Intervention With Drug-Eluting Stents: A Meta-Analysis of Randomized Clinical Trials.","authors":"Thomas Fretz, Srikiran Dasari, John Sakaleros, Abdul Mueez Alam Kayani, Nathaniel Bluckner, Kristina Pond, Nathan Markus, Alejandra Cardona-Perez, Alan Garcia, Ricky Lemus-Zamora, Jeffrey Breall","doi":"10.1002/ccd.70163","DOIUrl":"https://doi.org/10.1002/ccd.70163","url":null,"abstract":"<p><p>Dual antiplatelet therapy (DAPT) is recommended after percutaneous coronary intervention (PCI), though the optimal duration is unclear. DAPT reduces stent thrombosis, repeat myocardial infarction, and cardiovascular death, though at the cost of increased bleeding events. Currently, both European and American guidelines recommend a 6-month duration of DAPT following PCI with drug-eluting stents (DES) for stable coronary disease and a 12-month regimen following PCI for acute coronary syndrome. Recent randomized clinical trials (RCTs) suggest a shorter duration of DAPT may be acceptable. PubMed, EMBASE, and Cochrane databases were queried from inception to June 2025 to identify RCTs comparing short ( ≤ 3 months) with traditional durations of DAPT following PCI with DES and reporting outcomes of interest at 1 year, including major adverse cardiovascular and cerebrovascular events (MACCE) and net adverse clinical events (NACE). Individual endpoints including mortality, cardiovascular mortality, myocardial infarction, stroke, stent thrombosis, significant bleeding, and target vessel revascularization were analyzed. Effect estimates were pooled using a random-effects model and reported as risk ratios (RR) for dichotomous outcomes with 95% confidence intervals. Thirteen studies met the inclusion criteria, reporting results on 53,421 patients, of whom 26,712 patients were in the short DAPT cohort and 26,719 in the traditional DAPT cohort. Duration of DAPT ranged from 1 to 3 months. Ten studies used P2Y12 inhibitors as the single antiplatelet agent following DAPT, whereas three studies used aspirin. Patients were 76.0% male, mean age 64.0 years, and 64.9% with ACS on presentation. Shorter duration of DAPT significantly decreased NACE (RR: 0.80; [0.71, 0.91], p < 0.001) without impacting MACE (RR: 0.98; [0.89, 1.07], p = 0.64) at 1 year following PCI with DES. A 3-month duration of DAPT demonstrated favorable results over shorter durations, and monotherapy with a high-potency P2Y12 inhibitor was preferable over aspirin or a low-potency P2Y12 inhibitor. In patients who underwent a PCI with DES placement, a 3-month duration of DAPT decreased NACE without impacting other MACCE compared to guideline-directed DAPT durations.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083173","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}
引用次数: 0
"Less Metal" in a Complex Left Main Trifurcation Lesion. 复杂左主干三分叉病变的“少金属”。
Georgios Zormpas, Aristi Boulmpou, Christodoulos E Papadopoulos, Vassilios Vassilikos
{"title":"\"Less Metal\" in a Complex Left Main Trifurcation Lesion.","authors":"Georgios Zormpas, Aristi Boulmpou, Christodoulos E Papadopoulos, Vassilios Vassilikos","doi":"10.1002/ccd.70205","DOIUrl":"https://doi.org/10.1002/ccd.70205","url":null,"abstract":"<p><p>Management of complex left main (LM) coronary artery trifurcation lesions remains a significant challenge. Herein, we report a case where a provisional stenting strategy was employed in a patient with distal LM trifurcation lesion involving left anterior descending artery (LAD), left circumflex artery (LCx) and ramus intermedius (RI). A single drug-eluting stent (DES) was deployed from the LM into the LAD, while the LCx managed with a drug-coated balloon (DCB) and RI conservatively as already had a previous ostial stent. Intravascular ultrasound (IVUS) was utilized throughout the procedure to assess coronary anatomy, lesion morphology and guiding stent sizing and placement. Post-procedural IVUS imaging demonstrated good stent deployment without malapposition, edge dissection, or residual disease. This case underscores the feasibility and safety of a hybrid approach incorporating provisional stenting and DCB therapy in selected LM trifurcation lesions, with IVUS guidance playing a critical role in procedural success.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083152","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}
引用次数: 0
Interventional Cardiovascular Magnetic Resonance in Children Undergoing Pre-Operative Fontan Evaluation: One-Stop Shop. 介入心血管磁共振在儿童术前Fontan评估中的应用:一站式服务。
Pezad Doctor, Yousef Arar, Roby Sebastian, Gerald Greil, Tarique Hussain, Surendranath Veeram Reddy
{"title":"Interventional Cardiovascular Magnetic Resonance in Children Undergoing Pre-Operative Fontan Evaluation: One-Stop Shop.","authors":"Pezad Doctor, Yousef Arar, Roby Sebastian, Gerald Greil, Tarique Hussain, Surendranath Veeram Reddy","doi":"10.1002/ccd.70167","DOIUrl":"https://doi.org/10.1002/ccd.70167","url":null,"abstract":"<p><strong>Background: </strong>Interventional cardiovascular magnetic resonance (iCMR) provides cardiovascular magnetic resonance (CMR) and cath-derived hemodynamic assessment under the same anesthesia. In this study, we describe the role of iCMR in children with single-ventricle lesions before Fontan palliation.</p><p><strong>Methods: </strong>iCMR-guided right and left heart catheterization were performed using balanced steady-state free precession (bSSFP) or T1 overlay sequences to visualize the gadolinium-filled balloon-tipped catheter in the Phillips Ingenia 1.5 T system scanner. iCMR procedure was defined as successful if all predefined MRI imaging and catheter-based goals were met within the CMR scanner.</p><p><strong>Results: </strong>iCMR pre-Fontan evaluations were successfully performed in 56 patients between August 2017 to August 2022. 54 (96%) completed the study without complications. Of the 54, 11 (20%) completed the study in the MRI suite with no radiation exposure. The remaining 43 (80%) were transferred to the cardiac catheterization laboratory, mostly for fluoroscopy-guided catheter-based interventions (n = 37 [69%]). Additionally, we performed T2-weighted lymphatic evaluation in 54 (100%), MRI liver elastography in 16 (30%), selective pulmonary gadolinium angiogram in 20 (37%), and pressure-volume loop analysis in 3 (6%) as relevant. During the same period, 68 pre-Fontan evaluations were performed via the traditional \"combined approach\" wherein children had an CMR study followed by fluoroscopy-guided cardiac catheterization under the same anesthesia. Higher radiation dose was noted in these children via the \"combined approach\" versus those iCMR studies that required fluoroscopy after iCMR, despite similar rates of cardiac interventions between the two groups.</p><p><strong>Conclusion: </strong>In children undergoing pre-Fontan evaluation, iCMR is a safe and feasible method for comprehensive cardiovascular assessment under single anesthesia with reduced/no radiation exposure, fewer anesthetic inductions, and minimal procedure-related complications.</p>","PeriodicalId":520583,"journal":{"name":"Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083145","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}
引用次数: 0
Methodological Considerations in Assessing Coronary Flow Reserve After Percutaneous Coronary Intervention. 评估经皮冠状动脉介入治疗后冠状动脉血流储备的方法学考虑。
Maheen Rizwan
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