Eurointervention最新文献

{"title":"Outcomes of high-risk PCI assisted by VA-ECMO with local anaesthesia.","authors":"Alexander M Griffioen, Marleen H van Wely, Lokien X van Nunen, Stijn C H van den Oord, Herbert B van Wetten, Sytse F de Jong, Peter Damman, Niels van Royen, Robert Jan M van Geuns","doi":"10.4244/EIJ-D-24-00599","DOIUrl":"10.4244/EIJ-D-24-00599","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e376-e378"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal access and procedural anticoagulation to prevent radial artery occlusion after coronary angiography - the randomised RAPID trial.","authors":"Thomas Stiermaier, Matthias Grünewälder, Toni Pätz, Elias Rawish, Alexander Joost, Moritz Meusel, Christoph Marquetand, Thomas Kurz, Tobias Schmidt, Christian Frerker, Georg Fuernau, Ingo Eitel","doi":"10.4244/EIJ-D-24-00846","DOIUrl":"10.4244/EIJ-D-24-00846","url":null,"abstract":"<p><strong>Background: </strong>Distal transradial access (TRA) and procedural anticoagulation (AC) are among the strategies to prevent radial artery occlusion (RAO) that have some gaps in evidence.</p><p><strong>Aims: </strong>This study assessed the efficacy and safety of different radial access sites and procedural AC in patients undergoing coronary angiography (CAG).</p><p><strong>Methods: </strong>The RAPID trial is a single-centre, open-label, 2x2 factorial study that randomised patients to procedural AC versus no procedural AC and also to distal versus conventional TRA with further stratification according to pre-existing oral AC. Patients with indicated percutaneous coronary intervention (PCI) were excluded from the analysis. The primary endpoints were the incidence of RAO, assessed by vascular ultrasound, and bleeding events.</p><p><strong>Results: </strong>The trial was stopped early for efficacy by the data and safety monitoring board after the second preplanned interim analysis and inclusion of 600 participants. Excluding patients with indicated PCI, the final study population consisted of 439 patients. Distal TRA was associated with more access site crossovers (14.9% vs 8.3%; p=0.032) and a longer total procedure time (25 min vs 20 min; p=0.001) than conventional TRA. The rates of RAO (20.3% vs 21.2%; p=0.810) and bleeding events (4.1% vs 6.9%; p=0.188) were similar after distal and conventional TRA. In contrast, procedural AC reduced the incidence of RAO (7.3% vs 33.9%; p<0.001) without increasing bleeding risk (7.3% vs 3.6%; p=0.087). These results were consistent in patients on pre-existing oral AC and those with distal TRA.</p><p><strong>Conclusions: </strong>While distal TRA did not reduce the risk of RAO, procedural AC proved effective in all patients undergoing transradial CAG including those on pre-existing oral AC. (Strategies to Maintain Radial Artery Patency Following Diagnostic Coronary Angiography [RAPID] trial; ClinicalTrials.gov: NCT04301921 [RAPID-1] and NCT04362020 [RAPID-2]).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e366-e375"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous coronary intervention for calcified and resistant lesions.","authors":"Gabriele Pesarini, Farrel Hellig, Ashok Seth, Richard Alan Shlofmitz, Flavio Luciano Ribichini","doi":"10.4244/EIJ-D-24-00195","DOIUrl":"10.4244/EIJ-D-24-00195","url":null,"abstract":"<p><p>Relevant calcified coronary artery disease (CCAD) may be present in around 20% of patients undergoing percutaneous coronary interventions, and it is known to add procedural challenges and risks. Careful patient selection and specific expertise in multimodality imaging and plaque modification techniques are required to plan and adopt the most appropriate therapeutic strategy. This review aims to present the contemporary clinical approach and procedural planning for CCAD patients, describing the available tools and strategies in view of the most recent scientific evidence.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e339-e355"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary stent retriever-assisted thrombectomy.","authors":"Jason Leo Walsh, Rafail A Kotronias, Giovanni Luigi De Maria","doi":"10.4244/EIJ-D-24-00989","DOIUrl":"10.4244/EIJ-D-24-00989","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e379-e380"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining what is important to prevent radial artery occlusion.","authors":"Sunil V Rao, Louai Razzouk","doi":"10.4244/EIJ-E-25-00010","DOIUrl":"10.4244/EIJ-E-25-00010","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e337-e338"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracoronary brachytherapy: will it rise from the ashes?","authors":"Manel Sabaté","doi":"10.4244/EIJ-E-25-00007","DOIUrl":"10.4244/EIJ-E-25-00007","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e335-e336"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical outcomes of intravascular brachytherapy for multilayer drug-eluting in-stent restenosis.","authors":"Richard Tanner, Vishal Dhulipala, Udit Joshi, Manish Vinayak, Serdar Farhan, Pier Pasquale Leone, Samantha Sartori, Kenneth Smith, Michael Buckstein, Amit Hooda, Raman Sharma, Joseph M Sweeny, Roxana Mehran, Annapoorna S Kini, Samin K Sharma","doi":"10.4244/EIJ-D-24-00807","DOIUrl":"10.4244/EIJ-D-24-00807","url":null,"abstract":"<p><strong>Background: </strong>Multilayer in-stent restenosis (ISR) remains a clinical challenge. Intravascular brachytherapy (IVBT) offers a \"metal-free\" treatment modality for multilayer drug-eluting stent (DES)-ISR; however, long-term outcome data on IVBT safety and efficacy are lacking.</p><p><strong>Aims: </strong>We sought to compare 3-year clinical outcomes between patients treated with IVBT and those treated with a non-IVBT strategy.</p><p><strong>Methods: </strong>Patients treated for multilayer DES-ISR (≥2 layers) at Mount Sinai Hospital (2012-2019) were included for analysis. The primary outcome was major adverse cardiac events (MACE), a composite of all-cause death, target lesion revascularisation and myocardial infarction, at 3-year follow-up.</p><p><strong>Results: </strong>A total of 647 patients (mean age 66.6±9.9 years, 25.5% female) were included: 453 patients (70%) were treated with IVBT and 194 patients (30%) with a non-IVBT strategy. Baseline characteristics were similar, except for IVBT-treated patients having a higher incidence of prior coronary artery bypass grafting. The IVBT group had a lower mean SYNTAX score (11.9±10.7 vs 14.2±11.3; p=0.028) and were significantly less likely to receive a DES (0.4% vs 25.8%; p<0.001). At 3-year follow-up, the incidence of MACE was lower in the IVBT-treated group compared to the non-IVBT group (propensity score-adjusted analysis: 39.5% vs 47.8%; hazard ratio 0.73, 95% confidence interval: 0.53-0.99; p=0.044). There were no significant differences between the incidence of the individual components of MACE in each group.</p><p><strong>Conclusions: </strong>Multilayer DES-ISR is associated with a high rate of adverse outcomes at 3-year follow-up. Treatment with IVBT was associated with a lower rate of MACE compared to treatment with a non-IVBT strategy at long-term follow-up.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e356-e365"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular treatment of tandem lesions in a novel cadaveric stroke model.","authors":"Iris Q Grunwald, Lukasz Tekieli, Anna Podlasek, Helen Donald-Simpson, Stephanie Clark, Chloe Voutsas, Sanjay Pillai, Graeme Houston, Magdalena Knapik, Leah White, Pamela Barr, Andreas Melzer, Piotr Musialek","doi":"10.4244/EIJ-D-24-00248","DOIUrl":"10.4244/EIJ-D-24-00248","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 6","pages":"e329-e331"},"PeriodicalIF":7.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sirolimus-coated versus paclitaxel-coated balloons for bifurcated coronary lesions in the side branch: the SPACIOUS trial.","authors":"You Zhou, Yiqing Hu, Xin Zhao, Zhangwei Chen, Chenguang Li, Likun Ma, Zongjun Liu, Hao Zhou, Xiwen Zang, Xingwei Zhang, Gaoxing Zhang, Zhanqian Cui, Yin Liu, Suxia Han, Lianpin Wu, Haiming Shi, Jianjun Jiang, Juying Qian, Hao Lu, Junbo Ge","doi":"10.4244/EIJ-D-24-00742","DOIUrl":"10.4244/EIJ-D-24-00742","url":null,"abstract":"<p><strong>Background: </strong>The optimal strategy to treat coronary bifurcation lesions (CBL) has been a long-debated topic. The combination of a stent in the main vessel (MV) and a drug-coated balloon (DCB) in the side branch (SB) seems promising, but the evidence is limited.</p><p><strong>Aims: </strong>This study aims to investigate a novel sirolimus-coated balloon in the treatment of non-left main CBL compared with a paclitaxel-coated balloon.</p><p><strong>Methods: </strong>The SPACIOUS trial is a prospective, non-inferiority, multicentre trial. A total of 230 patients were randomised to the sirolimus DCB or the paclitaxel DCB group in a 1:1 ratio. Angiographic and clinical follow-ups were planned at 9 months and 1 year, respectively. The primary endpoint was diameter stenosis (DS) in the SB at 9 months.</p><p><strong>Results: </strong>At 9 months, DS in the sirolimus group was 30.5±16.1% compared with 33.5±16.2% in the paclitaxel group (difference -2.94%; 95% confidence interval: -7.62% to 1.74%; p for non-inferiority<0.01). The incidence of binary restenosis was significantly lower in the sirolimus group compared to the paclitaxel group (4.4% vs 12.8%; p=0.043). Secondary angiographic endpoints, including late lumen loss and net lumen gain, and 1-year clinical outcomes were not significantly different between groups.</p><p><strong>Conclusions: </strong>In de novo non-left main CBL treatment, MV stenting accompanied by SB dilation with the sirolimus DCB was non-inferior to the paclitaxel DCB.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 6","pages":"e307-e317"},"PeriodicalIF":7.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of individual COVADIS criteria in patients undergoing acetylcholine provocation testing.","authors":"Riccardo Rinaldi, Michele Russo, Ilaria Torre, Michele Colucci, Andrea Caffè, Vincenzo Scarica, Francesco Maria Animati, Matteo Manzato, Alice Bonanni, Jacopo Lenkowicz, Andrada Mihaela Tudor, Giovanna Liuzzo, Tommaso Sanna, Gaetano A Lanza, Antonio Maria Leone, Carlo Trani, Francesco Burzotta, Filippo Crea, Rocco A Montone","doi":"10.4244/EIJ-D-24-00832","DOIUrl":"10.4244/EIJ-D-24-00832","url":null,"abstract":"<p><strong>Background: </strong>The prognostic significance of the Coronary Vasomotor Disorders International Study Group (COVADIS) criteria during acetylcholine (ACh) provocation testing is uncertain.</p><p><strong>Aims: </strong>The aim of this study was to assess the prognostic impact of COVADIS criteria in patients with myocardial ischaemia (INOCA) or myocardial infarction (MINOCA) and non-obstructive coronary arteries undergoing ACh provocation testing.</p><p><strong>Methods: </strong>We enrolled consecutive INOCA and MINOCA patients undergoing ACh provocation testing. The occurrence of each COVADIS criterion was recorded. The primary outcome was the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) at follow-up.</p><p><strong>Results: </strong>Among 519 patients (346 [66.7%] INOCA and 173 [33.3%] MINOCA), 274 (52.8%) exhibited a positive ACh test. Over a median 22-month follow-up, the highest incidence of MACCE occurred in patients with 3 positive criteria (15.4%), followed by those with 2 (10.3%) and 1 (9.2%), while the lowest incidence occurred in patients with 0 (3.1%; p=0.004). Patients with ≥1 positive criteria had significantly higher MACCE rates than those with 0 (12.5% vs 3.1%; p=0.003). MACCE-free survival differed significantly among the four groups, with the best survival for 0 criteria and the worst for 3 (p=0.004). Epicardial coronary diameter reduction ≥90% and MINOCA were independent MACCE predictors. Among patients with a negative test, an epicardial coronary diameter reduction ≥90% was the only independent predictor of MACCE, and the presence of ≥1 criteria in this group was associated with a significantly higher MACCE rate compared to patients without any criteria.</p><p><strong>Conclusions: </strong>Our findings challenge the binary stratification (positive vs negative) of COVADIS criteria, suggesting an added value of a comprehensive analysis of their components to provide prognostic stratification and personalised treatment.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 6","pages":"e296-e306"},"PeriodicalIF":7.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11891921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}