Eurointervention最新文献

{"title":"Impact of prolonged balloon inflation on valve expansion and early clinical outcomes following contemporary balloon-expandable transcatheter aortic valve implantation.","authors":"Francesco Cardaioli, Luca Nai Fovino, Tommaso Fabris, Giulia Masiero, Andrea Panza, Massimo Napodano, Chiara Fraccaro, Francesco Putortì, Giuseppe Tarantini","doi":"10.4244/EIJ-D-26-00494","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00494","url":null,"abstract":"<p><strong>Background: </strong>Incomplete expansion of balloon-expandable (BE) transcatheter heart valves (THVs) after transcatheter aortic valve implantation (TAVI) may affect valve performance and durability. Routine THV post-dilatation (the \"double-tap\" technique) has been proposed to optimise device expansion; however, it may increase procedural complexity.</p><p><strong>Aims: </strong>We sought to evaluate the impact of a prolonged balloon inflation implantation strategy on BE THV expansion, haemodynamic performance, and early clinical outcomes.</p><p><strong>Methods: </strong>This single-centre study analysed consecutive TAVI patients treated for native tricuspid aortic stenosis with the SAPIEN 3 Ultra RESILIA THV using a prolonged balloon inflation strategy (8 seconds). Valve expansion was assessed by fluoroscopy at multiple frame levels and compared with three validated reference standards. Results were also descriptively compared with previously published data on the double-tap technique. Clinical and haemodynamic outcomes at 30 days were adjudicated according to Valve Academic Research Consortium 3 criteria.</p><p><strong>Results: </strong>A total of 84 patients (mean age 78.8 years, 58% male, median Society of Thoracic Surgeons Predicted Risk of Mortality score 3.9%) were included. Prolonged inflation resulted in complete THV expansion at the inflow and outflow levels, with only mild underexpansion (98.5±1.3%) detected at the midframe level when manufacturer-defined nominal values were used as the reference. When compared with previously published data on the double-tap technique, expansion values for the 23, 26, and 29 mm valves were consistently similar or higher, whereas lower expansion was observed for the 20 mm size. Device success was achieved in all cases, with no stroke at 30 days. Permanent pacemaker implantation occurred in 6% of patients. Haemodynamic performance was favourable (mean gradient 9.2 [interquartile range 7.0-10.3] mmHg at 30 days), with no patients having moderate or severe paravalvular leak.</p><p><strong>Conclusions: </strong>Prolonged balloon inflation during BE THV deployment is associated with favourable valve expansion, haemodynamic results, and a favourable safety profile, consistent with values reported in double-tap series. If confirmed in larger studies, this strategy may represent a simple alternative to routine double-tap in selected patients.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous coronary intervention using sirolimus-eluting balloons in patients at high bleeding risk: the SELUTION DeNovo HBR substudy.","authors":"Tuomas T Rissanen, Simon Eccleshall, Florian Krackhardt, Kris Bogaerts, Tanios Akiki, Carlo Briguori, Guillaume Cayla, Nick Cruden, Alexander W den Hartog, Philippe Garot, Jonas Häner, Juan F Iglesias, Victor Jiménez, Thomas W Johnson, Christoph Langer, Ludovic Meunier, Pierre Poustis, Karim Ratib, Manel Sabaté, Gioel Secco, Gabor G Toth, Stuart Watkins, Marcus Wiemer, Joanna Wykrzykowska, Christian Spaulding, Philip Urban, On Behalf Of The Selution DeNovo Investigators","doi":"10.4244/EIJ-D-26-00889","DOIUrl":"10.4244/EIJ-D-26-00889","url":null,"abstract":"<p><strong>Background: </strong>Drug-eluting stents (DES) are the current mainstay of percutaneous coronary intervention (PCI) in high bleeding risk (HBR) patients. However, drug-coated balloons may be an alternative that reduces reliance on prolonged courses of antiplatelet therapy.</p><p><strong>Aims: </strong>The SELUTION DeNovo trial randomised 3,323 PCI candidates 1:1 to treatment with either sirolimus-eluting balloons (SEBs) and provisional stenting or systematic DES implantation. We report on a prespecified subgroup of HBR patients.</p><p><strong>Methods: </strong>A total of 522 enrolled patients met the Academic Research Consortium-HBR criteria. At 1 year, we assessed target vessel failure (TVF; a composite of cardiac death, target vessel myocardial infarction and clinically driven target vessel revascularisation), major bleeding (Bleeding Academic Research Consortium [BARC] 3-5) and net adverse clinical events (NACE; a composite of TVF and BARC 3-5 bleeding). Antithrombotic treatment was prescribed according to current guidelines and local practice.</p><p><strong>Results: </strong>Altogether, 269 and 253 patients were identified as HBR in the SEB strategy and DES strategy arms, respectively. In the SEB arm, 17.1% of patients had bailout stenting. Overall, 67% of patients were discharged on oral anticoagulants. At 1 year, TVF occurred in 4.9% of the SEB arm vs 7.9% of the DES arm (absolute risk difference [RD] -3.05%, 95% confidence interval [CI]: -7.27 to 1.17). BARC 3-5 bleeding occurred in 2.3% vs 3.2% (absolute RD -0.91%, 95% CI: -3.71 to 1.89) and NACE in 6.8% vs 10.7% (absolute RD -3.94%, 95% CI: -8.80 to 0.92) in the SEB and DES arms, respectively. While the proportion of patients on dual antiplatelet therapy and single antiplatelet therapy did not differ significantly between the two groups during follow-up, all antiplatelet medication was stopped in 7.7% vs 2.5% at 30 days (p=0.005) and in 27.8% vs 14.9% of patients at 6 months (p<0.001) in the SEB and DES arms, respectively.</p><p><strong>Conclusions: </strong>Although this subset analysis is not powered for definitive conclusions, our data suggest that an SEB strategy with minimal stenting appears to be a safe and effective alternative to systematic DES implantation for HBR patients.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1025-e1035"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118424","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":"Beyond the visual estimate: standardising device success after PCI.","authors":"Donald E Cutlip, Joseph M Kim","doi":"10.4244/EIJ-D-26-01050","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-01050","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1023-e1024"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118499","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":"Cardiogenic shock with multivessel disease: should we leave non-culprit lesions unattended?","authors":"Manel Sabaté, Marta Sabaté-Tormos","doi":"10.4244/EIJ-D-26-01084","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-01084","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1021-e1022"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118444","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":"Drug-coated balloons in high bleeding risk PCI: can we safely drop the scaffold?","authors":"Chao Gao, Xingqiang He","doi":"10.4244/EIJ-D-26-01027","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-01027","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1019-e1020"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118449","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":"Reply: How firmly can single-vessel physiology anchor endotypeguided therapy in angina with non-obstructive coronary arteries?","authors":"Jacopo Farina, Gianluca Campo","doi":"10.4244/EIJ-D-26-00970","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00970","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1072-e1073"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118419","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":"Longitudinal progression of coronary calcium density on serial computed tomography.","authors":"Lionel Chong, Doosup Shin, Adil Ansari, Christian Calistro, Roosha Parikh, Richard A Shlofmitz, Allen Jeremias, Evan Shlofmitz, Jonathan Weber, Omar K Khalique, Ziad A Ali","doi":"10.4244/EIJ-D-26-00382","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00382","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1064-e1066"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118466","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":"Remodelling of distal coronary vessels in chronic total occlusions.","authors":"Alexander M Griffioen, Jonathan Los, Marleen H van Wely, Lokien X van Nunen, Stijn C H van den Oord, Mohamed M Reda, Kensuke Nishimiya, Poornima Mohan, Guus A de Waard, Peter Damman, Niels van Royen, Robert-Jan M van Geuns","doi":"10.4244/EIJ-D-26-00326","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00326","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1067-e1069"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118451","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":"Standardised versus visual assessment of device success after percutaneous coronary intervention.","authors":"Asahi Oshima, Pruthvi C Revaiah, Nozomu Kanehama, Adrian Wlodarczak, Helge Möllmann, Raul Moreno, Milosz Dziarmaga, Manel Sabaté, Jacek Legutko, Marc Silvestri, Julien Lemoine, Anirban Choudhury, Hüseyin Ince, Alper Öner, Faisal Sharif, Simone Biscaglia, Janusz Kochman, Joanna Wykrzykowska, Maciej Lesiak, Ignacio J Amat-Santos, Abhishek Kumar, Nicolas Meneveau, Martin Landt, Michael Magro, Azfar Zaman, Murugapathy Veerasamy, Giuseppe Tarantini, Bruno Farah, Peter O'kane, Bruno Garcia Del Blanco, Joan Antoni Gomez-Hospital, Robert Jozwa, Thomas Schmitz, Richard Anderson, Stephan Achenbach, Angela Hoye, Andrew McNeice, Alexander Lauten, Eric Van Belle, Stanislaw Bartus, Piotr Wacinski, Sen Devadathan, Adrian Bednarek, Szymon Wlodarczak, Aishwarya Gurav, Jacopo Farina, Gonçalo Ferraz-Costa, Jerzy Paluszkiewicz, Kotaro Miyashita, Akihiro Tobe, Albert Chinhenzva, Scot Garg, Sofia Sunny, Gráinne Ní Bheoláin, Emma Harte, Tsung-Ying Tsai, Yoshinobu Onuma, Patrick W Serruys","doi":"10.4244/EIJ-D-26-00413","DOIUrl":"10.4244/EIJ-D-26-00413","url":null,"abstract":"<p><strong>Background: </strong>The European Association of Percutaneous Cardiovascular Interventions (EAPCI)-endorsed algorithm for defining device success has not yet been prospectively tested against standardised quantitative coronary angiography (QCA) by a core lab.</p><p><strong>Aims: </strong>We sought to assess whether visually evaluated device success by the operator at the end of percutaneous coronary intervention (PCI) aligns with the EAPCI-endorsed standardised definition adjudicated by the core lab and to evaluate its association with clinical outcomes.</p><p><strong>Methods: </strong>This prespecified analysis of the Multivessel TALENT trial included 1,548 patients with three-vessel disease randomised to treatment with either Supraflex Cruz or SYNERGY stents. PCI was attempted in 4,052 lesions. The core lab assessed post-PCI residual in-stent percentage diameter stenosis (%DS) by QCA (target <20%) and exploratory delta (Δ) angiography-derived fractional flow reserve (angio-FFR) across the stent(s) (target <0.05). Device success was evaluated using the site-reported data (visual evaluation of in-stent %DS), core lab QCA, core lab angio-FFR, and combined core lab QCA+angio-FFR. The lesion-oriented composite endpoint (LOCE; comprising cardiovascular death, target vessel myocardial infarction, or target lesion revascularisation) was assessed at 1 year.</p><p><strong>Results: </strong>Site-reported device success was 97.4%. Core lab definitions yielded lower rates: 93.8% for Δangio-FFR <0.05, 88.0% for residual %DS <20%, and 83.2% for QCA+angio-FFR (all p<0.001 vs site report after Bonferroni correction). Lesions not meeting QCA-based device success had a higher incidence of LOCE than those meeting the definition (12.0% vs 9.1%; log-rank p=0.041). Device success and LOCE rates did not differ between the two stents for any definition.</p><p><strong>Conclusions: </strong>In this prespecified lesion-level substudy, standardised assessment using the EAPCI device success algorithm with core lab QCA reclassified a substantial proportion of operator-adjudicated successes and identified lesions at higher 1-year LOCE risk. (ClinicalTrials.gov: NCT04390672).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1048-e1063"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118507","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":"Complexity of coronary artery disease in infarct-related cardiogenic shock and multivessel disease: a substudy of the DanGer Shock trial.","authors":"Jasmine M Marquard, Rasmus P Beske, Christian Hassager, Lisette O Jensen, Hans Eiskjær, Norman Mangner, Amin Polzin, P Christian Schulze, Carsten Skurk, Peter Nordbeck, Vasileios Panoulas, Sebastian Zimmer, Andreas Schäfer, Nikos Werner, Lene Holmvang, Jacob T Lønborg, Nanna L J Udesen, Henrik Schmidt, Anders Junker, Christian J Terkelsen, Axel Linke, Saif Zako, Nedim Memisevic, Kostantinos Konstantinou, Benedikt Schrage, Peter Clemmensen, Jacob E Møller, Thomas Engstrøm, On Behalf Of The DanGer Shock Investigators","doi":"10.4244/EIJ-D-26-00460","DOIUrl":"10.4244/EIJ-D-26-00460","url":null,"abstract":"<p><strong>Background: </strong>The prognostic impact of multivessel coronary anatomy and complexity in infarct-related cardiogenic shock (CS) is insufficiently characterised.</p><p><strong>Aims: </strong>We sought to investigate the prognostic value of baseline and residual SYNTAX scores and their influence on the effect of microaxial flow pump (mAFP) support in multivessel disease (MVD) and infarct-related CS.</p><p><strong>Methods: </strong>In this secondary analysis of the DanGer Shock trial, MVD was defined as ≥1 non-culprit stenosis ≥70% or an isolated left main (LM) culprit lesion. Baseline SYNTAX scores were categorised as low (≤22), intermediate (23-32), or high (>32). Patients with an isolated LM culprit lesion were analysed separately. The primary outcome was 180-day all-cause mortality.</p><p><strong>Results: </strong>Of 355 patients included in DanGer Shock, 256 patients had MVD; 211 had an available baseline SYNTAX score, with 26% of these in the low, 47% in the intermediate, and 27% in the high baseline SYNTAX groups. In all, 35 patients had an isolated LM culprit lesion. A high baseline SYNTAX score was associated with higher odds of 180-day all-cause mortality compared with low and intermediate baseline SYNTAX scores (adjusted odds ratio [OR] 3.12, 95% confidence interval [CI]: 1.17-8.69). A higher baseline SYNTAX score was associated with a higher residual SYNTAX score (p<0.001). The residual SYNTAX score independently predicted 180-day all-cause mortality. The mAFP effect was not modified by the baseline SYNTAX group (p for interaction=0.31). In patients with an isolated LM culprit lesion, mAFP use was associated with lower odds of 180-day all-cause mortality compared with standard care alone (adjusted OR 0.17, 95% CI: 0.03-0.99).</p><p><strong>Conclusions: </strong>Baseline and residual SYNTAX scores independently predicted 180-day mortality. The mAFP effect was not modified by SYNTAX measures. In the isolated left main subgroup, a hypothesis-generating signal towards a clinical benefit with mAFP use was observed.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 19","pages":"e1036-e1047"},"PeriodicalIF":9.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118460","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}