Eurointervention最新文献

{"title":"Reply: Completeness or complexity? A nuanced reflection on multivessel revascularisation.","authors":"Claudio Laudani, Giovanni Occhipinti, Antonio Greco, Marco Spagnolo, Daniele Giacoppo, Davide Capodanno","doi":"10.4244/EIJ-D-25-00325","DOIUrl":"10.4244/EIJ-D-25-00325","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e713-e714"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303602","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":"Antithrombotic drugs for acute coronary syndromes in women: sex-adjusted treatment and female representation in randomised clinical trials. A clinical consensus statement of the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and the ESC Working Group on Thrombosis.","authors":"Valeria Paradies, Giulia Masiero, Andrea Rubboli, Heleen M M Van Beusekom, Francesco Costa, Piera Capranzano, Sophie Degrauwe, Diana A Gorog, Claudia Moreira Jorge, Gill Louise Buchanan, Mirvat Alasnag, Daniela Trabattoni, Chiara Fraccaro, Dirk Sibbing, Dariusz Dudek, Gemma Vilahur, Alaide Chieffo, Roxana Mehran, Davide Capodanno, Emanuele Barbato, Jolanta M Siller-Matula","doi":"10.4244/EIJ-D-24-00876","DOIUrl":"10.4244/EIJ-D-24-00876","url":null,"abstract":"<p><p>Thrombotic and bleeding risks differ between sexes, partly in relation to distinct biology and hormonal status, but also due to differences in age, comorbidities, and body size at presentation. Women experience frequent fluctuations of prothrombotic and bleeding status related to menstrual cycle, use of oral contraceptives, hormone replacement therapy, or menopause. Although clinical studies tend to underrepresent women, available data consistently support sex-specific differences in the baseline thrombotic and haemorrhagic risks. Compared with men, women feature an increased risk of in-hospital bleeding related to invasive procedures, as well as long-term out-of-hospital bleeding events. In addition, the inappropriate dosing of antithrombotic drugs, which is not adapted to body weight or renal function, is more frequently associated with an increased risk of bleeding in women compared to men. While acute coronary syndrome (ACS) studies support similar antithrombotic drug efficacy, irrespective of sex, women may receive delayed treatment due to bias in their referral, diagnosis, and invasive treatment decisions. The current clinical consensus statement highlights the need for an increased awareness of sex-specific risks and biases in ACS management, with a focus on sex-specific bleeding mitigation strategies, antithrombotic management in special conditions (e.g., myocardial infarction with non-obstructive coronary arteries), and barriers to female representation in cardiovascular trials. This manuscript aims to provide expert opinion, based on the best available evidence, and consensus statements on optimising antithrombotic therapy according to sex, which is critical to improve sex-based disparities in outcome.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e655-e667"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095886","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":"Chimney stenting for preventing coronary obstruction in redo-TAVI with balloon-expandable valves within self-expanding valves.","authors":"Alessandro Beneduce, Arif A Khokhar, Jonathan Curio, Francesco Giannini, Adriana Zlahoda-Huzior, Won-Keun Kim, Francesco Maisano, Ole De Backer, Dariusz Dudek","doi":"10.4244/EIJ-D-24-01018","DOIUrl":"10.4244/EIJ-D-24-01018","url":null,"abstract":"<p><strong>Background: </strong>Coronary obstruction (CO) is a major concern in redo-transcatheter aortic valve implantation (TAVI) for failing supra-annular self-expanding transcatheter aortic valves (TAVs).</p><p><strong>Aims: </strong>This ex vivo study tested chimney stenting (ChS) for redo-TAVI in patients with high-risk anatomy for CO by evaluating stent outcomes and the feasibility of subsequent coronary access (CA) for percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>Patient-specific anatomical models were three-dimensionally printed from pre-TAVI computed tomography (CT) scans. Index TAVI was performed using ACURATE neo2 (ACn2) or Evolut PRO (EvPRO) with varying degrees of commissural misalignment (CMA). Redo-TAVI with bilateral ChS was performed in a pulsatile flow simulator using the balloon-expandable SAPIEN 3 Ultra (S3U) at different implant depths. Stent expansion was measured by intravascular ultrasound. Stent interactions and distortion angles were assessed by micro-CT. CA for PCI was attempted subsequently.</p><p><strong>Results: </strong>In the tested redo-TAVI combinations, interactions with index TAV frames or the aortic wall caused chimney stent distortion and underexpansion. A high S3U implant within an EvPRO resulted in the greatest stent underexpansion (complete crush) and vertical distortion (up to 75°). Severe CMA of the index TAV resulted in the greatest lateral stent distortion (up to 41° for ACn2 and 53° for EvPRO). The combination of CMA of the index TAV and a high S3U implant rendered CA and PCI after ChS unfeasible in 75% of cases.</p><p><strong>Conclusions: </strong>ChS during redo-TAVI with the S3U within a degenerated ACn2 or EvPRO valve is susceptible to interactions between the coronary stent and the TAV frames or the aortic wall, leading to stent distortion and underexpansion, which might compromise procedural efficacy and future CA.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e692-e703"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303597","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":"Guideline recommendations for QFR should be revisited: pros and cons.","authors":"William F Fearon, Simone Biscaglia","doi":"10.4244/EIJ-E-25-00009","DOIUrl":"10.4244/EIJ-E-25-00009","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e652-e654"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303598","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":"Letter: Completeness or complexity? A nuanced reflection on multivessel revascularisation.","authors":"Alessandro Sticchi, Giuseppe Biondi-Zoccai","doi":"10.4244/EIJ-D-25-00197","DOIUrl":"10.4244/EIJ-D-25-00197","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e711-e712"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303599","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":"Predictors of pacemaker implantation in aortic regurgitation patients treated with a dedicated transcatheter heart valve.","authors":"Hendrik Wienemann, Martin Geyer, Malte Stukenberg, Sara Waezsada, Kush P Patel, Elmar W Kuhn, Marc Adrian Rogmann, Duane S Pinto, Lenard Conradi, Sabine Bleiziffer, Stephan Baldus, Andreas Baumbach, Tanja K Rudolph, Matti Adam","doi":"10.4244/EIJ-D-24-01117","DOIUrl":"10.4244/EIJ-D-24-01117","url":null,"abstract":"<p><strong>Background: </strong>The JenaValve Trilogy System (JVTS) is the only dedicated transcatheter heart valve system approved for treating patients with aortic regurgitation (AR). Recently, several studies have revealed high rates of permanent pacemaker implantation (PPI) exceeding 20% in patients with AR.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the incidence and risk factors for new PPI after transcatheter aortic valve implantation (TAVI) with the JVTS.</p><p><strong>Methods: </strong>This retrospective multicentre registry included 141 patients without prior PPI who underwent transfemoral TAVI with the JVTS. Comparative analyses were performed regarding baseline and procedural parameters between patients with and without new PPI at discharge. Logistic regression models were fitted to identify predictors of PPI.</p><p><strong>Results: </strong>The median age of patients was 81 (interquartile range [IQR] 76-85) years, 41% were female, and the median European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was 3.6% (IQR 2.0-6.4). All patients presented with ≥moderate AR. At discharge, 34 patients (24.1%) required a new PPI. Pre-existing first-degree atrioventricular block and right bundle branch block were identified as independent predictors of new PPI. Anatomical characteristics, including annular and left ventricular outflow tract perimeters, were not predictive. Procedural factors such as implantation depth and valve oversizing were also not statistically different between patients with or without new PPI.</p><p><strong>Conclusions: </strong>Overall, 24.1% of patients undergoing TAVI with the JVTS required a new PPI. While rates of new PPI were strongly associated with pre-existing first-degree atrioventricular block and right bundle branch block using the JVTS, no modifiable risk factors were identified.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e681-e691"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303601","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":"Transcaval transcatheter aortic valve implantation via left-sided venous access.","authors":"Conor J Doyle, Ivan P Casserly","doi":"10.4244/EIJ-D-24-00795","DOIUrl":"10.4244/EIJ-D-24-00795","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e709-e710"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303603","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":"One- versus three-month DAPT after everolimus-eluting stent implantation in diabetic patients at high bleeding risk: results from the XIENCE Short DAPT programme.","authors":"Angelo Oliva, Dominick J Angiolillo, Marco Valgimigli, Davide Cao, Samantha Sartori, Sripal Bangalore, Deepak L Bhatt, Gianluca Campo, Bassem M Chehab, James W Choi, Jose M de la Torre Hernandez, Yihan Feng, Junbo Ge, Mauro Gitto, James Hermiller, Mitchell W Krucoff, Vijay Kunadian, Raj R Makkar, Aziz Maksoud, Franz-Josef Neumann, Hector Picon, Shigeru Saito, Gennaro Sardella, Holger Thiele, Ralph Toelg, Olivier Varenne, Birgit Vogel, Pascal Vranckx, Stephan Windecker, Roxana Mehran","doi":"10.4244/EIJ-D-24-00897","DOIUrl":"10.4244/EIJ-D-24-00897","url":null,"abstract":"<p><strong>Background: </strong>In patients with diabetes mellitus (DM) and high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI), the optimal duration of dual antiplatelet therapy (DAPT) remains uncertain.</p><p><strong>Aims: </strong>We sought to compare early DAPT discontinuation in DM and non-DM patients enrolled in the prospective XIENCE Short DAPT programme.</p><p><strong>Methods: </strong>The effects of 1- versus 3-month DAPT on ischaemic and bleeding outcomes were compared using propensity score stratification. The primary endpoint was a composite of all-cause death or myocardial infarction (MI) at 1 year. The incidence of Bleeding Academic Research Consortium (BARC) Type 2 to 5 bleeding was the key secondary endpoint.</p><p><strong>Results: </strong>Out of 3,352 included patients, 1,299 (38.8%) had DM; diabetic patients had a higher 1-year incidence of death or MI (DM vs non-DM: 10.1% vs 6.6%) and similar BARC 2-5 bleeding (DM vs non-DM: 9.5% vs 9.2%). With 1- versus 3-month DAPT, the incidence of death or MI did not statistically differ in DM patients (adjusted hazard ratio [adjHR] 0.70, 95% confidence interval [CI]: 0.47-1.05) and non-DM patients (adjHR 1.26, 95% CI: 0.87-1.81), although heterogeneity by DM status was evident (p for interaction=0.015). BARC 2-5 bleeding was numerically lower with 1-month DAPT in both groups (DM: adjHR 0.67, 95% CI: 0.45-1.01; non-DM: adjHR 0.78, 95% CI: 0.56-1.07; p for interaction=0.973).</p><p><strong>Conclusions: </strong>Among HBR patients with DM undergoing PCI, 1-month DAPT, as compared to 3-month DAPT, was not associated with an excess of fatal or non-fatal MI and even reduced the occurrence of bleeding. These findings should be interpreted in the context of a predominantly stable patient population with low procedural complexity and may not be generalisable to higher-risk cases.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 12","pages":"e668-e680"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303600","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":"Next-day and 48-hour discharge following alternative access for transcatheter aortic valve implantation.","authors":"Yohanna John Zendo, Santiago Ordoñez, Michael W A Chu, Matthew Valdis, Siobhan Molloy, Mosa Abbadi, Patrick Teefy, Pantelis Diamantouros, Rodrigo Bagur","doi":"10.4244/EIJ-D-24-01048","DOIUrl":"10.4244/EIJ-D-24-01048","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e704-e708"},"PeriodicalIF":7.6,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112766","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":"Polymer-free biolimus-eluting stents: there is no such thing as a free lunch.","authors":"Raffaele Piccolo, Ernest Spitzer","doi":"10.4244/EIJ-E-25-00014","DOIUrl":"10.4244/EIJ-E-25-00014","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 11","pages":"e592-e593"},"PeriodicalIF":7.6,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217600","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}