Eurointervention最新文献

{"title":"Left atrial appendage occlusion needs lifetime management not lifetime medications.","authors":"Sameer Gafoor, Sidakpal Panaich","doi":"10.4244/EIJ-E-24-00041","DOIUrl":"10.4244/EIJ-E-24-00041","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127349","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":"The patent foramen ovale does not spontaneously close in patients aged 60.","authors":"David Hildick-Smith, Sandeep Arunothayaraj","doi":"10.4244/EIJ-E-24-00040","DOIUrl":"10.4244/EIJ-E-24-00040","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127350","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":"Double-tap to treat paravalvular leak in high-risk annuli.","authors":"Ali Husain, Julius Jelisejevas, John King Khoo, Mariama Akodad, Andrew Chatfield, Fady Zaky, Stephanie L Sellers, Jonathon A Leipsic, Philipp Blanke, David A Wood, David Meier, Janarthanan Sathananthan, John G Webb","doi":"10.4244/EIJ-D-24-00204","DOIUrl":"10.4244/EIJ-D-24-00204","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1042-1043"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001360","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 therapy for transcatheter structural heart intervention.","authors":"Paul Guedeney, Josep Rodés-Cabau, Jurriën M Ten Berg, Stephan Windecker, Dominick J Angiolillo, Gilles Montalescot, Jean-Philippe Collet","doi":"10.4244/EIJ-D-23-01084","DOIUrl":"10.4244/EIJ-D-23-01084","url":null,"abstract":"<p><p>Percutaneous transcatheter structural heart interventions have considerably expanded within the last two decades, improving clinical outcomes and quality of life versus guideline-directed medical therapy for patients frequently ineligible for surgical treatment. Transcatheter structural heart interventions comprise valve implantation or repair and also occlusions of the patent foramen ovale, atrial septal defects and left atrial appendage. These procedures expose structural devices to arterial or venous blood flow with various rheological conditions leading to potential thrombotic complications and embolisation. Furthermore, these procedures may concern comorbid patients at high risk of both ischaemic and bleeding complications. This state-of-the-art review provides a description of the device-related thrombotic risk associated with these transcatheter structural heart interventions and of the current evidence-based guidelines regarding antithrombotic treatments. Gaps in evidence for each of the studied transcatheter interventions and the main ongoing trials are also summarised.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"972-986"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001355","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":"Determinants of adverse outcomes following patent foramen ovale closure in elderly patients.","authors":"Julio I Farjat-Pasos, Paul Guedeney, Eric Horlick, Jeremie Abtan, Luis Nombela-Franco, Benjamin Hibbert, Lars Sondergaard, Xavier Freixa, Jean-Bernard Masson, Ignacio Cruz-González, Rodrigo Estévez-Loureiro, Laurent Faroux, Ashish H Shah, Lusine Abrahamyan, Jules Mesnier, Adrián Jerónimo, Omar Abdel-Razek, Troels Højsgaard Jørgensen, Mike Al Asmar, Samuel Sitbon, Mohammed Abalhassan, Mathieu Robichaud, Christine Houde, Mélanie Côté, Angel Chamorro, Sylvain Lanthier, Steve Verreault, Gilles Montalescot, Josep Rodés-Cabau","doi":"10.4244/EIJ-D-24-00156","DOIUrl":"10.4244/EIJ-D-24-00156","url":null,"abstract":"<p><strong>Background: </strong>Limited data are available on transcatheter patent foramen ovale (PFO) closure outcomes in the elderly.</p><p><strong>Aims: </strong>Through this study, we aimed to determine the incidence and predictors of adverse events (recurrent cerebrovascular events [CVE] and atrial fibrillation [AF]) post-PFO closure in older patients with cryptogenic events.</p><p><strong>Methods: </strong>This multicentre international study included patients over 60 years undergoing PFO closure for cryptogenic thromboembolic events. A dedicated database compiled baseline, procedural, and follow-up data. Competing risk and adjusted outcome predictor analyses were conducted.</p><p><strong>Results: </strong>A total of 689 patients were included (median age 65 years, 41.2% female, mean Risk of Paradoxical Embolism [RoPE] score 4.5). The procedural success rate was 99.4%. After a median follow-up of 2 (interquartile range 1-5) years, 66 patients (9.6%) had died. CVE and stroke rates were 1.21 and 0.55 per 100 patient-years, respectively. Diabetes (hazard ratio [HR] 3.89, 95% confidence interval [CI]: 1.67-9.07; p=0.002) and atrial septal aneurysm (ASA; HR 5.25, 95% CI: 1.56-17.62; p=0.007) increased the CVE risk. New-onset AF occurred at a rate of 3.30 per 100 patient-years, with 51.3% within one month post-procedure. Older age (HR 1.05 per year, 95% CI: 1.00-1.09; p=0.023) and the absence of hypertension (HR 2.04, 95% CI: 1.19-3.57; p=0.010) were associated with an increased risk of AF.</p><p><strong>Conclusions: </strong>Older patients undergoing PFO closure had a relatively low rate of CVE and new-onset AF after a median follow-up of 2 years. The presence of diabetes, ASA, and a more advanced age determined an increased risk of adverse clinical events. These factors may be considered in the clinical decision-making process regarding PFO closure in this challenging population.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1029-1038"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001358","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":"   Atrial fibrillation and acute coronary syndrome.","authors":"Tatjana Potpara","doi":"10.4244/EIJ-E-24-00043","DOIUrl":"10.4244/EIJ-E-24-00043","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":""},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127347","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":"A comparison of simplified or conventional antithrombotic regimens after left atrial appendage closure in patients at high bleeding risk: the PLATEBRISK study.","authors":"Pablo Antúnez-Muiños, Sergio López-Tejero, Pedro Cepas-Guillén, Matias Mon-Noboa, Juan M Ruiz-Nodar, Luis Andrés-Lalaguna, Fernando Rivero, Juan Gabriel Córdoba-Soriano, Ignacio J Amat-Santos, Berenice Caneiro-Queija, David Martí Sánchez, Javier Jimeno Sánchez, Fernando Torres Mezcua, Fabián Blanco-Fernández, Jorge Sanz Sánchez, Cristina Moreno-Ambroj, Rodrigo Estévez-Loureiro, Luis Nombela-Franco, Xavier Freixa-Rofastes, Ignacio Cruz-González","doi":"10.4244/EIJ-D-24-00116","DOIUrl":"10.4244/EIJ-D-24-00116","url":null,"abstract":"<p><strong>Background: </strong>Antithrombotic treatment (ATT) post-left atrial appendage occlusion (LAAO) remains controversial. Furthermore, most of the patients undergoing LAAO are at a very high bleeding risk.</p><p><strong>Aims: </strong>This study aimed to compare a simplified versus conventional ATT after LAAO in very high bleeding risk patients.</p><p><strong>Methods: </strong>This is a multicentre, retrospective study including very high bleeding risk patients, according to the Bleeding Academic Research Consortium (BARC) definition, who underwent LAAO. These included patients at >4% risk of BARC 3 to 5 bleeding or >1% risk of intracranial bleeding after the procedure. Two groups were established based on the discharge ATT. The simplified group included single antiplatelet treatment or no treatment, and the conventional group comprised dual antiplatelet treatment or anticoagulation (combined or not with antiplatelet therapy).</p><p><strong>Results: </strong>A total of 1,135 patients were included. The mean CHA₂DS₂-VASc and HAS-BLED scores were 4.5±1.5 and 3.7±1.0, respectively. There were no differences in the composite endpoint (death, stroke, transient ischaemic attack, device-related thrombus or major bleeding) between the 2 groups (hazard ratio [HR] 0.81, 95% confidence interval [CI]: 0.59-1.11; p=0.188). Although the rate of major bleeding during the first year was numerically lower in the simplified group, it did not reach statistical significance (HR 0.67, 95% CI: 0.41-1.10; p=0.104). Nonetheless, patients with previous major bleeding presented a significantly lower rate of major bleeding when using the simplified treatment (HR 0.61, 95% CI: 0.36-0.99; p=0.049).</p><p><strong>Conclusions: </strong>In patients with very high bleeding risk, a simplified ATT after LAAO seems to be as effective as conventional protocols. Furthermore, patients with a history of major bleeding experienced a lower risk of major bleeding with the simplified ATT.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1018-1028"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001354","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: Identifying vulnerable coronary atherosclerotic plaques: from theory to practice.","authors":"David Del Val, Fernando Alfonso, Elvin Kedhi, On Behalf Of The Combine Oct-Ffr Trial Investigators","doi":"10.4244/EIJ-D-24-00594","DOIUrl":"10.4244/EIJ-D-24-00594","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 16","pages":"1046-1047"},"PeriodicalIF":7.6,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001365","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 bifurcation coronary lesions using optimised angiographic guidance: the 18th consensus document from the European Bifurcation Club.","authors":"Francesco Burzotta, Yves Louvard, Jens Flensted Lassen, Thierry Lefèvre, Gérard Finet, Carlos Collet, Jacek Legutko, Maciej Lesiak, Yutaka Hikichi, Remo Albiero, Manuel Pan, Yiannis S Chatzizisis, David Hildick-Smith, Miroslaw Ferenc, Thomas W Johnson, Alaide Chieffo, Olivier Darremont, Adrian Banning, Patrick W Serruys, Goran Stankovic","doi":"10.4244/EIJ-D-24-00160","DOIUrl":"10.4244/EIJ-D-24-00160","url":null,"abstract":"<p><p>The 2023 European Bifurcation Club (EBC) meeting took place in Warsaw in October, and the latest evidence for the use of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) to optimise percutaneous coronary interventions (PCI) on coronary bifurcation lesions (CBLs) was a major focus. The topic generated deep discussions and general appraisal on the potential benefits of IVUS and OCT in PCI procedures. Nevertheless, despite an increasing recognition of IVUS and OCT capabilities and their recognised central role for guidance in complex CBL and left main PCI, it is expected that angiography will continue to be the primary guidance modality for CBL PCI, principally due to educational and economic barriers. Mindful of the restricted access/adoption of intracoronary imaging for CBL PCI, the EBC board decided to review and describe a series of tips and tricks which can help to optimise angiography-guided PCI for CBLs. The identified key points for achieving an optimal angiography-guided PCI include a thorough analysis of pre-PCI images (computed tomography angiography, multiple angiographic views, quantitative coronary angiography vessel estimation), a systematic application of the technical steps suggested for a given selected technique, an intraprocedural or post-PCI use of stent enhancement and a low threshold for bailout use of intravascular imaging.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e915-e926"},"PeriodicalIF":7.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946536","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":"Impact of morphofunctional assessment with quantitative flow ratio and optical coherence tomography in patients with acute coronary syndromes.","authors":"Yuto Osumi, Hiroyuki Kawamori, Takayoshi Toba, Takashi Hiromasa, Daichi Fujimoto, Shunsuke Kakizaki, Koichi Nakamura, Tomoyo Hamana, Hiroyuki Fujii, Satoru Sasaki, Seigo Iwane, Tetsuya Yamamoto, Shota Naniwa, Yuki Sakamoto, Koshi Matsuhama, Yuta Fukuishi, Amane Kozuki, Junya Shite, Tomofumi Takaya, Akihiko Ishida, Masamichi Iwasaki, Ken-Ichi Hirata, Hiromasa Otake","doi":"10.4244/EIJ-D-23-01043","DOIUrl":"10.4244/EIJ-D-23-01043","url":null,"abstract":"<p><strong>Background: </strong>Combining morphological and physiological evaluations might improve the risk stratification of patients who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) culprit lesions.</p><p><strong>Aims: </strong>We aimed to investigate the clinical utility of morphofunctional evaluation after PCI for identifying ACS patients with increased risk of subsequent clinical events.</p><p><strong>Methods: </strong>We retrospectively studied 298 consecutive ACS patients who had undergone optical coherence tomography (OCT)-guided PCI. We performed OCT-based morphological analysis and quantitative flow ratio (QFR)-based physiological assessment immediately after PCI. The non-culprit segment (NCS) was defined as the most stenotic untreated segment in the culprit vessel. The primary outcome was target vessel failure (TVF), a composite of cardiac death, target vessel-related myocardial infarction, and ischaemia-driven target vessel revascularisation.</p><p><strong>Results: </strong>During a median follow-up period of 990 days, 42 patients experienced TVF. Cox regression analysis revealed that the presence of thin-cap fibroatheroma (TCFA) in the NCS and a low post-PCI QFR, or the presence of TCFA in the NCS and a high ΔQFR in the NCS (QFR_NCS), were independently associated with TVF. The subgroup with TCFA in the NCS and a low post-PCI QFR had a significantly higher incidence of TVF (75%) than the other subgroups, and those with TCFA in the NCS and a high ΔQFR_NCS had a significantly higher incidence of TVF (86%) than the other subgroups. The integration of TCFA in NCS, post-PCI QFR, and ΔQFR_NCS with traditional risk factors significantly enhanced the identification of subsequent TVF cases.</p><p><strong>Conclusions: </strong>Combining post-PCI OCT and QFR evaluation may enhance risk stratification for ACS patients after successful PCI, particularly in predicting subsequent TVF.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 15","pages":"e927-e936"},"PeriodicalIF":7.6,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11285042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890959","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}