Eurointervention最新文献

{"title":"Computed tomography versus near-infrared spectroscopy for the assessment of coronary atherosclerosis.","authors":"Anantharaman Ramasamy, Ramya Parasa, Hessam Sokooti, Xiaotong Zhang, Ibrahim Halil Tanboga, Pieter Kitslaar, Alexander Broersen, Krishnaraj S Rathod, Rajiv Amersey, Ajay Jain, Mick Ozkor, Johan H C Reiber, Jouke Dijkstra, Patrick W Serruys, James C Moon, Anthony Mathur, Ryo Torii, Francesca Pugliese, Andreas Baumbach, Christos V Bourantas","doi":"10.4244/EIJ-D-24-00096","DOIUrl":"10.4244/EIJ-D-24-00096","url":null,"abstract":"<p><strong>Background: </strong>Coronary computed tomography angiography (CCTA) has been proposed as an alternative to intravascular imaging for assessing plaque pathology.</p><p><strong>Aims: </strong>We aimed to assess the efficacy of CCTA against near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) in evaluating atheroma burden and composition and for guiding coronary interventions.</p><p><strong>Methods: </strong>Seventy patients with a chronic coronary syndrome were recruited and underwent CCTA and NIRS-IVUS. The imaging data were matched, and the estimations of lumen, vessel wall and plaque dimensions and composition of the two modalities were compared. The primary endpoint of the study was the efficacy of CCTA in detecting lipid-rich plaques identified by NIRS-IVUS. Secondary endpoints included the performance of CCTA in evaluating coronary artery pathology in the studied segments and its value in stent sizing, using NIRS-IVUS as the reference standard.</p><p><strong>Results: </strong>In total, 186 vessels were analysed. The attenuated plaque volume on CCTA had weak accuracy in detecting lipid-rich plaques (58%; p=0.029). Compared to NIRS-IVUS, CCTA underestimated the lumen volume (309.2 mm³ vs 420.4 mm³; p=0.001) and plaque dimensions (total atheroma volume 116.1 mm³ vs 292.8 mm³; p<0.001 and percentage atheroma volume 27.67% vs 41.06%; p<0.001) and overestimated the lipid component (lipid core burden index 48.6 vs 33.8; p=0.007). In the 86 lesions considered for revascularisation, CCTA underestimated the reference vessel area (8.16 mm² vs 12.30 mm²; p<0.001) and overestimated the lesion length (23.5 mm vs 19.0 mm; p=0.029) compared to NIRS-IVUS.</p><p><strong>Conclusions: </strong>CCTA has limited efficacy in assessing plaque composition and quantifying lumen and plaque dimensions and tissue types, which may potentially impact revascularisation planning.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 23","pages":"e1465-e1475"},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774746","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":"Elderly patients with ACS should not be denied invasive coronary angiography: pros and cons.","authors":"Simone Biscaglia, Gianluca Campo, Guillaume Cayla, Thomas Cuisset","doi":"10.4244/EIJ-E-24-00057","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00057","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 23","pages":"e1451-e1453"},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774765","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":"Rescue stenting for failed basilar artery thrombectomy in acute stroke.","authors":"Iris Q Grunwald, Anna L Kuhn, Anna Podlasek","doi":"10.4244/EIJ-E-24-00060","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00060","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 23","pages":"e1449-e1450"},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774775","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":"Outcomes of coronary intravascular lithotripsy for the treatment of calcified nodules: a pooled analysis of the Disrupt CAD studies.","authors":"Ziad A Ali, Doosup Shin, Mandeep Singh, Sarah Malik, Koshiro Sakai, Benjamin Honton, Dean J Kereiakes, Jonathan M Hill, Shigeru Saito, Carlo Di Mario, Nieves Gonzalo, Robert F Riley, Akiko Maehara, Mitsuaki Matsumura, Jason Hokama, Nick E J West, Gregg W Stone, Richard A Shlofmitz","doi":"10.4244/EIJ-D-24-00282","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00282","url":null,"abstract":"<p><strong>Background: </strong>Coronary intravascular lithotripsy (IVL) safely facilitates stent implantation in severely calcified lesions.</p><p><strong>Aims: </strong>This analysis sought to determine the relative impact of IVL on acute and long-term outcomes specifically in calcified nodules (CNs).</p><p><strong>Methods: </strong>Individual patient-level data (N=155) were pooled from the Disrupt CAD optical coherence tomography (OCT) substudies. Severely calcified lesions with and without CNs were compared by OCT for acute procedural results and for target lesion failure (TLF) at 2 years - a composite of cardiac death, target vessel myocardial infarction, and ischaemia-driven target lesion revascularisation.</p><p><strong>Results: </strong>A CN was identified in 18.7% (29/155) of lesions. When comparing lesions with and without CNs, there were no significant differences in preprocedure minimal lumen area or diameter stenosis; however, the mean calcium angle and calcium volume were greater in CN lesions. Despite a higher calcium burden, the final minimal stent area (CN: 5.7 mm²[interquartile range [IQR] 4.4, 8.3] vs non-CN: 5.7 mm² [IQR 4.7, 7.2]; p=0.80) and stent expansion (CN: 79.3% [IQR 64.3, 87.0] vs 80.2% [IQR 68.9, 92.4]; p=0.30) were comparable between the two groups. In the CN group, the final stent area and expansion at CN sites were 7.6 mm² (IQR 5.5, 8.5) and 89.7% (IQR 79.8, 102.5), respectively. The cumulative incidence of TLF at 2 years was 13.9% and 8.0% in the CN and non-CN groups, respectively (p=0.32).</p><p><strong>Conclusions: </strong>Despite a greater calcium volume in CNs, IVL use was associated with comparable stent expansion and luminal gain in both CN and non-CN lesions. Further studies powered for clinical outcomes comparing different plaque modification techniques in this lesion subset are warranted.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 23","pages":"e1454-e1464"},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774771","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":"Outcomes of stenting after failed basilar artery thrombectomy for acute stroke: a nationwide registry-based cohort study.","authors":"Shuai Yu, Xiao-Feng Dong, Zhi-Liang Guo, Zhi-Chao Huang, Peng-Fei Xu, Chun-Rong Tao, Rui Li, Wei Hu, Guo-Dong Xiao","doi":"10.4244/EIJ-D-24-00300","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00300","url":null,"abstract":"<p><strong>Background: </strong>Mechanical thrombectomy is the most effective treatment for restoring reperfusion in large vessel occlusion acute ischaemic stroke, even in patients with posterior circulation. However, the strategy for optimal treatment of patients with acute basilar artery occlusion (BAO) in difficult-to-treat cases in which thrombectomy has failed is unknown.</p><p><strong>Aims: </strong>The purpose of this study was to evaluate the clinical efficacy and safety of rescue intracranial stenting (RIS) in patients with acute BAO treated with thrombectomy.</p><p><strong>Methods: </strong>Stroke patients with acute BAO who had undergone failed mechanical thrombectomy in the ATTENTION registry were enrolled in this study. Univariable and multivariable regression analyses were performed to assess the clinical efficacy and safety of RIS.</p><p><strong>Results: </strong>A total of 477 patients were included in the analysis, and 346 patients underwent RIS, of whom 167 (35.0%) patients had a favourable outcome. Symptomatic intracranial haemorrhage (sICH) occurred in 24 (5.0%) patients, and 172 (36.1%) patients died. There were no significant differences between the two groups of patients in the outcomes of modified Rankin Scale (mRS) 0-1 (p=0.541), mRS 0-2 (p=0.374), mRS 0-3 (p=0.600), or death (p=0.706). Patients in the RIS+ group had a significantly higher incidence of sICH (1.5% vs 6.4%; p=0.031). Nevertheless, after adjusting for confounders, RIS was not found to be an independent risk factor for sICH (adjusted odds ratio 4.189, 95% confidence interval: 0.960-18.286; p=0.057).</p><p><strong>Conclusions: </strong>In this national, multicentre, prospective study, RIS in patients with acute BAO who had undergone failed first-line thrombectomy was feasible, but we could not show significance regarding improved long-term outcomes.</p><p><strong>Trial registration number: </strong>ChiCTR2000041117.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 23","pages":"e1476-e1483"},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774773","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":"Stenting of outflow graft obstruction after left ventricular assist device implantation.","authors":"Joanna Jozwiak, Michal Nozdrzykowski, Sandra Eifert, Christian Krieghoff, Ricardo Spampinato, Joao Carlos Correia, Diyar Saeed, Alexey Dashkevich, Matthias Gutberlet, Michael Andrew Borger, Holger Thiele, Dmitry Sulimov, Marcus Sandri","doi":"10.4244/EIJ-D-24-00017","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00017","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 23","pages":"e1484-e1486"},"PeriodicalIF":7.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774779","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":"Low-flow, low-gradient aortic stenosis: an understanding is still a long way off.","authors":"John Webb, Sophie Offen","doi":"10.4244/EIJ-E-24-00052","DOIUrl":"10.4244/EIJ-E-24-00052","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1364-1365"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649706","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":"TAVI patients with bystander coronary artery disease should receive PCI: pros and cons.","authors":"Josep Rodés-Cabau, Marisa Avvedimento, Benedict McDonaugh, Tiffany Patterson","doi":"10.4244/EIJ-E-24-00054","DOIUrl":"10.4244/EIJ-E-24-00054","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1366-1369"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649716","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":"Feasibility of redo-TAVI in the self-expanding ACURATE neo2 valve: a computed tomography study.","authors":"Gintautas Bieliauskas, Yusuke Kobari, Arif A Khokhar, Mohamed Abdel-Wahab, Ahmed Abdelhafez, Miho Fukui, Klaus Fuglsang Kofoed, Dariusz Dudek, Andreas Fuchs, Joao Cavalcante, Kentaro Hayashida, Gilbert H L Tang, Darren Mylotte, Vinayak N Bapat, Ole De Backer","doi":"10.4244/EIJ-D-24-00367","DOIUrl":"10.4244/EIJ-D-24-00367","url":null,"abstract":"<p><strong>Background: </strong>Redo-transcatheter aortic valve implantation (TAVI) may be unfeasible because of the risk of compromising coronary flow or coronary access by the pinned back leaflets of the index transcatheter aortic valve.</p><p><strong>Aims: </strong>We aimed to evaluate the feasibility of redo-TAVI using the balloon-expandable SAPIEN 3 (S3) implanted within the self-expanding ACURATE neo2 (ACn2) valve and to identify predictors associated with a high risk of compromising coronary flow.</p><p><strong>Methods: </strong>A total of 153 post-ACn2 TAVI cardiac computed tomography scans were analysed. Redo-TAVI using an S3 was simulated in two positions: S3 outflow to the ACn2 upper crown (low implant) and S3 outflow to the base of the ACn2 commissural posts (high implant). The risk for coronary flow compromise and inaccessibility was determined by the height of the neoskirt created by the pinned back leaflets and the valve-to-aorta distances.</p><p><strong>Results: </strong>At a low S3 implant position, risk of coronary flow compromise was predicted in only 8% of patients and this increased to 60% with a high S3 position. In accordance, coronary access was predicted to be unrestricted in 52% versus 13% of patients with a low versus high S3 implantation. Female sex, a small aortic annular dimension and a sinotubular junction-to-aortic annulus mean diameter ratio <1.15 were independent predictors associated with a high risk for coronary flow compromise.</p><p><strong>Conclusions: </strong>The feasibility of redo-TAVI with an S3 in an ACn2 depends on the implant depth of the S3 and the geometry of the surrounding aorta. A low S3 implant may reduce the risk of coronary flow compromise and inaccessibility.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1405-1415"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649703","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 and clinical impact of worsening left ventricular ejection fraction after mitral transcatheter edge-to-edge repair.","authors":"Sachiyo Ono, Shunsuke Kubo, Takeshi Maruo, Naoki Nishiura, Kazunori Mushiake, Kohei Osakada, Kazushige Kadota, Masanori Yamamoto, Mike Saji, Masahiko Asami, Yusuke Enta, Shinichi Shirai, Masaki Izumo, Shingo Mizuno, Yusuke Watanabe, Makoto Amaki, Kazuhisa Kodama, Junichi Yamaguchi, Yoshifumi Nakajima, Toru Naganuma, Hiroki Bota, Yohei Ohno, Masahiro Yamawaki, Hiroshi Ueno, Kazuki Mizutani, Toshiaki Otsuka, Kentaro Hayashida, Ocean-Mitral Investigators","doi":"10.4244/EIJ-D-23-01092","DOIUrl":"10.4244/EIJ-D-23-01092","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the effects of left ventricular ejection fraction (LVEF) worsening after transcatheter edge-to-edge valve repair (TEER) for mitral regurgitation (MR).</p><p><strong>Aims: </strong>This study investigated the predictors and clinical impact of LVEF worsening after TEER for primary MR (PMR) and secondary MR (SMR).</p><p><strong>Methods: </strong>This study included 2,019 patients (493 with PMR and 1,526 with SMR) undergoing successful TEER (postprocedural MR grade ≤2+) in the OCEAN-Mitral registry. The patients were categorised into worsened LVEF (wEF), defined as a relative decrease of >12.9% in LVEF at discharge, and preserved LVEF (pEF). The serial changes in left ventricular (LV) function at 1 year were also evaluated.</p><p><strong>Results: </strong>Following TEER, 657 (32%) patients demonstrated wEF. The pEF group demonstrated both decreased left ventricular end-diastolic volumes (LVEDV) and end-systolic volumes (LVESV), and the wEF group showed significantly increased LVESV at discharge. Higher LVEF, larger LVEDV, higher B-type natriuretic peptide levels, and moderate/severe aortic regurgitation predicted wEF. Compared with baseline, the wEF group still demonstrated lower LVEF (46% to 43%; p<0.001) but significantly increased stroke volume (48 mL to 53 mL; p=0.001) at 1 year. The incidence of death or heart failure hospitalisation was similar between the wEF and pEF groups (hazard ratio 1.14, 95% confidence interval: 0.72-1.80; p=0.84) and also in patients with PMR and SMR.</p><p><strong>Conclusions: </strong>LVEF worsening after TEER was not uncommon and was caused by the increased LVESV. LV volumes and some patient-specific factors predicted worsened LVEF which was not associated with long-term clinical outcomes. OCEAN-Mitral registry: UMIN-CTR ID: UMIN000023653.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 22","pages":"1430-1441"},"PeriodicalIF":7.6,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649708","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}