Eurointervention最新文献

{"title":"Radial wall strain for residual risk stratification after percutaneous coronary intervention.","authors":"Jiayue Huang, Shengxian Tu, Haocheng Huang, Simone Fezzi, Jiaxin Zhong, Andreas Baumbach, Zhiqing Wang, Helen Parise, Chunming Li, Lianglong Chen, C Michael Gibson, Alexandra Lansky, William Wijns, On Behalf Of The Target All Comers Investigators","doi":"10.4244/EIJ-D-26-00126","DOIUrl":"10.4244/EIJ-D-26-00126","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention effectively treats flow-limiting stenoses; however, untreated non-target vessels with vulnerable plaques remain a major contributor to future adverse cardiovascular events. Plaque strain is a promising marker of plaque vulnerability but traditionally requires complex modelling and expensive intracoronary imaging. We developed a novel artificial intelligence algorithm for subpixel-level lumen delineation, enabling real-time automated assessment of radial wall strain (RWS) from routine angiography.</p><p><strong>Aims: </strong>This post hoc study sought to determine the prognostic value of RWS for predicting future cardiac events in non-target vessels over 5 years, using the high-quality TARGET All Comers randomised trial.</p><p><strong>Methods: </strong>This blinded analysis included all 1,551 enrolled patients. Angiographic image quality was independently assessed prior to blinded computation of RWS. A prespecified cutoff value of maximal RWS (RWS_max) ≥13% was used to define increased plaque vulnerability. The primary endpoint was a non-target vessel-oriented composite endpoint (NT-VOCE), a composite of cardiac death, non-target vessel myocardial infarction and non-target vessel revascularisation over 5 years, as prospectively adjudicated in the parent trial. Following blinded RWS analysis, the results were integrated into the trial database, and the outcomes were unblinded and linked to corresponding vessel-level outcomes.</p><p><strong>Results: </strong>RWS was successfully evaluated in 1,384 non-target vessels from 802 patients. Baseline RWS_max independently predicted the NT-VOCE, with an adjusted hazard ratio (HR) of 4.82 (95% confidence interval [CI]: 3.14-7.40; p<0.0001) and an adjusted area under the curve (AUC) of 0.73 (95% CI: 0.69-0.78; p<0.0001). Predictive accuracy was highest for non-target vessel revascularisation (adjusted AUC 0.92, 95% CI: 0.88-0.95; p<0.0001). In the subgroup with high-quality angiographic images, RWS demonstrated even greater predictive performance for the NT-VOCE (adjusted HR 6.89, 95% CI: 3.15-15.07; p<0.0001).</p><p><strong>Conclusions: </strong>In this retrospective post hoc analysis, RWS was independently associated with long-term adverse events in deferred non-target vessels, with its prognostic value most evident for subsequent non-target vessel revascularisation. Elevated baseline RWS_max was strongly associated with the NT-VOCE, with the highest predictive accuracy in vessels with high-quality angiographic imaging. Ongoing and planned prospective, randomised trials are evaluating the role of RWS-guided risk stratification.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e978-e989"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013315","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":"Phenotypes of cardiogenic shock after out-of-hospital cardiac arrest: the SCAI-V classification.","authors":"Roman Roy, Muhamad Abd Razak, Shamika Mohanan, Rupert Simpson, Aleksandra Parczewska, Michael McGarvey, Prajith Jeyaprakash, Hugh Lurcott, Milosz Jaguszewski, Rafal Dworakowski, Jan Bělohlávek, Halvor Langeland, Joachim Düring, Tiziano Cassina, Anders M Grejs, Matt P Wise, Matthias Haenggi, Christian Storm, Niklas Nielsen, Ajay M Shah, Jonathan Byrne, Grigoris V Karamasis, John R Davies, Daniel Stahl, Philip MacCarthy, Josef Dankiewicz, Thomas R Keeble, Nilesh Pareek","doi":"10.4244/EIJ-D-26-00092","DOIUrl":"10.4244/EIJ-D-26-00092","url":null,"abstract":"<p><strong>Background: </strong>Classifying cardiogenic shock (CS) after out-of-hospital cardiac arrest (OHCA) is challenging, with end-organ hypoperfusion arising from mechanisms distinct to non-arrested CS.</p><p><strong>Aims: </strong>We sought to evaluate the performance of current CS classifications and to develop the Society for Cardiovascular Angiography and Interventions (SCAI)-V classification of CS after resuscitated OHCA.</p><p><strong>Methods: </strong>We performed a retrospective analysis of an international derivation cohort (London, United Kingdom; GdaÅsk, Poland; n=627) and external validation of the 2x2 SCAI-V construct in the TTM-2 trial cohort (n=1,781). The primary outcome was mortality; the secondary outcome was non-neurological mortality at hospital discharge (derivation cohort) or at 180 days (TTM-2 cohort).</p><p><strong>Results: </strong>In the derivation cohort, the median age was 63 years (interquartile range 53-74), and 76% were male. Applying the 2022 SCAI classification (SCAI-2022), 60% of patients had discordant haemodynamic parameters and lactate levels. We developed the SCAI-V classification, grouping patients according to their SCAI grade (shock absent or present) and lactate level (<5 mmol/L or ≥5 mmol/L) into four phenotypes - non-shock, systemic ischaemia, haemodynamic shock, and haemometabolic shock - using a 2x2 factorial framework. The SCAI-V classification was associated with all-cause and non-neurological mortality (p<0.001). Survival was highest in the non-shock group (78% and 68%, in the derivation and validation cohorts, respectively), followed by haemodynamic shock (60% and 51%), then systemic ischaemia (50% and 42%), and lowest in the haemometabolic group (20% and 27%). In the derivation cohort, the SCAI-V classification displayed superior model fit, discrimination, and calibration than the 2019 and 2022 SCAI classifications. In the TTM-2 cohort, external evaluation using SCAI-V showed consistent model fit advantages and discrimination comparable to SCAI-2022.</p><p><strong>Conclusions: </strong>The SCAI-V classification enhances phenotypic profiling of CS after resuscitated OHCA and may improve patient selection for early invasive therapies in this population.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 18","pages":"e1001-e1012"},"PeriodicalIF":9.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13573860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013290","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":"Sex differences in computed tomography-derived fractional flow reserve-guided management of stable coronary artery disease: a subgroup analysis of the TARGET trial.","authors":"Yipu Ding, Zinuan Liu, Dongkai Shan, Xi Wang, Ziqiang Guo, Ran Xin, Lei Xu, Mei Zhang, Xinyang Hu, Hongbin Liu, Yundai Chen, Junjie Yang, On Behalf Of The Target Investigators","doi":"10.4244/EIJ-D-25-01383","DOIUrl":"10.4244/EIJ-D-25-01383","url":null,"abstract":"<p><strong>Background: </strong>Females with stable coronary artery disease (CAD) often present with less obstructive disease on invasive coronary angiography (ICA) yet experience worse outcomes than males. Coronary computed tomography-derived fractional flow reserve (CT-FFR) guidance improves the physiological assessment of coronary lesions beyond coronary computed tomography angiography (CCTA), but its sex-specific clinical impact remains uncertain.</p><p><strong>Aims: </strong>This study aimed to investigate sex-based differences in treatment and clinical outcomes between CT-FFR-guided and standard care strategies in patients with stable CAD.</p><p><strong>Methods: </strong>In this post hoc subanalysis of the randomised TARGET trial, 1,216 patients with 30-90% coronary stenosis on CCTA were randomised to onsite CT-FFR-guided care or standard care. The primary endpoint was the proportion of patients who underwent ICA without obstructive CAD or had no intervention despite obstructive CAD on ICA within 90 days of CCTA. The secondary endpoint was major adverse cardiovascular events (MACE) at 2 years.</p><p><strong>Results: </strong>Females were older than males (62.3±8.1 years vs 58.2±10.7 years; p<0.001) but had comparable anatomical CAD severity. CT-FFR-guided care significantly reduced ICA without obstructive CAD and increased early revascularisation in males but not in females. Over 2 years, CT-FFR-guided management was associated with a significantly lower MACE rate in females compared with standard care (adjusted hazard ratio [HR] 0.48, 95% confidence interval [CI]: 0.27-0.87; p=0.015), whereas no significant difference was observed in males (adjusted HR 0.89, 95% CI: 0.59-1.33; p=0.574).</p><p><strong>Conclusions: </strong>CT-FFR-guided management was associated with different clinical patterns between females and males. Particularly in males, CT-FFR guidance reduced unnecessary angiography. A lower 2-year adverse event rate was observed among females in the CT-FFR group. However, given the absence of a statistically significant interaction between sex and treatment strategy, these findings should be considered exploratory and hypothesis-generating. (ClinicalTrials.gov: NCT03901326).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 17","pages":"e946-e954"},"PeriodicalIF":9.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901674","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":"Lower noradrenaline-mediated mean arterial pressure target in patients with acute myocardial infarction-related cardiogenic shock: rationale and design of the NORshock study.","authors":"Sanne Ten Berg, Elma J Peters, Margriet Bogerd, Luuk C Otterspoor, Annemarie E Engström, Wim K Lagrand, Mina Karami, Niels J W Verouden, Jose M Montero-Cabezas, Adriaan O Kraaijeveld, Erik Lipšic, Sakir Akin, Corstiaan A den, Alexander D Cornet, Pascalle S Monraats, Krischan D Sjauw, Christian Hassager, Martin S Frydland, Christian Jung, Ibrahim Akin, Tim Balthazar, Pascal Frederiks, Pieter Jan Palmers, Tomaz Goslar, Jure Fluher, Arash Mokhtari, Andreas S Triantafyllis, Jan Bělohlávek, Alastair G Proudfoot, Olusegun Olusanya, Gard F T Svingen, David Fagnoul, Vasileios Panoulas, Matthew Govier, Marcel G W Dijkgraaf, Alexander P J Vlaar, Jose P S Henriques","doi":"10.4244/EIJ-D-26-00112","DOIUrl":"10.4244/EIJ-D-26-00112","url":null,"abstract":"<p><p>Acute myocardial infarction-related cardiogenic shock (AMI-CS) is commonly clinically characterised by low blood pressure. Noradrenaline is the guideline-recommended first-line vasopressor therapy in patients in cardiogenic shock to increase blood pressure. Although no strict criteria exist, noradrenaline is commonly titrated to a mean arterial pressure (MAP) of above 65 mmHg. No evidence exists, however, that targeting a pharmacologically induced MAP of above 65 mmHg improves clinical outcome. Furthermore, noradrenaline is associated with unwanted effects such as elevated afterload, increased myocardial oxygen demand, and arrhythmias. Therefore, we sought to investigate whether treatment with a lower noradrenaline-mediated MAP-target regimen in AMI-CS patients leads to improved outcomes. In this international, open-label, multicentre, randomised superiority trial, 776 patients will be allocated in a 1:1 ratio to either the index treatment of a lower noradrenaline-mediated MAP-target regimen (MAP of 55 mmHg) or a standard noradrenaline-mediated MAP-target regimen (MAP of at least 65 mmHg). The NORshock trial tests the hypothesis that a permissive hypotension treatment strategy with reduced use of noradrenaline in patients with AMI-CS is superior to standard care in terms of a combined endpoint of all-cause death and renal replacement therapy within 30 days. The NORshock trial is the first randomised trial investigating a strategy of a lower noradrenaline-mediated MAP-target regimen (MAP of 55 mmHg) compared with a standard noradrenaline-mediated MAP-target regimen (MAP of at least 65 mmHg) on clinical outcomes in AMI-CS patients.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 17","pages":"e955-e961"},"PeriodicalIF":9.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901589","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":"Dual antiplatelet therapy after left atrial appendage closure: time to move on.","authors":"Xavier Freixa, Giovanni Occhipinti","doi":"10.4244/EIJ-D-26-00863","DOIUrl":"10.4244/EIJ-D-26-00863","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 17","pages":"e913-e915"},"PeriodicalIF":9.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901522","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":"Reduced-dose direct oral anticoagulant versus antiplatelet strategies after left atrial appendage occlusion.","authors":"Laurent Fauchier, Mathieu Nasarre, Bertrand Pierre, Arnaud Bisson, Gregory Y H Lip","doi":"10.4244/EIJ-D-26-00102","DOIUrl":"10.4244/EIJ-D-26-00102","url":null,"abstract":"<p><strong>Background: </strong>The optimal antithrombotic therapy after left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) remains uncertain. Reduced-dose direct oral anticoagulation (DOAC) is increasingly used in clinical practice as an alternative to antiplatelet-based strategies, but comparative outcome data are limited.</p><p><strong>Aims: </strong>We sought to compare the clinical outcomes associated with low-dose DOAC therapy versus dual antiplatelet therapy (DAPT) or single antiplatelet therapy (SAPT) after LAAO.</p><p><strong>Methods: </strong>Using the TriNetX Global Network, we identified adult patients with AF who underwent percutaneous LAAO between 2010 and 2025. Three parallel propensity score-matched analyses were conducted: reduced-dose DOAC versus DAPT, SAPT versus DAPT, and reduced-dose DOAC versus SAPT. Outcomes included all-cause death, thromboembolic events, device-related thrombosis, bleeding events, and net clinical benefit (NCB).</p><p><strong>Results: </strong>After matching, 1,773 patients were included in each group for the reduced-dose DOAC versus DAPT comparison (mean follow-up 1.4±1.0 years). Reduced-dose DOAC was associated with lower risks of all-cause death (hazard ratio [HR] 0.79, 95% confidence interval [CI]: 0.65-0.96) and major bleeding (HR 0.87, 95% CI: 0.77-0.98), with no significant differences in ischaemic stroke, thromboembolism, or device-related thrombosis. NCB favoured reduced-dose DOAC (HR 0.87, 95% CI: 0.78-0.96). SAPT was also associated with fewer bleeding events and favourable outcomes compared with DAPT. In the reduced-dose DOAC versus SAPT comparison (1,582 matched patients per group), reduced-dose DOAC showed estimates compatible with a slightly higher risk of major bleeding compared with SAPT (HR 1.14, 95% CI: 1.00-1.30; p=0.06), while mortality, thromboembolic outcomes, and NCB did not differ significantly.</p><p><strong>Conclusions: </strong>In contemporary practice after LAAO, reduced-dose DOAC therapy was associated with more favourable outcomes than DAPT but showed no clear advantage over SAPT, supporting simplified and individualised post-implantation antithrombotic strategies.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 17","pages":"e935-e945"},"PeriodicalIF":9.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901678","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":"Multimodality imaging for pre-, intra-, and postprocedural guidance of left atrial appendage closure: a European Left Atrial Appendage Closure Club (ELAACC) expert consensus statement.","authors":"Nina C Wunderlich, Laura Sanchis Ruiz, Adel Aminian, Sergio Berti, Lorenz Räber, Roberto Galea, Xavier Freixa, Christoph Hammerstingl, Jens Erik Nielsen-Kudsk, Tom De Potter, Andi Rroku, Ignacio Cruz-Gonzalez, Ole De Backer, Philippe Garot","doi":"10.4244/EIJ-D-25-01372","DOIUrl":"10.4244/EIJ-D-25-01372","url":null,"abstract":"<p><p>Left atrial appendage closure (LAAC) is an established alternative for stroke prevention in patients with non-valvular atrial fibrillation who are not suitable candidates for long-term oral anticoagulation. Imaging is central to procedural success and safety, yet variability in acquisition, measurement, and reporting contributes to inconsistent workflows and outcomes among centres. This expert consensus document from the European Left Atrial Appendage Closure Club provides a unified framework for pre-, intra-, and postprocedural imaging in LAAC with the aim of reducing variability, standardising workflows, and improving clinical reproducibility. The consensus emphasises high-quality image acquisition, reproducible measurements, and the prioritisation of three-dimensional (3D) imaging techniques and multiplanar reconstruction. Standardised terminology, core anatomical parameters, and device-oriented requirements are defined to support consistent procedural planning and device selection. Intraprocedural recommendations focus on real-time guidance using 3D transoesophageal echocardiography, intracardiac echocardiography, and fusion imaging for transseptal puncture, device alignment, deployment, and sealing assessment. Postprocedural guidance harmonises echocardiographic and cardiac computed tomography criteria and proposes structured follow-up pathways for the assessment of device-related thrombus, peridevice leak, and device stability. By promoting consistent nomenclature and structured, evidence-informed imaging strategies across the entire LAAC pathway, this consensus aims to enhance procedural safety, improve reproducibility, and support uniform, high-quality LAAC practice across centres.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 17","pages":"e918-e934"},"PeriodicalIF":9.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901505","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":"CT-FFR in females: a benefit in search of a mechanism?","authors":"Stephane Fournier, Georgios Tzimas","doi":"10.4244/EIJ-D-26-00883","DOIUrl":"10.4244/EIJ-D-26-00883","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 17","pages":"e916-e917"},"PeriodicalIF":9.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901577","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 randomised trial of carbon dioxide flushing to reduce vascular brain injury in patients undergoing TAVI.","authors":"Saud Ahmed Khawaja, Lydia Hanna, Abhinav Singh, Carla Lucarelli, Prerna Garg, Iqbal Malik, Nearchos Hadjiloizou, Neil Ruparelia, Adam Hartley, Ramzi Khamis, Matthew Shun Shin, Richard Gibbs, Ghada W Mikhail","doi":"10.4244/EIJ-D-26-00425","DOIUrl":"10.4244/EIJ-D-26-00425","url":null,"abstract":"<p><strong>Background: </strong>Stroke remains a significant concern in patients undergoing transcatheter aortic valve implantation (TAVI). Despite advances in TAVI technology and techniques, stroke rates have remained unchanged, with trials of cerebral embolic protection devices failing to reduce rates. The concept of air emboli has not been previously investigated in TAVI procedures. We hypothesised that gaseous emboli could play a significant role in TAVI and that carbon dioxide (CO₂) flushing of the TAVI valves could reduce the incidence of new neurological lesions post-TAVI.</p><p><strong>Aims: </strong>We aimed to demonstrate the neuroprotective benefits of CO₂ flushing in TAVI patients.</p><p><strong>Methods: </strong>INTERCEPTavi is a single-centre, blinded, randomised controlled pilot trial that studied the effects of flushing TAVI valves with CO₂ versus conventional saline on neurological outcomes post-TAVI, assessed using magnetic resonance imaging (MRI) and transcranial Doppler (TCD). Patients with aortic stenosis were randomised after obtaining vascular access. Periprocedural TCD assessed solid and gaseous emboli to the brain. Post-procedure, patients underwent brain MRI to detect lesions. Here, we report the primary outcome of feasibility, as well as the secondary MRI and mechanistic TCD outcomes.</p><p><strong>Results: </strong>A total of 60 patients were recruited and randomised 1:1 to CO₂ and saline flushing (TAVI-CO₂) versus saline flushing only (TAVI-S). CO₂ flushing significantly reduced the average number of lesions per patient (TAVI-CO₂: 4 lesions/patient vs TAVI-S: 8.5 lesions/patient; p=0.031). The total infarct area was numerically lower in the TAVI-CO₂ group (40.32 mm² vs 93.20 mm²), although this did not reach statistical significance (p=0.111). Similarly, TCD showed fewer microembolic signals in the TAVI-CO₂ arm, primarily due to a reduction in gaseous emboli, but this difference was not statistically significant (p=0.5).</p><p><strong>Conclusions: </strong>INTERCEPTavi is a pioneering, first-in-human randomised trial that demonstrated that CO₂ flushing of the TAVI valve reduces the number of cerebral lesions measured on MRI. CO₂ flushing is an accessible, cost-effective method that can be easily implemented in any catheter laboratory to provide neurological advantages.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"883-890"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037677","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 bioadaptors will replace drug-eluting stents: pros and cons.","authors":"David Erlinge, Giandomenico Mancini, Valeria Paradies","doi":"10.4244/EIJ-E-26-00014","DOIUrl":"https://doi.org/10.4244/EIJ-E-26-00014","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 16","pages":"837-839"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801567","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}