Eurointervention最新文献

{"title":"Intermediate coronary stenosis evaluation in patients with or without diabetes: are FFR and IVUS equally \"sweet\"?","authors":"Nieves Gonzalo, Marco Lombardi","doi":"10.4244/EIJ-E-24-00073","DOIUrl":"10.4244/EIJ-E-24-00073","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e147-e148"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124022","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 intravascular imaging-guided percutaneous coronary intervention according to lesion complexity.","authors":"Sang Yoon Lee, Seung-Jae Lee, Woochan Kwon, Seung Hun Lee, Doosup Shin, Sang Yeub Lee, Sang Min Kim, Kyeong Ho Yun, Jae Young Cho, Chan Joon Kim, Hyo-Suk Ahn, Chang-Wook Nam, Hyuck-Jun Yoon, Yong Hwan Park, Wang Soo Lee, Ki Hong Choi, Taek Kyu Park, Jeong Hoon Yang, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Young Bin Song, Joo-Yong Hahn, Jong-Young Lee, Joo Myung Lee, The Renovate-Complex-Pci Investigators","doi":"10.4244/EIJ-D-24-00755","DOIUrl":"10.4244/EIJ-D-24-00755","url":null,"abstract":"<p><strong>Background: </strong>Recent trials have shown that intravascular imaging (IVI)-guided percutaneous coronary intervention (PCI) improves clinical outcome, as compared to angiography-guided PCI, in complex coronary artery lesions. However, it is unclear whether this benefit is affected by overall lesion complexity in each patient.</p><p><strong>Aims: </strong>The present study sought to investigate the impact of overall lesion complexity on the benefit of IVI-guided PCI.</p><p><strong>Methods: </strong>A total of 4,611 patients with complex coronary artery lesions from the RENOVATE-COMPLEX-PCI trial (n=1,639) and the institutional registry of the Samsung Medical Center (n=2,972) were classified according to the number of complex lesion features found in each patient. The primary outcome was target vessel failure (TVF) at 3 years, a composite of cardiac death, target vessel myocardial infarction, or target vessel revascularisation.</p><p><strong>Results: </strong>The cutoff value for the number of complex lesion features to predict TVF, determined using the maximally selected log-rank test, was 3. Patients with ≥3 complex lesion features had a higher risk of TVF than those with <3 complex lesion features (11.0% vs 7.2%, hazard ratio [HR] 1.59, 95% confidence interval [CI]: 1.28-1.96; p<0.001). IVI-guided PCI significantly reduced the risk of TVF compared with angiography-guided PCI in both groups (≥3 complex lesion features: 7.4% vs 14.4%, HR 0.49, 95% CI: 0.35-0.69; p<0.001; <3 complex lesion features: 5.7% vs 8.1%, HR 0.72, 95% CI: 0.53-0.98; p=0.039). The benefit of IVI-guided PCI tended to increase as the number of complex lesion features increased (absolute risk reduction for TVF: -0.012 vs -0.027 vs -0.055 vs -0.077, respectively, for 1 vs 2 vs 3 vs ≥4 complex lesion features; interaction p=0.048).</p><p><strong>Conclusions: </strong>In patients with complex coronary artery lesions, IVI-guided PCI showed a lower risk of TVF across all degrees of lesion complexity. The prognostic benefit of IVI-guided PCI tended to increase as patients had more complex lesion features. (RENOVATE-COMPLEX-PCI [ClinicalTrials.gov: NCT03381872]; Institutional cardiovascular catheterisation database of the Samsung Medical Center [ClinicalTrials.gov: NCT03870815]).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e171-e182"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124037","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 pressure wire holds its ground: the debacle of QFR.","authors":"Carlos Collet, Kazumasa Ikeda, Takuya Mizukami","doi":"10.4244/EIJ-E-25-00001","DOIUrl":"10.4244/EIJ-E-25-00001","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e143-e144"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124040","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":"Reverse CART facilitated by a novel perfusion balloon in chronic total occlusion percutaneous coronary intervention.","authors":"Primero Ng, Nestor Mercado, William L Lombardi, Lorenzo Azzalini","doi":"10.4244/EIJ-D-24-00895","DOIUrl":"10.4244/EIJ-D-24-00895","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e193-e194"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124038","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 revascularisation deferral based on quantitative flow ratio or fractional flow reserve: a post hoc analysis of the FAVOR III Europe trial.","authors":"Birgitte K Andersen, Niels R Holm, Lone J H Mogensen, Luc Maillard, Truls Råmunddal, Andrea Erriquez, Evald H Christiansen, Javier Escaned, On Behalf Of The Favor Iii Europe Study Team","doi":"10.4244/EIJ-D-24-01001","DOIUrl":"10.4244/EIJ-D-24-01001","url":null,"abstract":"<p><strong>Background: </strong>Safe deferral of revascularisation is a key aspect of physiology-guided percutaneous coronary intervention (PCI). While recent evidence gathered in the FAVOR III Europe trial showed that quantitative flow ratio (QFR) guidance did not meet non-inferiority to fractional flow reserve (FFR) guidance, it remains unknown if QFR might have a specific value in revascularisation deferral.</p><p><strong>Aims: </strong>We aimed to evaluate the safety of coronary revascularisation deferral based on QFR as compared with FFR.</p><p><strong>Methods: </strong>Patients randomised in the FAVOR III trial in whom PCI was deferred in at least one coronary artery, based on QFR or FFR>0.80, were included in the present substudy. The primary outcome was the 1-year rate of major adverse cardiac events (MACE), with results reported for two subsets of deferred patients: (1) any study lesion deferral and (2) complete study lesion deferral.</p><p><strong>Results: </strong>A total of 523 patients (55.2%) in the QFR group and 599 patients (65.3%) in the FFR group had at least one coronary revascularisation deferral. Of these, 433 patients (82.8%) and 511 (85.3%) patients, respectively, had complete study lesion deferral. In the \"complete study lesion deferral\" patient group, the occurrence of MACE was significantly higher in QFR-deferred patients as compared with FFR-deferred patients (24 [5.6%] vs 14 [2.8%], adjusted hazard ratio [HR] 2.07, 95% confidence interval [CI]: 1.07-4.03; p=0.03). In the subgroup of \"any study lesion deferral\", the MACE rate was 5.6% vs 3.6% (QFR vs FFR), adjusted HR 1.55, 95% CI: 0.88-2.73; p=0.13.</p><p><strong>Conclusions: </strong>QFR-based deferral of coronary artery revascularisation resulted in a higher incidence of 1-year MACE as compared with FFR-based deferral.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e161-e170"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924089","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":"Fractional flow reserve- and intravascular ultrasound-guided strategies for intermediate coronary stenosis and low lesion complexity in patients with or without diabetes: a post hoc analysis of the randomised FLAVOUR trial.","authors":"Sung Woo Cho, Jeehoon Kang, Jinlong Zhang, Xinyang Hu, Ji-Won Hwang, Jae-Jin Kwak, Joo-Yong Hahn, Chang-Wook Nam, Bong-Ki Lee, Weon Kim, Jinyu Huang, Fan Jiang, Hao Zhou, Peng Chen, Lijiang Tang, Wenbing Jiang, Xiaomin Chen, Wenming He, Sung Gyun Ahn, Myeong-Ho Yoon, Ung Kim, Joo Myung Lee, Doyeon Hwang, You-Jeong Ki, Eun-Seok Shin, Hyo-Soo Kim, Seung-Jea Tahk, Jian'an Wang, Bon-Kwon Koo, Joon-Hyung Doh","doi":"10.4244/EIJ-D-24-00589","DOIUrl":"10.4244/EIJ-D-24-00589","url":null,"abstract":"<p><strong>Background: </strong>A recent randomised trial demonstrated fractional flow reserve (FFR) guidance for percutaneous coronary intervention (PCI) was non-inferior to intravascular ultrasound (IVUS) guidance regarding clinical outcomes, with a lower frequency of PCI.</p><p><strong>Aims: </strong>We sought to evaluate the prognosis of FFR versus IVUS guidance for PCI of intermediate coronary artery stenosis and low lesion complexity in diabetic and non-diabetic patients.</p><p><strong>Methods: </strong>This study is a prespecified post hoc analysis from the FLAVOUR trial. The primary outcome was major adverse cardiac events (MACE) at 24 months, defined as a composite of death, myocardial infarction or any revascularisation. The secondary outcomes were target vessel failure (TVF) and each component of MACE and TVF at 24 months.</p><p><strong>Results: </strong>Among 1,682 randomly assigned patients, 554 (32.9%) had diabetes, and the mean SYNTAX score was 8.64±6.03 at baseline. The FFR group had a lower PCI rate than the IVUS group in both diabetic (48.2% vs 69.1%; p<0.001) and non-diabetic (42.6% vs 63.3%; p<0.001) patients. At 24 months, there was no difference in the cumulative incidence of MACE between the FFR and the IVUS groups in either diabetic (9.3% vs 8.3%; p=0.90) or non-diabetic (7.5% vs 8.6%; p=0.50) patients. The cumulative incidence of TVF was also comparable between the FFR and the IVUS groups regardless of diabetic status.</p><p><strong>Conclusions: </strong>In patients with intermediate coronary stenosis and low lesion complexity, regardless of diabetic status, FFR guidance had no significant differences in MACE or TVF with a lower frequency of PCI compared with IVUS guidance.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e183-e192"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124019","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":"Intracoronary imaging: routine precision or reserve for complexity?","authors":"Ziad A Ali, Keyvan Karimi Galougahi, Gregg W Stone","doi":"10.4244/EIJ-E-24-00069","DOIUrl":"10.4244/EIJ-E-24-00069","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e145-e146"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124026","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":"Mechanical circulatory support for complex, high-risk percutaneous coronary intervention.","authors":"Enrico G Ferro, Joseph M Kim, Christina Lalani, Dawn J Abbott, Robert W Yeh","doi":"10.4244/EIJ-D-24-00386","DOIUrl":"10.4244/EIJ-D-24-00386","url":null,"abstract":"<p><p>The evidence base evaluating the use of mechanical circulatory support (MCS) devices in complex, high-risk percutaneous coronary intervention is evolving from a small number of randomised clinical trials to incorporate an amassing body of real-world data. Due to both the growing incidence of the procedures and the limitations of the evidence, there is wide variability in the use of MCS, and the benefits are actively debated. The goal of this review is to perform an integrated analysis of randomised and non-randomised studies which have informed clinical and regulatory decision-making in contemporary clinical practice. In addition, we describe forthcoming studies that have been specifically designed to advance the field and resolve ongoing controversies that remain unanswered for this complex, high-risk patient population.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 3","pages":"e149-e160"},"PeriodicalIF":7.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124028","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 with the ACURATE neo2 in severe bicuspid aortic valve stenosis: the Neo2 BAV Registry.","authors":"Andreas Ruck, Won-Keun Kim, Paolo Alberto Del Sole, Max Wagener, Angela McInerney, Magdi S Yacoub, Elfatih A Hasabo, Cagri Ayhan, Hesham Elzomor, Dina Neiroukh, Abdul Amir, Nawzad Saleh, Magnus Settergren, Rickard Lindler, Dinos Verouhis, Samuel Sossalla, Matthias Renker, Matteo Montorfano, Barbara Bellini, Xavier Carrillo Suarez, Victoria Vilalta Del Olmo, Federico De Marco, Matteo Biroli, Helge Mollmann, Eckel Clemens Enno, Giuseppe Tarantini, Tommaso Fabris, Alfonso Ielasi, Giuliano Costa, Marco Barbanti, Osama Soliman, Darren Mylotte","doi":"10.4244/EIJ-D-24-00869","DOIUrl":"10.4244/EIJ-D-24-00869","url":null,"abstract":"<p><strong>Background: </strong>The ACURATE neo2 is a contemporary transcatheter aortic valve implantation (TAVI) system approved for the treatment of severe aortic stenosis in Europe. The ACURATE neo2 has not been evaluated in bicuspid aortic valve (BAV) stenosis.</p><p><strong>Aims: </strong>We sought to evaluate the safety and efficacy of ACURATE neo2 in patients with BAV stenosis.</p><p><strong>Methods: </strong>We retrospectively analysed consecutive severe BAV stenosis patients undergoing TAVI with ACURATE neo2 at 10 European centres. Imaging data from preprocedural multislice computed tomography, pre- and postprocedural echocardiography, and procedural cinefluoroscopy were evaluated by a core laboratory. Valve Academic Research Consortium 3 (VARC-3)-defined 30-day procedure safety and efficacy were the primary endpoints. Adverse events were site-reported according to VARC-3 criteria.</p><p><strong>Results: </strong>Among 181 patients with BAV stenosis treated with the ACURATE neo2, the mean age was 77.5±7.2 years, 58.0% were female, and the Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score was 2.3% (1.6-3.7%). Most procedures were transfemoral, and predilatation was performed in all cases. A second valve was required in 4 cases (2.2%). VARC-3-defined technical success was 95.6%. The primary endpoints of device success and early safety occurred in 90.6% and 82.3%, respectively. At 30 days, cardiovascular death occurred in 2.2% (N=4) and stroke in 1.6% (N=3). Core laboratory-adjudicated echocardiography reported an effective orifice area of 2.0 (1.7-2.5) cm² and a mean transvalvular gradient of 6.5 (4.6-9.0) mmHg. Half of all cases (51.2%) had no paravalvular leak, while moderate leak occurred in 4.3%. A new permanent pacemaker was required in 11 patients (6.5%).</p><p><strong>Conclusions: </strong>The ACURATE neo2 demonstrated favourable clinical outcomes and bioprosthetic valve performance at 30 days in selected patients with severe BAV stenosis.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e130-e139"},"PeriodicalIF":7.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711883","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":"Myval transcatheter heart valve system: a new TAVI contender and remaining uncertainties.","authors":"Stephan Windecker, Daijiro Tomii","doi":"10.4244/EIJ-E-24-00067","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00067","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 2","pages":"e97-e99"},"PeriodicalIF":7.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016581","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}