Eurointervention最新文献

{"title":"Spontaneous coronary artery dissection of the left anterior descending artery: a challenge in management.","authors":"Jacqueline Saw, Cathevine Yang","doi":"10.4244/EIJ-D-26-00799","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00799","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 16","pages":"840-841"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801648","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":"Characteristics and outcomes of spontaneous coronary artery dissection of the left anterior descending artery.","authors":"Alexander Marschall, Marcos García-Guimarães, Ricardo Sanz-Ruiz, Manel Sabaté, Maite Velazquez-Martín, Gabriela Veiga, Xacobe Flores-Rios, Helena Tizón-Marcos, Juan Manuel Nogales, Fernando Macaya, Soledad Ojeda, Santiago Camacho Freire, Gerard Roura, Pascual Bordes, Santiago Jimenez Valero, Xavier Carrillo-Suárez, Teresa Bastante, David Del Val, Rajiv Gulati, Fernando Alfonso","doi":"10.4244/EIJ-D-25-01394","DOIUrl":"10.4244/EIJ-D-25-01394","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous coronary artery dissection (SCAD) is an underrecognised cause of acute coronary syndrome (ACS). The left anterior descending artery (LAD) is most frequently affected, but the clinical and prognostic implications of SCAD in this location unclear.</p><p><strong>Aims: </strong>We sought to evaluate the clinical characteristics, angiographic features, management, and outcomes of patients with SCAD involving the LAD (LAD-SCAD) using data from a nationwide registry.</p><p><strong>Methods: </strong>The Spanish Registry on SCAD (SR-SCAD) is a prospective, multicentre registry enrolling consecutive patients with angiographically confirmed SCAD from 34 hospitals across Spain. Coronary angiograms were reviewed by a central core laboratory, and all clinical events were independently adjudicated. Primary endpoints were in-hospital major adverse events and long-term major adverse cardiovascular and cerebrovascular events (MACCE). Outcomes were compared between patients with and without LAD involvement.</p><p><strong>Results: </strong>Among 388 patients (mean age 54±11.5 years), 190 (49%) had LAD involvement, after excluding 8 patients with concomitant left main extension. Compared with other vessels, LAD dissections were longer (35 mm [interquartile range [IQR] 22-50] vs 30 mm [IQR 20-40]; p=0.01), more often multivessel (16% vs 3%; p<0.001) and multisegment (30% vs 19%; p=0.024), with higher creatine kinase-myocardial band (170 U/L [IQR 112-190] vs 24 U/L [IQR 4-78]; p=0.032), lower left ventricular ejection fraction (55±5.4% vs 58±6.6%; p=0.034), and more frequently treated with percutaneous coronary intervention (27% vs 17%; p=0.027). Notably, LAD involvement independently predicted higher long-term MACCE (adjusted hazard ratio 2.00, 95% confidence interval: 1.10-3.97; p=0.046), compared with SCAD in other locations.</p><p><strong>Conclusions: </strong>LAD-SCAD identifies patients with more complex angiographic features and higher long-term risk compared with non-LAD-SCAD. Despite frequent percutaneous coronary intervention, outcomes were not improved in this high-risk LAD population, emphasising the prognostic relevance of dissection location and supporting individualised treatment.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 16","pages":"874-882"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801615","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-dose, short-duration catheter-directed thrombolysis for acute intermediate-high-risk pulmonary embolism: the BETULA trial.","authors":"Jacob Schultz, Gro Egholm, Mikael Kjær Poulsen, Bo Løfgren, Morten Würtz, Hanne Maare Søndergaard, Mads Jønsson Andersen, Jacob Valentin Hansen, Gratien Andersen, Shifan Thangavel, Søren Mellemkjær, Anushree Burade, Mannudeep Kalra, Jens Erik Nielsen-Kudsk, Asger Andersen","doi":"10.4244/EIJ-D-26-00292","DOIUrl":"10.4244/EIJ-D-26-00292","url":null,"abstract":"<p><strong>Background: </strong>Catheter-directed thrombolysis (CDT) reduces the right-to-left ventricular ratio (RV/LV ratio) in patients with intermediate-risk pulmonary embolism (PE). Prior randomised studies comparing CDT to anticoagulation used ultrasound-assisted devices and high doses of thrombolytics with extended infusion durations, which may increase healthcare costs and complications, thereby limiting its clinical applicability.</p><p><strong>Aims: </strong>We sought to evaluate the efficacy and safety of low-dose, short-duration CDT compared with unfractionated heparin (UFH) in patients with acute intermediate-high-risk PE.</p><p><strong>Methods: </strong>In this open-label, randomised controlled trial, patients with acute intermediate-high-risk PE were randomised 1:1 to receive CDT (4 mg recombinant tissue plasminogen activator [r-tPA] per catheter over 2 hours) plus UFH or UFH alone. The primary endpoint was the change in RV/LV ratio at 24 hours. Secondary endpoints included thrombus burden reduction, changes in vital signs and echocardiographic measures of RV function, length of hospital stay, 30-day mortality, and 90-day recurrent PE. Safety endpoints included major and minor bleeding.</p><p><strong>Results: </strong>Between August 2020 and October 2024, 60 patients were randomised, with 58 completing follow-up (CDT: n=29; UFH: n=29). CDT plus UFH improved the RV/LV ratio at 24 hours compared with UFH alone (-0.17 vs +0.02; p=0.01). Secondary endpoints did not differ between groups. One death occurred in the UFH group. One patient experienced haemodynamic deterioration during CDT, successfully managed with additional r-tPA. No major bleeding occurred. Minor bleeding occurred in three patients (10%) in the CDT group and one (3%) in the UFH group (p=0.29).</p><p><strong>Conclusions: </strong>Low-dose, short-duration CDT plus UFH improved the RV/LV ratio without increasing major bleeding compared with UFH alone in intermediate-high-risk PE.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 16","pages":"903-912"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801549","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 patients with large anatomies undergoing transcatheter tricuspid valve replacement with the LuX-Valve Plus system.","authors":"Ole De Backer, Yinghao Lim, Ralph Stephan von Bardeleben, Arnaud Sudre, Augustin Coisne, Erwan Donal, Guillaume Leurent, Lionel Leroux, Mohammed Nejjari, Julien Dreyfus, Emmanuel Teiger, Thierry Folliguet, Thomas Cuisset, Pierre Deharo, Tobias Kister, Rodrigo Estévez-Loureiro, Eric Durand, Hélène Eltchaninoff, Yusuke Kobari, Jacob Eifer Møller, Tiffany Patterson, Guangyuan Song, Ignacio Cruz-Gonzalez, Omar Abdul-Jawad Altisent, Jean-François Obadia, Gilles Rioufol, Luis Nombela-Franco, Julien Ternacle, Didier Tchétché, Nicolas Dumonteil, Jörg Hausleiter, Juan F Granada, Thomas Modine","doi":"10.4244/EIJ-D-26-00062","DOIUrl":"https://doi.org/10.4244/EIJ-D-26-00062","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter tricuspid valve replacement (TTVR) is increasingly performed to treat patients with severe or greater symptomatic tricuspid regurgitation (TR) at high risk for surgery. However, patients with large tricuspid annuli are not eligible for most TTVR systems.</p><p><strong>Aims: </strong>This study aimed to report intraprocedural and 30-day clinical success rates for patients undergoing TTVR with the 55-70 mm LuX-Valve Plus system in the European TRINITY study cohort.</p><p><strong>Methods: </strong>The co-primary endpoints were intraprocedural and 30-day clinical success, as defined by the Tricuspid Valve Academic Research Consortium criteria. Clinical and echocardiographic outcomes were reported.</p><p><strong>Results: </strong>Enrolled patients (n=114) had a mean age of 77.8±5.8 years and a high Society of Thoracic Surgeons risk score of 9.9±6.0%. Intraprocedural success was 95.6%, with no cases of intraprocedural mortality or stroke. Two patients (1.8%) required cardiac surgery within the first 24 hours. At 30 days, 7 patients (6.1%) required a pacemaker implantation. Thirty-day clinical success was 91.2%, with residual severe TR being the primary reason for failure. In 93.7% of patients, residual TR was moderate or less. The mean Kansas City Cardiomyopathy Questionnaire score improved from 57.3±20.7 points to 71.0±23.5 points (p<0.001), and the proportion of patients with New York Heart Association Class III-IV symptoms reduced from 57.1% at baseline to 20.9% at 30 days (p<0.001).</p><p><strong>Conclusions: </strong>TTVR with the LuX-Valve Plus system to treat patients with severe or greater symptomatic TR and a large tricuspid annulus was associated with high intraprocedural and 30-day clinical success rates, significant TR reduction and functional improvement, and low permanent pacemaker implantation rates.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 16","pages":"891-902"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical outcomes of high-risk plaques with negative fractional flow reserve: the PECTUS-obs study.","authors":"Rick H J A Volleberg, Jan-Quinten Mol, Geert A A Versteeg, Joske L van der Zande, Anouar Belkacemi, Renicus S Hermanides, Martijn Meuwissen, Alexey V Protopopov, Peep Laanmets, Oleg V Krestyaninov, Casper F Laclé, Rohit M Oemrawsingh, Jan-Peter van Kuijk, Karin Arkenbout, Dirk J van der Heijden, Saman Rasoul, Erik Lipšic, Laura Rodwell, Cyril Camaro, Peter Damman, Tomasz Roleder, Elvin Kedhi, Maarten A H van Leeuwen, Robert-Jan M van Geuns, Niels van Royen","doi":"10.4244/EIJ-D-26-00416","DOIUrl":"10.4244/EIJ-D-26-00416","url":null,"abstract":"<p><strong>Background: </strong>High-risk plaques (HRP) in non-flow-limiting, deferred non-culprit lesions have been associated with adverse short-term cardiovascular outcomes after myocardial infarction (MI). However, the long-term prognostic implications remain largely unknown.</p><p><strong>Aims: </strong>This study sought to evaluate the long-term association between HRP and clinical outcome after MI Methods: In the prospective, observational PECTUS-obs study, 438 patients with recent MI underwent optical coherence tomography (OCT) of all fractional flow reserve-negative non-culprit lesions. Patients were grouped according to the presence or absence of at least one OCT-identified HRP. The current study evaluates the final long-term outcome. The primary patient-level endpoint was defined as major adverse cardiovascular events (MACE), a composite of cardiac death, non-fatal MI, or unplanned revascularisation, excluding all periprocedural, indeterminate, and stent failure-related events.</p><p><strong>Results: </strong>After a median follow-up of 1,828 days (interquartile range [IQR] 1,821-1,842), the presence of at least one HRP was associated with MACE (hazard ratio [HR] 1.87, 95% confidence interval [CI]: 1.11-3.14; p=0.017). Among the individual endpoint components, non-fatal MI (HR 4.07, 95% CI: 1.23-13.52; p=0.013) and unplanned revascularisation (HR 1.97, 95% CI: 1.07-3.64; p=0.027) occurred more frequently in patients with at least one HRP. In an exploratory landmark analysis, the risk associated with presence of HRP was observed only during the first 2 years of follow-up. The lesion-level incidence of target lesion failure did not differ significantly between groups (HR 1.65, 95% CI: 0.91-2.96; p=0.097).</p><p><strong>Conclusions: </strong>Non-flow-limiting, high-risk non-culprit plaques are associated with adverse patient-level clinical outcomes during long-term follow-up after MI, potentially with a more pronounced short-term risk.</p><p><strong>Clinicaltrials: </strong>gov: NCT03857971.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"864-873"},"PeriodicalIF":9.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037599","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":"Establishing the role of drug-coated balloons in bifurcation PCI: more difficult than it seems.","authors":"Tom Adriaenssens, Fernando Alfonso","doi":"10.4244/EIJ-E-26-00012","DOIUrl":"10.4244/EIJ-E-26-00012","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 15","pages":"e802-e804"},"PeriodicalIF":9.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665264","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":"Drug-coated versus conventional balloons for side branch treatment in coronary bifurcation lesions: an optical coherence tomography substudy of the OCVC-BIF randomised trial.","authors":"Daisuke Nakamura, Takayuki Ishihara, Tomoharu Dohi, Daisuke Sakamoto, Shumpei Kosugi, Naotaka Okamoto, Atsushi Kikuchi, Tsutomu Kawai, Naoki Mori, Ryu Shutta, Minoru Ichikawa, Yasunori Ueda, Toshiaki Mano, Masami Nishino, Tetsuya Watanabe, Yoshiharu Higuchi, Eisuke Hida, Tomoharu Sato, Shungo Hikoso, Daisaku Nakatani, Yohei Sotomi, Yasushi Sakata, On Behalf Of The Ocvc-Bif Investigators","doi":"10.4244/EIJ-D-26-00428","DOIUrl":"10.4244/EIJ-D-26-00428","url":null,"abstract":"<p><strong>Background: </strong>Coronary bifurcation lesions remain prone to side branch (SB) ostial restenosis. Kissing balloon inflation (KBI) is the standard of care for provisional stenting, but it induces mechanical injury. Drug-coated balloons (DCBs) may pharmacologically inhibit neointimal hyperplasia to improve long-term patency.</p><p><strong>Aims: </strong>We sought to evaluate mechanistic vascular healing and luminal changes of the SB after adjunctive SB-DCB versus SB-conventional balloon treatment using high-resolution serial optical coherence tomography (OCT).</p><p><strong>Methods: </strong>The randomised OCVC-BIF trial compared adjunctive SB-DCB (n=149) with non-DCB treatment (n=150) following main vessel stenting and protocolled KBI. The present prespecified study was restricted to those patients who completed analysable follow-up OCT pullbacks (n=221). Endpoints included the SB volume change and the main vessel stent healing parameters.</p><p><strong>Results: </strong>There was no significant difference in the ostium, minimum SB area, or SB volume between the DCB and non-DCB groups following percutaneous coronary intervention (PCI). Serial OCT analysis showed that the DCB group exhibited a lumen volume gain at the SB of 0.14±5.64 mm3 from post-PCI to 9-month follow-up, whereas the non-DCB group showed a mean loss of 2.15±9.51 mm3. Although this difference reached statistical significance in the prespecified parametric analysis (p=0.042), in the sensitivity analysis using the Wilcoxon rank-sum test, the difference was attenuated (0.45 [interquartile range [IQR] -3.83, 4.00] in DCB vs -0.65 [IQR -5.00, 2.50] in non-DCB; p=0.093). While in the DCB group, the SB lumen volume change from immediately after PCI to follow-up was not statistically significant (p=0.81), the non-DCB group demonstrated a statistically significant reduction in SB lumen volume (p=0.03). At 9 months, the incidence of uncovered and malapposed struts was low and comparable between groups across all segments.</p><p><strong>Conclusions: </strong>Adjunctive SB-DCB treatment after KBI showed no adverse effect on main vessel stent healing and a possible signal towards preservation of the SB lumen. These findings may support the mechanistic feasibility of this strategy in selected bifurcation lesions. (Japan Registry of Clinical Trials: jRCTs052200077).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e820-e831"},"PeriodicalIF":9.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037631","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: From feasibility to optimisation in PINNACLE-I.","authors":"Stefan Verheye","doi":"10.4244/EIJ-D-26-00314","DOIUrl":"10.4244/EIJ-D-26-00314","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 15","pages":"e836"},"PeriodicalIF":9.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665321","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: From feasibility to optimisation in PINNACLE-I.","authors":"Andrea Denegri, Michal Pruc, Lukasz Szarpak","doi":"10.4244/EIJ-D-26-00290","DOIUrl":"10.4244/EIJ-D-26-00290","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 15","pages":"e834-e835"},"PeriodicalIF":9.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148665299","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":"Intravascular lithotripsy in comparison to rotational atherectomy for calcified lesions: the ICARE OFDI randomised trial.","authors":"Benjamin Honton, Pascal Motreff, Jean-Sébastien Mallet, Thomas Hovasse, Matthieu Godin, Guilhem Malclès, Jerome Brunet, Nicolas Meneveau, Pierre Deharo, Benoit Lattuca, Erwan Bressollette, Michael Angioi, Hakim Benamer, Edouard Gerbaud, Bruno Pereira, Vincenzo Cesario, Antoine Poinas, Clémence Laperche, Antoine Sauguet, Géraud Souteyrand, Nicolas Amabile, Nicolas Combaret","doi":"10.4244/EIJ-D-26-00426","DOIUrl":"10.4244/EIJ-D-26-00426","url":null,"abstract":"<p><strong>Background: </strong>The management of calcified coronary lesions remains challenging. Although several devices for advanced plaque modification are available, their relative efficacy is debated.</p><p><strong>Aims: </strong>We aimed to compare intravascular lithotripsy (IVL)- and rotational atherectomy (RA)-based strategies for calcified plaque preparation during percutaneous coronary interventions (PCI).</p><p><strong>Methods: </strong>This multicentre, prospective, randomised non-inferiority trial compared IVL with RA for plaque preparation in moderate-to-severe stable calcified coronary lesions. All interventions were guided by optical frequency domain imaging. A non-inferiority margin of 0.75 mm² was prospectively defined based on prior intracoronary imaging studies, and the sample size calculation was based on a standard deviation of 1.9 mm², a one-sided alpha risk of 5%, and a power of 80%, under the assumption of no true difference between groups. The primary endpoint was the minimal stent area (MSA) following stent implantation. The target lesion failure (TLF) rate was analysed after 12 months.</p><p><strong>Results: </strong>A total of 169 patients (RA: n=86, IVL: n=83; 81.1% male; mean age 71.8±8.2 years) were included in the final analysis. The baseline characteristics of each group were balanced. Calcified nodules were identified in 48% of the patients. IVL was not inferior to RA for the primary endpoint (6.0±2.3 mm² vs 5.9±2.2 mm², respectively; p for non-inferiority<0.05). Adequate geometrical stent expansion was similar in both groups (RA: 65.1%, IVL: 65.1%; p=0.994), whereas major strut malapposition was more frequently observed in the RA group (RA: 80.2% vs IVL: 57.8%; p=0.002). There was no difference between groups in terms of periprocedural complications. The TLF rates between groups after 12 months were equivalent (RA: 1.2%, IVL: 2.4%; p=0.61).</p><p><strong>Conclusions: </strong>In this trial, the IVL strategy was non-inferior to the RA strategy regarding MSA for PCI in moderate-to-severe calcified coronary lesions, with a comparable safety profile and equivalent clinical outcomes.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e808-e819"},"PeriodicalIF":9.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13404358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037633","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}