Eurointervention最新文献

{"title":"A novel tricuspid flow optimiser for severe tricuspid regurgitation (TRiFlO).","authors":"Gian Paolo Ussia, Valeria Cammalleri, Massimiliano Carassiti, Francesco Grigioni, Antonio Mangieri, Antonio Colombo","doi":"10.4244/EIJ-D-24-00600","DOIUrl":"10.4244/EIJ-D-24-00600","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 24","pages":"e1523-e1525"},"PeriodicalIF":7.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830835","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":"Readmissions after next-day discharge following transcatheter aortic valve implantation.","authors":"Rodrigo Bagur, Michael W A Chu, Conrad Kabali, Santiago Ordoñez, Ali S Husain, Sung-Han Yoon, Luis A Palma Dallan, Abdulmajeed Alosail, Jasem Althekrallah, Mathew Valdis, Patrick Teefy, Pantelis Diamantouros, John G Webb, Guilherme F Attizzani","doi":"10.4244/EIJ-D-24-00514","DOIUrl":"10.4244/EIJ-D-24-00514","url":null,"abstract":"<p><strong>Background: </strong>No data compare newer-generation transcatheter heart valves (THVs) in terms of next-day discharge (NDD) following transfemoral (TF) transcatheter aortic valve implantation (TAVI).</p><p><strong>Aims: </strong>We aimed to evaluate the safety of NDD in unselected patients who received ACURATE (neo/neo2), Evolut (PRO/PRO+/FX) and the SAPIEN (3/Ultra) THVs.</p><p><strong>Methods: </strong>This multicentre registry included patients who underwent TF-TAVI without a preprocedural permanent pacemaker implantation (PPI) and were discharged the next day without a new PPI. The primary endpoint was unplanned readmissions at 30 days. Multinomial gradient-boosted inverse probability of treatment-weighted (IPTW) propensity scores (stage 1) followed by the modified Poisson regression (stage 2) approach were used to compare the average effects of the THVs on the primary outcome.</p><p><strong>Results: </strong>A total of 963 all-comer patients (ACURATE=264, Evolut=306, and SAPIEN=393) were included in this study. ACURATE patients were older (p<0.001) and included a greater proportion of females (p<0.001), whereas Evolut patients had a higher risk profile as assessed by the Society of Thoracic Surgeons score (p=0.01). There were no differences between the groups in terms of right or left bundle branch block (p=0.75). At 30 days, the overall readmission rate was 8%, and there were no differences in cardiac (ACURATE 4.6% vs Evolut 4.2% vs SAPIEN 3.1%; p=0.56) or non-cardiac readmissions (ACURATE 4.6% vs Evolut 3.3% vs SAPIEN 4.6%; p=0.64). Readmission for new PPI was 2.7%, 1.0% and 1.8% (p=0.32) and for heart failure (HF) was 1.5%, 2.0% and 1.3% (p=0.76) in ACURATE, Evolut and SAPIEN patients, respectively. The IPTW propensity score model followed by modified Poisson regression indicate that, using ACURATE as the reference, no significant differences were found in 30-day readmissions (relative risk [RR] 0.76, 95% confidence interval [CI]: 0.38-1.52; p=0.38 for Evolut and RR 0.74, 95% CI: 0.44-1.22; p=0.28 for SAPIEN).</p><p><strong>Conclusions: </strong>In pacemaker-naïve patients undergoing TF-TAVI with newer-generation THVs, NDD was not associated with a negative impact on overall 30-day readmissions, cardiac or non-cardiac readmissions, readmissions for PPI or HF after discharge, or mortality, regardless of the type of THV.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 24","pages":"e1505-e1519"},"PeriodicalIF":7.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830855","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":"Lifetime management considerations to optimise transcatheter aortic valve implantation: a practical guide.","authors":"Karan Rao, Alexandra Baer, Vinayak N Bapat, Nicolo Piazza, Peter Hansen, Bernard Prendergast, Ravinay Bhindi","doi":"10.4244/EIJ-D-24-00332","DOIUrl":"10.4244/EIJ-D-24-00332","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) is a safe and effective procedure for the treatment of aortic stenosis. With the recently broadened indications, there is a larger cohort of patients likely to outlive their first transcatheter heart valve (THV). This review discusses relevant lifetime planning considerations, focusing on the utility of preprocedural computed tomography imaging to help implanters future-proof their patients who are likely to outlive their first valve. The initial priority is to optimise the index procedure by maximising THV haemodynamic function and durability. This involves maximising the effective orifice area, minimising the risk of new pacemaker implantation, reducing paravalvular regurgitation, and preventing coronary obstruction and annular rupture. In patients requiring a second valve procedure, a significant proportion will require a TAVI-in-TAVI, and implanters should consider the key priorities for a redo procedure, including the increased risks of patient-prosthesis mismatch and conduction abnormalities, promoting coronary reaccessibility, and preventing coronary obstruction and sinus sequestration. Careful planning can identify potential hurdles as well as predict the feasibility and likely outcomes of redo-TAVI, to help individualise care over the lifetime of each patient.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 24","pages":"e1493-e1504"},"PeriodicalIF":7.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830853","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 computed tomography angiography is the new reference standard for the diagnosis of coronary artery disease: pros and cons.","authors":"Marc Dewey, Federico Biavati, Alfredo Marchese, Roberta Rossini","doi":"10.4244/EIJ-E-24-00055","DOIUrl":"10.4244/EIJ-E-24-00055","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 24","pages":"e1490-e1492"},"PeriodicalIF":7.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830849","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":"Very long-term outcomes of mitral transcatheter edge-to-edge repair.","authors":"Marta Bargagna, Nicola Buzzatti, Paolo Denti, Alessandra Sala, Guido Ascione, Nicolò Azzola Guicciardi, Matteo Saccocci, Claudio Ruffo, Roberta Meneghin, Francesco Ancona, Cosmo Godino, Eustachio Agricola, Anna M Scandroglio, Ottavio Alfieri, Michele De Bonis, Francesco Maisano","doi":"10.4244/EIJ-D-24-00392","DOIUrl":"10.4244/EIJ-D-24-00392","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 24","pages":"e1520-e1522"},"PeriodicalIF":7.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830857","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":"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}