Eurointervention最新文献

{"title":"IVUS has more robust data than OCT for PCI guidance: PROS and CONS.","authors":"Akiko Maehara, Jorge Sanz-Sánchez, Hector M Garcia-Garcia","doi":"10.4244/EIJ-E-24-00028","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00028","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1132-e1135"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301083","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":"Vascular response following implantation of the third-generation drug-eluting resorbable coronary magnesium scaffold: an intravascular imaging analysis of the BIOMAG-I first-in-human study.","authors":"Masaru Seguchi, Alp Aytekin, Erion Xhepa, Michael Haude, Adrian Wlodarczak, René J van der Schaaf, Jan Torzewski, Bert Ferdinande, Javier Escaned, Juan F Iglesias, Johan Bennett, Gabor G Toth, Ralph Toelg, Marcus Wiemer, Göran Olivecrona, Paul Vermeersch, Ron Waksman, Hector M Garcia-Garcia, Michael Joner","doi":"10.4244/EIJ-D-24-00055","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00055","url":null,"abstract":"<p><strong>Background: </strong>The 12-month outcomes of BIOMAG-I - the first-in-human study investigating the third-generation drug-eluting resorbable magnesium scaffold (DREAMS 3G) - showed promising results regarding clinical outcomes and late lumen loss.</p><p><strong>Aims: </strong>The current study aimed to investigate vascular healing parameters assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS), focusing on strut visibility, vessel and scaffold areas, and neointimal growth patterns.</p><p><strong>Methods: </strong>This is a BIOMAG-I substudy including patients with available serial OCT and IVUS data. We conducted a frame-based analysis of OCT findings in conjunction with IVUS-derived vessel and scaffold areas, evaluating the qualitative and quantitative aspects of vascular healing.</p><p><strong>Results: </strong>Among the 116 patients enrolled in this trial, 56 patients treated with DREAMS 3G were included in the analysis. At 12 months, OCT imaging revealed that 99.0% of the struts were invisible, and no malapposed struts were depicted. While the vessel area showed no significant difference between the timepoints, the minimum lumen area significantly decreased from post-percutaneous coronary intervention to 6 months (6.88 mm² to 4.75 mm²; p<0.0001), but no significant changes were observed between 6 and 12 months. Protruding neointimal tissue (PNT) - a unique neointimal presentation observed following resorbable magnesium scaffold implantation - was observed in 89.3% of the study patients at 12 months, and its area exhibited a 47.4% decrease from 6 to 12 months.</p><p><strong>Conclusions: </strong>This imaging substudy revealed that, at 12-month follow-up, virtually all struts of the DREAMS 3G scaffold became invisible, without evident malapposition. The vascular healing response to DREAMS 3G implantation also appeared favourable up to 12 months, which is indicated by advanced strut degradation and spontaneous regressing PNT between 6 and 12 months.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1173-e1183"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301086","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":"Impact of lesion morphology on stent elongation during bifurcation PCI: an in vivo OCT study.","authors":"Michael McGarvey,Lap-Tin Lam,Muhamad Abd Razak,Jennifer Barraclough,Kevin O'Gallagher,Ian Webb,Narbeh Melikian,Sundeep Kalra,Philip MacCarthy,Ajay M Shah,Jonathan M Hill,Thomas W Johnson,Jonathan Byrne,Rafal Dworakowski,Nilesh Pareek","doi":"10.4244/eij-d-23-00663","DOIUrl":"https://doi.org/10.4244/eij-d-23-00663","url":null,"abstract":"BACKGROUNDRecent observations in silico and in vivo reported that, during proximal optimisation technique, drug-eluting stents (DES) elongate, challenging conventional wisdom. The interaction between plaque morphology and radial expansion is well established, but little is known about the impact of plaque morphology on elongation.AIMSWe aimed to assess the longitudinal mechanical behaviour of contemporary DES in vivo and evaluate the relationship between post-percutaneous coronary intervention (PCI) stent elongation and lesion morphology, as assessed with optical coherence tomography (OCT).METHODSPatients treated with OCT-guided PCI to left main or left anterior descending artery bifurcations, between July 2017 and March 2022, from the King's Optical coherence Database Analysis Compendium were included. Patients were excluded if there were overlapping stents, if they had undergone prior PCI, or if there was inadequate image quality. Lesions were characterised as fibrocalcific, fibrous or lipid-rich by pre-PCI OCT. Following stent post-dilatation, stent expansion and final stent length were assessed. The primary outcome was the percentage change in stent length from baseline.RESULTSOf 501 eligible consecutive patients from this period, 116 were included. The median age was 66 years (interquartile range [IQR] 57-76), 31% were female, and 53.4% were treated for an acute coronary syndrome. A total of 50.0% of lesions were classified as fibrocalcific, 6.9% were fibrous, and 43.1% were lipid-rich. The change in relative stent length was 4.4% (IQR 1.0-8.9), with an increase of 3.1% (IQR 0.5-6.3) in fibrocalcific lesions, 3.3% (IQR 0.5-5.9) in fibrous lesions, and 6.4% (IQR 3.1-11.1) in lipid-rich plaque (p=0.006). In multivariate regression modelling, lipid-rich plaque was an independent predictor of stent elongation (odds ratio 3.689, 95% confidence interval: 1.604-8.484).CONCLUSIONSContemporary DES elongate following implantation and post-dilatation, and this is significantly mediated by plaque morphology. This is an important consideration when planning a strategy for DES implantation.","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"22 1","pages":"e1184-e1194"},"PeriodicalIF":6.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269710","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":"Serial intracoronary imaging to predict efficacy and safety of magnesium-based resorbable scaffolds.","authors":"Lorenz Räber, Ryota Kakizaki","doi":"10.4244/EIJ-E-24-00044","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00044","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1124-e1126"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301084","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":"Treatment extent of femoropopliteal disease and clinical outcomes following endovascular therapy.","authors":"Yong-Hoon Yoon, Jae-Hwan Lee, Won-Mook Hwang, Hyun-Woong Park, Jae-Hyung Roh, Seung-Jun Lee, Young-Guk Ko, Chul-Min Ahn, Cheol Woong Yu, Seung-Whan Lee, Young Jin Youn, Jong Kwan Park, Chang-Hwan Yoon, Seung-Woon Rha, Pil-Ki Min, Seung-Hyuk Choi, In-Ho Chae, Donghoon Choi, Of The K-Vis Investigators On Behalf","doi":"10.4244/EIJ-D-24-00037","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00037","url":null,"abstract":"<p><strong>Background: </strong>Endovascular therapy (EVT) has become the preferred treatment modality for femoropopliteal disease. However, there is limited evidence regarding its procedural and clinical outcomes according to the affected area.</p><p><strong>Aims: </strong>The aim of this study is to investigate clinical outcomes and device effectiveness according to treatment extent in the superficial femoral artery (SFA), popliteal artery (PA), or both.</p><p><strong>Methods: </strong>In this study, we analysed EVT for SFA (2,404 limbs), PA (155 limbs), SFA/PA (383 limbs) using the population in the K-VIS ELLA (Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases) registry. The primary endpoint was target lesion revascularisation (TLR) at 2 years.</p><p><strong>Results: </strong>The SFA/PA group exhibited a higher prevalence of anatomical complexity, characterised by long lesions, moderate to severe calcification, and total occlusion. The procedures were successful in 97.2% of SFA, 92.9% of PA, and 95.6% of SFA/PA EVTs. The 2-year TLR rates were 21.1%, 18.6%, and 32.7% in the SFA, PA, and SFA/PA groups, respectively. SFA/PA EVT was associated with a significantly increased risk for TLR compared to the SFA group (adjusted hazard ratio [HR] 1.48 [1.09-2.00]; p=0.008) and a trend towards an increased risk compared to the PA group (adjusted HR 1.80 [1.00-3.27]; p=0.052). After overlap weighting, the use of a drug-coated balloon (DCB) was shown to be beneficial, with the lowest TLR rate after SFA and SFA/PA EVT.</p><p><strong>Conclusions: </strong>In this large real-world registry, SFA/PA EVT was associated with an increased risk for TLR at 2 years compared to the SFA or PA EVT groups, with favourable outcomes when using a DCB or drug-eluting stent in the SFA/PA EVT group.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1154-e1162"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301085","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":"Clinical outcomes of acute limb ischaemia caused by femoropopliteal stent thrombosis.","authors":"Sho Nakao, Osamu Iida, Mitsuyoshi Takahara, Nobuhiro Suematsu, Terutoshi Yamaoka, Daisuke Matsuda, Tatsuya Nakama, Masahiko Fujihara, Kazuki Tobita, Eiji Koyama, Takuya Haraguchi, Kenji Ogata, Toshiaki Mano","doi":"10.4244/EIJ-D-24-00016","DOIUrl":"10.4244/EIJ-D-24-00016","url":null,"abstract":"<p><strong>Background: </strong>Although femoropopliteal-specific stents have durable patency, stent thrombosis (ST) may occur, which can lead to acute limb ischaemia (ALI).</p><p><strong>Aims: </strong>We aimed to investigate the clinical features and outcomes of ALI caused by femoropopliteal ST in patients with lower extremity artery disease.</p><p><strong>Methods: </strong>This multicentre retrospective study included 499 patients with ALI - of whom 108 patients had ALI caused by femoropopliteal ST (ST-ALI) and 391 patients had ALI caused by other aetiologies (de novo ALI) - who underwent treatment between September 2011 and March 2023. Clinical features and outcomes were compared between the two groups. The primary outcome measure was 12-month amputation-free survival; factors associated with amputation or death were investigated using multivariate Cox proportional hazards regression analysis.</p><p><strong>Results: </strong>Patients with ST-ALI were significantly more likely to exhibit conventional atherosclerotic risk factors, including diabetes mellitus (63% vs 26%) and haemodialysis (51% vs 10%) compared to patients with de novo ALI, whereas patients with de novo ALI were older (80 years vs 74 years) and more likely to have atrial fibrillation (49% vs 18%) than patients with ST-ALI. The 12-month amputation-free survival rate was significantly lower in the ST-ALI group than that in the de novo ALI group (51% vs 76%; p<0.001). Multivariate analysis revealed that ST-ALI, older age, haemodialysis, atrial fibrillation, the presence of a wound, peak C-reactive protein level, and non-ambulatory status all have an independent, positive association with death or major amputation.</p><p><strong>Conclusions: </strong>The current study revealed that patients with ST-ALI had worse clinical outcomes than those with de novo ALI, highlighting the need to maximise ST prevention.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1163-e1172"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301079","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":"Acute limb ischaemia from stent thrombosis: bad luck or bad protoplasm?","authors":"Sahil A Parikh,Robert S Zilinyi","doi":"10.4244/eij-e-24-00050","DOIUrl":"https://doi.org/10.4244/eij-e-24-00050","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"208 1","pages":"e1122-e1123"},"PeriodicalIF":6.2,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262044","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":"Drug-eluting devices for lower limb peripheral arterial disease.","authors":"Yann Gouëffic, Marianne Brodmann, Koen Deloose, Maxime Dubosq-Lebaz, Joakim Nordanstig","doi":"10.4244/EIJ-D-23-01080","DOIUrl":"10.4244/EIJ-D-23-01080","url":null,"abstract":"<p><p>Peripheral arterial disease is the third leading cause of cardiovascular morbidity after coronary artery disease and stroke. Lower limb peripheral arterial disease commonly involves infrainguinal arteries, may impair walking ability (intermittent claudication) and may confer a significant risk of limb loss (chronic limb-threatening ischaemia), depending on the severity of ischaemia. Endovascular treatment has become the mainstay revascularisation option in both the femoropopliteal and the below-the-knee arterial segments. After crossing and preparing the lesion, treatment results in these arterial segments can be enhanced by using drug-coated devices (drug-eluting stents and drug-coated balloons) that mitigate the occurrence of restenosis. As for other medical devices, the use of drug-eluting devices is based on their demonstrated safety and efficacy profiles when applied in the distinct segments of the lower limb vasculature. In this state-of-the-art narrative review we provide an overview of the safety and efficacy of drug-coated devices when used in the femoropopliteal and below-the-knee arterial segments.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1136-e1153"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301080","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":"Is it time for a myocardial infarction approach to high- and intermediate-high-risk pulmonary embolism?","authors":"Marco Zuin, Gregory Piazza","doi":"10.4244/EIJ-D-24-00267","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00267","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1129-e1131"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301082","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":"Expanding our understanding on stent expansion.","authors":"Gabor G Toth, Goran Stankovic","doi":"10.4244/EIJ-E-24-00042","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00042","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"20 18","pages":"e1127-e1128"},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301081","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}