Eurointervention最新文献

{"title":"Outcomes of complex, high-risk percutaneous coronary intervention in patients with severe aortic stenosis: the ASCoP registry.","authors":"Claudio Montalto, Andrea R Munafò, Francesco Soriano, Ketina Arslani, Stephanie Brunner, Sarah Verhemel, Ottavia Cozzi, Antonio Mangieri, Andrea Buono, Mattia Squillace, Stefano Nava, José Luis Díez Gil, Andrea Scotti, Marco Foroni, Giuseppe Esposito, Alessandro Mandurino-Mirizzi, David Bauer, Benjamin De Ornelas, Pablo Codner, Kerstin Piayda, Italo Porto, Federico De Marco, Horst Sievert, Ran Kornowski, Petr Tousek, Dionigi Fischetti, Azeem Latib, Jorge Sanz Sanchez, Diego Maffeo, Francesco Bedogni, Bernhard Reimers, Damiano Regazzoli, Nicolas Van Mieghem, Lars Sondergaard, Francesco Saia, Stefan Toggweiler, Ole De Backer, Jacopo A Oreglia","doi":"10.4244/EIJ-D-24-00933","DOIUrl":"10.4244/EIJ-D-24-00933","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of evidence to guide treatment of patients with a concomitant indication for transcatheter aortic valve implantation (TAVI) and complex, high-risk percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>We aimed to assess different strategies of PCI timing in this high-risk TAVI cohort.</p><p><strong>Methods: </strong>The ASCoP registry retrospectively included patients with a clinical indication for both TAVI and PCI with at least 1 criterion of complex or high-risk PCI. The primary endpoint was a composite of all-cause death and unplanned rehospitalisation for cardiovascular causes. The secondary endpoint was a composite of all-cause death, stroke, acute myocardial infarction, major bleeding, major vascular complication and unplanned revascularisation. Multivariable analysis was used to adjust for possible confounders.</p><p><strong>Results: </strong>A total of 519 patients were included: 363 (69.9%) underwent staged procedures and 156 (30.1%) concomitant TAVI and PCI. After 441 (interquartile range 182-824) days, the primary endpoint occurred in 151 (36.5%) cases, without any significant difference between the 2 groups (p=0.98), while the secondary endpoint occurred more frequently in the concomitant group (n=36 [25.8%] vs n=57 [17.4%]; p=0.014).</p><p><strong>Conclusions: </strong>In patients undergoing TAVI and complex/high-risk PCI, a concomitant strategy is associated with a higher rate of adverse events and increased procedural risk. (ClinicalTrials.gov: NCT05750927).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e426-e436"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058209","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":"Mapping interventional cardiology in Europe: the second edition of the European Society of Cardiology (ESC)/European Association of Percutaneous Cardiovascular Interventions (EAPCI) Atlas project.","authors":"Andreas Baumbach, Anantharaman Ramasamy, Christoph Naber, Adam Timmis, Dariusz Dudek, Dzianis Kazakevich, Radu Huculeci, Victor Aboyans, Panos Vardas, Emanuele Barbato, And Contributing National Cardiac Societies","doi":"10.4244/EIJ-D-24-00342","DOIUrl":"10.4244/EIJ-D-24-00342","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e437-e439"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025856","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":"Management of complications after valvular interventions.","authors":"Agam Bansal, Rishi Puri, James Yun, Amar Krishnaswamy, Hasan Jilaihawi, Raj Makkar, Samir R Kapadia","doi":"10.4244/EIJ-D-24-00066","DOIUrl":"10.4244/EIJ-D-24-00066","url":null,"abstract":"<p><p>Transcatheter valve interventions have transformed the outcomes of patients with valvular heart disease who are at high risk for surgery. With the increasing utilisation and expansion of transcatheter valve interventions, it is of utmost importance to be familiar with their potential complications and their subsequent management, especially given the relative infrequency of many of these issues in contemporary practice. Herein, we present a state-of-the-art review article focusing on the complications, their prevention, and treatment following transcatheter aortic valve implantation, mitral transcatheter edge-to-edge repair, and transcatheter mitral valve replacement.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e390-e410"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995289","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":"Transcatheter aortic valve implantation with complex, high-risk indicated PCI.","authors":"Tiffany Patterson, Benedict McDonaugh","doi":"10.4244/EIJ-E-25-00011","DOIUrl":"10.4244/EIJ-E-25-00011","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e385-e386"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042910","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":"Could the age threshold for TAVI be relaxed to below 65 years? Pros and cons.","authors":"Philippe Garot, Mariama Akodad, Mateo Marin-Cuartas, Michael A Borger","doi":"10.4244/EIJ-E-24-00071","DOIUrl":"10.4244/EIJ-E-24-00071","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e387-e389"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042166","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":"Management of bioprosthetic valve failure at 10 years after TAV-in-SAV.","authors":"Julius Jelisejevas, John G Webb-, David A Wood","doi":"10.4244/EIJ-D-24-00871","DOIUrl":"10.4244/EIJ-D-24-00871","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e440-e441"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058336","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":"Prognostic value of invasive versus echocardiography-derived aortic gradient in patients undergoing TAVI.","authors":"Mark M P van den Dorpel, Sraman Chatterjee, Rik Adrichem, Sarah Verhemel, Isabella Kardys, Rutger-Jan Nuis, Joost Daemen, Claire Ben Ren, Alexander Hirsch, Marcel L Geleijnse, Nicolas M Van Mieghem","doi":"10.4244/EIJ-D-24-00341","DOIUrl":"10.4244/EIJ-D-24-00341","url":null,"abstract":"<p><strong>Background: </strong>Recent studies report a discordance between invasive and echocardiography-derived gradients after transcatheter aortic valve implantation (TAVI) with balloon-expandable (BEV) and self-expanding valves (SEV). There are limited data on the determinants and clinical implications of this discordance.</p><p><strong>Aims: </strong>We aimed to examine the prognostic value of invasive and echocardiography-derived gradients after implantation of SEV and BEV and to compare gradients for SEV versus BEV.</p><p><strong>Methods: </strong>We performed a retrospective, propensity score-matched study. Invasive measurements were obtained before and immediately after TAVI. Echocardiography was performed before and within 24 hours after TAVI, and at 1 year. Clinical outcomes were assessed at 30 days, 1 year, and 2 years.</p><p><strong>Results: </strong>The 1:1 propensity score matching resulted in 436 matched pairs (436 SAPIEN 3 and 436 Evolut). Invasive gradients post-TAVI independently predicted higher risk for all-cause mortality at 30 days, 1 year and 2 years as a continuous variable (hazard ratio [HR] 1.07, 95% confidence interval [CI]: 1.00-1.14; p=0.038; HR 1.06, 95% CI: 1.01-1.11; p=0.007; HR 1.05, 95% CI: 1.01-1.09; p=0.011, respectively) and by using >10 mmHg as a cutoff (HR 1.95, 95% CI: 1.13-4.78; p=0.028; HR 1.91, 95% CI: 1.11-3.65; p=0.030; HR 1.61, 95% CI: 1.03-2.96; p=0.021, respectively), but echocardiography-derived gradients did not (HR 1.13, 95% CI: 0.87-1.75; p=0.247; HR 1.02, 95% CI: 0.95-1.10; p=0.639; HR 0.99, 95% CI: 0.94-1.07; p=0.979, respectively). Mean gradients before and after TAVI were higher by echocardiography than by invasive measurements. The difference was more pronounced after implantation with BEV than SEV (7.0 [25th-75th percentile: 4.0-11.0] mmHg vs 5.0 [2.0-7.0] mmHg; p<0.001). Smaller valve size, higher ejection fraction and higher stroke volume amplified the discordance. Invasive mean gradients were similar after SEV and BEV (3.0 [0.0-6.0] mmHg vs 3.0 [0.0-6.0] mmHg; p=0.166), but echo-derived mean gradients were lower after SEV versus BEV (8.0 [6.0-11.0] mmHg vs 11.0 [8.0-14.0] mmHg; p<0.001).</p><p><strong>Conclusions: </strong>Only invasively measured but not echocardiography-derived transvalvular mean gradients correlate with 30-day, 1-year and 2-year mortality. Aortic gradient measurements are higher by echocardiography than by invasive assessment and more so for BEV than SEV. Smaller valve size, higher ejection fraction and higher stroke volume increase this discordance between echocardiography and invasive assessment.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 8","pages":"e411-e425"},"PeriodicalIF":7.6,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026878","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 high-risk PCI assisted by VA-ECMO with local anaesthesia.","authors":"Alexander M Griffioen, Marleen H van Wely, Lokien X van Nunen, Stijn C H van den Oord, Herbert B van Wetten, Sytse F de Jong, Peter Damman, Niels van Royen, Robert Jan M van Geuns","doi":"10.4244/EIJ-D-24-00599","DOIUrl":"10.4244/EIJ-D-24-00599","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e376-e378"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797050","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":"Distal access and procedural anticoagulation to prevent radial artery occlusion after coronary angiography - the randomised RAPID trial.","authors":"Thomas Stiermaier, Matthias Grünewälder, Toni Pätz, Elias Rawish, Alexander Joost, Moritz Meusel, Christoph Marquetand, Thomas Kurz, Tobias Schmidt, Christian Frerker, Georg Fuernau, Ingo Eitel","doi":"10.4244/EIJ-D-24-00846","DOIUrl":"10.4244/EIJ-D-24-00846","url":null,"abstract":"<p><strong>Background: </strong>Distal transradial access (TRA) and procedural anticoagulation (AC) are among the strategies to prevent radial artery occlusion (RAO) that have some gaps in evidence.</p><p><strong>Aims: </strong>This study assessed the efficacy and safety of different radial access sites and procedural AC in patients undergoing coronary angiography (CAG).</p><p><strong>Methods: </strong>The RAPID trial is a single-centre, open-label, 2x2 factorial study that randomised patients to procedural AC versus no procedural AC and also to distal versus conventional TRA with further stratification according to pre-existing oral AC. Patients with indicated percutaneous coronary intervention (PCI) were excluded from the analysis. The primary endpoints were the incidence of RAO, assessed by vascular ultrasound, and bleeding events.</p><p><strong>Results: </strong>The trial was stopped early for efficacy by the data and safety monitoring board after the second preplanned interim analysis and inclusion of 600 participants. Excluding patients with indicated PCI, the final study population consisted of 439 patients. Distal TRA was associated with more access site crossovers (14.9% vs 8.3%; p=0.032) and a longer total procedure time (25 min vs 20 min; p=0.001) than conventional TRA. The rates of RAO (20.3% vs 21.2%; p=0.810) and bleeding events (4.1% vs 6.9%; p=0.188) were similar after distal and conventional TRA. In contrast, procedural AC reduced the incidence of RAO (7.3% vs 33.9%; p<0.001) without increasing bleeding risk (7.3% vs 3.6%; p=0.087). These results were consistent in patients on pre-existing oral AC and those with distal TRA.</p><p><strong>Conclusions: </strong>While distal TRA did not reduce the risk of RAO, procedural AC proved effective in all patients undergoing transradial CAG including those on pre-existing oral AC. (Strategies to Maintain Radial Artery Patency Following Diagnostic Coronary Angiography [RAPID] trial; ClinicalTrials.gov: NCT04301921 [RAPID-1] and NCT04362020 [RAPID-2]).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e366-e375"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797037","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":"Percutaneous coronary intervention for calcified and resistant lesions.","authors":"Gabriele Pesarini, Farrel Hellig, Ashok Seth, Richard Alan Shlofmitz, Flavio Luciano Ribichini","doi":"10.4244/EIJ-D-24-00195","DOIUrl":"10.4244/EIJ-D-24-00195","url":null,"abstract":"<p><p>Relevant calcified coronary artery disease (CCAD) may be present in around 20% of patients undergoing percutaneous coronary interventions, and it is known to add procedural challenges and risks. Careful patient selection and specific expertise in multimodality imaging and plaque modification techniques are required to plan and adopt the most appropriate therapeutic strategy. This review aims to present the contemporary clinical approach and procedural planning for CCAD patients, describing the available tools and strategies in view of the most recent scientific evidence.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 7","pages":"e339-e355"},"PeriodicalIF":7.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797076","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}