Journal of the Society for Cardiovascular Angiography & Interventions最新文献

{"title":"Intravascular Imaging Guidance for Percutaneous Coronary Intervention: Balancing Clinical Outcomes and Cost-Effectiveness","authors":"Massoud A. Leesar MD, Mehmet Cilingiroglu MD","doi":"10.1016/j.jscai.2026.105441","DOIUrl":"10.1016/j.jscai.2026.105441","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105441"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148546681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover","authors":"","doi":"10.1016/S2772-9303(26)01302-5","DOIUrl":"10.1016/S2772-9303(26)01302-5","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105555"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148546722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transfemoral Valve-in-Valve Transcatheter Aortic Valve Replacement in a Patient With Chronic Dissection Flap","authors":"Stevan S. Pupovac MD, Caleb A. Sokolowski MD, James R. Taylor MD, Alan R. Hartman MD, Elana Koss MD, Robert S. Palazzo MD, Bruce Rutkin MD","doi":"10.1016/j.jscai.2026.105443","DOIUrl":"10.1016/j.jscai.2026.105443","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105443"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148531988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Use of Fibrinolytic Therapy for Treatment of STEMI in Northern New England Over Two Decades","authors":"Eric Rothstein MD,&nbsp;Thara Ali MD,&nbsp;Jared Christensen MD,&nbsp;Cassandra Brugger MA,&nbsp;Hannah Chaudry MD,&nbsp;Benjamin Kelemen,&nbsp;Natalia Berry MD","doi":"10.1016/j.jscai.2026.105390","DOIUrl":"10.1016/j.jscai.2026.105390","url":null,"abstract":"<div><h3>Background</h3><div>Geographic challenges complicate treatment of rural patients with ST-elevation myocardial infarction (STEMI), and many undergo a pharmacoinvasive (PI) strategy for optimal STEMI management. The PI population remains vastly understudied in contemporary interventional cardiology practice. This study sought to evaluate the changing comorbidities, clinical characteristics, treatment strategies and in-hospital outcomes over a twenty-year period between the premodern era (2001-2012) and the modern era (2013-2020) of patients who underwent a PI strategy for STEMI.</div></div><div><h3>Methods</h3><div>All patients presenting with a STEMI and treated with a PI strategy within the Dartmouth-Health regional STEMI network over a 20-year period were retrospectively analyzed. Patients were stratified to the premodern era (2000-2012) or the modern era (2013-2020), and patient-level data were compared between eras. Two coprimary outcomes of in-hospital major adverse cardiac events (death, recurrent myocardial infarction, ischemic stroke, and hemorrhagic stroke) and bleeding complications were compared between eras.</div></div><div><h3>Results</h3><div>Despite an increase in the global burden of cardiovascular comorbidities over the past 2 decades, comorbidities remained constant in this patient population over time. In contrast with the observed temporal improvements in STEMI outcomes in urban populations, adjusted in-hospital MACE (7.2% vs 6.9%, <em>P</em> = .76) and bleeding rates (8.0% vs 7.0%, <em>P</em> = .4) were similar between STEMI patients treated with a PI strategy in the premodern and modern era.</div></div><div><h3>Conclusions</h3><div>In a large cohort of rural STEMI patients treated with a PI strategy over the past 20 years, care delivery metrics improved, while in-hospital outcomes remained largely unchanged over time. This presents a target for future strategies to improve cardiovascular care in rural patient populations.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105390"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of Supersaturated Oxygen Delivery for Infarct Size Reduction in Patients With Anterior ST-Segment Elevation Myocardial Infarction","authors":"Katherine Vilain MPH,&nbsp;Harun Kundi MD, MMSc, MSc,&nbsp;Bjorn Redfors MD, PhD,&nbsp;Emily M. Bucholz MD, MPH,&nbsp;Neel M. Butala MD, MBA,&nbsp;David J. Cohen MD, MSc","doi":"10.1016/j.jscai.2026.105321","DOIUrl":"10.1016/j.jscai.2026.105321","url":null,"abstract":"<div><h3>Background</h3><div>Myocardial infarct size (IS) is a key determinant of long-term outcomes after acute myocardial infarction (MI). Although infusion of supersaturated oxygen (SSO₂) after primary percutaneous coronary intervention (PPCI) has been shown to reduce IS among patients with acute anterior ST-segment elevation myocardial infarction (STEMI), the cost-effectiveness of this approach remains unknown.</div></div><div><h3>Methods</h3><div>We developed a Markov model to project long-term mortality, quality of life, and costs among patients with acute anterior STEMI undergoing PPCI. Among surviving patients, we modeled the incidence of post-MI heart failure, cardiovascular death, and noncardiovascular death as a function of IS, using population-based data for calibration. Health state–specific costs were derived from Medicare data. The cost of SSO₂ (including supplies, procedure time, and physician costs) was assumed to be $10,528. Deterministic and probabilistic sensitivity analyses were used to quantify the effects of uncertainty on the results.</div></div><div><h3>Results</h3><div>In our base case analysis (mean age 61 years; 22% female; mean IS 25% of LV mass), treatment with SSO₂ was projected to increase discounted life expectancy (14.21 vs 14.12 years) and quality-adjusted life expectancy (10.78 vs 10.69 quality-adjusted life-years [QALYs]) while increasing lifetime costs by $3205/patient. The incremental cost-effectiveness ratio for SSO₂ vs standard care was $38,415/QALYs gained, which was sensitive to patient age, IS with standard care, and the impact of SSO₂ on IS. For this population, the probability that SSO₂ provides good economic value (at a societal willingness-to-pay threshold of $120,000/QALYs) was 73%.</div></div><div><h3>Conclusions</h3><div>Based on our disease simulation model, SSO₂ therapy for patients undergoing PPCI for acute anterior STEMI appears to be a cost-effective adjunct to PPCI from the perspective of the US health care system.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105321"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148546679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sixteen Years After TRANSFER-AMI, Rural STEMI In-hospital Outcomes Remain Unchanged: Confronting the Pharmacoinvasive Paradox","authors":"Amir Lofti MD,&nbsp;Aravdeep Jhand MD","doi":"10.1016/j.jscai.2026.105453","DOIUrl":"10.1016/j.jscai.2026.105453","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105453"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Tunnel Length: Tunnel Width–Derived Cover Index Improves Device Sizing and Predicts Outcomes After Transcatheter Patent Foramen Ovale Closure","authors":"Tanuka D. Piech MD,&nbsp;Nicholas Ruggiero MD,&nbsp;Andrew C. Peters MD,&nbsp;Ashley Pender MD,&nbsp;Rebecca Marcantuono CRNP,&nbsp;Alec Vishnevsky MD,&nbsp;Praveen Mehrotra MD","doi":"10.1016/j.jscai.2026.105391","DOIUrl":"10.1016/j.jscai.2026.105391","url":null,"abstract":"<div><h3>Background</h3><div>Residual shunting after transcatheter patent foramen ovale (PFO) closure occurs in up to 25% of patients and increases the risk of recurrent neurologic events. Existing sizing strategies may be insufficient as they overlook the tunnel’s complex 3-dimensional (3D) anatomy. The aim of this study was to evaluate PFO tunnel dimensions with 3D transesophageal echocardiography (TEE) and determine whether tunnel width (TW) metrics would predict procedural outcomes.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 102 patients undergoing PFO closure (n = 82 with follow-up bubble study). 3D-TEE was used to assess TW at right (TW_RA) and left (TW_LA) atrial openings, tunnel length, tunnel height at RA opening, and presence of septal aneurysm. We calculated an absolute TW_RA cover index for each patient as follows: RA disc diameter − TW_RA. Receiver operating characteristic curve analysis was used to determine predictors of procedural outcomes.</div></div><div><h3>Results</h3><div>Tunnel length did not correlate with TW_RA, TW_LA, or tunnel height; TW_RA (and not tunnel length) was significantly larger in patients with a septal aneurysm. TW_RA (area under the curve [AUC], 0.79; <em>P</em> &lt; .001) and derived cover index (AUC, 0.88; <em>P</em> &lt;.001) predicted residual shunting; a cover index of ≤9.5 mm provided optimal sensitivity (90%) and specificity (78%). The rate of residual shunting was 2% in patients with a cover index of &gt;9.5 mm (median follow-up, 6.3 months). The TW_RA cover index also predicted the need for device upsizing (AUC, 0.99; <em>P</em> &lt;.001; optimal cutoff ≤4.5 mm). Tunnel length did not predict either outcome.</div></div><div><h3>Conclusions</h3><div>Despite its widespread use for sizing, tunnel length is unrelated to TW, septal excursion, or procedural outcomes after PFO closure. In contrast, TW-based metrics reliably predict outcomes, underscoring their potential to refine sizing strategies in patients undergoing this procedure.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105391"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pump Up the O2: Is Supersaturated Oxygen Therapy the Holy Grail to Reduce Infarct Size in Anterior STEMI?","authors":"Benjamin Z. Galper MD, MPH","doi":"10.1016/j.jscai.2026.105440","DOIUrl":"10.1016/j.jscai.2026.105440","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105440"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148546721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid Suture- and Plug-Based Closure Versus Dual Suture Devices in Transfemoral Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis","authors":"Abdul Moeez MBBS,&nbsp;Syed Wajihullah Shah MBBS,&nbsp;Sundus Huma MBBS,&nbsp;Umm E. Salma Shabbar Banatwala MBBS,&nbsp;Aizaz Ali MBBS,&nbsp;Lintha Zafar Khattak MBBS,&nbsp;Zaryab Bacha MBBS,&nbsp;Afra Khan MBBS,&nbsp;Fazlina Shaid MBBS,&nbsp;Touba Azeem MBBS,&nbsp;Sayyam Razzaq MBBS,&nbsp;Malik Waleed Zeb Khan MD,&nbsp;Jibran Ikram MD,&nbsp;Farid Ullah MBBS,&nbsp;Mohammed Shaban MD","doi":"10.1016/j.jscai.2026.105339","DOIUrl":"10.1016/j.jscai.2026.105339","url":null,"abstract":"<div><h3>Background</h3><div>Effective vascular closure is crucial in transfemoral transcatheter aortic valve replacement (TAVR) to minimize access-related complications. Although dual suture-based closure is widely used, a hybrid approach combining suture- and plug-based vascular closure devices (VCD) has gained increasing attention. This meta-analysis compared these 2 strategies in terms of vascular outcomes and procedural success.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched through January 2025 for studies comparing suture-plus-plug–based vs suture-based VCD in TAVR patients. Primary outcomes were major and minor vascular complications, bleeding events, VCD failure, and unplanned interventions. Risk ratios (RRs) with 95% CIs were calculated.</div></div><div><h3>Results</h3><div>Six studies involving 2308 patients were included. The suture-plus-plug–based approach significantly reduced major vascular complications (RR, 0.50; <em>P</em> = .001), minor vascular complications (RR, 0.58; <em>P</em> &lt; .00001), and VCD failure (RR, 0.26; <em>P</em> &lt; .00001) compared with suture-based closure alone. No significant differences were observed in major (<em>P</em> = .30) or minor bleeding (<em>P</em> = .47). Unplanned interventions were less frequent with the hybrid approach, but the difference was not statistically significant (RR, 0.68; <em>P</em> = .19).</div></div><div><h3>Conclusions</h3><div>The combination of suture- and plug-based closure devices in transfemoral TAVR provides superior vascular outcomes and lower device failure rates without increasing bleeding risk. These findings support the hybrid approach as a safe and effective strategy, although further randomized controlled trials are warranted to confirm long-term outcomes.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105339"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148532009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valve-in-Ring TMVR Following Antegrade Base-to-Tip LAMPOON With ELASTIC on VA-ECMO Support: A Case Report","authors":"Chantal Y. Asselin MD, MSc,&nbsp;Mostafa Naguib MD,&nbsp;Christopher Song MD,&nbsp;Konstantinos Koulogiannis MD,&nbsp;Robert M. Kipperman MD,&nbsp;Howard Axelrod MD,&nbsp;Linda D. Gillam MD, MPH,&nbsp;Philippe Généreux MD,&nbsp;Gennaro Giustino MD","doi":"10.1016/j.jscai.2026.105394","DOIUrl":"10.1016/j.jscai.2026.105394","url":null,"abstract":"<div><div>Transcatheter mitral valve replacement (TMVR) in failed surgical rings with an Alfieri stich represents a therapeutic challenge. A 70-year-old man with prior robotic surgical mitral valve repair with an incomplete ring and an Alfieri stich presented with acute decompensated heart failure and was found to have severe mitral regurgitation and pulmonary hypertension. He was deemed not to be suitable for redo surgery. Preprocedural computed tomography demonstrated anterior mitral leaflet length of 29 mm, indicative of high-risk for dynamic left ventricular outflow tract obstruction. This case described the successful combination of antegrade laceration of the anterior mitral valve leaflet to prevent outflow obstruction and electrosurgical laceration of Alfieri stitch to facilitate valve-in-ring TMVR while on venoarterial extracorporeal membrane oxygenation support to prevent hemodynamic compromise during high-risk valve-in-ring TMVR.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 7","pages":"Article 105394"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148531986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}