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

{"title":"Harnessing Artificial Intelligence for Innovation in Interventional Cardiovascular Care","authors":"Arya Aminorroaya MD, MPH ,&nbsp;Dhruva Biswas MD, PhD ,&nbsp;Aline F. Pedroso PhD ,&nbsp;Rohan Khera MD, MS","doi":"10.1016/j.jscai.2025.102562","DOIUrl":"10.1016/j.jscai.2025.102562","url":null,"abstract":"<div><div>Artificial intelligence (AI) serves as a powerful tool that can revolutionize how personalized, patient-focused care is provided within interventional cardiology. Specifically, AI can augment clinical care across the spectrum for acute coronary syndrome, coronary artery disease, and valvular heart disease, with applications in coronary and structural heart interventions. This has been enabled by the potential of AI to harness various types of health data. We review how AI-driven technologies can advance diagnosis, preprocedural planning, intraprocedural guidance, and prognostication in interventional cardiology. AI automates clinical tasks, increases efficiency, improves reliability and accuracy, and individualizes clinical care, establishing its potential to transform care. Furthermore, AI-enabled, community-based screening programs are yet to be implemented to leverage the full potential of AI to improve patient outcomes. However, to transform clinical practice, AI tools require robust and transparent development processes, consistent performance across various settings and populations, positive impact on clinical and care quality outcomes, and seamless integration into clinical workflows. Once these are established, AI can reshape interventional cardiology, improving precision, efficiency, and patient outcomes.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102562"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641899","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":"Can AI Capture and Quantify Clinical Expertise? Implications for Intracoronary Imaging in Percutaneous Coronary Intervention","authors":"Ricardo Petraco MD, PhD ,&nbsp;Rahul Bahl MBBS ,&nbsp;Guilherme Almeida MD ,&nbsp;Daniel Bandeira MD ,&nbsp;Henry Seligman MBBS, PhD ,&nbsp;Anissa Alloula BSc ,&nbsp;Abigail Demuyakor MD ,&nbsp;Alexandra J. Lansky MD ,&nbsp;Tom Johnson MBBS, MD ,&nbsp;Darrel Francis MB BChir, PhD ,&nbsp;Gary S. Mintz MD ,&nbsp;Matthew Shun-Shin BM BCh, PhD ,&nbsp;Daniel Chamié MD, PhD","doi":"10.1016/j.jscai.2024.102523","DOIUrl":"10.1016/j.jscai.2024.102523","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102523"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641901","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":"EchoNavigator-Guided Transcatheter Aortic Paravalvular Leak Closure in a Patient With Mechanical Prosthetic Aortic Valve","authors":"Madhura Myla MD,&nbsp;Mustafa Alkhawam MD,&nbsp;Amr Salama MD,&nbsp;Weihan Chen MD,&nbsp;Ali J. Ebrahimi MD,&nbsp;Mustafa I. Ahmed MD","doi":"10.1016/j.jscai.2024.102431","DOIUrl":"10.1016/j.jscai.2024.102431","url":null,"abstract":"<div><div>We present the case of a 72-year-old man with severe anterior and posterior paravalvular aortic leakages and discuss the patient’s presentation, management, and outcome. Our case demonstrates integration of the EchoNavigator system during a paravalvular leak procedure, which combined echocardiography and fluoroscopy to improve outcomes. EchoNavigator can assist in device positioning, helping prevent possible complications. Moreover, EchoNavigator can increase safe and consistent results to help universalize complex structural interventions.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102431"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637734","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":"Effects of Artificial Intelligence Clinical Decision Support Tools on Complications Following Percutaneous Coronary Intervention","authors":"Karley B. Fischer MD ,&nbsp;Damian N. Valencia MD ,&nbsp;Ananya Reddy BS, MPH ,&nbsp;John Paul Khouzam BS ,&nbsp;Ziwar F. Karabatak MD ,&nbsp;Ajay Reddivari MD ,&nbsp;Ammar Safar MD ,&nbsp;M. Niranjan Reddy MD ,&nbsp;Raja A. Nazir MD ,&nbsp;Brian P. Schwartz MD","doi":"10.1016/j.jscai.2024.102497","DOIUrl":"10.1016/j.jscai.2024.102497","url":null,"abstract":"<div><h3>Background</h3><div>Artificial intelligence (AI) models have been created that incorporate unique patient characteristics to risk stratify patients undergoing cardiac catheterization with percutaneous coronary intervention (PCI). The most frequent complications following PCI are contrast-induced acute kidney injury (CI-AKI) and postprocedural bleeding, resulting in increased adverse outcomes, length of stay (LOS), and health care costs. Our study investigates the impact of AI clinical decision support tools on these events.</div></div><div><h3>Methods</h3><div>A retrospective review of patients undergoing PCI at our institution from April 2023 to March 2024 was performed. All patients had an ePRISM (Terumo Health Outcomes AI clinical decision support tool) generated risk assessment and maximum contrast volume recommendation reported during procedure time-out. Statistical analysis was performed to determine the incidence of post-PCI CI-AKI, bleeding events, and LOS.</div></div><div><h3>Results</h3><div>A total of 642 patients were analyzed. The incidence of CI-AKI significantly declined from a baseline of 10% to an average of 2.18% (<em>P</em> &lt; .0001). Of the remaining CI-AKI, 92.9% occurred in hospitalized patients. The incidence of bleeding complications declined from a baseline incidence of 2.15 per month to an average of 1.54 per month. Our institution’s average LOS declined from a baseline of 3.44 to 1.79 days.</div></div><div><h3>Conclusions</h3><div>AI clinical decision support tools can be effectively incorporated into clinical practice. ePRISM successfully risk-stratified patients undergoing PCI for CI-AKI and bleeding events and gave meaningful recommendations which resulted in a significant reduction in adverse events and LOS.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102497"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641798","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":"Artificial Intelligence in Coronary Artery Interventions: Preprocedural Planning and Procedural Assistance","authors":"Saurabhi Samant MBBS ,&nbsp;Anastasios Nikolaos Panagopoulos MD ,&nbsp;Wei Wu PhD ,&nbsp;Shijia Zhao PhD ,&nbsp;Yiannis S. Chatzizisis MD, PhD","doi":"10.1016/j.jscai.2024.102519","DOIUrl":"10.1016/j.jscai.2024.102519","url":null,"abstract":"<div><div>Artificial intelligence (AI) has profoundly influenced the field of cardiovascular interventions and coronary artery procedures in particular. AI has enhanced diagnostic accuracy in coronary artery disease through advanced invasive and noninvasive imaging modalities, facilitating more precise diagnosis and personalized interventional strategies. AI integration in coronary interventions has streamlined diagnostic and procedural workflows, improved procedural accuracy, increased clinician efficiency, and enhanced patient safety and outcomes. Despite its potential, AI still faces significant challenges, including concerns regarding algorithmic biases, lack of transparency in AI-driven decision making, and ethical challenges. This review explores the latest advancements of AI applications in coronary artery interventions, focusing on preprocedural planning and real-time procedural guidance. It also addresses the major limitations and obstacles that hinder the widespread clinical adoption of AI technologies in this field.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102519"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641797","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":"Artificial Intelligence–Powered Electrocardiogram Detecting Culprit Vessel Blood Flow Abnormality: AI-ECG TIMI Study Design and Rationale","authors":"Robert Herman MD ,&nbsp;Timea Kisova MD ,&nbsp;Marta Belmonte MD ,&nbsp;Adriaan Wilgenhof MD ,&nbsp;Gabor Toth MD, PhD ,&nbsp;Anthony Demolder MD, PhD ,&nbsp;Adam Rafajdus MSc ,&nbsp;H. Pendell Meyers MD ,&nbsp;Stephen W. Smith MD ,&nbsp;Jozef Bartunek MD, PhD ,&nbsp;Emanuele Barbato MD, PhD","doi":"10.1016/j.jscai.2024.102494","DOIUrl":"10.1016/j.jscai.2024.102494","url":null,"abstract":"<div><h3>Background</h3><div>The 12-lead electrocardiogram (ECG) is the gold standard for detecting patients who will benefit from emergent revascularization due to occlusive myocardial infarction (OMI). However, the pathophysiology of acute coronary syndromes (ACS) is dynamic, and nearly half of patients with OMI do not present with typical ST elevation or have dynamic ECG changes due to spontaneous recanalization before invasive coronary angiography (ICA). Recently, an ECG-based artificial intelligence (AI) model was developed using expert interpretation of OMI. However, its performance is limited to retrospective evaluation of ECGs recorded minutes to hours before ICA.</div></div><div><h3>Methods</h3><div>The AI-ECG thrombolysis in myocardial infarction (TIMI) study is an investigator-initiated prospective multicenter registry planning to enroll over 700 consecutive patients with ACS undergoing ICA in 9 centers across Europe. For all participants, a standard 10-second 12-lead ECG will be recorded at the time of coronary angiography. The primary end point is the AI model’s ability to identify patients with an actively occluded (TIMI 0-1) culprit coronary artery at the time of invasive coronary angiography using only single-standard 12-lead ECGs. Standardized angiograms will be used as a reference standard.</div></div><div><h3>Conclusions</h3><div>AI-ECG TIMI is the first prospective registry of consecutive patients with ACS with standard 12-lead ECGs recorded at the very moment of ICA. This study will help characterize ECG findings of abnormal myocardial perfusion due to acute active ischemia and prospectively validate an AI model’s ability to detect them.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102494"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641799","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":"SCAI Expert Consensus Statement on Alternative Access for Transcatheter Aortic Valve Replacement","authors":"Matthew Sherwood MD, MHS, FSCAI ,&nbsp;Keith B. Allen MD ,&nbsp;Thom G. Dahle MD, FSCAI ,&nbsp;Chandan M. Devireddy MD, FSCAI ,&nbsp;Jeffrey Gaca MD ,&nbsp;Santiago Garcia MD, FSCAI ,&nbsp;Kendra J. Grubb MD, MHA ,&nbsp;Tsuyoshi Kaneko MD ,&nbsp;Chad A. Kliger MD, FSCAI ,&nbsp;Robert J. Lederman MD ,&nbsp;John C. Messenger MD, FSCAI ,&nbsp;Puja B. Parikh MD, MPH, FSCAI ,&nbsp;Marie-France Poulin MD, FSCAI ,&nbsp;Carlos Sanchez MD, FSCAI ,&nbsp;Anene Ukaigwe MD, FSCAI ,&nbsp;James J. Yun MD ,&nbsp;Paul D. Mahoney MD, FSCAI","doi":"10.1016/j.jscai.2024.102514","DOIUrl":"10.1016/j.jscai.2024.102514","url":null,"abstract":"<div><div>Transcatheter aortic valve replacement (TAVR) has become a widely accepted procedure for treating patients with symptomatic aortic stenosis. While transfemoral access remains the primary route due to its lower complication rates and favorable outcomes, a subset of patients have anatomical or clinical factors precluding this approach. For these patients, alternative access routes such as transaxillary, transcarotid, and transcaval provide viable options. This expert consensus statement aims to provide a comprehensive review of case selection, technical considerations, and outcomes associated with these alternative access routes in TAVR. Additionally, this document highlights the advancements in device technology and imaging guidance that have contributed to improving the safety and efficacy of alternative access TAVR. This consensus statement serves as a practical guide on best practices for interventional cardiologists, cardiothoracic surgeons, and heart teams in selecting patients and performing alternative access TAVR.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102514"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637729","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":"Tibial Artery Stent Deformations From Ankle Plantarflexion and Dorsiflexion, Knee Flexion, and Simulated Calf Muscle Contraction","authors":"Christopher P. Cheng PhD ,&nbsp;Johan Bondesson PhD ,&nbsp;Anna Johnson ,&nbsp;Stanley K. Zimmerman MD","doi":"10.1016/j.jscai.2024.102522","DOIUrl":"10.1016/j.jscai.2024.102522","url":null,"abstract":"<div><h3>Background</h3><div>Tibial artery stent deformations have not been previously published and are critical for the evaluation and development of below-the-knee treatments.</div></div><div><h3>Methods</h3><div>Balloon-expandable stents were implanted into the anterior tibial, posterior tibial, and peroneal arteries of cadaver legs, including ostium-crossing locations. Computed tomography and geometric modeling were used to quantify cross-sectional, axial, and bending stent deformations from ankle plantarflexion/dorsiflexion, knee flexion, and simulated calf muscle contraction for walking/running.</div></div><div><h3>Results</h3><div>Single and overlapping stents (N = 53) were deployed into 23 tibial arteries and across 6 ostia. Diametric crush was experienced in the posterior tibial with knee flexion (–5.3% ± 3.2%, <em>P</em> &lt; .0001) and peroneal with ankle dorsiflexion (–2.4% ± 2.0%, <em>P</em> = .0016), and posterior tibial stents experienced greater diametric crush from knee flexion (–5.3% ± 3.2%) and calf compression (–3.4% ± 5.9%) compared to ankle motion (–0.2% ± 4.3%; <em>P</em> = .0009 and <em>P</em> = .0061, respectively). Ostium-crossing stents experienced order of magnitude higher axial shortening with knee flexion and ankle plantarflexion compared to those in single arteries. No stent bending was observed from any leg motion.</div></div><div><h3>Conclusions</h3><div>Diametric crush in posterior tibial and peroneal stents was potentially due to their location in the deep posterior compartment and adjacent to the soleus/gastrocnemius muscles that bulge with joint motion. Crush in the posterior tibial is greater for knee flexion and calf compression compared to ankle motion from a higher bone-to-muscle ratio near the ankle protecting against crush. Ostium-crossing stents experience larger shortening than those in individual arteries potentially because of a more oblique orientation. No significant stent bending was observed possibly because the midcalf is distant from knee and ankle joints and protected by the rigid tibia and fibula. These stent deformations can guide device development, interventional site selection, and indications for use.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102522"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637737","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":"Comparison of Different PCI Strategies for Coronary DES In-stent Restenosis: A Bayesian Network Meta-analysis","authors":"Prakash Raj Oli MBBS ,&nbsp;Dhan Bahadur Shrestha MD ,&nbsp;Sagun Dawadi MBBS ,&nbsp;Shraddha Poudel MD ,&nbsp;Furkhan Ali MS ,&nbsp;Jurgen Shtembari MD ,&nbsp;Kailash Pant MD ,&nbsp;Bishesh Shrestha MD ,&nbsp;Rafay Khan MD ,&nbsp;Jishanth Mattumpuram MD ,&nbsp;Daniel H. Katz MD","doi":"10.1016/j.jscai.2024.102428","DOIUrl":"10.1016/j.jscai.2024.102428","url":null,"abstract":"<div><h3>Background</h3><div>Though superior to bare-metal stents (BMS), drug-eluting stents (DES) based PCI still have significant in-stent restenosis (ISR). Balloon angioplasty (BA), drug-coated balloons (DCBs), and DES are common modalities to treat ISR. The existing guidelines recommend treating ISR with either DCB or DES for BMS-ISR and DES-ISR, despite differences in the underlying mechanisms. Because DES are currently the most used stents worldwide, we performed a network meta-analysis (NMA) to compare DES-ISR treatment strategies.</div></div><div><h3>Methods</h3><div>We searched Cochrane Central Register of Controlled Trials, PubMed, Embase, and Scopus for relevant studies published until March 30, 2024 and performed a Bayesian NMA to synthesize direct and indirect evidence. The primary outcome was a target lesion revascularization (TLR) at follow-up.</div></div><div><h3>Results</h3><div>Of 1202 studies, 30 were deemed eligible, with 15 being randomized studies. This included 8016 patients with DES-ISR who were assigned to 12 different PCI strategies. In the NMA for DES-ISR, paclitaxel-eluting stent (76.42) was the most effective strategy for TLR; paclitaxel-coated balloon (PCB) and scoring balloon angioplasty (75.88) for major adverse cardiovascular events (MACE); sirolimus-coated balloon (SCB) for target lesion failure (64.16), myocardial infarction (93.57), and stent thrombosis (98.53); and PCB for all-cause death (76.39) and cardiac death (83.74) based on SUCRA value. BA-based strategies were less effective alternatives for DES-ISR treatment with DCB or DES.</div></div><div><h3>Conclusions</h3><div>DES and DCB PCI such as PCB and SCB should be considered for treatment of coronary DES-ISR to achieve the most clinical efficacy and safety benefits for MACE. Further studies are required for more robust evidence on different treatment strategies.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102428"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637393","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":"Governing the Unbound: SCAI’s Role in the Future of Artificial Intelligence","authors":"Kusum Lata MD ,&nbsp;Curtis Rooney JD ,&nbsp;Deepali Tukaye MBBS, PhD ,&nbsp;Raghava Velagaleti MD ,&nbsp;Afnan Tariq MD, JD","doi":"10.1016/j.jscai.2024.102517","DOIUrl":"10.1016/j.jscai.2024.102517","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 3","pages":"Article 102517"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641893","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}