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

{"title":"Comparative Effectiveness of 2 Next-Generation Scatter Radiation Shielding Systems","authors":"Robert F. Riley MD, MS ,&nbsp;Stephen Kidd MD ,&nbsp;Juliette Power MD ,&nbsp;Brian Stegman MD ,&nbsp;Thom G. Dahle MD","doi":"10.1016/j.jscai.2025.103786","DOIUrl":"10.1016/j.jscai.2025.103786","url":null,"abstract":"<div><h3>Background</h3><div>Scatter radiation is a health risk for personnel in x-ray–guided procedure rooms. This study compared the effectiveness of scatter radiation reduction from 2 next-generation radiation shielding systems.</div></div><div><h3>Methods</h3><div>Vertical poles with mounted radiation survey meters were positioned at 6 points around a catheterization laboratory imaging table where procedural staff typically stand. Meters were mounted on vertical tracks where the sensor could be raised on the track with stops every 20 cm (up to 200 cm). Fluoroscopy (15 frames per second) was then performed on an anthropomorphic phantom with a cardiac silhouette in PA and 4 quadrant angulations using a Philips Allura C-arm with a 9-inch detector and ClarityIQ dose reduction software (both Philips). Scatter radiation measurements were reported in μSv/h under 3 radiation shielding conditions: no shielding, using the Rampart IC shielding system, and using the EggNest Complete shielding system (Egg Medical Inc).</div></div><div><h3>Results</h3><div>Scatter radiation was not evenly distributed around the table, with higher doses noted at the head of the bed compared to the feet and on the left side of the table compared to the right. Positions correlating with the primary operator and assistant had similarly significant average reductions in scatter radiation for both novel protection systems (EggNest Complete 3 ± 7 μSv/h vs Rampart IC 10 ± 40 μSv/h; <em>P</em> = .18). However, the EggNest Complete system showed substantial reductions in scatter radiation measurements compared to the Rampart IC for positions at the head of the bed and the nursing position (26 ± 56 vs 131 ± 157 μSv/h; <em>P</em> &lt; .01). These results were similar in all standard x-ray angulations.</div></div><div><h3>Conclusions</h3><div>Compared to no shielding, both the EggNest Complete and the Rampart IC systems significantly lowered radiation measurements for the operator and assistant positions. However, the EggNest Complete system provided additional significant protection for the head of the bed and the nurse positions, which was not seen with the Rampart IC system.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103786"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Nitroglycerin Administration on Acetylcholine Provocation Testing in Angina With Nonobstructive Coronary Arteries","authors":"Rajan Rehan MBBS, MPH ,&nbsp;Christopher C.Y. Wong MBBS, PhD ,&nbsp;James Weaver MBBS, PhD ,&nbsp;Pankaj Jain MBBS, PhD ,&nbsp;Mark Adams MBBS, PhD ,&nbsp;Martin K.C. Ng MBBS, PhD ,&nbsp;Jennifer A. Tremmel MD, MS ,&nbsp;Andy S.C. Yong MBBS, PhD","doi":"10.1016/j.jscai.2025.103668","DOIUrl":"10.1016/j.jscai.2025.103668","url":null,"abstract":"<div><h3>Background</h3><div>Invasive coronary function testing, using acetylcholine (ACh) to diagnose coronary artery spasm (CAS) and coronary microvascular dysfunction assessment, is considered the gold standard for evaluating patients suffering from angina with nonobstructive coronary arteries. Notably, equipoise remains regarding the optimal sequence for coronary function testing, and no global consensus exists. Although nitroglycerin (NTG) is routinely administered post–radial access and prior to coronary microvascular dysfunction testing, its effect on subsequent ACh testing remains unclear. This study aimed to evaluate the diagnostic impact of preceding intravascular NTG on ACh provocation testing.</div></div><div><h3>Methods</h3><div>Multivessel ACh provocation testing was systematically performed in patients with suspected CAS. To assess the reinducibility of epicardial spasm, an ACh rechallenge was performed in patients who tested positive by readministering the spasm provocation dose into the affected coronary artery at different time intervals following the administration of intravascular NTG.</div></div><div><h3>Results</h3><div>This multicenter study enrolled 102 patients (mean age 59.3 ± 10.0 years; 55% female), of whom 40 were diagnosed with epicardial CAS and underwent ACh rechallenge. Among these, 25 patients (62.5%) exhibited a diffuse spasm pattern, whereas 15 patients (37.5%) demonstrated focal spasm. After the ACh rechallenge, epicardial spasm was reinduced in 22 patients (55%), microvascular spasm in 6 patients (15%), and no spasm in 12 patients (30%). The sensitivity of ACh provocation testing declined to 55% at the end of the rechallenge.</div></div><div><h3>Conclusions</h3><div>Nitroglycerin administration reduces the diagnostic accuracy of ACh provocation testing for CAS in angina with nonobstructive coronary arteries patients. Findings from this study indicate that clinicians should avoid NTG administration prior to ACh testing or significantly delay ACh testing after NTG exposure to preserve diagnostic sensitivity.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103668"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Intravascular Lithotripsy Within a Covered Coronary Stent","authors":"Michael S. Cross MD ,&nbsp;Vinh Duong MD ,&nbsp;Shiv K. Agarwal MD ,&nbsp;Barry F. Uretsky MD","doi":"10.1016/j.jscai.2025.103733","DOIUrl":"10.1016/j.jscai.2025.103733","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103733"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Big MAC on the Interventional Menu","authors":"Pedro Engel Gonzalez MD ,&nbsp;Anna E. Bortnick MD, PhD, MSc","doi":"10.1016/j.jscai.2025.103860","DOIUrl":"10.1016/j.jscai.2025.103860","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103860"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting the Course and Uncharted Territories: SCAI 2025 Guidelines for Chronic Venous Disease","authors":"Irfan Ullah MD ,&nbsp;Khansa Ahmad MD ,&nbsp;Hashim Ahmed MD ,&nbsp;Bernardo Cortese MD","doi":"10.1016/j.jscai.2025.103810","DOIUrl":"10.1016/j.jscai.2025.103810","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103810"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Regarding Robotic-Assisted Percutaneous Coronary Intervention","authors":"Ehtisham Mahmud MD,&nbsp;Giora Weisz MD","doi":"10.1016/j.jscai.2025.103854","DOIUrl":"10.1016/j.jscai.2025.103854","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103854"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover","authors":"","doi":"10.1016/S2772-9303(25)01356-0","DOIUrl":"10.1016/S2772-9303(25)01356-0","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103914"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent Presentation of an Anomalous Right Coronary Artery and an Unusual Bovine Arch: Case Report","authors":"Vasiliki Tasouli-Drakou DO, MS ,&nbsp;Jasmine Dugal DO, MPH ,&nbsp;Divyansh Sharma MD ,&nbsp;KaChon Lei MD ,&nbsp;Chowdhury Ahsan MD","doi":"10.1016/j.jscai.2025.103759","DOIUrl":"10.1016/j.jscai.2025.103759","url":null,"abstract":"<div><div>Anomalous coronary arteries from the opposite sinus of Valsalva are rare but can increase the risk for life-threatening complications. We present the case of a 59-year-old man who was found to have an anomalous right coronary artery and a rare bovine arch variant with a single common brachiocephalic trunk, along with severe proximal left anterior descending artery stenosis on left heart catheterization. The patient underwent a minimally invasive coronary artery bypass graft and unroofing of the anomalous coronary artery. To our knowledge, this is the first reported case of these concurrent anomalies in an individual without tetralogy of Fallot.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103759"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral Annular Calcification: Natural History, Prognosis, and Clinical Outcomes","authors":"Gustavo Mendez-Hirata MD,&nbsp;Christian W. Schmidt MS,&nbsp;Hanad I. Bashir MD,&nbsp;Kofi N. Ansah MD,&nbsp;Geoffrey A. Answini MD,&nbsp;J. Michael Smith MD,&nbsp;Saad Hasan MD,&nbsp;Jeffrey Griffin MD,&nbsp;Robert Dowling MD,&nbsp;Meghna Seshiah BS,&nbsp;Alton Headworth BMSc,&nbsp;Raviteja R. Guddeti MD,&nbsp;Nadia El Hangouche MD,&nbsp;Richard Bae MD,&nbsp;Puvi Seshiah MD,&nbsp;Dean J. Kereiakes MD,&nbsp;Santiago Garcia MD","doi":"10.1016/j.jscai.2025.103732","DOIUrl":"10.1016/j.jscai.2025.103732","url":null,"abstract":"<div><h3>Background</h3><div>Mitral annular calcification (MAC) is a chronic and progressive degenerative process characterized by calcium and lipid deposition of the mitral valve annulus. We sought to describe the natural history of patients with MAC with and without mitral valve dysfunction (MVD).</div></div><div><h3>Methods</h3><div>We conducted an observational study of patients with an echocardiogram-based diagnosis of MAC from 2006-2023. Patients were matched by age and sex in a 1:1 ratio to patients without MAC. We collected baseline clinical, echocardiographic, and computed tomography data. The primary end point was all-cause mortality. We also report predictors of mortality in patients with MAC and MVD.</div></div><div><h3>Results</h3><div>We included 15,372 patients in the analysis: 7686 with MAC (median age, 76 years [68-84], 58% women) and 7686 without MAC matched by age and sex. Patients with MAC had higher rates of comorbidities, cardiovascular risk factors, MVD, and multivalvular heart disease (aortic stenosis/regurgitation and tricuspid regurgitation) relative to patients without MAC (all <em>P</em> &lt; .001). Two-year mortality was 14%, 26%, and 21% for patients with MAC and no MVD, MAC with ≥moderate MR, and MAC with ≥moderate MS, respectively (<em>P</em> &lt; .001). Surgical or transcatheter mitral valve interventions in patients with MAC and significant MVD were infrequently performed (n = 136/788, 17.2%).</div></div><div><h3>Conclusions</h3><div>Ten percent of patients with MAC have clinically significant MVD, with mitral regurgitation being more common than mitral stenosis. The presence of MVD is associated with significantly increased mortality in patients with MAC.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103732"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balloon Pericardiotomy: A Comprehensive Review and Case Series","authors":"Jason B. Katz MD ,&nbsp;Aravind Kalluri MD ,&nbsp;Marysa Leya MD ,&nbsp;Paul C. Cremer MD ,&nbsp;Douglas R. Johnston MD ,&nbsp;Mohamed Al-Kazaz MD ,&nbsp;Daniel R. Schimmel MD, MS","doi":"10.1016/j.jscai.2025.103800","DOIUrl":"10.1016/j.jscai.2025.103800","url":null,"abstract":"<div><div>Pericardial effusions can occur owing to a variety of reasons such as trauma, infection, autoimmune disease, and malignancy. Cardiac tamponade depends on the rate of fluid accumulation and not solely on the volume of the pericardial effusion. Rapid accumulation of pericardial fluid can lead to impaired cardiac filling and output with hemodynamic consequences, requiring urgent or emergent intervention. Despite initial intervention on patients with cardiac tamponade, recurrence of pericardial effusions has been estimated at approximately 20%, with a mean interval to recurrence of approximately 1 month. Both interventional and surgical techniques have been developed to relieve excess pericardial fluid including pericardiocentesis, surgical pericardiotomy, and percutaneous balloon pericardiotomy (PBP) with the latter 2 generally reserved for recurrent effusions. Rarely, surgical pericardiectomy is pursued. While safety and outcomes data are readily available for both pericardiocentesis and surgical pericardiotomies, PBPs are performed less frequently and at the few medical centers with the necessary expertise. In this case series, we present our center’s experience with PBP in the management of recurrent pericardial effusions in 4 different patients. We highlight their comorbidities and corresponding high surgical risk as well as review the technical considerations and outcomes of each patient. Aside from a small pneumothorax managed conservatively, there were no adverse side effects encountered. Balloon pericardiotomy is a safe and effective modality for pericardial effusion drainage in high-risk patients, which can improve patient comfort and hemodynamics.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103800"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}