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

{"title":"Percutaneous Mechanical Aspiration for Right-Sided Endocarditis: A Step Forward While Awaiting Randomized Data","authors":"Pedro Engel Gonzalez MD, Siavash Saadat MD","doi":"10.1016/j.jscai.2026.105569","DOIUrl":"10.1016/j.jscai.2026.105569","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105569"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961476","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":"Single-Access Subintimal Arterial Flossing With Antegrade-Retrograde Intervention—The Novel S-SAFARI Technique: A Case Report","authors":"Shadi Halabi MD, MPH,&nbsp;Eric Gonsiorowski MD","doi":"10.1016/j.jscai.2026.105513","DOIUrl":"10.1016/j.jscai.2026.105513","url":null,"abstract":"<div><div>Chronic total occlusions of tibial vessels present a major challenge in performing successful revascularization in patients with peripheral artery disease. The subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) technique is an established method in which both antegrade and retrograde access are gained on either side of an occluded vessel. These 2 catheters are then “flossed” together to create a single guide wire channel across the occlusion to aid in revascularization. This report will describe a case in which the novel single-access SAFARI (S-SAFARI) technique can utilize just 1 access point via an intact pedal loop to achieve the same treatment results in patients with tibial chronic total occlusions while safely preserving their pedal loop vasculature.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105513"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961487","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":"Early Aspirin Discontinuation Following PCI for Acute Coronary Syndromes: A Systematic Review and Meta-Analysis of Reconstructed Individual Patient Data","authors":"Vinícius Martins Rodrigues Oliveira MS,&nbsp;Lucas M. Barbosa MS,&nbsp;Ludimilla Pereira Tartuce MD, MSc,&nbsp;Robert Willian Anastácio Alcântara MD,&nbsp;Paulo Roberto Ferreira Tartuce Filho MD,&nbsp;Maria do Carmo Pereira Nunes MD, PhD,&nbsp;Humberto Graner Moreira MD, PhD,&nbsp;Bruno Ramos Nascimento MD, PhD,&nbsp;Deepak L. Bhatt MD, MPH, MBA","doi":"10.1016/j.jscai.2026.105456","DOIUrl":"10.1016/j.jscai.2026.105456","url":null,"abstract":"<div><h3>Background</h3><div>Dual antiplatelet therapy (DAPT) is well established for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Contemporary studies demonstrated that a shorter DAPT strategy may reduce bleeding, while preserving ischemic protection. However, optimal timing of aspirin discontinuation remains uncertain.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis of randomized controlled trials comparing standard 12-month DAPT versus early aspirin discontinuation (≤1-2 months), following PCI for ACS, excluding studies with immediate aspirin withdrawal. We systematically searched PubMed, Embase, and Cochrane. Individual patient data were reconstructed from Kaplan–Meier (KM) curves. Hazard ratios (HRs) and their 95% CIs were estimated using Cox regression. All statistical analyses were performed using R software, version 4.5.0.</div></div><div><h3>Results</h3><div>We included 5 randomized controlled trials comprising 12,984 patients; 6473 (49.8%) were randomized to early aspirin discontinuation. Short-term DAPT was associated with a reduction in the risk of bleeding (HR, 0.44; 95% CI, 0.34-0.55; <em>P</em> &lt; .001), while preserving ischemic protection, with no differences in the risk of major adverse cardiac events (HR, 1.05; 95% CI, 0.83-1.32; <em>P</em> = .71). Stratified bleeding analyses demonstrated a reduction in major bleeding (HR, 0.40; 95% CI, 0.26-0.61; <em>P</em> &lt; .01) and a reduction in clinically relevant bleeding (HR, 0.43; 95% CI, 0.34-0.55; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>In trials evaluating aspirin discontinuation at approximately 1 month following PCI for ACS, transitioning to P2Y₁₂ inhibitor monotherapy reduced bleeding while preserving ischemic protection in selected patients.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105456"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961473","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":"A Multicenter, Mixed Methods Study of United States Heart Teams and Health Policy: The EVOLVE Study Design and Protocol","authors":"Megan Coylewright MD, MPH,&nbsp;Dhaval Kolte MD, PhD, MPH,&nbsp;Gina Kruse MD, MS, MPH,&nbsp;Rakesh M. Suri MD, DPhil,&nbsp;Sammy Elmariah MD, MPH,&nbsp;Susan R. Strong MA,&nbsp;Elizabeth M. Perpetua DNP","doi":"10.1016/j.jscai.2026.105512","DOIUrl":"10.1016/j.jscai.2026.105512","url":null,"abstract":"<div><h3>Background</h3><div>The management of patients with aortic stenosis is rapidly evolving, along with the “heart team,” a multidisciplinary group collaborating in program management. There is scant research providing rigorous data on the variability in heart teams’ approach to optimal patient care delivery. This investigation aimed to describe the current health care delivery strategies and attitudes of contemporary heart teams at diverse hospitals across the United States and provide key insight into future health policy and guideline directions.</div></div><div><h3>Methods</h3><div>We will conduct a convergent parallel design mixed methods study integrating quantitative (survey) and qualitative (semistructured interviews, coded using qualitative research software) data to develop a deeper understanding of heart valve team roles, functions, health care delivery strategies, and clinician perceptions of the impacts of health policy mandates on team and patient experience. Guided by a grounded theory approach, we will generate themes inductively from perspectives expressed by the participants. Heart valve teams will be recruited until saturation of themes and to maximize variation in practice settings (academic status, geographical location, transcatheter aortic valve replacement program volume, program tenure). We anticipate 8 to 20 programs and 40 to 100 participants. This study is approved by the Western Copernicus Group Institutional Review Board and adheres to Good Reporting of a Mixed Methods Study guidelines for mixed methods research.</div></div><div><h3>Conclusions</h3><div>This study is designed to be the largest investigation to date of United States heart teams focused on aortic stenosis, aimed to inform health policy and guideline efforts to streamline care, address continued inequities and undertreatment, and optimize patient outcomes.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105512"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961479","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":"Balloon Rupture During Balloon-Expandable TAVR: Insights Into the Role of Calcium Distribution and Lesion Preparation From Two Cases","authors":"Vagisha Sharma MD,&nbsp;Shiavax J. Rao MD,&nbsp;Guy Rogers MPAS,&nbsp;Sudhakar Sattur MD, MHSA,&nbsp;Edo Kaluski MD","doi":"10.1016/j.jscai.2026.105506","DOIUrl":"10.1016/j.jscai.2026.105506","url":null,"abstract":"<div><div>Balloon rupture during balloon-expandable transcatheter aortic valve replacement is a rare but potentially catastrophic complication, often driven by an underlying anatomic substrate. We present 2 cases demonstrating how calcium distribution and timing of rupture relative to valve expansion determine outcome. Late rupture after near-complete expansion resulted in no hemodynamic consequence, whereas early rupture in the setting of dense intravalvular calcification caused incomplete expansion, severe aortic regurgitation, ventricular fibrillation, repeat balloon failure, and fatal stroke. These cases highlight the importance of calcium assessment, lesion preparation, and anatomy-tailored procedural planning.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105506"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961481","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":"A Prospective Evaluation of Optical Coherence Tomography in Below-the-Knee Endovascular Interventions","authors":"Jun Li MD,&nbsp;Armando Vergara-Martel MS,&nbsp;Neda S. Hassani MD,&nbsp;Vladislav Zimin MD, PhD,&nbsp;Shilp Arora MD, MPH,&nbsp;John Harlock MD, MSc,&nbsp;Fadi Elias MD, BHSc, MSc,&nbsp;Tej Sheth MD,&nbsp;Yulanka Castro-Dominguez MD,&nbsp;Mehdi H. Shishehbor DO, MPH, PhD","doi":"10.1016/j.jscai.2026.105516","DOIUrl":"10.1016/j.jscai.2026.105516","url":null,"abstract":"<div><h3>Background</h3><div>Image-guided therapy has become the standard of care for most, if not all, coronary interventions. However, the utility of imaging, in particular, intravascular ultrasound (IVUS) and optical coherence tomography (OCT), in endovascular interventions of the lower extremities has been limited by a lack of quantitative data and evidence-based protocols. This prospective, multicenter, core-lab adjudicated study aimed to correlate IVUS, OCT, and fluoroscopic quantitative findings in the below-the-knee tibial arteries.</div></div><div><h3>Methods</h3><div>Patients with chronic limb-threatening ischemia were prospectively recruited from 2 sites. All patients underwent predefined protocols for obtaining angiography, IVUS, and OCT. All images were analyzed by the University Hospitals Harrington HVI Cardiovascular Imaging Core Laboratory. IVUS and OCT images were compared for vessel and lesion minimum lumen diameter, average lumen diameter, area, calcium arc, calcium thickness, and cap thickness. Clinical outcomes were ascertained per standard-of-care surveillance visits and hemodynamic data for 1 year.</div></div><div><h3>Results</h3><div>Forty-four patients were enrolled between August 2021 and June 2023. Most (92.5%) had Rutherford V to VI disease, and nearly half had chronic total occlusion. Undiluted (100%) contrast provided better image quality and longer clear image length (70.2 vs 54.7 mm, <em>P</em> = .03) compared to diluted (50%) contrast. Quantitative measurements by OCT correlated well with IVUS and angiographic analysis, though the former provides the most defined calcium analysis. Patients with increased calcium thickness in OCT analysis trended toward increased target lesion revascularization and major amputation, though with no difference in all-cause mortality.</div></div><div><h3>Conclusions</h3><div>Optical coherence tomography of tibial arteries is feasible and correlates well with IVUS. However, its unique ability to better define tibial artery calcification burden compared to IVUS and fluoroscopy may alter treatment strategies for below-the-knee vessels in chronic limb-threatening ischemia as the landscape of therapies continues to transform.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105516"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961484","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":"High-Fidelity Simulation for Assessing Catheterization-Based Skills Among Trainees","authors":"Nicholas B. Mitchell MD,&nbsp;Luai Madanat MD,&nbsp;Shazil Mahmood MD,&nbsp;Justin Armstrong DO,&nbsp;Michael Gallagher MD,&nbsp;Robert D. Safian MD,&nbsp;Ryan D. Madder MD","doi":"10.1016/j.jscai.2026.105499","DOIUrl":"10.1016/j.jscai.2026.105499","url":null,"abstract":"<div><h3>Background</h3><div>Simulation-based training for coronary angiography has not been widely adopted, and an operator’s skillset should be accurately reflected in a simulation-based task. The purpose of this study is to determine whether increasing levels of clinical experience were associated with improved performance and whether trainees’ confidence improved with use of a high-fidelity simulator.</div></div><div><h3>Methods</h3><div>Physicians with different catheterization experience (internal medicine residents, first- through third-year cardiology fellows, interventional fellows, and attending interventional cardiologists) performed multiple coronary artery catheter engagements on a high-fidelity endovascular simulator. The primary outcome was coronary engagement time (from the ascending aorta to coronary). Trainees completed presimulation and postsimulation surveys assessing confidence in catheter engagement (10-point Likert scale: 1, no confidence; 10, supreme confidence).</div></div><div><h3>Results</h3><div>Across 240 catheter engagements by 24 physicians, median coronary engagement time was 37 seconds (IQR, 22-64). Engagement times were longer on the right coronary artery (42 seconds [22-70]) than on the left (34 seconds [21-56]; <em>P</em> = .04). Engagement time decreased with increasing operator experience (<em>P</em>_trend &lt; .001). Baseline confidence increased with training stage (<em>P</em>_trend &lt; .001), and among all trainees combined, confidence in catheter engagement improved after simulation (6 [2-7] vs 7 [5-8]; <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>Using a high-fidelity simulator, increasing operator experience was associated with less time to coronary catheter engagement. Simulation was associated with a significant increase in trainee confidence in performing coronary catheter engagement.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105499"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961774","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":"ALARA Without Modern Equipment: Aging Cardiac Catheterization Laboratory Fluoroscopy Infrastructure in Illinois and California","authors":"Joshua H. Arnold MD, MS,&nbsp;Arnold H. Seto MD, MPA,&nbsp;Mladen I. Vidovich MD","doi":"10.1016/j.jscai.2026.105495","DOIUrl":"10.1016/j.jscai.2026.105495","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105495"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961775","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":"Building a Multidisciplinary Cardiogenic Shock Program in Latin America: Outcomes From the TecSalud Program","authors":"Vicente Jimenez-Franco MD,&nbsp;Jahir Rodriguez-Rivera MD,&nbsp;Renata Quevedo-Salazar MD,&nbsp;Jose A. Salinas-Casanova MD,&nbsp;Monica Flores-Zertuche MD,&nbsp;Cecilia Gocher-Janet MD,&nbsp;Juan Carlos Ibarrola-Peña MD,&nbsp;Carlos Jerjes-Sanchez MD,&nbsp;Rene D. Gomez-Gutierrez MD,&nbsp;Guillermo Quezada-Valenzuela MD,&nbsp;Erasmo de la Peña MD,&nbsp;Guillermo Torre-Amione MD","doi":"10.1016/j.jscai.2026.105508","DOIUrl":"10.1016/j.jscai.2026.105508","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenic shock (CS) remains associated with high mortality despite modern reperfusion and mechanical circulatory support. Multidisciplinary “CS teams” have demonstrated improved outcomes; however, data from low- and middle-income countries are scarce. This study describes the experience and outcomes following the implementation of a dedicated CS team at a tertiary hospital in Mexico.</div></div><div><h3>Methods</h3><div>We conducted a retrospective, single-center cohort study including consecutive adults with CS admitted to TecSalud between January 2021 and August 2025. The multidisciplinary CS team was established in August 2022. Patients were divided into 2 cohorts: pre-team (January 2021 to July 2022) and post-team (August 2022 to August 2025). The primary end point was 30-day all-cause mortality. Mortality rates were compared using the Fisher exact test.</div></div><div><h3>Results</h3><div>A total of 67 patients were included (27 preteam, 40 postteam). Among the postteam cohort, the mean age was 63 ± 15.2 years, and 73% were male. The leading etiology was acute myocardial infarction–related CS (67.5%), followed by decompensated heart failure (20%). The median hospital stay was 11.5 days (0-122), and the average ICU stay was 7 days (1-105). Most patients presented in the Society for Cardiovascular Angiography &amp; Interventions (SCAI) SHOCK stage E (33%), 80% required mechanical circulatory support, and 18% underwent extracorporeal cardiopulmonary resuscitation. Implementation of the CS team was associated with a reduction in 30-day mortality from 63% to 25%.</div></div><div><h3>Conclusions</h3><div>The implementation of a multidisciplinary CS team at a tertiary center in Mexico was associated with a substantial reduction in 30-day mortality and improved care coordination. These findings support the feasibility and effectiveness of structured CS programs in complex health care environments.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105508"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961777","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":"The Catheterization Laboratory: An Occupational Anachronism","authors":"Alexandra J. Lansky MD,&nbsp;Dean J. Kereiakes MD,&nbsp;James A. Goldstein MD","doi":"10.1016/j.jscai.2026.105565","DOIUrl":"10.1016/j.jscai.2026.105565","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 9","pages":"Article 105565"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961776","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}