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

{"title":"Fully Automated Aortic Root Localization and Tilt Alignment in Cardiac Computed Tomography","authors":"Elham Mahmoudi MD, MPH ,&nbsp;Vinayak Nagaraja MD ,&nbsp;Mohamad Sarraf MD ,&nbsp;Paul Friedman MD ,&nbsp;Mohamad Alkhouli MD ,&nbsp;Mackram F. Eleid MD ,&nbsp;Mandeep Singh MD ,&nbsp;Zachi I. Attia PhD ,&nbsp;Joseph D. Sobek MSc ,&nbsp;Mohammadreza Naderian MD, MPH ,&nbsp;Fred Nugen PhD ,&nbsp;Bardia Khosravi MD, MPH, MHPE ,&nbsp;Sanaz Vahdati MD ,&nbsp;Bradley J. Erickson MD, PhD","doi":"10.1016/j.jscai.2025.103716","DOIUrl":"10.1016/j.jscai.2025.103716","url":null,"abstract":"<div><h3>Background</h3><div>Automated analysis of cardiac computed tomography (CCT) studies may help in personalized management and outcome prediction of patients undergoing transcatheter aortic valve replacement (TAVR). The current methods are often preceded by a manual selection of the region of interest. To address this limitation, this study aims to develop an object-oriented aortic root detection pipeline.</div></div><div><h3>Methods</h3><div>All consecutive patients who underwent CCT for TAVR procedure, from January to July 2023 at our center, were retrospectively collected. Patients with previous prosthesis or permanent pacemaker were excluded. Baseline bounding box annotations were performed by a single expert, and tilt angle measurements were performed by 2 for interobserver comparison. A pretrained convolutional neural network was used for aortic root detection, and its performance was evaluated by recall, precision, F1, average precision at an intersection over union overlap of 50% and mean average precision (mAP) 50%-95% on 100 unseen test set. For tilt alignment, intensity thresholding, connected component, and principal component analyses were proposed. Results were evaluated by Bland-Altman comparison.</div></div><div><h3>Results</h3><div>Of the 228 TAVR patients with preprocedural CCT, 179 were eligible, and their axial contrast-enhanced CCTs could be retrieved successfully; 100 CCTs were assigned to the test set, and the remaining to the training and validation using a 4:1 split. The model detected the aortic root with recall, precision, and F1 score of 99.0%, for all 3; mAP50 of 99.5%; and mAP50-95 of 60.4%. The tilt prediction algorithm had a mean error of 7.9° (Q1-Q3, −5.3° to 21.1°) compared with 3.3° (Q1-Q3, −6.7° to 13.4°) interobserver difference.</div></div><div><h3>Conclusions</h3><div>This study demonstrates the robust performance of a fully automated pipeline for aortic root detection and analysis of key features in pre-TAVR CCTs. Further prospective studies are required for clinical developments.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103716"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864460","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":"2025 SCAI Clinical Practice Guidelines for the Management of Chronic Venous Disease","authors":"Robert R. Attaran MD, FSCAI ,&nbsp;Matthew L. Edwards DO, FSCAI ,&nbsp;Frank J. Arena MD, FSCAI ,&nbsp;Matthew C. Bunte MD, MS, FSCAI ,&nbsp;Jeffrey G. Carr MD, FSCAI ,&nbsp;Yulanka Castro-Dominguez MD, FSCAI ,&nbsp;Andrey Espinoza MD, FSCAI ,&nbsp;Dmitriy N. Feldman MD, FSCAI ,&nbsp;Scott Firestone MS ,&nbsp;Eri Fukaya MD ,&nbsp;Karem Harth MD ,&nbsp;Beau M. Hawkins MD, FSCAI ,&nbsp;Sasanka N. Jayasuriya MD, FSCAI ,&nbsp;Pamela Kim MD ,&nbsp;Faisal Latif MD, FSCAI ,&nbsp;Sahil A. Parikh MD, FSCAI ,&nbsp;Eric A. Secemsky MD, MSc, FSCAI ,&nbsp;Emily Senerth MS, MPH ,&nbsp;Yngve Falck-Ytter MD ,&nbsp;Rebecca L. Morgan PhD, MPH","doi":"10.1016/j.jscai.2025.103729","DOIUrl":"10.1016/j.jscai.2025.103729","url":null,"abstract":"<div><h3>Background</h3><div>Chronic venous disease (CVD) is a common vascular condition that can have debilitating effects on quality of life and daily function. The Society for Cardiovascular Angiography &amp; Interventions (SCAI) sought to develop evidence-based guidelines to support patients, clinicians, and other stakeholders in their treatment decisions about management of CVD.</div></div><div><h3>Methods</h3><div>SCAI convened a balanced multidisciplinary guideline panel to minimize potential bias from conflicts of interest. The Evidence Foundation, a registered 501(c)(3) nonprofit organization, provided methodological support for the development of the guidelines. The guideline panel formulated and prioritized clinical questions following the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach in population, intervention, comparison, outcome format. A technical review team of clinical and methodological experts conducted systematic reviews of the published evidence, synthesized data, and graded the certainty of the evidence across outcomes. The guideline panel then reconvened to develop recommendations and supporting remarks informed by the results of the technical review, as well as additional contextual factors described in the GRADE evidence-to-decision framework.</div></div><div><h3>Results</h3><div>The guideline panel reached consensus on 9 recommendations to address variations in treatment of CVD across 8 different clinical scenarios. The panel also identified 4 anatomical scenarios with significant knowledge gaps.</div></div><div><h3>Conclusions</h3><div>Key recommendations address patient selection for compression therapy, ablation of saphenous and perforator veins, sclerotherapy, phlebectomy, and deep vein revascularization. Two algorithms for the management of symptomatic varicose veins and venous ulcer disease were created to facilitate implementation of these evidence-based recommendations. The panel also identified several anatomical and clinical areas where future research is needed to advance the CVD field.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103729"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864465","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":"Breaking Down the Risk During Intravascular Lithotripsy: Is It the Lesion, the Lithotripsy, or the Lack of Intravascular Imaging?","authors":"Arsalan Abu-Much MD ,&nbsp;Ajay J. Kirtane MD, SM","doi":"10.1016/j.jscai.2025.103799","DOIUrl":"10.1016/j.jscai.2025.103799","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103799"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863226","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":"The Essential Role of Physiologic Assessment in Anomalous Aortic Origin of Coronary Arteries: Moving Beyond Purely Anatomical Evaluation","authors":"David G. Rizik MD ,&nbsp;Morton J. Kern MD","doi":"10.1016/j.jscai.2025.103758","DOIUrl":"10.1016/j.jscai.2025.103758","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103758"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863232","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":"Robotic Percutaneous Coronary Intervention in Real-World Practice: Performance, Complexity, and Learning Curves in Focus","authors":"Ioannis Skalidis MD, PhD,&nbsp;Philippe Garot MD,&nbsp;Antoinette Neylon MD,&nbsp;Thomas Hovasse MD,&nbsp;Mariama Akodad MD, PhD","doi":"10.1016/j.jscai.2025.103811","DOIUrl":"10.1016/j.jscai.2025.103811","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103811"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863234","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":"Is Egg Ready to Leave the Nest and Fly?","authors":"Natalija Odanovic MD ,&nbsp;Pedro Engel Gonzalez MD ,&nbsp;Amit N. Vora MD, MPH","doi":"10.1016/j.jscai.2025.103863","DOIUrl":"10.1016/j.jscai.2025.103863","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103863"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864034","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":"Sex-Specific Outcomes of Transcatheter Edge-to-Edge Repair for Degenerative Mitral Regurgitation: Results From the CLASP IID Trial","authors":"Molly Szerlip MD ,&nbsp;Linda D. Gillam MD, MPH ,&nbsp;D. Scott Lim MD ,&nbsp;Jörg Hausleiter MD ,&nbsp;Firas Zahr MD ,&nbsp;Scott Chadderdon MD ,&nbsp;Raj R. Makkar MD ,&nbsp;Ralph Stephan von Bardeleben MD, PhD ,&nbsp;Tobias Friedrich Ruf MD ,&nbsp;Robert M. Kipperman MD ,&nbsp;Andrew N. Rassi MD ,&nbsp;Scott Goldman MD ,&nbsp;Konstantinos Koulogiannis MD ,&nbsp;Leo Marcoff MD ,&nbsp;Robert L. Smith MD ,&nbsp;CLASP IID Pivotal Trial Investigators","doi":"10.1016/j.jscai.2025.103713","DOIUrl":"10.1016/j.jscai.2025.103713","url":null,"abstract":"<div><h3>Background</h3><div>Female patients with degenerative mitral regurgitation (DMR) can have worse mitral valve repair outcomes. We aim to study sex-specific differences in contemporary mitral transcatheter edge-to-edge repair (M-TEER).</div></div><div><h3>Methods</h3><div>One-year outcomes in prohibitive surgical risk patients with 3+/4+ DMR from the randomized CLASP IID trial were analyzed by sex.</div></div><div><h3>Results</h3><div>The analysis population comprised 34.7% female patients (n = 102) and 65.3% male patients (n = 192). Female patients had significantly lower body mass index, fewer comorbidities, and smaller left ventricular indexed volumes and mitral valve area at baseline. At 1 year, there were no significant differences between female and male patients in survival (92.1% vs 90.9%, <em>P</em> = .754), freedom from heart failure hospitalization (91.7% vs 94.4%, <em>P</em> = .366), and freedom from major adverse events (86.0% vs 85.9%, <em>P</em> = .985), respectively. Both sexes achieved a significant reduction in mitral regurgitation from baseline at 1 year (<em>P</em> &lt; .001), with comparable mitral regurgitation ≤1+ (75.6% vs 75.0%, <em>P</em> = 1.000). Baseline-adjusted changes in indexed left ventricular volumes (diastolic: –18.8 vs –15.7 mL, <em>P</em> = .087; systolic: –5.6 vs –5.0 mL, <em>P</em> = .645) and mitral gradients (+1.4 vs +1.1 mm Hg, <em>P</em> = .116) were similar, with no indication of stenosis. New York Heart Association class I/II was achieved in 86.4% of female patients vs 88.7% of male patients (<em>P</em> = .674), and the Kansas City Cardiomyopathy Questionnaire overall score increased by 14.1 vs 15.8 points (<em>P</em> = .502), respectively.</div></div><div><h3>Conclusions</h3><div>In the CLASP IID randomized trial, both sexes experienced high survival and freedom from major adverse events and heart failure hospitalization at 1 year post–M-TEER, with comparable improvements in echocardiographic, functional, and quality-of-life measures, despite differences in clinical presentation and the procedure. Results demonstrate that female patients achieve favorable safety and effectiveness outcomes, comparable to male patients, with contemporary M-TEER in DMR.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103713"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864458","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":"Evaluation of Long-Term Key Outcomes and Safety in Pulmonary Embolism: The EKOS-PE Study","authors":"Sameh Sayfo MD ,&nbsp;Taylor Pickering DO ,&nbsp;Ghadi Moubarak MD ,&nbsp;Kyle M. McCullough MD ,&nbsp;Cody W. Dorton DO ,&nbsp;Mohamad Bader AboHajar MD ,&nbsp;Tanushree Prasad MS ,&nbsp;Colleen Parro BS ,&nbsp;Maya Raghunathan ,&nbsp;Pratham Bhavikati ,&nbsp;Swapnil Gupta MBBS, MPH ,&nbsp;Madhura Kapil Shah MPH ,&nbsp;J. Michael DiMaio MD ,&nbsp;Sibi Thomas DO ,&nbsp;Karim Al-Azizi MD ,&nbsp;Dennis Gable MD ,&nbsp;John Kedora MD ,&nbsp;Chadi Dib MD ,&nbsp;Srini Potluri MD ,&nbsp;Molly Szerlip MD ,&nbsp;Subhash Banerjee MD","doi":"10.1016/j.jscai.2025.103712","DOIUrl":"10.1016/j.jscai.2025.103712","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) is a major cause of morbidity and mortality, particularly in massive and submassive cases that lead to right ventricular (RV) strain and long-term complications. The EkoSonic Endovascular System (EKOS) offers a catheter-directed thrombolytic treatment option for patients with contraindications to systemic thrombolysis, but data on long-term outcomes remain limited. We aimed to evaluate long-term mortality, RV function, and quality of life (QoL) in patients with massive or submassive PE who were treated with EKOS therapy.</div></div><div><h3>Methods</h3><div>The EKOS-PE is a retrospective cohort study of 137 patients with massive or submassive PE who underwent EKOS therapy within a single health care system from 2020 to 2024. The primary outcome was all-cause mortality; secondary outcomes included changes in the RV-to-left ventricular (LV) (RV/LV) ratio, residual RV dysfunction, and QoL as assessed using the Pulmonary Embolism Quality of Life questionnaire.</div></div><div><h3>Results</h3><div>All-cause mortality was 7.2% at a mean follow-up of 26.5 ± 17.2 months. During the index hospitalization, 1 retroperitoneal bleed (0.7%) and 1 ischemic stroke (0.7%) were observed. The mean RV/LV ratio decreased from 1.13 ± 0.24 to 0.83 ± 0.19 (<em>P</em> &lt; .01). No residual RV dysfunction was evident in 105 (75.5%) patients, whereas 16 (11.5%) exhibited moderate to severe residual dysfunction. Of 52 respondents who completed the QoL survey at a mean follow-up of 37.2 ± 12.1 months, minimal residual symptoms, limited functional interference, and improved perceived lung health were reported.</div></div><div><h3>Conclusions</h3><div>The EKOS therapy is associated with significant long-term improvement in RV function, low mortality, and favorable perceived QoL, supporting its use in massive and submassive PE, aligning with current guideline recommendations for high-risk patients.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103712"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864377","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":"Temporal Trends and Practice Patterns Associated With Utilization of Catheter-Based Interventions for Pulmonary Embolism","authors":"Nathan W. Watson MD ,&nbsp;Michael R. Jaff DO ,&nbsp;Brett J. Carroll MD ,&nbsp;Hibiki Orui MA ,&nbsp;Siling Li MSc ,&nbsp;Yang Song MSc ,&nbsp;Jeffrey L. Weinstein MD ,&nbsp;Robert W. Yeh MD, MSc, MBA ,&nbsp;Eric A. Secemsky MD, MSc","doi":"10.1016/j.jscai.2025.103736","DOIUrl":"10.1016/j.jscai.2025.103736","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, there has been increasing utilization of catheter-based interventions (CBI) for the treatment of acute pulmonary embolism (PE). We aimed to investigate the trends and practice patterns associated with the utilization of CBI among older patients hospitalized with a PE in US hospitals.</div></div><div><h3>Methods</h3><div>All Medicare fee-for-service beneficiaries hospitalized with a PE from June 1, 2018, to September 30, 2023, were identified. For outcomes analysis, a subset of patients hospitalized between June 1, 2018, and December 31, 2021, was identified to allow for follow-up to occur.</div></div><div><h3>Results</h3><div>In total, 313,522 patients were hospitalized with a concomitant PE; of which, 9.12% (n = 28,597) underwent a CBI (4.76% [n = 14,914] catheter-directed thrombolysis and 4.76% [n = 14,918] mechanical thrombectomy). Utilization of CBI increased over time from 5.92% in 2018 to 14.1% in 2023, attributed to increases in mechanical thrombectomy. CBI was used more frequently at teaching hospitals (adjusted OR, 1.10; 95% CI, 1.04-1.15) and in male patients (adjusted OR, 1.15; 95% CI, 1.10-1.21), while less frequently at smaller institutions (adjusted OR, 0.14; 95% CI, 0.09-0.22) and in patients with Black race (adjusted OR, 0.90; 95% CI, 0.85-0.95) or dual enrollment (adjusted OR, 0.80; 95% CI, 0.76-0.86). Older age, Black race, geographic region, and distressed communities were associated with higher rates of death or periprocedural complications.</div></div><div><h3>Conclusions</h3><div>In this contemporary nationwide analysis of hospitalized patients with PE, we found that rates of CBI increased over time, although uptake of CBI remains heterogeneous. Our findings suggest that there are differences in access to advanced therapies and outcomes among particular populations following CBI for PE management.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103736"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864378","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":"Antithrombotic Therapy After Transcatheter Aortic Valve Replacement: A Meta-analysis and Trial Sequential Analysis of Randomized Trials","authors":"Ankur Sethi MBBS ,&nbsp;Emily Hiltner MD ,&nbsp;Marc Sandhaus MD ,&nbsp;Tana LaPlaca DNP, APN-BC ,&nbsp;Mark Russo MD, MS","doi":"10.1016/j.jscai.2025.103787","DOIUrl":"10.1016/j.jscai.2025.103787","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 8","pages":"Article 103787"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144864461","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}