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

{"title":"Closing the Gap: Why Percutaneous Patent Foramen Ovale and All Atrial Septal Defect Closures Belong in the NCDR IMPACT Registry","authors":"Georges Ephrem MD, MSc","doi":"10.1016/j.jscai.2026.105502","DOIUrl":"10.1016/j.jscai.2026.105502","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105502"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148730433","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/ASE/HRS/SIR/SVS Expert Consensus Statement on Enhanced Radiation Protection: Time for Mandatory and Urgent Action","authors":"David G. Rizik MD, MSCAI,&nbsp;Nadia R. Sutton MD, MPH, FSCAI,&nbsp;Alexandra J. Lansky MD, MSCAI,&nbsp;Mirvat Alasnag MD, FSCAI,&nbsp;Gabriel Bartal MD,&nbsp;Mary Beth Brady MD,&nbsp;Megan Coylewright MD, MPH, FSCAI,&nbsp;James A. Goldstein MD, FSCAI,&nbsp;Scott M. Firestone MS,&nbsp;Andrew M. Goldsweig MD, MS, FSCAI,&nbsp;Dean J. Kereiakes MD, MSCAI,&nbsp;Melissa Kirkwood MD,&nbsp;Ryan D. Madder MD, FSCAI,&nbsp;Roxana Mehran MD, MSCAI,&nbsp;William J. Nicholson MD,&nbsp;Graciano Paulo PhD,&nbsp;Sunil V. Rao MD, MSCAI,&nbsp;Kenneth Rosenfield MD, MSCAI,&nbsp;Cheryl C. Schultz MS,&nbsp;Kamala P. Tamirisa MD,&nbsp;James B. Hermiller MD, MSCAI","doi":"10.1016/j.jscai.2026.105455","DOIUrl":"10.1016/j.jscai.2026.105455","url":null,"abstract":"<div><div>Health care professionals in fluoroscopic laboratories face significant occupational hazards, including cancer, cataracts, and reproductive concerns due to prolonged exposure to iodizing radiation, and orthopedic injuries stemming from long-term use of heavy aprons as protection from radiation. Despite substantial advancements in radiation protection technology, adoption of these advancements has been slow, hindered by the high upfront costs of implementation and the lag in revising institutional and regulatory radiation exposure thresholds to reflect the capabilities of contemporary enhanced radiation protection devices (ERPDs). This multisociety statement, endorsed by the Society for Cardiovascular Angiography &amp; Interventions, American College of Cardiology, the American Society of Echocardiography, the Heart Rhythm Society, the Society of Interventional Radiology, and the Society for Vascular Surgery, calls for mandatory implementation of ERPDs to meet as low as reasonably achievable standards. This expert consensus statement outlines the ethical and legal responsibilities of government, fluoroscopy laboratory manufacturers, and health care institutions to protect all health care professionals from avoidable workplace hazards and the urgent need to implement ERPDs. The document does not promote or recommend any single ERPD system, and the choice of protection technology is left to department preference. It also addresses the importance of training, monitoring, and continuous research to optimize radiation safety practices. The document advocates for updated regulations and standardized practices across states to ensure comprehensive protection for all fluoroscopy laboratory personnel.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105455"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148745971","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":"Persistent One-Year Mortality Gradient After STEMI and COVID-19: Long-Term Outcomes From the NACMI Registry","authors":"Payam Dehghani MD,&nbsp;Chase J. Ellingson BKin,&nbsp;Jyotpal Singh PhD,&nbsp;Ellen Cravero MS,&nbsp;G.B. John Mancini MD,&nbsp;Larissa Stanberry PhD,&nbsp;Mina Madan MD,&nbsp;Catherine P. Benziger MD,&nbsp;Nima Ghasemzadeh MD,&nbsp;Anna E. Bortnick MD, PhD, MSc,&nbsp;Rohan Kankaria MD,&nbsp;Cindy L. Grines MD,&nbsp;Keshav Nayak MD,&nbsp;Ehtisham Mahmud MD,&nbsp;Kevin R. Bainey MD, MSc,&nbsp;M. Chadi Alraies MD,&nbsp;Akshay Bagai MD,&nbsp;Rajan A.G. Patel MD,&nbsp;Shy Amlani MD,&nbsp;Brian C. Case MD,&nbsp;Timothy D. Henry MD","doi":"10.1016/j.jscai.2026.105395","DOIUrl":"10.1016/j.jscai.2026.105395","url":null,"abstract":"<div><h3>Background</h3><div>Patients with COVID-19 and ST-elevation myocardial infarction (STEMI) from the North American COVID-19 Myocardial Infarction (NACMI) registry had elevated in-hospital mortality compared with COVID-19-negative patients and historical controls. We examined 1-year mortality outcomes from the NACMI registry.</div></div><div><h3>Methods</h3><div>This was a substudy of NACMI centers that participated in long-term follow-up. Patients in the NACMI registry were stratified into COVID-19-positive and COVID-19-negative groups. A historical 2018-2019 control group was derived from the Midwest STEMI Consortium registry. The primary outcome was 1-year mortality.</div></div><div><h3>Results</h3><div>A total of 2358 STEMI patients (30% female) were included in this study, divided into 3 subgroups: COVID-19-positive (n = 623), COVID-19-negative (n = 694), and historical controls (n = 1041). One-year mortality in COVID-19-positive patients was 45% (HR, 4.88; 95% CI, 3.73-6.39; <em>P</em> &lt; .001), compared with 27% (HR, 3.93; 95% CI, 2.92-5.29; <em>P</em> &lt; .001) in COVID-19-negative patients and 11% in matched controls (<em>P</em> &lt; .001). Most deaths (86%) occurred during the index hospitalization, with a median time to death of 27 days (IQR 6, 343) in the COVID-19-positive group. Among survivors of index hospitalization, 1-year mortality was 12% (COVID-19-positive; HR, 2.20; 95% CI, 1.26-3.85; <em>P</em> = .006), 9.6% (COVID-19-negative; HR, 2.31; 95% CI, 1.26-4.21; <em>P</em> = .007), and 5.3% (controls) (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>This study describes long-term outcomes in patients with STEMI and COVID-19. We demonstrate that the excess mortality risk associated with COVID-19 STEMI extends beyond the index hospitalization and exhibits a clear risk gradient. The cause is likely multifactorial, including pandemic-era disruptions in care, longer time-to-treatment, and the unique pathophysiology of COVID-19 STEMI.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105395"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746514","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":"Durability of the DETOUR System for Long and Complex Femoral-Popliteal Lesions: 3-Year Results From the DETOUR2 Trial","authors":"Sean P. Lyden MD,&nbsp;Peter A. Schneider MD,&nbsp;Ami Sood MD,&nbsp;Erik Zendejas MD,&nbsp;Peter A. Soukas MD,&nbsp;Arthur Tarricone DPM,&nbsp;Prakash Krishnan MD,&nbsp;DETOUR2 Trial Investigators","doi":"10.1016/j.jscai.2026.105457","DOIUrl":"10.1016/j.jscai.2026.105457","url":null,"abstract":"<div><h3>Background</h3><div>The DETOUR2 Trial assessed the safety and effectiveness of the DETOUR System for percutaneous transmural arterial bypass (PTAB) of the femoral-popliteal (FP) artery. Previously published data reported that the procedure met key safety and effectiveness criteria with durable results through 12 months of follow-up, demonstrating a high technical success rate, few major complications, and maintained patency at rates comparable to surgical bypass. This final report describes the 36-month outcomes.</div></div><div><h3>Methods</h3><div>The DETOUR2 Trial evaluated a novel PTAB technique for treating long-segment (&gt;200 mm) FP lesions in patients with severe peripheral arterial disease (Rutherford Class 3-5) using the DETOUR System (NCT03119233). This international, multicenter, prospective, single-arm trial presents data from participants followed for 36 months.</div></div><div><h3>Results</h3><div>Thirty-two sites enrolled 202 patients, and 200 patients were treated with the DETOUR System. Mean target lesion length was 327.1 ± 61.4 mm. Primary patency through 36 months was 58.2%. Freedom from clinically driven target lesion revascularization through 36 months was 66.8%, and freedom from major adverse limb events was 64.5%. Occurrence of deep venous thrombosis at 36 months was 4.1%, with no pulmonary emboli reported.</div></div><div><h3>Conclusions</h3><div>PTAB with the DETOUR System provides durable results with favorable safety through three years for very long FP lesions exceeding 200 mm in length. DETOUR System patency is comparable to prosthetic FP bypass but with lower complication rates and outperforms traditional endovascular therapy in these long, complex lesions.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105457"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746003","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":"Impact of Radiation-Attenuating Drape on Exposure in a Contemporary Cardiac Catheterization Laboratory: The ATTENUATE Trial","authors":"Giorgio A. Medranda MD,&nbsp;Dimitrios Bliagos MD,&nbsp;Brian C. Case MD","doi":"10.1016/j.jscai.2026.105511","DOIUrl":"10.1016/j.jscai.2026.105511","url":null,"abstract":"<div><h3>Background</h3><div>Despite recent improvements in radiation safety, interventionalists are increasingly exposed to radiation during cardiac catheterization laboratory (CCL) procedures. The RADPAD was designed as a protective scatter-radiation absorbing shield with early studies demonstrating a 20% to 62% reduction in scatter-radiation. The objective of this study was to examine the impact of the protective scatter-radiation absorbing shield in a large contemporary randomized controlled trial across multiple CCL procedures.</div></div><div><h3>Methods</h3><div>The investigator-initiated, prospective, randomized, controlled ATTENUATE (rAdpad proTecTion drapE iN redUcing rAdiaTion Exposure) trial randomized CCL procedures 1:1 to use of the RADPAD vs no use of the RADPAD. The primary outcome of interest was the most proximal operator’s dose area product (DAP)-normalized operator dose (E).</div></div><div><h3>Results</h3><div>A total of 1000 CCL procedures were randomized 1:1 to use of the protective scatter-radiation absorbing shield (n = 500) vs no use (n = 500). The use of the protective scatter-radiation absorbing shield was associated with a 45.1% relative reduction in the DAP-normalized operator dose compared with no use of the protective scatter-radiation absorbing shield (0.64 vs 0.35 μSv/Gy⋅cm²; <em>P</em> &lt; .0001). Coronary cases (n = 720) saw a 21.9% relative reduction in the DAP-normalized E using the RADPAD (0.33 vs 0.43 μSv/Gy⋅cm²; <em>P</em> &lt; .001), and structural cases (n = 210) saw a 54.4% relative reduction in the DAP-normalized E using the RADPAD (0.30 vs 0.66 μSv/Gy⋅cm²; <em>P</em> = .1094).</div></div><div><h3>Conclusions</h3><div>In the largest randomized controlled trial to date evaluating the RADPAD protective scatter-radiation absorbing shield, encompassing contemporary coronary and structural CCL procedures, use of the protective scatter-radiation absorbing shield led to a marked decrease in proximal operator radiation exposure when adjusted for the total radiation delivered during each procedure.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105511"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746485","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":"Enhanced Radiation Protection Devices in Every Fluoroscopic Laboratory: A Call to Action","authors":"Farouc A. Jaffer MD, PhD","doi":"10.1016/j.jscai.2026.105398","DOIUrl":"10.1016/j.jscai.2026.105398","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105398"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746511","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 Persistent Failure of Catheterization Laboratory Safety: Time for Enhanced Radiation Protection Devices","authors":"David G. Rizik MD,&nbsp;David A. Cox MD","doi":"10.1016/j.jscai.2026.105442","DOIUrl":"10.1016/j.jscai.2026.105442","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105442"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746515","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)01359-1","DOIUrl":"10.1016/S2772-9303(26)01359-1","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105612"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746488","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":"Leading by Example: Arizona’s Bold Step for Safer Catheterization Laboratories to Protect Our Doctors and Nurses","authors":"Carine Werner","doi":"10.1016/j.jscai.2026.105405","DOIUrl":"10.1016/j.jscai.2026.105405","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105405"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148745973","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":"Mechanical Thrombectomy of an Obstructive Mechanical Mitral Valve Thrombus Using the FlowTriever Device With Embolic Protection: A Case Report","authors":"Asad Rizvi MD,&nbsp;Shane Metzler MD,&nbsp;Amir Malik MD,&nbsp;Farhan Ali MD","doi":"10.1016/j.jscai.2026.105459","DOIUrl":"10.1016/j.jscai.2026.105459","url":null,"abstract":"<div><div>Management of obstructive mechanical mitral valve thrombosis in patients with prohibitive surgical risk and contraindication to thrombolytics is not well defined. Transcatheter approaches, such as manipulation of immobile valve leaflets and aspiration of the obstructive thrombus using various devices, have been successfully attempted. We report the first case of mechanical thrombectomy of an obstructive mechanical mitral valve thrombosis using the FlowTriever system. Future research should focus on developing comprehensive embolic protection strategies and larger studies to establish the safety, efficacy, and indications of this procedure.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"5 8","pages":"Article 105459"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148746512","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}