Cardiovascular Intervention and Therapeutics最新文献

{"title":"Comparison of the incidence of slow flow following rotational atherectomy to severely calcified coronary artery lesions between short single session and long single session strategies: the randomized ROTASOLO trial.","authors":"Kenichi Sakakura, Hiroyuki Jinnouchi, Yousuke Taniguchi, Kei Yamamoto, Yoshimasa Tsurumaki, Takunori Tsukui, Yusuke Watanabe, Takaaki Mase, Masaru Seguchi, Taku Kasahara, Masashi Hatori, Shun Ishibashi, Hiroshi Wada, Yusuke Tamanaha, Kenshiro Arao, Norifumi Kubo, Hideo Fujita","doi":"10.1007/s12928-025-01177-8","DOIUrl":"https://doi.org/10.1007/s12928-025-01177-8","url":null,"abstract":"<p><p>Slow flow is the most common complication of rotational atherectomy (RA). Compared with long single sessions, short single sessions may reduce the incidence of slow flow just after RA. This study aimed to compare the incidence of slow flow just after RA between short single session and long single session strategies. This multicenter, 1:1 randomized clinical trial was conducted at 3 hospitals in Japan. The short single session strategy was defined as repeating short single sessions (up to 15 s) of RA, whereas the long single session strategy was defined as repeating long single sessions (20-30 s) until the burr crossed the target lesion. The primary outcome was slow flow just after RA, which was defined as [(initial TIMI-frame count before RA) × 1.1 minus (TIMI-frame count just after RA)] less than 0. During the study period, 266 patients were included in the final study population and were randomly assigned to the Short single session group (n = 132) or the long single session group (n = 134). The protocol adherence rate was equally high in both groups (Short single session: 98.5% versus long single session 94.8%, p = 0.172). The incidence of slow flow just after RA was similar between the 2 groups (short single session:14.4% versus long single session: 14.9%, p > 0.999). In conclusion, this randomized trial did not show a benefit of the short single session strategy compared with the long single session strategy in RA with respect to the prevention of slow flow (Unique identifier: UMIN000047231).</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688938","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":"Correction: The potential role of major dissection observed on optical frequency-domain imaging in optimal lumen expansion after coronary intravascular lithotripsy: a comparative analysis with calcium fractures.","authors":"Kotaro Miyata, Taku Asano, Takahiro Suzuki, Masafumi Ono, Jiro Aoki","doi":"10.1007/s12928-025-01167-w","DOIUrl":"https://doi.org/10.1007/s12928-025-01167-w","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682070","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":"Improvement in residual paravalvular leakage after transcatheter aortic valve replacement with a self-expanding valve: ACURATE neo2 versus ACURATE neo.","authors":"Yoichi Sugiyama, Hirokazu Miyashita, Sebastian Dahlbacka, Tommi Vähäsilta, Tiina Vainikka, Mikko Jalanko, Juho Viikilä, Mika Laine, Noriaki Moriyama","doi":"10.1007/s12928-025-01170-1","DOIUrl":"https://doi.org/10.1007/s12928-025-01170-1","url":null,"abstract":"<p><p>The paravalvular leakage (PVL) incidence immediately after transcatheter aortic valve replacement (TAVR) is reportedly lower with ACURATE neo2 than with ACURATE neo. However, the difference in the subsequent PVL improvement between these valves and the improvement mechanism remain unclear. This study aimed to compare the incidence of and changes in the PVL between these valves and investigate the factors associated with PVL improvement. We included 403 patients who underwent TAVR with ACURATE neo2 (n = 134) or ACURATE neo (n = 269). The study endpoint was PVL improvement, defined as a reduction in the PVL grade from mild or higher at discharge to none/trace at 3 months. The PVL incidence of mild grade or higher was significantly lower with ACURATE neo2 than with ACURATE neo at 3 months (15.7% vs. 25.7%; p = 0.0234) but did not differ significantly at discharge (33.3% vs. 27.5%; p = 0.2291). A significant decrease in the PVL was observed only with ACURATE neo2 (p < 0.0001). Multivariate analysis demonstrated that ACURATE neo2 and calcium volume of the aortic leaflets were independent predictors of PVL improvement. The incidence of mild grade or higher PVL was lower with ACURATE neo2 than with ACURATE neo at 3 months due to the subsequent improvement. Patient selection focusing on leaflet calcification is important for preventing PVL because severe calcification impedes PVL improvement.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667233","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":"A hybrid hemostatic strategy with single suture- and plug-based closure devices for percutaneous venoarterial extracorporeal membrane oxygenation decannulation: using Perclose and AngioSeal VIP.","authors":"Riho Suzuki, Yutaka Dannoura, Naoya Asakawa, Takao Makino, Hisashi Yokoshiki","doi":"10.1007/s12928-025-01176-9","DOIUrl":"https://doi.org/10.1007/s12928-025-01176-9","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667232","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 aortic angulation on outcomes in transcatheter aortic valve replacement with balloon-expandable and self-expanding valves: a systematic review and meta-analysis.","authors":"Basma Badrawy Khalefa, Ahmed Reda Gonnah, Mazen Negmeldin Aly Yassin, Hossam Fayed, Moumen Arnaout, Mohamed Karam Allah Elkholy, Mohamed Ramadan, Abdelrahman Mohammed Elettreby, Ali Dway, Hatem Eldeeb, Abdullah Saeed Abujabal, David Hesketh Roberts","doi":"10.1007/s12928-025-01169-8","DOIUrl":"https://doi.org/10.1007/s12928-025-01169-8","url":null,"abstract":"<p><p>High aortic angulation (AA) can pose significant challenges during TAVR. This meta-analysis determines the impact of a horizontal aorta on TAVR outcomes with balloon-expandable (BEV) and self-expanding valves (SEVs). A comprehensive search was conducted from inception to June 2024. Thirteen observational studies assessing the impact of aortic angulation in patients undergoing TAVR replacement were included. The pooled results indicated that short-term mortality was significantly lower in patients with a non-horizontal aorta (RR = 0.76; 95% CI 0.62-0.95, P = 0.01). Subgroup analysis displayed that BEVs had a lower short-term mortality with a horizontal aorta than SEVs. The incidence of stroke was not significantly affected by aortic angulation with either valve type. However, the overall risk of permanent pacemaker implantation was lower in patients with a non-horizontal aorta for both valve types. Paravalvular regurgitation was also reduced in the non-horizontal aorta group, with no difference between aortic angulations in patients with BEVs. In contrast, SEVs favored a non-horizontal aorta in reducing paravalvular leak (RR = 0.66; 95% CI 0.46-0.94, P = 0.02). Both BEVs and SEVs show better results in patients with lower aortic root angulation. The increased incidence of conduction abnormalities and PPI rates with both valve types in patients with horizontal aorta is a concern. BEVs could be potentially used preferentially to SEVs in patients with a horizontal aorta as there was no difference between horizontal and non-horizontal aorta groups regarding short-term mortality, moderate-to-severe paravalvular leak, and need for a second valve.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658432","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 need for future coronary access in older medicare beneficiaries following transcatheter aortic-valve replacement.","authors":"Christopher Brown, Michael Ryan, Marcella Kelley, Christin Thompson, Candace Gunnarsson, James Hermiller","doi":"10.1007/s12928-025-01171-0","DOIUrl":"https://doi.org/10.1007/s12928-025-01171-0","url":null,"abstract":"<p><strong>Background: </strong>While approximately 17% of patients less than 80 years old require coronary access in the 7 years following their TAVR, the need for coronary access among older TAVR patients is unknown.</p><p><strong>Methods: </strong>We examined the percentage of Medicare beneficiaries aged 80-90 years that require coronary access [percutaneous coronary intervention (PCI) or angiogram] in the 8 years following their TAVR using data from the Medicare 5% Standard Analytic File (2011-2021). The need for coronary access in older patients was estimated for all TAVRs, TAVR patients with and without a history of PCI, and TAVR patients with and without coronary artery disease (CAD) using time-to-event models adjusted for age, sex, race, region, ECI score, concomitant CABG, CAD, PCI, and current or recent smoker status. Multivariate log-gamma regressions were used to estimate the total cost of hospitalizations requiring coronary access post-TAVR.</p><p><strong>Results: </strong>A total of 6845 patients met inclusion criteria. The incidence rates for undergoing PCI or angiogram at 1, 3, 5, and 8 years were 1.9%, 4.0%, 5.5%, and 6.3%, respectively. TAVR patients with PCI demonstrated higher rates of coronary intervention compared to those without PCI (10.2% vs. 6.2% at 8 years, respectively). Similarly, TAVR patients with a prior CAD diagnosis exhibited increased rates of coronary intervention compared to those without a prior CAD diagnosis (7.4% vs. 2.1% at 8 years, respectively). The mean adjusted cost of hospitalizations requiring coronary access was $30,170 [95% Confidence Interval: $27,865-$32,665].</p><p><strong>Conclusions: </strong>Approximately 6.8% of older TAVR patients require coronary access in the 8 years following their index procedure. The presence of a prior PCI or CAD diagnosis is associated with an increased requirement for subsequent coronary access.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658434","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":"Short-term outcomes of transcatheter aortic valve implantation in patients with bicuspid aortic valve: insights from nationwide readmission analysis.","authors":"Laith Alhuneafat, Fares Ghanem, Omar Obeidat, Anas Alzyoud, Abdel Latif Ma'aita, Mustafa Ajam, Ahmed M Altibi","doi":"10.1007/s12928-025-01173-y","DOIUrl":"https://doi.org/10.1007/s12928-025-01173-y","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) TAVI outcomes for patients with bicuspid aortic valve (BAV) and severe aortic stenosis are uncertain due to their exclusion from major clinical trials. We analyzed TAVI patients in the United States using data from the Nationwide Readmissions Database (2016-2019) identified using ICD-10 codes. We established matched cohorts of BAV and trileaflet aortic valve (TAV) patients using propensity-score matching (PSM). Primary outcomes were in-hospital mortality, 30-day mortality, and 30-day readmission rates. Out of 233,683 TAVI patients identified, 3169 (1.4%) had BAV. BAV patients were younger with fewer comorbidities. After PSM, 2,840 pairs were analyzed. Compared to TAV patients, TAVI in BAV patients showed comparable in-hospital mortality (1.2% vs. 2.0%; OR 0.62; 95% CI 0.36-1.04; p = 0.07) and 30-day readmission rates (10.0% vs. 12.3%; OR 0.79; 95% CI 0.60-1.03; p = 0.08), with lower 30-day mortality rates (0.88% vs. 1.96%; OR 0.44; 95% CI 0.23-0.84; p = 0.01). Post-TAVI in-hospital complications rates, including stroke, acute kidney injury, pacemaker need, and others, were similar between BAV and TAV patients. TAVI in BAV shows acceptable safety compared to TAV, but further randomized trials are needed to establish long-term outcomes and durability.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658433","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":"Five-year outcomes after surgical versus transcatheter aortic valve replacement with new generation devices from the prospective OBSERVANT studies.","authors":"Stefano Rosato, Fausto Biancari, Marco Barbanti, Giuseppe Tarantini, Marco Ranucci, Giuliano Costa, Timo Mäkikallio, Gian Paolo Ussia, Giovanni Baglio, Mahin Tatari, Gabriella Badoni, Paola D'Errigo","doi":"10.1007/s12928-025-01155-0","DOIUrl":"https://doi.org/10.1007/s12928-025-01155-0","url":null,"abstract":"<p><p>The efficacy and durability of transcatheter (TAVR) over surgical aortic valve replacement (SAVR) for severe aortic stenosis (AS) has been demonstrated in randomized studies, but these findings were not confirmed in several observational studies. This is an analysis of 5706 AS patients who underwent SAVR from 2010 and 2012, and 2989 AS patients who underwent TAVR from 2017 and 2018 from the prospective OBSERVANT I and II studies. TAVR procedures were performed with new-generation devices. Five-year all-cause mortality was the primary outcome of this analysis. Propensity score matching yielded 1008 pairs of TAVR and SAVR patients. The mean EuroSCORE II was comparable between the study cohorts (TAVR 4.7 ± 4.0% and SAVR 4.5 ± 5.7%, p = 0.419). At 5 years, TAVR was associated with higher mortality (44.4% vs. 33.2%, HR 1.36, 95%CI 1.18-1.57, Log-rank test p < 0.001), major adverse cardiac and cerebrovascular events (MACCEs) (49.3% vs. 37.9%, HR 1.32, 95%CI 1.15-1.51, Log-rank test p < 0.001), permanent pacemaker implantation (23.1% vs. 9.3%, HR 2.72, 95%CI 2.14-3.45, Log-rank test p < 0.001) and percutaneous coronary intervention rates (3.7% vs. 1.2%, HR 3.44, 95%CI 1.76-6.71, Log-rank test p < 0.001) compared to SAVR. Age ≤ 80 years, male gender, EuroSCORE II ≤ 4.0%, absence of coronary artery disease and absence of diabetes were associated with higher 5-year mortality after TAVR compared to SAVR. TAVR had a significantly higher 5-year mortality than SAVR both in patients with left ventricular ejection fraction ≤ 50% and > 50%. This observational study from prospective data showed that TAVR using new-generation devices was associated with increased rates of all-cause mortality compared to SAVR at 5 years. These findings should be viewed considering the non-randomized nature of this study and may be attributable to the characteristics of patients selected for TAVR, rather than the procedure itself.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583083","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":"Single catheter primary percutaneous coronary intervention method in patients with ST-elevation myocardial infarction: the SPEEDY-PCI study.","authors":"Sho Torii, Akihiko Takahashi, Yujiro Ono, Masanori Taniwaki, Mitsutoshi Oguri, Masanori Teramura, Ryuichi Kato, Shuji Otsuki, Hiroshi Suzuki, Fuminobu Yoshimachi, Hironori Ueda, Keisuke Shioji, Gaku Nakazawa, Kaoru Sakurai, Mitsuru Tsujimoto, Motosu Ando, Toshiyuki Kozai, Rie Aoyama, Yuji Ikari","doi":"10.1007/s12928-025-01162-1","DOIUrl":"https://doi.org/10.1007/s12928-025-01162-1","url":null,"abstract":"<p><p>Reducing total ischemic time in ST-elevation myocardial infarction (STEMI) is crucial for improving outcomes. While procedural time during primary percutaneous coronary intervention (PCI) is critical, strategies to shorten it need to be explored. To examine whether the single-catheter PCI (SC-PCI) method using a universal guiding catheter, Ikari-Left curve, without catheter exchange reduces PCI time compared to conventional PCI (C-PCI). The Speedy PCI study is a prospective, multicenter, randomized trial comparing SC-PCI versus C-PCI. The primary endpoint was the time from sheath insertion to first device activation (S2B) time. Secondary endpoints included door-to-balloon time, total ischemia time, fluoroscopy time, contrast volume, hospital expenses, and 30-day mortality. A total of 380 patients (SC-PCI: 194; C-PCI: 186) were analyzed. Both groups had high primary PCI success rates (92.3 vs. 91.9%, p = 0.74) and similar radial access usage (higher than 97%). SC-PCI method showed a significantly shorter S2B time (15.8 ± 10.9 min) compared to the C-PCI method (18.7 ± 10.6 min, p = 0.007) with reduced number of total catheters used (1.2 ± 0.6 vs. 2.7 ± 0.7, p < 0.0001, respectively). No cases of coronary dissection caused by the guiding catheter were observed in the SC-PCI method. Clinical outcomes at 30 days and 1-year follow-up, including all-cause mortality and stroke rates, were similar between the groups. The SC-PCI method using the Ikari curve demonstrated a significant reduction in PCI procedure time while maintaining safety and primary PCI success in primary PCI for STEMI.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583084","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":"In-stent restenosis caused by late-protruding native atherosclerosis through uncovered struts: observations with coronary angioscopy.","authors":"Tsukasa Murakami, Keisuke Kojima, Hiroyuki Jinnouchi, Masanori Takenoya","doi":"10.1007/s12928-025-01166-x","DOIUrl":"https://doi.org/10.1007/s12928-025-01166-x","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564615","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}