{"title":"Long-term outcomes of endovascular therapy for chronic limb-threatening ischemia patients with connective tissue disease.","authors":"Shohei Ouchi, Kao Takehisa, Naotaka Murata, Iwao Okai, Yuichi Chikata, Hirokazu Konishi, Masashi Nakao, Shinya Okazaki, Junichi Yamaguchi, Toru Minamino","doi":"10.1007/s12928-025-01157-y","DOIUrl":"https://doi.org/10.1007/s12928-025-01157-y","url":null,"abstract":"<p><p>In patients with connective tissue disease (CTD) and chronic limb-threatening ischemia (CLTI), revascularization is reported to be ineffective, with a poor prognosis and a high rate of lower-limb amputation. However, limited actual data are available. To study the long-term outcomes of endovascular therapy for CLTI patients with CTD, we established a multicenter registry (retrospective cohort study) in Japan. This study looked at major adverse extremity events, amputation-free survival, and all-cause mortality to better understand these rates. We registered 44 consecutive patients. The patients' mean age was 69.6 ± 11.4 years. There were 19 patients (43.2%) with diabetes, but only 4 patients (9.1%) were on dialysis. The average follow-up was 36.1 ± 31.7 months. In 11 patients (25.0%), the target wound healed without requiring lower-limb amputation. Target lesion revascularization occurred in 19 cases (43.2%), while unexpected minor amputations occurred in 11 cases (25.0%), major amputations in 8 cases (18.2%), and death in 15 cases (34.1%). The rates of freedom from major adverse extremity events at 1 and 3 years were 40.3% and 22.3%, respectively. The amputation-free survival rates were 69.3% at 1 year and 58.3% at 3 years. The survival rates were 85.5% at 1 year and 70.3% at 3 years. We conducted a multicenter study to look into the outcomes of CLTI patients with CTD who received endovascular therapy. Given the poor outcomes, more therapeutic advances for CLTI in CTD patients are needed.</p>","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":"144559296","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 prognostic value of small psoas muscle area in patients undergoing mitral transcatheter edge-to-edge repair.","authors":"Ryo Shigeno, Masaki Miyasaka, Takao Morikawa, Arudo Hiraoka, Atsushi Hirohata","doi":"10.1007/s12928-025-01156-z","DOIUrl":"https://doi.org/10.1007/s12928-025-01156-z","url":null,"abstract":"<p><p>Sarcopenia may be more advanced in high-surgical-risk patients undergoing mitral transcatheter edge-to-edge repair (M-TEER). However, the clinical significance of psoas muscle area (PMA), measured by computed tomography (CT) as an index of sarcopenia, remains uncertain in this population. To determine the association between PMA and clinical outcomes following M-TEER in high-risk patients. Of 238 patients who underwent M-TEER at our facility between January 2019 and July 2023, 214 patients with available preoperative CT were enrolled. Bilateral cross-sectional PMA was measured at the L4 vertebra level and indexed to body surface area. Patients in the lowest sex-specific tertile of index PMA were classified as the smaller PMA group, and the remainder as the larger PMA group. The composite outcome comprised heart failure hospitalization or all-cause death. The mean age and median Society of Thoracic Surgeons score was 80.6 ± 9.0 years and 11.6% (interquartile range 7.3%-17.1%). Seventy-one patients were assigned to the smaller PMA group, and 143 to the larger PMA group. At 1 year, the smaller PMA group had higher rates of the composite outcome and heart failure hospitalization than the larger PMA group (composite outcome: 46.5% versus 26.6%, P = 0.003; heart failure hospitalization: 35.1% versus 17.3%, P = 0.006). The rate of all-cause death was numerically higher in the smaller PMA group, though the difference was not statistically significant (25.4% versus 16.1%, P = 0.10). Decreased PMA measured by preprocedural CT in patients undergoing M-TEER was associated with adverse clinical outcomes.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144552394","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":"Complex PCI and 1-year outcomes in the OPTIVUS-complex PCI study multivessel cohort.","authors":"Masaomi Gohbara, Kiyoshi Hibi, Takeshi Morimoto, Hidekuni Kirigaya, Ko Yamamoto, Koh Ono, Hiroki Shiomi, Masanobu Ohya, Kyohei Yamaji, Hiroki Watanabe, Tetsuya Amano, Yoshihiro Morino, Kensuke Takagi, Junko Honye, Hitoshi Matsuo, Mitsuru Abe, Kazushige Kadota, Kenji Ando, Koichi Nakao, Shinjo Sonoda, Satoru Suwa, Kazuya Kawai, Ken Kozuma, Yoshihisa Nakagawa, Yuji Ikari, Mamoru Nanasato, Keiichi Hanaoka, Kengo Tanabe, Yoshiki Hata, Takashi Akasaka, Takeshi Kimura","doi":"10.1007/s12928-025-01110-z","DOIUrl":"10.1007/s12928-025-01110-z","url":null,"abstract":"<p><p>It remains unknown whether intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) can improve the clinical outcomes of complex PCI to a level equivalent to that of non-complex PCI. In the OPTIVUS-Complex PCI (Optimal Intravascular Ultrasound-Guided Complex PCI) Study multivessel cohort, a total of 1011 patients who underwent multivessel PCI involving a target lesion in the left anterior descending coronary artery (LAD) were divided into 2 groups: complex PCI (N = 760) and non-complex PCI groups (N = 251). Complex PCI was defined as a procedure with the following characteristics: 3 vessels treated, 3 stents implanted, 3 lesions treated, bifurcation with 2 stents implanted, total stent length > 60 mm, or target of chronic total occlusion. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE) defined by a composite of death, myocardial infarction, stroke, or any coronary revascularization. The cumulative 1-year incidences of the primary endpoint and any coronary revascularization were not significantly different between the complex and non-complex PCI groups (10.9% vs. 8.3%, P = 0.24, and 7.7% vs. 4.8%, P = 0.12, respectively). In the multivariable Cox proportional hazards models, there was no significant excess risk of the complex PCI group relative to the non-complex PCI group for the primary endpoint (HR, 1.35; 95%CI, 0.83-2.18; P = 0.22), or for any coronary revascularization (HR, 1.64; 95%CI, 0.87-3.06; P = 0.11). After optimal IVUS-guided multivessel PCI with a target lesion in the LAD, 1-year risk of MACCE or coronary revascularization in patients with complex PCI was numerically higher than that in patients with non-complex PCI.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"516-526"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794300","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":"Transcatheter edge-to-edge repair for a small mitral valve following surgical annuloplasty.","authors":"Ryo Shigeno, Takao Morikawa, Arudo Hiraoka, Misako Toki, Atsushi Hirohata","doi":"10.1007/s12928-025-01103-y","DOIUrl":"10.1007/s12928-025-01103-y","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"721-722"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440292","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":"Pericoronary adipose tissue: potential for pathological diagnosis and therapeutic applications.","authors":"Tomoya Hara, Masataka Sata","doi":"10.1007/s12928-025-01126-5","DOIUrl":"10.1007/s12928-025-01126-5","url":null,"abstract":"<p><p>Excessive accumulation of epicardial adipose tissue (EAT) is known to be a risk factor for coronary artery disease and heart failure. In particular, it is thought that inflammation of pericoronary adipose tissue (PCAT) affects the pathology of various coronary artery diseases (CAD). EAT and PCAT are thought to be new therapeutic targets for preventing cardiovascular disease. Although there are no established drugs that specifically reduce inflammation of EAT or PCAT, the basic approach is to improve lifestyle-related diseases through exercise and diet, and to use metabolic improvement drugs and anti-inflammatory drugs as soft support. Potential candidates include statins, SGLT2 inhibitors, and GLP- 1 receptor agonists. In addition to conventional treatments that target substances within blood vessels, treatments that target EAT and PCAT by directly enveloping the coronary arteries and myocardium from outside the body are expected to further suppress cardiovascular events.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"465-473"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787968","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 pullback speed on evaluation of lipid core plaque using near-infrared spectroscopy-intravascular ultrasound.","authors":"Tetsuharu Kasahara, Hideki Kitahara, Kenta Takou, Kazuya Tateishi, Yuichi Saito, Ken Kato, Takashi Iimori, Yoshio Kobayashi","doi":"10.1007/s12928-025-01124-7","DOIUrl":"10.1007/s12928-025-01124-7","url":null,"abstract":"<p><p>Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) can assess the amount of lipid core plaque, and the latest generation catheter allows for imaging at several different pullback speeds. The purpose of this study was to investigate the impact of pullback speed on evaluation of lipid core plaque using the latest generation NIRS-IVUS catheter. Patients with coronary artery disease who underwent coronary angiography or percutaneous coronary intervention with NIRS-IVUS examination at 2 different pullback speeds (0.5 and 2.0 mm/sec) for the same vessel were enrolled. The values of lipid core burden index (LCBI) and maxLCBI4mm were compared between the images recorded with pullback speeds of 0.5 and 2.0 mm/sec, and match or mismatch of the location where maxLCBI4mm was detected was investigated. In a total of 286 NIRS-IVUS image sets, the location of maxLCBI4mm measured at 0.5 and 2.0 mm/sec was mismatched in 81 (28.3%) image sets. In comparison by vessel type, 20.8% were mismatched in LAD, 31.1% in LCx, and 37.8% in RCA (p = 0.023). In 205 image sets with matched maxLCBI4mm location, the maxLCBI4mm value at 2.0 mm/sec was significantly greater compared with that at 0.5 mm/sec (348.0 vs. 302.0 in median, p < 0.001). In a substantial proportion of patients, the location of maxLCBI4mm values measured at 0.5 and 2.0 mm/sec was mismatched. In the image sets with matched maxLCBI4mm location, the maxLCBI4mm value at 2.0 mm/sec was significantly greater compared with that at 0.5 mm/sec. These results should be noted when applying the cut-off values of maxLCBI4mm recorded at 2.0 mm/sec.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"536-543"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771276","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":"Incremental value of physiological indices to predict high-risk plaques detected by NIRS-IVUS.","authors":"Kazuyoshi Kakehi, Masafumi Ueno, Nobuhiro Yamada, Kyohei Onishi, Keishiro Sugimoto, Yohei Funauchi, Takayuki Kawamura, Kosuke Fujita, Hiroki Matsuzoe, Koichiro Matsumura, Gaku Nakazawa","doi":"10.1007/s12928-025-01116-7","DOIUrl":"10.1007/s12928-025-01116-7","url":null,"abstract":"<p><p>Identification of vulnerable plaques is important for reducing future cardiovascular events. This study aimed to investigate optimal modalities other than intravascular imaging in evaluating vulnerable plaques. We prospectively evaluated 105 non-culprit coronary lesions by CCTA imaging and near-infrared spectroscopy-intravascular ultrasound in 32 patients with acute coronary syndrome. Angiographically-derived ΔQFR and ΔFFR<sub>CT</sub> were measured as the difference in QFR and FFR<sub>CT</sub> across the stenosis. A receiver operating characteristic curve analysis was performed to determine the optimal cutoff values of angiographically- and CCTA-derived plaque features for a maxLCBI<sub>4mm</sub> ≥ 400. The best cutoff values for ΔQFR and ΔFFR<sub>CT</sub> to predict a maxLCBI<sub>4mm</sub> ≥ 400 were 0.05 and 0.06, respectively. ΔQFR and ΔFFR<sub>CT</sub> values and percent diameter stenosis on QCA or CCTA were associated with a maxLCBI<sub>4mm</sub> ≥ 400 (both P < 0.05). The combination of ΔFFR<sub>CT</sub> ≥ 0.06 and plaque density predicted a maxLCBI<sub>4mm</sub> ≥ 400 with 89.4% sensitivity and 84.5% specificity (area under the curve, 0.90; P < 0.0001). There was no significant difference in area under the curve values between ΔQFR and plaque density + ΔFFR<sub>CT</sub> ≥ 0.06 (0.92 vs. 0.90, P = 0.50). In the diagnosis of vulnerable plaques in acute coronary syndrome, the combination of ΔFFR<sub>CT</sub> and plaque density shows a diagnostic capability similar to that of ΔQFR in non-culprit lesions.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"588-598"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613405","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}
Yoshinobu Murasato, Jinya Takahashi, Kyohei Meno, Takahiro Mori
{"title":"Balloon blocking technique for antegrade wiring in a chronic total occlusion of the left anterior descending artery ostium.","authors":"Yoshinobu Murasato, Jinya Takahashi, Kyohei Meno, Takahiro Mori","doi":"10.1007/s12928-025-01108-7","DOIUrl":"10.1007/s12928-025-01108-7","url":null,"abstract":"","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":"707-709"},"PeriodicalIF":3.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572252","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}