Catheterization and Cardiovascular Interventions最新文献

{"title":"Enhanced Drug Effect With Cutting Balloon Followed by Drug Coated Balloon in a Rabbit Model.","authors":"Manabu Shiozaki, Sho Torii, Yu Sato, Kazuki Aihara, Yuki Matsumoto, Norihito Nakamura, Daiki Suzuki, Ayako Yoshikawa, Yuji Ikari, Gaku Nakazawa","doi":"10.1002/ccd.31505","DOIUrl":"https://doi.org/10.1002/ccd.31505","url":null,"abstract":"<p><strong>Background: </strong>Drug-coated balloon (DCB) are effective treatment options for patients with coronary artery disease and using of scoring or cutting balloon before the DCB usage were recommended. However, the effectiveness of lesion preparation with cutting balloons (CB) followed by DCB (CB + DCB) has not been evaluated before.</p><p><strong>Aims: </strong>The aim of the current study was to compare the biological effect of various types of balloon angioplasty in a healthy rabbit iliac artery model.</p><p><strong>Methods: </strong>Each of the four kinds of treatments as balloon angioplasty (BA), CB alone, DCB alone, and CB + DCB were performed in the healthy iliac arteries of 12 rabbits, which were euthanized after 14 days. The treated iliac arteries were sequentially cut, stained with hematoxylin and eosin and Movat Pentachrome, and histopathologically evaluated.</p><p><strong>Results: </strong>The depth of medial smooth muscle cell (SMC) loss score, an indicator of drug effect, was highest with CB + DCB, followed by DCB, CB, and BA (CB + DCB vs. DCB vs. CB vs. BA: 3.83 (3.67-4.00) vs. 3.17 (2.67-3.67), 1.67 (1.67-2.08) vs. 1.50 (1.00-1.67), p < 0.0001). The angle with severe SMC loss was also the highest with CB + DCB group, followed by DCB group, CB group, and BA group (123.7 (104.5-132.2) vs. 52.1 (34.7-100.6), 0.0 (0.0-14.2) vs. 0.0 (0.0-0.0), respectively, p < 0.0001), suggesting a higher drug effect in CB + DCB compared with DCB alone.</p><p><strong>Conclusions: </strong>The drug effect of DCB was enhanced when CB was used before DCB treatment, suggesting the effectiveness of the combination therapy of CB and DCB.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pressure Guidewire Indicated for Coronary Fractional Flow Reserve Assessment: Structural Design, Deficiencies and Potential Solutions.","authors":"Wengang Liu, Jun Shi, Rong Shan, Yu Wang, Liangfeng Zhao, Honglei Zhou, Wei Li, Liuliu Feng","doi":"10.1002/ccd.31504","DOIUrl":"https://doi.org/10.1002/ccd.31504","url":null,"abstract":"<p><p>Coronary heart disease (CHD) is one of the leading causes of mortality worldwide. It is primarily caused by myocardial ischemia and hypoxia resulting from atherosclerotic plaques in the coronary arteries, leading to symptoms such as angina. The severity of CHD determines the treatment approach, which may include medication or interventional therapy. Therefore, accurately assessing the severity of myocardial ischemia is crucial for effective CHD management. In recent years, fractional flow reserve (FFR), derived from the relationship between flow and pressure, has gained widespread recognition for providing valuable information to guide coronary revascularization. Pressure guidewires equipped with pressure sensors at their tips are the most commonly used tools for clinical FFR assessment. These wires measure vessel pressure to determine the severity of coronary lesions. However, during their use, issues such as signal drift, tip breakage, core wire fractures, and coating detachment may occur. This article reviews the historical development of pressure guidewires, examines the general structure of two commonly used pressure guidewires available in the market, highlights typical issues encountered during clinical use, and proposes corresponding solutions.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Coronary Calcification on Complete Revascularization in Patients With Acute Coronary Syndrome and Multivessel Disease.","authors":"William Camilleri, Hala Kakar, Jacob J Elscot, Eric Boersma, Nicolas M Van Mieghem, Roberto Diletti, Joost Daemen, Elena Ntantou, Jeroen Wilschut, Rutger Jan Nuis, Wijnand K Den Dekker","doi":"10.1002/ccd.31495","DOIUrl":"https://doi.org/10.1002/ccd.31495","url":null,"abstract":"<p><strong>Background: </strong>Coronary calcification is a well-known marker of atherosclerotic plaque burden and a determinant of stent under expansion with unfavorable long-term outcomes.</p><p><strong>Aims: </strong>This sub study of the randomized BIOVASC trial aimed to compare immediate complete revascularization (ICR) and staged complete revascularization (SCR) in patients with acute coronary syndrome (ACS) and multi vessel disease (MVD), stratified by calcification of the culprit lesion.</p><p><strong>Methods: </strong>The primary endpoint consisted of a composite of all-cause mortality, myocardial infarction, unplanned ischemia driven revascularization (UIDR) and cerebrovascular events at 2 year follow-up. Secondary endpoints included the individual components of the primary composite and major bleedings. We used cox regression models to relate study endpoints with randomized treatment stratified by calcification of the culprit lesion.</p><p><strong>Results: </strong>The BIOVASC trial enrolled 103 patients with a moderately or severely calcified culprit lesion. The composite primary outcome occurred in 8/57 (14.3%) versus 9/46 (19.7%) patients randomized to ICR and SCR (hazard ratio [HR] 0.66% and 95% confidence interval [CI] 0.25-1.71, p = 0.39). In the non-calcified culprit lesions, there were 83 events in the ICR (12.4%) and 82 events in the SCR (11.9%) (HR 1.01 [0.75-1.37], p = 0.94, P-interaction = 0.42). There was no evidence of a differential effect of ICR vs. SCR on the primary endpoint in relation to culprit lesion calcification (P-interaction = 0.42).</p><p><strong>Conclusion: </strong>No differential treatment effect of ICR versus SCR was observed when comparing the primary composite outcome between calcified and non-calcified culprit lesion.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implications for Fabric Leak After Watchman FLX Device Implantation: A Study Update.","authors":"Marco Frazzetto, Sung-Han Yoon, Steven J Filby","doi":"10.1002/ccd.31494","DOIUrl":"https://doi.org/10.1002/ccd.31494","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Residual Postsurgical Left Atrial Appendage Closure Using the Watchman Device Guided by CT Planning: A Case Report.","authors":"Yusef Saeed, Rafey Feroze, Marco Frazetto, Steven J Filby","doi":"10.1002/ccd.31483","DOIUrl":"https://doi.org/10.1002/ccd.31483","url":null,"abstract":"<p><p>Percutaneous and surgical approaches have been developed for left atrial appendage occlusion. Residual stump formation with a depth of ≥ 10 mm is a recognized complication after surgical LAAO using AtriClip (Atricure, Mason, Ohio). The standard imaging modality for preprocedural planning and postprocedural follow up during these procedures has been transesophageal echocardiography. The current case describes successful closure of a residual stump, measuring 13 mm in depth, using percutaneous LAAO, with CT imaging utilized for preprocedural planning and postprocedural follow up. Accordingly, this case demonstrates that CT imaging is a viable, convenient, and less invasive alternative for these situations.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty Years of Experience in One Thousand De-Novo Left Main Coronary Angioplasty With Angiographic Control in a High-Volume Centre Without On-Site Cardiac Surgery.","authors":"Alfonso Franzé, Simone Zecchino, Francesco Tomassini, Cristina Rolfo, Enrico Cerrato, Marco Pavani, Giulio Piedimonte, Greca Zanda, Rosanna Di Fonzo, Martina Massino, Marco Lococo, Dario Celentani, Alessandro Migliardi, Roberto Gnavi, Alessandra Chinaglia, Ferdinando Varbella","doi":"10.1002/ccd.31488","DOIUrl":"https://doi.org/10.1002/ccd.31488","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Given the widespread use of percutaneous coronary intervention (PCI) for the treatment of unprotected left main coronary artery (ULMCA) disease, real-world data are needed to understand the current practice and identify pitfalls and potential benefits, especially for an older and frail population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective analysis including all patients, namely 1000, who underwent PCI on ULMCA for de-novo lesions, at our high-volume Italian center without on-site cardiac surgery, from 2002 to April 2023. Cases of restenosis, stent thrombosis, and coronary artery bypass grafting (CABG) were excluded. The primary clinical endpoint is major adverse cardiovascular and cerebrovascular event (MACCE), a composite endpoint including all-cause mortality, unplanned revascularization, myocardial infarction and stroke. Secondary clinical endpoints included the individual components of MACCE. Angiographic follow-up data, derived from both elective and clinical-driven procedures, were extensively available. The primary angiographic endpoint is target lesion failure (TLF), defined as significant restenosis or stent thrombosis of the LMCA. We performed a dedicated analysis comparing patients with a protocol-driven elective angiographic follow-up to those without, to evaluate the potential impact of this strategy on clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our registry encompasses a real-world frail and compromised population, with most patients (75%) presenting with acute coronary syndrome. Angiographic follow-up data were available for 739 patients (73.9%), of whom 612 (82.8%) demonstrated good results of the previous PCI and 127 patients (17.2%) experienced TLF. Multivariate analysis identified insulin-dependent diabetes, moderate to severe renal impairment, and a two-stents bifurcation technique as independent predictors of TLF. Among bifurcation techniques, the highest restenosis rates were observed in the Culotte technique (33.3%), followed by T and protrusion (30%) and Minicrush (28.2%), while the single stent approach was associated with the lowest rate of TLF (12.8%, p = &lt; 0.001). Clinical follow-up data were available for 966 patients, with a survival rate of 95% at 7 days, 86.1% at 1 year, and 70% at an average follow-up of 2033 days. Multivariate analysis identified age over 70 years, moderate to severe renal impairment, multivessel disease, ejection fraction lower than 40%, hemodynamic instability (HDI) and endotracheal intubation (ETI) as independent predictors of MACCE and all-cause mortality while intravascular imaging was found to be protective for both. A propensity score matched analysis comparing two homogenous cohorts of 131 patients with and without elective angiographic follow-up demonstrated a significant survival advantage in the elective follow-up group, highlighting the potential benefits of this strategy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In the real worl","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Access-Site Complications in Chronic Total Occlusion Percutaneous Coronary Intervention.","authors":"Michaella Alexandrou, Dimitrios Strepkos, Pedro E P Carvalho, Deniz Mutlu, Ozgur Selim Ser, Khaldoon Alaswad, Mir B Basir, Dmitrii Khelimskii, Oleg Krestyaninov, Jaikirshan J Khatri, Laura Young, Omer Goktekin, Paul Poommipanit, Farouc A Jaffer, Sevket Gorgulu, Lorenzo Azzalini, Ramazan Ozdemir, Mahmut Uluganyan, Leah M Raj, Olga Mastrodemos, JaskanwalDeep S Sara, Bavana V Rangan, Sandeep Jalli, Konstantinos V Voudris, Yader Sandoval, M Nicholas Burke, Emmanouil S Brilakis","doi":"10.1002/ccd.31501","DOIUrl":"https://doi.org/10.1002/ccd.31501","url":null,"abstract":"<p><strong>Background: </strong>Vascular access-site complications (VASC) can occur during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).</p><p><strong>Methods: </strong>We compared the baseline and procedural characteristics, and outcomes of patients with versus without VASC in a large multicenter CTO PCI registry. VASC was defined as any of the following: small hematoma (hematoma < 5 cm), large hematoma (hematoma ≥ 5 cm), arteriovenous fistula, pseudoaneurysm and acute arterial closure.</p><p><strong>Results: </strong>VASC occurred in 158 of 16,810 CTO PCIs (0.9%). VASC patients were older (67 ± 11 vs. 64 ± 10 years, p < 0.001), more likely to be women (28.4% vs. 19.1%, p = 0.004) and less likely to be current smokers (18.9% vs. 27.2%, p = 0.026). They were more likely to have at least one femoral access (89.2% vs. 75.3%, p < 0.001) and less likely to have any radial access (38.0% vs. 52.3%, p < 0.001). Transfemoral access was more common in patients with VASC (60.1% vs. 45.7%, p < 0.001). VASC cases had higher J-CTO (2.57 vs. 2.38, p = 0.05) and PROGRESS-CTO major adverse cardiac events (MACE) scores (3.27 vs. 2.58, p < 0.001). They had similar technical (87.3% vs. 87.1%, p > 0.9) and procedural (82.3% vs. 85.9%, p = 0.2) success, but higher MACE (6.3% vs. 1.9%, p < 0.001) and bleeding (23.4% vs. 0.4%, p < 0.001). Female gender (odds ratio [OR] 1.95, 95% confidence intervals [CI] 1.24-3.00, p = 0.003), at least one femoral access (OR 2.02, 95% CI 1.09-4.04, p = 0.034) and sheath size (7-F: OR 2.16, 95% CI 1.12-4.60, p = 0.031; 8-F: OR 2.11, 95% CI 1.03-4.70,p = 0.051) were associated with VASC in multivariable analysis.</p><p><strong>Conclusion: </strong>Female sex, femoral access and larger sheaths ≥ 7 F were associated with VASC in patients undergoing CTO PCI.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital Atherectomy in Calcified Coronary Lesions: A 1-Year Retrospective Observational Outcome Study.","authors":"Ayman Helal, Nasir Ahmad, Omar Bajmmal, Javed Ehtisham, Kai Hogrefe, Prashanth Raju, David Sharman, Naeem Shaukat, Mohsin Farooq","doi":"10.1002/ccd.31502","DOIUrl":"https://doi.org/10.1002/ccd.31502","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) has advanced rapidly since its inception. Not only in stent technology, but there have been advancements in adjunctive tools including intra-coronary imaging, stent delivery tools and calcium modification techniques. The interventional community is well aware of the difficulties posed by calcified coronary lesions and their impact on outcomes. More recently, orbital atherectomy (OA) has seen itself on the fore front of managing such complex and challenging situations.</p><p><strong>Aims: </strong>This retrospective study analyses a 1-year experience of using OA in a high-volume primary PCI center in a UK district general hospital.</p><p><strong>Methods: </strong>Patient demographics, procedural details, and outcomes, including MACE rates and procedural success, were reviewed in all-comers undergoing OA between January 1 and December 31, 2024.</p><p><strong>Results: </strong>A total 53 patients were identified that had undergone OA in a 1-year period. Procedural success was achieved in 98.1% of patients. Thirty-days MACE was 5.7% (three patients). One patient experiencing in-hospital procedural related myocardial infarction and two patients had major bleeding events during the follow up period which is not related to OA. No-flow/slow-flow were observed in seven patients (13.2%), and seven patients (13.2%) experienced coronary dissection that were successfully treated with stent implantation.</p><p><strong>Conclusion: </strong>OA is a new but safe and effective tool for calcium modification in an all-comers cohort of patients treated in a high-volume UK district general hospital setting.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture of Rotational Atherectomy Burr: Pre-Fracture Signs, Mechanisms, and Management Strategies.","authors":"Umihiko Kaneko, Yoshifumi Kashima, Takuro Sugie, Shoichi Kuramitsu, Yutaka Tadano, Tsuyoshi Takeuchi, Ken Kobayashi, Daitaro Kanno, Tsutomu Fujita","doi":"10.1002/ccd.31496","DOIUrl":"https://doi.org/10.1002/ccd.31496","url":null,"abstract":"<p><strong>Background: </strong>Burr fracture during rotational atherectomy (RA) is a rare but potentially devastating complication. Due to its infrequency, comprehensive data on its incidence, mechanisms, and management are lacking. This study aimed to investigate the incidence, contributing factors, and management strategies for burr fractures during RA procedures.</p><p><strong>Methods: </strong>This retrospective analysis included all patients who underwent PCI with RA at a single center between January 2013 and October 2024. Data were collected from a prospective registry.</p><p><strong>Results: </strong>Among 3738 patients, three cases of burr fracture without entrapment were identified (incidence: 0.08%). Burr fractures occurred at the burr-driveshaft junction (tip fracture) in two cases and at the driveshaft in one case. Pre-fracture warning signs included incoherent burr-advancer knob movement, fluoroscopic translucency, and frequent driveshaft prolapse. Significant proximal tortuosity or enlargement and non-coaxiality between the RA device and the coronary artery were identified as potential contributing factors. In two cases involving tip fractures, simple manual traction removed the fractured burr. In the third case involving driveshaft fracture, coronary rupture necessitated covered stent implantation and urgent surgery.</p><p><strong>Conclusion: </strong>Burr fractures during RA are rare but potentially serious complications. Significant proximal tortuosity or enlargement and non-coaxiality between the RA device and the coronary artery may increase the risk of burr fracture. Recognizing pre-fracture warning signs and understanding the underlying mechanisms are crucial for minimizing complications and optimizing procedural safety.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Contrast Strategies in TAVR: Feasibility and Outcomes to Prevent Renal Injury in Chronic Kidney Disease.","authors":"Brigitte Kazzi, David I Blusztein, Chunhui Wang, Yuming Ning, Tamim Nazif, Rebecca T Hahn, Martin Leon, Paul A Kurlansky, Susheel Kodali, Isaac George","doi":"10.1002/ccd.31490","DOIUrl":"https://doi.org/10.1002/ccd.31490","url":null,"abstract":"<p><strong>Background: </strong>Contrast volume is a major risk factor for acute kidney injury (AKI) in patients with chronic kidney disease (CKD) after TAVR. Use of a low-contrast (LC) protocol in TAVR may reduce AKI without impacting other clinical outcomes.</p><p><strong>Methods: </strong>TAVR patients with Stage 3b or worse CKD between 2015 and 2020 were grouped into LC and normal-contrast (NC). LC was defined as TAVR procedure contrast use (mL) less than estimated glomerular filtration rate (eGFR, mL/min/1.73 m²). The primary outcome was AKI, defined as creatinine elevation > 200% or ≥ 0.3 mg/dL from baseline. Secondary outcomes were 30-day mortality, length of stay, paravalvular leak at 30 days, new dialysis requirement, major vascular complication, re-admission, bleeding, and a composite primary endpoint of secondary outcomes. We performed a propensity-matched analysis, compared cohort outcomes, and stratified outcomes by AKI severity.</p><p><strong>Results: </strong>Four hundred thirty-seven patients were analyzed. The LC group (n = 173) were more commonly male and had a lower baseline eGFR (31 vs. 33, p = 0.03) than the NC group (n = 264). After propensity-matching, AKI occurred less frequently in LC patients than in the NC patients (17.9 vs. 28.3%, p = 0.0217). There were no inter-group differences in mortality, new dialysis requirement, major vascular complications, bleeding, or re-admissions.</p><p><strong>Conclusions: </strong>In TAVR patients with CKD, LC volume was associated with reduced risk of AKI, supporting a LC approach for TAVR in CKD patients.</p><p><strong>Aims: </strong>We sought to evaluate the outcomes of a LC versus normal-contrast dose strategy in TAVR amongst patients with CKD.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}