Catheterization and Cardiovascular Interventions最新文献

{"title":"Emergency Trans-Femoral Stenting After Accidental Right Renal Artery Occlusion Following Endovascular Aortic Repair With Endoanchors for Abdominal Aortic Aneurysm With Short Angulated Neck.","authors":"Suko Adiarto, Ayers Gilberth Ivano Kalaij, Suci Indriani, Taofan","doi":"10.1002/ccd.31614","DOIUrl":"https://doi.org/10.1002/ccd.31614","url":null,"abstract":"<p><strong>Background: </strong>Although endovascular aortic repair (EVAR) has been widely used in abdominal aortic aneurysm (AAA), significant proportion are still considered unsuitable anatomically, especially in short neck anatomies. Endoanchors has been reported to be successfully treat challenging AAA with short neck; however, in such case, renal artery can be accidentally occluded by the graft, potentially leading to renal ischemia and necrosis. Emergency renal stenting has been shown to be safe and effective to salvage the kidney, however none of this procedure has been reported after the use of endoanchors.</p><p><strong>Aims: </strong>In this case, we presented a 69-year-old hypertensive male with AAA which went through successful emergency trans-femoral renal stenting after accidental right renal artery occlusion following EVAR with endoanchors for AAA with short angulated neck.</p><p><strong>Methods and results: </strong>We presented a case report of a 69-year-old hypertensive male with an infrarenal abdominal aortic aneurysm and challenging short, angulated neck anatomy, treated with EVAR using EndoAnchors for graft fixation. Following the procedure, the patient developed an acute right renal artery occlusion. Clinical data, imaging findings, procedural details, and outcomes were retrospectively collected and analyzed. Emergency revascularization was performed via a trans-femoral approach, utilizing advanced endovascular techniques and devices typically reserved for complex interventions. Key factors contributing to successful revascularization of an occluded right renal artery after EVAR with an endoanchors were success included the availability of a steerable guiding catheter, allowing for near 320-degree manipulation for optimal co-axial orientation to the renal artery, providing better device support. Despite initial difficulty with wire insertion, a micro-catheter was used to facilitate renal artery wiring. After pre-dilatation, a Guidezilla guide extension was utilized to deliver the stent smoothly, overcoming resistance from the graft and anchors, a technique often used in complex coronary interventions.</p><p><strong>Conclusion: </strong>Accidental right renal artery occlusion following EVAR with endo-anchors could be successfully treated with renal stenting. Renal artery stenting remained possible despite strong attachment of the graft with the aortic wall after Endo-anchors implantation.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109542","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":"Intravascular Imaging of Left Circumflex Occlusion After Mitral Surgery.","authors":"Verdiana Galli, Gabriele Pesarini, Flavio Luciano Ribichini, Roberto Scarsini","doi":"10.1002/ccd.31572","DOIUrl":"https://doi.org/10.1002/ccd.31572","url":null,"abstract":"<p><p>Left circumflex coronary artery occluson rarely occurs after mitral valve surgery. The underlying mechanisms, as well as the clinical presentation and severity may vary. No consensus on the best therapeutic strategy exists. We present a case of left circumflex dynamic occlusion after mitral valve replacement, in which the use of intravascular ultrasound helped in clarifying the mechanism of the occlusion and in guiding the percutaneous revascularization.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109622","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":"When the Going Gets Tough: Stepping-Up With the Penumbra System for Aneurismatic Right Coronary Artery.","authors":"Gabriele Venturi, Alberto Zamboni, Francesco Bacchion, Antonio Mugnolo","doi":"10.1002/ccd.31608","DOIUrl":"https://doi.org/10.1002/ccd.31608","url":null,"abstract":"<p><p>Coronary aneurysms represent a challenge in terms of percutaneous interventions, due to the possible large amount of coronary thrombus and the subsequent risk of no-reflow phenomenon. In this case, a step-up approach from a failed manual thrombus aspiration to a mechanical system led to immediate and long-term angiographic success.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101497","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":"Letter to the Editor: Dual Antiplatelet Therapy Prior to Percutaneous Coronary Intervention for Acute Coronary Syndrome: Prevalence and Outcomes in Contemporary Practice.","authors":"Azmir Ali Khan, Maria Hashim, Muhammad Abdullah, Muhammad Umar","doi":"10.1002/ccd.31610","DOIUrl":"https://doi.org/10.1002/ccd.31610","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101491","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":"Platypnea-Orthodeoxia Syndrome (POS): A Retrospective Study of Percutaneous Closure of the Foramen Ovale in a Single Center.","authors":"Alejandro Rasines-Rodríguez, Alexis Otero González, Jorge Salgado Fernández, Fernando Rueda Núñez","doi":"10.1002/ccd.31604","DOIUrl":"https://doi.org/10.1002/ccd.31604","url":null,"abstract":"<p><p>Platypnea-Orthodeoxia Syndrome (POS) is an uncommon but underdiagnosed condition characterized by dyspnea and oxygen desaturation in the upright position, which resolves in the supine position. The most common cause is a right-to-left intracardiac shunt at the foramen ovale (FO). This study reviews the outcomes of 11 patients who underwent percutaneous FO closure for POS at our center between 2007 and 2023. The cohort consisted of six women and five men, with a median age of 77 years. All patients had cardiovascular risk factors, particularly hypertension. Pre-procedure oxygen saturation was low (median 83%), but all patients showed immediate improvement after FO closure, with a median post-procedure saturation of 97%. The median length of stay before the procedure was 40 days, reflecting the diagnostic delay typical of this syndrome. Postprocedure, the median length of stay was 8 days. No complications were recorded. The study also explores the pathophysiology of POS, identifying potential risk factors such as structural changes in the heart and thoraco-abdominal surgeries that may contribute to the development of this syndrome. These findings confirm that percutaneous FO closure is a safe and effective treatment for POS, offering rapid improvement in oxygen saturation and emphasizing the importance of early diagnosis.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101494","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 CHA₂DS₂-VASc Score in the Outcomes of Patients Undergoing a Simplified Pathway for Percutaneous Left Atrial Appendage Closure.","authors":"Claudio Sanfilippo, Marco Frazzetto, Giuliano Costa, Claudia Contrafatto, Chiara Giacalone, Francesco Briguglio, Chiara Barbera, Jessica De Santis, Maria Sanfilippo, Giuseppe Castania, Maria Elena Di Salvo, Salvatore Scandura, Guilherme Attizzani, Steven Filby, Corrado Tamburino, Marco Barbanti, Carmelo Grasso, Davide Capodanno","doi":"10.1002/ccd.31613","DOIUrl":"https://doi.org/10.1002/ccd.31613","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous left atrial appendage closure (LAAC) is usually performed after a pre-procedural evaluation by transesophageal echocardiography (TOE) or cardiac computed tomography angiography (CCTA). Nevertheless, these ad-hoc examinations imply an additional use of hospital resources and time spending.</p><p><strong>Aims: </strong>To investigate long-term clinical outcomes, effectiveness and safety of performing LAAC procedures without pre-procedural imaging assessment in patients with high and very high thromboembolic risk based on CHA₂DS₂-VASc score.</p><p><strong>Methods: </strong>From January 2016 to January 2023, 227 consecutive patients undergoing LAAC following an optimized pathway that removed the use of pre-procedural TOE or CCTA imaging assessment, were enrolled in this single-center, retrospective study. Patients were divided into two groups based on thromboembolic risk: 94 had CHA₂DS₂-VASc scores ≥ 5 and 133 had CHA₂DS₂-VASc scores < 5). The primary endpoint was a composite of all-cause death, stroke, systemic embolization, or bleeding events at 2 years. Co-primary endpoints were device success, device-related thrombosis (DRT) and peri-device leaks (PDL) ≥ 3 mm at TOE follow-up.</p><p><strong>Results: </strong>At 2 years, no significant differences were observed between groups in the primary composite endpoint (KM est. 24.81% vs. 20.21%, p_log-rank = 0.7; aHR 0.85, CI: 0.48-1.50, p = 0.58). Device success was 98.7% overall, with no significant differences between groups (aOR 0.32% CI: 0.03-3.80; p = 0.37). DRT and PDL ≥ 3 mm rates were low (4.3% vs. 1.5%, p = 0.26% and 3.2% vs. 2.3%, p = 0.75, respectively). In-hospital complications were low and comparable in both groups.</p><p><strong>Conclusions: </strong>In a consecutive series of patients undergoing LAAC, a simplified approach without pre-operative imaging assessment showed comparable results at 2-year for the primary composite endpoint of all-cause death, stroke, systemic embolization, or bleeding events in patients with CHA₂DS₂-VASc score ≥ 5 and those with CHA₂DS₂-VASc score < 5.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109704","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":"The Importance of Temporal Trend in Left Main Coronary Intervention.","authors":"Aybüke Şimşek, Kaan Gökçe, Fatih Furkan Bedir, Abdullah Doğan, Ahmet Güner","doi":"10.1002/ccd.31617","DOIUrl":"https://doi.org/10.1002/ccd.31617","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109772","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 Periprocedural Statin Therapy on Mortality and Cardiovascular Outcomes in Transcatheter Aortic Valve Replacement: A Meta-Analysis and Meta-Regression.","authors":"Aman Goyal, Surabhi Maheshwari, Yusra Mashkoor, Ajeet Singh, Faryal Rafique, Abu Baker Sheikh, Kamna Bansal","doi":"10.1002/ccd.31607","DOIUrl":"https://doi.org/10.1002/ccd.31607","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter aortic valve replacement (TAVR) stands as a notable alternative to surgical valve replacement for severe aortic stenosis (AS). Despite the established benefits of statins in cardiovascular pathologies, their specific impact in patients with severe AS undergoing TAVR remains uncertain.</p><p><strong>Aims: </strong>Our meta-analysis aims to assess whether periprocedural statin therapy improves survival and outcomes post-TAVR, thus addressing this gap in literature.</p><p><strong>Methods: </strong>A comprehensive literature search using various databases with relevant keywords terms was conducted to identify studies on the impact of periprocedural statin therapy on TAVR outcomes. We assessed the primary outcome of all-cause mortality alongside various secondary outcomes including stroke/transient ischemic attack (TIA), myocardial infarction, acute kidney injury (AKI), 30-day mortality, in-hospital mortality, rehospitalization, cardiovascular complications, and pacemaker requirement. A random-effects model using Comprehensive Meta Analysis Software was employed to analyze the data for each outcome. Statistical significance was set at a p < 0.05.</p><p><strong>Results: </strong>Our analysis of 19 observational studies revealed that periprocedural statin therapy significantly reduces all-cause mortality following TAVR surgery (OR = 0.71, 95% CI: 0.61-0.83, p < 0.001). However, the influence of statins on other outcomes remains inconclusive. These outcomes include stroke/TIA (OR = 0.90, 95% CI: 0.68-1.19, p = 0.455), risk of MI (OR = 1.72, 95% CI: 0.73-4.04, p = 0.214), AKI (OR = 0.99, 95% CI: 0.75-1.31, p = 0.968), 30-day mortality (OR = 0.71, 95% CI: 0.46-1.10, p = 0.126), in-hospital mortality (OR = 0.42, 95% CI: 0.13-1.38, p = 0.151), rehospitalization (OR = 0.92, 95% CI: 0.66-1.29, p = 0.645), cardiovascular complications (OR = 1.12, 95% CI: 0.91-1.37, p = 0.297), and pacemaker requirement (OR = 0.83, 95% CI: 0.65-1.06, p = 0.133).</p><p><strong>Conclusion: </strong>Our meta-analysis indicates a potentially promising role for periprocedural statin therapy in enhancing patient outcomes post-TAVR surgery. We found a notable association between statin therapy and a reduction in all-cause mortality. However, the effects on secondary outcomes did not reach statistical significance, which warrants further investigation through larger, well-designed, randomized controlled trials.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109661","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":"Procedural Factors Associated With High Radiation Exposure During Percutaneous Coronary Intervention.","authors":"Yuyang Ye, Xuan Zhou, Yiming Li, Lin Bai, Junwen Wang, Xuefeng Chen, Xinru Hu, Yong Peng","doi":"10.1002/ccd.31606","DOIUrl":"https://doi.org/10.1002/ccd.31606","url":null,"abstract":"<p><strong>Background and aims: </strong>An air kerma (AK) radiation dose of 5 Gy is considered a threshold that may result in clinically significant radiation injury during percutaneous coronary intervention (PCI). This study aimed to identify procedural characteristics associated with patient AK ≥ 5 Gy during PCI.</p><p><strong>Methods: </strong>This retrospective study included consecutive PCI procedures performed at West China Hospital between July 30, 2018, and October 31, 2021. Descriptive analysis was conducted to explore associations between baseline characteristics and high radiation doses. Multivariate logistic regression was used to identify procedural predictors of AK ≥ 5 Gy, and a receiver operating characteristic (ROC) curve was applied to assess the model's predictive performance.</p><p><strong>Results: </strong>A total of 8444 PCI procedures were analyzed. Multivariate logistic regression identified the following procedural predictors of AK ≥ 5 Gy: number of stents implanted (odds ratio [OR]: 1.67; 95% CI: 1.50-1.87), PCI involving left circumflex coronary artery (OR: 1.58; 95% CI: 1.18-2.10), use of intra-aortic ballon pump (OR: 1.91; 95% CI: 1.18-2.99), use of intravascular ultrasound (OR: 1.67; 95% CI: 1.31-2.14), PCI of in-stent restenosis (OR: 2.14; 95% CI: 1.36-3.28), and PCI of chronic total occlusion (OR: 3.40; 95% CI: 2.72-4.24). The area under the ROC curve for the logistic regression model was 0.795, with a specificity of 78.3% and a sensitivity of 67.4%.</p><p><strong>Conclusion: </strong>Specific procedural characteristics are associated with AK ≥ 5 Gy during PCI. Identifying these risk factors may help optimize radiation safety strategies and minimize patient exposure.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109664","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":"The Diagnostic and Prognostic Value of Circulating miR-126-3p and miR-145-5p in Coronary Artery Calcification Lesions.","authors":"Weiwei Chen, Fengwen Cui, Jiwen Fan, Kun Liu, Yuquan He","doi":"10.1002/ccd.31616","DOIUrl":"https://doi.org/10.1002/ccd.31616","url":null,"abstract":"<p><strong>Background: </strong>Arterial calcification and its associated major adverse cardiovascular events (MACEs) are significant contributors to rehospitalization and poor clinical outcomes. This study aims to evaluate the diagnostic utility of miR-126-3p and miR-145-5p in detecting arterial calcification, as well as their prognostic value in predicting the occurrence of MACEs.</p><p><strong>Methods: </strong>A total of 131 patients who underwent coronary artery intervention and intravascular imaging were enrolled. Among them, 88 were diagnosed with arterial calcification, while 33 showed no evidence of calcification. Plasma levels of miR-126-3p and miR-145-5p were quantified using qRT-PCR. Clinical and demographic data were also collected to identify potential risk factors with calcification. Patients with calcified lesions were followed for 12 months to document the incidence of MACEs and rehospitalizations, and to evaluate predictors of MACE occurrence.</p><p><strong>Results: </strong>Compared to patients without arterial calcification, those with calcification were older, and exhibited significantly lower plasma levels of miR-126-3p and miR-145-5p (p < 0.01). Among patients in the calcification group, those with low miR-126-3p expression [0 (0-0.223), p < 0.05] were more likely to experience MACEs within 12 months. Additionally, in the MACEs group, HDL-C levels were lower [0.081 (0.009-0.698), p < 0.05], while neutrophil ratio were higher [1.081 (1.022-1.143), p < 0.01].</p><p><strong>Conclusion: </strong>Circulating miR-126-3p and miR-145-5p demonstrate diagnostic value for arterial calcification. In particular, miR-126-3p could serve as a blood-based biomarker for predicting the risk of MACEs.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109770","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}