Catheterization and Cardiovascular Interventions最新文献

{"title":"Comparison of Oxidative Stress Effects Between Drug-Eluting Stents and Drug-Coated Balloons: Insights Into Vascular Response and Clinical Implications","authors":"Muzaffer Aslan,&nbsp;Dogac Oksen,&nbsp;Yunus Emre Yavuz,&nbsp;Çağdaş Kaynak","doi":"10.1002/ccd.70209","DOIUrl":"10.1002/ccd.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Percutaneous coronary intervention (PCI) has evolved with the development of drug-eluting stents (DES) and drug-coated balloons (DCB), both of which play a crucial role in reducing restenosis and major adverse cardiovascular events (MACE). Despite their benefits, the oxidative stress response triggered by these interventions and its implications for vascular healing remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to compare the oxidative stress burden associated with DES and DCB by evaluating changes in plasma total peroxidase (TP) levels over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational, comparative study included 110 patients (60 DES and 50 DCB) who underwent PCI for stable coronary artery disease. TP levels were measured pre-procedure, 24 h postprocedure, and 1 month after PCI. Statistical comparisons were used to determine significant differences in oxidative stress between the two groups over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Preoperative TP levels were comparable between the DES and DCB groups (431.00 ± 4.56 vs. 436.50 ± 4.14 µmol/L, <i>p</i> = 0.110). At 24 h post-PCI, TP levels increased significantly in both groups (DES: 449.50 ± 6.51 µmol/L, DCB: 442.50 ± 4.14 µmol/L), with a greater rise observed in the DES group, though not statistically significant (<i>p</i> = 0.42). At the 1-month follow-up, TP levels decreased significantly below baseline in both groups, with a more pronounced reduction in the DCB group (398.50 ± 4.14 vs. 406.50 ± 4.51 µmol/L, <i>p</i> = 0.11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study reveals that both DES and DCB procedures trigger an initial rise in oxidative stress markers, emphasizing their acute vascular impact. Intriguingly, although not statistically significant, the DCB group demonstrated a trend toward a more rapid decline in oxidative stress at 1 month post-PCI. These preliminary findings highlight the potential of DCBs to foster quicker vascular recovery, warranting further investigation into their long-term clinical advantages.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2791-2798"},"PeriodicalIF":1.9,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133337","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":"Two-Year Results of Percutaneous Endocardial Septal Radiofrequency Ablation for Hypertrophic Obstructive Cardiomyopathy","authors":"NingNing Zheng,&nbsp;YiYuan Chen,&nbsp;YongBing Fu,&nbsp;Feng Xue,&nbsp;FangFang Zhang,&nbsp;Lin Ling,&nbsp;TingBo Jiang","doi":"10.1002/ccd.70119","DOIUrl":"10.1002/ccd.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hypertrophic obstructive cardiomyopathy (HOCM) is a hereditary myocardial disease. Percutaneous endocardial septal radiofrequency ablation (PESA) is an innovative approach for treating HOCM. Consequently, we present the outcomes of the PESA for HOCM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 20 patients with HOCM who received PESA. The primary outcomes include the control rate of the left ventricular outflow tract gradient (LVOTG) at rest and following the Valsalva maneuver and changes in New York Heart Association (NYHA) function. Secondary outcomes include changes in interventricular septal thickness (IVST), left ventricular ejection fraction (LVEF), pulmonary artery systolic pressure (PASP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP). In addition, this study assessed the incidence of complications during the perioperative period, the operation time of the PESA, and hospital stays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 2 years, the LVOTG for patients decreased 54% at rest and 55% after the Valsalva maneuver. In addition, the NYHA functional index increased from 3.25 ± 0.55 to 1.95 ± 0.88, and 15 patients (75%) achieved NYHA Class I/Ⅱ. The LVEF of patients significantly increased from 63.95 ± 6.29% to 65.75 ± 3.39%, the PASP decreased from 32.50 (31.00, 40.50) mmHg to 23.50 (19.50, 28.50) mmHg, the NT-proBNP decreased from 388.90 (278.80, 1039.00) ng/mL to 227.4 (121.6, 499.6) ng/mL, and the IVST decreased from 17.20 ± 3.72 mm to 15.80 ± 3.14 mm. Importantly, no patients needed pacemaker treatment. The operative time for the PESA was 186.63 ± 22.47 min, and the median postoperative hospital stay for patients was 10.00 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PESA could reduce the LVOTG with the advantages of a low risk of arrhythmias, minimal trauma, rapid postoperative recovery, and shorter hospital stays.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2763-2769"},"PeriodicalIF":1.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Pathophysiological Disease Pattern and an Increase in Absolute Coronary Flow Velocity After Elective Percutaneous Coronary Intervention","authors":"Hikaru Shimosato,&nbsp;Eisuke Usui,&nbsp;Yoshihisa Kanaji,&nbsp;Masahiro Hada,&nbsp;Tatsuhiro Nagamine,&nbsp;Hiroki Ueno,&nbsp;Mirei Setoguchi,&nbsp;Kodai Sayama,&nbsp;Takahiro Watanabe,&nbsp;Takashi Mineo,&nbsp;Nobutaka Wakasa,&nbsp;Taishi Yonetsu,&nbsp;Tetsuo Sasano,&nbsp;Tsunekazu Kakuta","doi":"10.1002/ccd.70122","DOIUrl":"10.1002/ccd.70122","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Percutaneous coronary intervention (PCI) aims to restore myocardial perfusion by relieving flow-limiting lesions. While fractional flow reserve (FFR) guides PCI decision-making, the relationship between lesion pathophysiological patterns and post-PCI absolute flow improvement remains elusive. Recent evidence suggests that disease pattern—focal versus diffuse—impacts PCI outcomes. The quantitative flow ratio (QFR)-derived pullback pressure gradient (PPG) offers a wire-free method to characterize these patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We investigated whether pre-PCI QFR-PPG index predicts absolute coronary flow velocity improvement, assessed by stress-transthoracic Doppler echocardiography (S-TDE), in elective PCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective analysis included 118 consecutive patients who underwent elective FFR-guided PCI and pre- and post-PCI LAD flow assessment using S-TDE. The study was conducted using the institutional QFR-PPG database registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000056097). Pre-PCI QFR-PPG index was calculated to assess its association with post-PCI changes in coronary flow velocity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-PCI hyperemic diastolic peak velocity (hDPV) improved in 81.3% of patients, but 18.6% showed decreased values despite FFR improvement. The median % increase in hDPV was 30.3%. Patients with greater hDPV improvement (&gt; 30%) had significantly lower pre-PCI FFR, lower pre-PCI hDPV, and higher QFR-PPG index. Multivariable logistic regression identified these three indices as independent predictors of flow improvement. ROC analysis and net reclassification improvement (NRI) supported incremental value of the QFR-PPG index over traditional metrics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pre-PCI QFR-PPG index, together with FFR and S-TDE-derived hDPV, predicts absolute flow improvement after PCI. This noninvasive, wire-free approach may help optimize revascularization decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2781-2790"},"PeriodicalIF":1.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986033","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":"Site-Specific Antithrombotic Therapy: 24-Month Outcomes of the Randomized DESyne BDS Plus Trial Using a Novel Triple-Drug Eluting Coronary Implant With Two Anticoagulants and Sirolimus","authors":"Stefan Verheye,&nbsp;Bert Ferdinande,&nbsp;Johan Bennett,&nbsp;Rodolfo Staico,&nbsp;Seif El-Jack,&nbsp;Pim A. L. Tonino,&nbsp;Alexandre Abizaid,&nbsp;Ian Buysschaert,&nbsp;Douglas Scott,&nbsp;Madhav Menon,&nbsp;Gerard Wilkins,&nbsp;Dougal McClean,&nbsp;Tomas Kovarnik,&nbsp;Uwe Christians,&nbsp;Antoinette Neylon,&nbsp;Zlatko Mehmedbegovic,&nbsp;Pieter C. Smits,&nbsp;Marie-Claude Morice,&nbsp;Mark Webster,&nbsp;the DESyne BDS Plus RCT Investigators","doi":"10.1002/ccd.70106","DOIUrl":"10.1002/ccd.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>DESyne BDS Plus represents a novel triple drug therapy (TRx) applied on a coronary stent platform eluting the antiproliferative drug Sirolimus along with two anticoagulants (Rivaroxaban and Argatroban) to reduce the site-specific thrombotic risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess the feasibility and safety of this novel device against a contemporary drug-eluting stent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, multicenter randomized (1:1) trial included 202 patients assigned between the device group (DESyne BDS Plus) and the control group (DESyne X2). A subgroup of 58 patients underwent imaging follow-up at 6 months. The blood pharmacokinetics of Sirolimus and both anticoagulants were assessed in 11 nonrandomized patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The primary endpoint, target lesion failure (TLF) at discharge or 3-day postprocedure, whichever occurred first, was 0.0% (0/98) in the device and 5.0% (5/100) in the control group (<i>p</i>_{noninferiority} &lt; 0.001). The secondary endpoint, late lumen loss at 6 months, was 0.14 mm [90% CI: 0.06; 0.23] and 0.09 mm [90% CI: 0.01; 0.18] in the device (<i>n</i> = 28) and control group (<i>n</i> = 27), respectively (<i>p</i>_{noninferiority} &lt; 0.001). Through 24 months, stent thrombosis (definite/probable) was 0.0% (0/97) versus 1.0% (1/96) in the control, <i>p</i> = 0.497, and TLF was 2.1% (2/97) versus 11.3% (11/97), <i>p</i> = 0.010, respectively. Optical coherence tomography findings including strut coverage and neointimal hyperplasia thickness/volume were similar between the groups. The pharmacokinetic study indicated median maximum blood concentrations (C_max) of Rivaroxaban and Argatroban of 1.38 ng/mL and 1.99 ng/mL, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first clinical evidence of the feasibility of site-specific antithrombotic therapeutic with two anticoagulants and an antiproliferative mTOR inhibitor.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2770-2780"},"PeriodicalIF":1.9,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Balloon Pulmonary Angioplasty on the Diagnosis of Chronic Thromboembolic Pulmonary Hypertension: From the COMMAND VTE Registry-2","authors":"Tatsunori Noto,&nbsp;Nobutaka Ikeda,&nbsp;Yugo Yamashita,&nbsp;Takeshi Morimoto,&nbsp;Ryuki Chatani,&nbsp;Kazuhisa Kaneda,&nbsp;Yuji Nishimoto,&nbsp;Yohei Kobayashi,&nbsp;Satoshi Ikeda,&nbsp;Kitae Kim,&nbsp;Moriaki Inoko,&nbsp;Toru Takase,&nbsp;Shuhei Tsuji,&nbsp;Maki Oi,&nbsp;Takuma Takada,&nbsp;Kazunori Otsui,&nbsp;Jiro Sakamoto,&nbsp;Yoshito Ogihara,&nbsp;Takeshi Inoue,&nbsp;Shunsuke Usami,&nbsp;Po-Min Chen,&nbsp;Kiyonori Togi,&nbsp;Norimichi Koitabashi,&nbsp;Seiichi Hiramori,&nbsp;Kosuke Doi,&nbsp;Hiroshi Mabuchi,&nbsp;Yoshiaki Tsuyuki,&nbsp;Koichiro Murata,&nbsp;Kensuke Takabayashi,&nbsp;Hisato Nakai,&nbsp;Daisuke Sueta,&nbsp;Wataru Shioyama,&nbsp;Tomohiro Dohke,&nbsp;Takeshi Kimura,&nbsp;COMMAND VTE Registry-2 Investigators","doi":"10.1002/ccd.70130","DOIUrl":"10.1002/ccd.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chronic thromboembolic pulmonary hypertension (CTEPH) is the most serious long-term complication of acute pulmonary embolism (PE). Balloon pulmonary angioplasty (BPA) has been an effective treatment for improving the prognosis of CTEPH patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the impact of BPA at each institution on the rate of CTEPH diagnosis based on the observations suggesting that the emergence of effective treatments could draw attention to targeted diseases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The COMMAND VTE Registry-2 is a multicenter, retrospective cohort study of 5197 patients diagnosed with venous thromboembolism (VTE) at 31 medical centers in Japan. The study included 2787 patients with acute PE, who were divided into the BPA-capable facility group (BPA centers) and the non-BPA-capable facility group (non-BPA centers). We investigated the difference in the rate of CTEPH diagnosis after acute PE between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among patients with acute PE, 723 patients (25.9%) and 2064 patients (74.1%) were diagnosed at BPA centers and non-BPA centers, respectively. There were 48 patients who were diagnosed with CTEPH, with a median follow-up period of 747 days. The cumulative 3-year incidence of CTEPH diagnosis was 5.0% in the BPA centers and 1.4% in the non-BPA centers (crude hazard ratio [HR]: 3.80; 95% CI: 2.15–6.72; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The cumulative 3-year incidence of CTEPH diagnosis after acute PE was significantly greater in BPA centers than in non-BPA centers, which suggests the importance of appropriate awareness of CTEPH and BPA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2753-2762"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986193","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":"Long-Term Clinical Association of Superficial and Nodular Calcification on Intravascular Ultrasound-Guided Successful Drug-Coated Balloon Endovascular Therapy for De Novo Femoropopliteal Artery Disease","authors":"Ji Woong Roh,&nbsp;Masahiko Fujihara,&nbsp;Yuko Yazu,&nbsp;Tomofumi Tsukizawa,&nbsp;Yoshiaki Yokoi","doi":"10.1002/ccd.70117","DOIUrl":"10.1002/ccd.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The long-term efficacy of drug-coated balloons (DCBs) is reduced in calcified lesions. While intravascular ultrasound (IVUS)-guided DCB endovascular therapy (EVT) has shown favorable results in femoropopliteal artery (FPA) disease, the prognostic significance of calcification type remains unclear. This study evaluated the impact of calcification types, as assessed by IVUS, on long-term patency after successful DCB treatment of de novo FPA lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective, single-center study, 131 symptomatic patients with 150 de novo FPA lesions underwent successful IVUS-guided IN.PACT DCB EVT (residual stenosis &lt; 30%). The median follow-up was 1185 days. The primary endpoint was freedom from restenosis. Multivariable analysis was performed to identify factors associated with restenosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean patient age was 74.4 ± 7.6 years, and 75.6% were male. Freedom from restenosis at 3 years differed significantly by calcification type: 78.3% in no calcification, 68.7% in deep calcification, and 43.4% in superficial/nodular calcification (<i>p</i> &lt; 0.001). Despite similar minimal lumen areas post-procedure, superficial/nodular calcification was independently associated with higher restenosis risk. Other significant predictors included dialysis-dependent renal failure, isolated popliteal artery lesions, subintimal involvement on IVUS, calcified lesion length ≥ 80 mm, and total DCB length ≥ 200 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Superficial/nodular calcification on IVUS is a major predictor of restenosis after successful DCB-EVT for de novo FPA disease. These findings suggest a potential role for plaque modification or debulking strategies before DCB use in such lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2744-2752"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986161","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":"Retrograde Stenting of the Left Main Coronary Artery After Double Chimney Stenting in Previously Double Implanted Self-Expandable Transcatheter Heart Valves in a Degenerated Stentless Surgical Bioprosthetic Aortic Valve","authors":"Chourdakis Emmanouil,&nbsp;Moos Sven,&nbsp;Schroefel Holger,&nbsp;Mashayekhi Kambis","doi":"10.1002/ccd.70121","DOIUrl":"10.1002/ccd.70121","url":null,"abstract":"<div>\u0000 \u0000 <p>We report an interesting complex percutaneous coronary intervention (PCI) case in an 84-year-old male, with typical angina pectoris after previous coronary artery bypass graft (CABG) surgery and coronary double chimney stenting during a transcatheter aortic valve replacement (TAVR)-in-TAVR procedure with double self-expanding transcatheter heart valve (THV) in his degenerated stentless aortic surgical valve bioprosthesis.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2708-2712"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985300","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 Influence of Radiographic Equipment, Setup, and Operator Experience on Radiation Exposure in Chronic Total Occlusion Interventions","authors":"Gerald S. Werner,&nbsp;Alexandre Avran,&nbsp;Nicolas Boudou,&nbsp;Fabrice Leroy,&nbsp;Joerg Dalibor,&nbsp;Gabriele Gasparini,&nbsp;Alexander Bufe,&nbsp;Leszek Bryniarski,&nbsp;Maciej Lesiak,&nbsp;Alessio La Manna,&nbsp;Jo Dens,&nbsp;Sinisa Stojkovic,&nbsp;Bertrand Ledermann,&nbsp;Evald H. Christiansen,&nbsp;Sergey Furkalo,&nbsp;Artis Kalnins,&nbsp;Andrew Ladwiniec,&nbsp;Eugenio La Scala,&nbsp;Nenad Bozinovic,&nbsp;Jaroslaw Wojcik,&nbsp;Artur Lange,&nbsp;Aigars Lismanis,&nbsp;Marios Vlachojannis,&nbsp;David Hildick-Smith,&nbsp;Luca Grancini,&nbsp;Kambis Mashayekhi","doi":"10.1002/ccd.70126","DOIUrl":"10.1002/ccd.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>High radiation exposure is a significant risk with recanalizations for chronic total coronary occlusions (CTO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To analyze the influence of radiographic equipment, radiation protocols, and operator experience on radiation exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 17,769 procedures by 27 operators from a multicenter European Registry between 2015 and 2023. Thirteen operators had an experience &gt; 10 years (Gen1), and 14 entered the registry after 2015 (Gen2). AirKerma (AK), dose area product (DAP), the dose rate index (DRI) as AK per fluoroscopy time (FT), and the collimation index (CLI) as DAP per AK were calculated to assess inter-operator variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite increased lesion complexity (2015−17: CASTLE score 1.83 ± 1.10, 2021−23: 2.20 ± 1.19; <i>p</i> &lt; 0.001), AK and DAP were reduced by 45%. Gen1 operators treated more complex lesions than Gen 2 (2.05 ± 1.13 vs. 1.85 ± 1.16; <i>p</i> &lt; 0.001) at more extended FT (38.4 [23−61] vs. 34.0 [20−57]; <i>p</i> &lt; 0.001) than Gen2 with slightly higher AK (1.6 [0.89−2.8] Gy vs. 1.4 [0.8−2.54]; <i>p</i> &lt; 0.001), but DRI was similar (42.9 [27.7−64.3] vs. [28.0−62.1]). In 2015−17, operators with Philips Clarity had a lower median AK (1.7 Gy; <i>p</i> &lt; 0.001) than other vendors (Siemens 2.1 Gy; General Electric 2.8 Gy), but with updated equipment, Philips systems had slightly higher AK (1.2 Gy) than Siemens systems (1.0 Gy; <i>p</i> &lt; 0.001). Inter-operator variability regarding DRI improved over time, but collimation did not change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Radiation exposure for CTO PCI was reduced for both long-time and recent CTO operators during 9 years. Equipment updates were instrumental to improved radiation management, but inter-operator differences remained regarding dose management and collimation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2734-2743"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985832","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":"Incidence and Predictors of Referral for Coronary Angiography and Revascularization in Non-ST-Segment Elevation Myocardial Infarction","authors":"Josephine Warren,&nbsp;Jocasta Ball,&nbsp;Luke Dawson,&nbsp;Emily Nehme,&nbsp;Emily Mahony,&nbsp;Shane Nanayakkara,&nbsp;Derek P. Chew,&nbsp;David M. Kaye,&nbsp;Andrew Taylor,&nbsp;Ziad Nehme,&nbsp;Dion Stub","doi":"10.1002/ccd.70111","DOIUrl":"10.1002/ccd.70111","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Routine invasive coronary angiography (ICA) is recommended for patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), but the rate of adherence to this recommendation in Australia is not known.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We sought to quantify the proportion of patients who undergo ICA and revascularization in a contemporary cohort of NSTEMI patients, and to determine predictors of clinical outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a population-based cohort study of consecutive patients transported by emergency medical services (EMS) in Victoria, Australia with chest pain who were diagnosed with NSTEMI between January 1, 2015, and June 30, 2019. Ambulance data were linked to hospital admission, emergency department, and mortality records.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 11,040 patients attended by EMS with NSTEMI, of which 5379 patients (48.7%) underwent ICA, with 2798 patients (25.3%) proceeding to coronary revascularization. Patients who underwent ICA were younger, more frequently male, less comorbid, and more likely to originate from a major city and a higher socioeconomic status compared to those who did not. Patients who underwent ICA had lower short- and long-term mortality, and coronary angiography was independently associated with reduced mortality on Cox-regression analysis (HR 0.45, 95% CI 0.41−0.50, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Less than half of ambulance-transported patients with NSTEMI underwent ICA, and only a quarter of the cohort received revascularization, despite there being a survival benefit with invasive management. Although patients who do not undergo ICA are older and more comorbid, there are potentially modifiable barriers to access to care, including socioeconomic status, rurality, and sex.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2713-2723"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986216","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 Aortic Atherosclerosis on Clinical Outcomes After Transfemoral Transcatheter Aortic Valve Replacement","authors":"Yoshinori Shirai,&nbsp;Akihito Tanaka,&nbsp;Yoshiyuki Tokuda,&nbsp;Hiroki Kondo,&nbsp;Koji Mizutani,&nbsp;Tomonari Uemura,&nbsp;Kenji Furusawa,&nbsp;Masato Mutsuga,&nbsp;Toyoaki Murohara","doi":"10.1002/ccd.70125","DOIUrl":"10.1002/ccd.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Aortic atherothrombotic lesions can cause systemic embolization and adverse outcomes after interventional procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to assess the association between the degree of aortic atherosclerosis and clinical outcomes after transfemoral transcatheter aortic valve replacement (TAVR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center observational study included data from 278 patients who underwent transfemoral TAVR. The degree of aortic atherosclerosis in the ascending aorta, aortic arch, descending aorta, and abdominal aorta according to preoperative enhanced computed tomography was evaluated, and extensive intimal thickening ≥ 4 mm or mobile-looking, ulcerated or protruding atheroma were considered to be atherothrombotic lesions. Patients were classified into two groups: those with and without atherothrombotic lesions. Clinical outcomes, including all-cause death, stroke, systemic embolization, and worsening renal function, were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 278 patients, 116 (41.4%) exhibited atherothrombotic lesions. Baseline renal function was significantly worse in patients with atherothrombotic lesions. There were no significant differences in the occurrence of all-cause death (0% vs. 0.6%; <i>p</i> &gt; 0.99), stroke (3.5% vs. 2.5%; <i>p</i> = 0.72), systemic embolism (0.9% vs. 0%; <i>p</i> = 0.42), and worsening renal function (increase in serum creatinine ≥ 0.3 mg/dL or ≥ 1.5-fold from baseline; 5.4% vs. 5.2%; <i>p</i> = 0.93) within 1-month. During a median follow-up of 3.0 years (interquartile range 2.0–4.0 years), the occurrence of all-cause death was numerically higher in patients with atherothrombotic lesions compared to those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Atherothrombotic lesions were commonly observed in patients undergoing transfemoral TAVR. No significant clinical effect of aortic atherosclerosis on short-term adverse outcomes was observed, although long-term mortality was numerically higher in patients who exhibited atherothrombotic lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2661-2667"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986123","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}