Catheterization and Cardiovascular Interventions最新文献

{"title":"Transcatheter Aortic Valve Replacement in Patients With Severe Rheumatic Aortic Stenosis: A Proportional Meta-Analysis.","authors":"Muhammad Junaid Ahsan, Soban Ahmad, Ghulam Mujtaba Ghumman, Mariam Dvalishvili, Shahbaz A Malik, Ashequl M Islam, Andrew M Goldsweig","doi":"10.1002/ccd.31288","DOIUrl":"https://doi.org/10.1002/ccd.31288","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675236","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 Vascular Response After Balloon Angioplasty of Infrapopliteal Intermediate Stenosis Evaluated by Optical Frequency Domain Imaging.","authors":"Haruya Yamane, Yasunori Ueda, Kuniyasu Ikeoka, Haruhiko Abe, Koichi Inoue, Yasushi Matsumura","doi":"10.1002/ccd.31291","DOIUrl":"10.1002/ccd.31291","url":null,"abstract":"<p><strong>Background: </strong>We often experience worsening of stenosis by balloon angioplasty of infrapopliteal (IP) lesion compared with the initial stenosis. However, reports on this phenomenon are limited.</p><p><strong>Aims: </strong>The main purpose of this study is to evaluate vascular response after balloon angioplasty of IP artery stenosis.</p><p><strong>Methods: </strong>Thirteen patients (15 arteries) who underwent endovascular treatment (EVT) and follow-up angiography with optical frequency domain imaging (OFDI) of intermediate IP stenosis were included. Serial OFDI images at 3 time points (before and after EVT and at follow-up) were analyzed. Diameter and area of external elastic lamina, internal elastic lamina, and lumen were measured, and plaque area and plaque burden (PB) were calculated. PB before EVT was classified into mild, moderate, and severe by 0%-20%, 21%-40%, and 41%-60%, respectively.</p><p><strong>Results: </strong>Analyzed were 229 cross sections. External elastic lamina diameter did not change significantly among three time points (3.8 ± 0.5 [95% confidence interval (CI): 3.7 to 3.9] mm, 3.9 ± 0.4 [95% CI: 3.8 to 4.0] mm, 3.9 ± 0.4 [95% CI: 3.8 to 4.0] mm, p = 0.06). Lumen area increased after EVT but became smaller at follow-up than before EVT (4.5 ± 1.5 [95% CI: 4.3 to 4.7] mm², 5.3 ± 1.3 [95% CI: 5.1 to 5.5] mm², 3.7 ± 1.2 [95% CI: 3.5 to 3.9] mm², p < 0.001). Plaque area became smaller after EVT and larger at follow-up than before EVT (3.0 ± 1.7 [95% CI: 2.8 to 3.2] mm², 2.4 ± 1.5 [95% CI: 2.2 to 2.6] mm², 4.0 ± 1.6 [95% CI: 3.8 to 4.2] mm², p < 0.001). Lumen area was significantly smaller at follow-up than before EVT in mild and moderate PB groups, but it was not different in severe PB group (mild PB group: 5.1 ± 1.5 [95% CI: 4.7 to 5.5] mm² vs. 4.0 ± 1.3 [95% CI: 3.7 to 4.3] mm², p < 0.001, moderate PB group: 4.6 ± 1.3 [95% CI: 4.4 to 4.8] mm² vs. 3.6 ± 1.2 [95% CI: 3.4 to 3.8] mm², p < 0.001, severe PB group: 3.0 ± 1.4 [95% CI: 2.5 to 3.5] mm² vs. 3.1 ± 1.0 [95% CI: 2.7 to 3.5] mm², p = 0.93).</p><p><strong>Conclusions: </strong>Balloon angioplasty of intermediate IP artery stenosis with mild or moderate PB led to smaller lumen area at follow-up than before EVT.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667158","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":"Iatrogenic Aortocoronary Dissection During Coronary Intervention: A Case Series.","authors":"Ammar Albayati, Nicholas J Collins, Andrew J Boyle, Mohammed S Al-Omary","doi":"10.1002/ccd.31303","DOIUrl":"10.1002/ccd.31303","url":null,"abstract":"<p><p>Iatrogenic aortocoronary dissection (IAD) during percutaneous coronary intervention (PCI) is an uncommon and potentially life-threatening complication. Extension of dissection to the ascending aorta, despite early surgical management, carries a high morbidity and mortality risk. Depending on the severity of dissection, the approach to management ranges from monitoring to surgical intervention; more extensive dissections into the ascending aorta, typically more than 40 mm above the coronary ostium, are considered an indication for surgery. We report six cases of IAD, highlighting the critical considerations concerning conservative management. These cases highlight the potential role of individualized management strategies, demonstrating instances where a conservative stance may prove effective in ensuring an optimal patient outcome and the key procedural features essential to optimize outcomes when considering nonsurgical management.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667119","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":"Pulsus Alternans: Caught in Action.","authors":"Emre Aslanger, Burcu Aggül, Duygu Genç Albayrak","doi":"10.1002/ccd.31295","DOIUrl":"10.1002/ccd.31295","url":null,"abstract":"<p><p>Pulsus alternans describes an arterial pulse waveform that shows alternating strong and weak beats despite a regular rhythm. Either discovered during physical examination or catheterization, pulsus alternans indicates severe left ventricular (LV) dysfunction and poor prognosis. There has been considerable debate about the underlying mechanism. We present a tracing which depicts a classic example of pulsus alternans and gives some clues about its initiation mechanism.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667157","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":"Pre-Procedural Virtual Reality Guiding Catheter Simulation Navigating Successful Percutaneous Coronary Intervention of a Chronic Total Occlusion of an Anomalous Origin of the Right Coronary Artery.","authors":"Masataka Yoshinaga, Takashi Muramatsu, Hiroki Higami, Kenya Nasu","doi":"10.1002/ccd.31296","DOIUrl":"10.1002/ccd.31296","url":null,"abstract":"<p><p>We report two cases of successful percutaneous coronary intervention (PCI) of a chronic total occlusion (CTO) lesion with an anomalous origin of the right coronary artery (AORCA) and challenging guiding catheter engagement using a new 3D virtual reality (VR) guiding catheter simulation system. Appropriate guiding catheter selection is critical for a successful complex PCI. A more suitable guiding catheter size, shape, and position with a robust backup force often leads to the successful completion of more accessible and safer procedures. The present case report highlights that VR simulation provides a greater possibility than usual of pre-procedural planning when selecting appropriate guiding catheters and vascular access. The present VR simulation system is based on three-dimensional volume rendering reconstructions of the computed tomography (CT) imaging data; thus, another strength of this technology is that it does not require radiation or radiocontrast exposure to patients. Therefore, transcatheter interventionalists who usually perform complex PCI should be familiar with this innovative system.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667151","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":"Percutaneous Pulmonary Valve Implantation With Self-Expanding Valves for Carcinoid Heart Diseases.","authors":"Ka-Chun Un, Chun-Ka Wong, San-Fui Sophia Yong, Robbert de Winter, Bart Straver, Steven Chamuleau, Eric Rosenthal, Shakeel A Qureshi, Marcel Beijk, Matthew I Jones","doi":"10.1002/ccd.31302","DOIUrl":"https://doi.org/10.1002/ccd.31302","url":null,"abstract":"<p><p>Carcinoid heart disease is an important complication of neuroendocrine tumors that may lead to significant morbidity and mortality. Right-sided heart valve involvement with consequent valve dysfunction is one of the common manifestations. Patients often have multiple, significant comorbidities with advanced metastatic disease and, as such, may not be suitable for surgical valve replacement due to excessive risk. Transcatheter valve replacement using balloon-expandable valves has been the mainstay of management for these patients, particularly with stenotic lesions but there is limited experience in patients with pulmonary regurgitation and dilated pulmonary arteries outside the dimensions that would be suitable for these valves. We report three successful cases of percutaneous pulmonary valve implantation with the VenusP-valve, a large self-expanding valve platform, and highlight the technical aspects and challenges specific to treatment of pulmonary regurgitation in patients with carcinoid heart disease. Percutaneous pulmonary valve implantation, using the VenusP-valve, may be considered an effective treatment in this patient group.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646880","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":"Utilizing Invasive Coronary Functional Testing in a Coronary Microvascular and Vasomotor Dysfunction Program: Methods and Considerations.","authors":"Odayme Quesada, Namrita D Ashokprabhu, Danielle N Tapp, Michelle S Hamstra, Melissa Losekamp, Christian Schmidt, Cassady Palmer, Julie Gallatin, Darlene Tierney, Tammy Trenaman, Mariana Canoniero, Jarrod Frizzell, Timothy D Henry","doi":"10.1002/ccd.31282","DOIUrl":"10.1002/ccd.31282","url":null,"abstract":"<p><strong>Background: </strong>Coronary microvascular and vasomotor dysfunction (CMVD) is associated with a threefold increased risk of major adverse cardiovascular events (MACE) and is the primary mechanism responsible for angina/ischemia in patients with nonobstructive coronary artery disease (ANOCA/INOCA). Proper assessment for CMVD is vital to provide targeted treatment and improve patient outcomes. Invasive coronary functional testing (ICFT) is the \"gold standard,\" for CMVD assessment and can be used to diagnose all endotypes. However, there is a lack of standardization for ICFT protocols and use in the treatment of CMVD.</p><p><strong>Aims: </strong>To provide a comprehensive overview of ICFT protocols utilized at the Christ Hospital Womens Heart Center (TCH-WHC).</p><p><strong>Methods: </strong>Here, we outline our standard operating procedures for ICFT utilized at TCH-WHC, including the procedures two main methods: Doppler and Thermodilution. We describe our structured approach for ICFT referral and postdiagnostic clinical management utilized at The Christ Hospital Women's Heart Center (TCH-WHC) CMVD program. We then quantified how ICFT has contributed to growth of the TCH-WHC.</p><p><strong>Results: </strong>From October of 2020 until July of 2024, a total of 422 patients have undergone ICFT at TCH-WCH, 64% were performed via the Doppler protocol and 36% were performed via the Thermodilution protocol. Based on exclusive endotype categories, 19% had an endothelial-independent CMD alone, 19% had endothelial-dependent CMD or microvascular VSA alone, 3% had epicardial VSA alone, 42% had mixed disease (any combination of the above categories), and 17% had a normal ICFT.</p><p><strong>Conclusions: </strong>ICFT provides opportunity to provide diagnostic clarity and optimize medical treatment for CMVD. TCH-WHC's structured approach for ICFT referral and protocol for conducting comprehensive ICFT which has been vital for the growth of our specialized CMVD program.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142646882","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":"Frailty as an independent predictor for midterm adverse outcomes in the elderly undergoing primary percutaneous coronary intervention: A longitudinal cohort study.","authors":"Quyen The Nguyen, Tri Van Nguyen, Thuy Viet Phuong Nguyen, Huy Minh Tran, Son Ngoc Dang, Bang Ngoc Hoan Nguyen, Hai Hoang Pham, Trung Tien Tran, Dang Ngoc Tran, Vien Truong Nguyen, Tan Van Nguyen","doi":"10.1002/ccd.31251","DOIUrl":"https://doi.org/10.1002/ccd.31251","url":null,"abstract":"<p><strong>Background: </strong>Frailty is associated with poor health outcomes in elderly population. However, its effect on midterm outcomes in elderly patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) remains unknown.</p><p><strong>Aims: </strong>This study aimed to evaluate the association between frailty, as classified by the Clinical Frailty Scale (CFS), and midterm adverse outcomes in elderly STEMI patients after primary PCI.</p><p><strong>Methods: </strong>In this prospective, observational, multicenter cohort study, frailty status of 426 STEMI patients aged ≥60 years undergoing primary PCI was determined using the nine-point CFS 2 weeks before the occurrence of STEMI. Patients scoring at least four points on the CFS were considered frail. The primary outcome was a composite of cardiovascular death or readmission. Secondary outcomes included cardiovascular death, cardiovascular readmission, heart failure-related death or readmission, and myocardial reinfarction. Follow-up data were collected through medical record reviews and/or telephone interviews.</p><p><strong>Results: </strong>Of 426 elderly patients, 116 were frail. The median follow-up period was 15 months (interquartile range 5-19 months). Primary outcome events occurred in 87 (75.0%) frail and 75 (24.2%) nonfrail patients. The adjusted hazard ratio was 3.278 after model selection using the Bayesian Model Averaging approach (95% confidence interval 2.372-4.531). Multivariate Cox proportional hazard survival analysis showed that frailty was significantly associated with a higher prevalence of all secondary outcome events after adjusting for TIMI, PAMI, and CADILLAC risk scores.</p><p><strong>Conclusions: </strong>Frailty, as defined by the CFS, was independently associated with midterm adverse outcomes in elderly patients undergoing primary PCI for STEMI.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643727","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 Outcomes and Practicality of Transferring Patients Immediately to Originating Hospitals After Primary Percutaneous Coronary Intervention-A Retrospective Study.","authors":"S Kamaraj, M L Firdaus, R Norfarahdina, A M Abdul Muizz, A R Asri Ranga, Timothy D Henry, Hadley Wilson, L S K Glendon, A G Abdul Raqib, A G Abd Kahar","doi":"10.1002/ccd.31290","DOIUrl":"https://doi.org/10.1002/ccd.31290","url":null,"abstract":"<p><strong>Background: </strong>Primary Percutaneous Coronary Intervention (PPCI) is the preferred treatment for ST-Segment Elevation Myocardial Infarction (STEMI) patients in both PCI centers and those transferred from non-PCI centers, provided it can be performed in a timely manner. The challenges in transferring patients from non-PCI centers include not only potential delays beyond 120 min but also the risk of overwhelming the resources at the PPCI hospital. We report a novel strategy implemented within the Serdang STEMI Network involving immediate transfer of patients back to the originating hospitals within 2 h post procedure.</p><p><strong>Aims: </strong>This study aims to evaluate the clinical outcomes and practicality of immediately transferring stable STEMI patients back to their originating hospitals within 2 h postprimary PCI, within the Serdang STEMI Network. Specifically, it seeks to assess the in-hospital mortality rate and 30-day major adverse cardiac events (MACE) among these patients to determine the safety and feasibility of this novel early transfer strategy.</p><p><strong>Methods: </strong>This retrospective cohort study involved 1374 STEMI patients participating in the Serdang STEMI network from May 2015 to December 2022, including 570 patients admitted directly to Hospital Sultan Idris Shah, Serdang (HSIS) and 804 transferred from non-PCI centers.</p><p><strong>Results: </strong>Of the 804 transferred patients, 415 (52%) were transferred back to referring hospitals within 2 h of PPCI. These patients met specific criteria including hemodynamic stability, absence of procedural complications, and fit for transfer at the discretion of the attending cardiologist. The primary outcomes measured were in-hospital and 30-day mortality rates, as well as major adverse cardiac events (MACE). MACE was defined as a composite of death, myocardial infarction, stroke, or repeat revascularization. In the early return group, there was no in-hospital or 30-day mortality. No patient required repeat revascularization or readmission within 30 days.</p><p><strong>Conclusions: </strong>Our results indicate that carefully selected patients can be safely returned to their originating hospitals very early following successful PPCI. These findings have important implications for large regional STEMI networks worldwide, particularly in areas where PPCI centers may have limited resources to handle high STEMI volumes.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643718","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":"Economic Analysis of Catheter-Directed Thrombolysis for Intermediate-Risk Pulmonary Embolism.","authors":"Elina Pliakos, Lauren Glassmoyer, Taisei Kobayashi, Steven Pugliese, Hari Shankar, William Matthai, Sameer Khandhar, Jay Giri, Ashwin Nathan","doi":"10.1002/ccd.31280","DOIUrl":"https://doi.org/10.1002/ccd.31280","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary embolism is associated with a significant burden of morbidity, mortality, and health care costs. Catheter-directed thrombolysis has emerged as a promising option for patients with intermediate-risk pulmonary embolism which aims to improve outcomes over standard anticoagulation.</p><p><strong>Methods: </strong>We constructed a decision-analytic model comparing the cost-effectiveness of catheter-directed thrombolysis to anticoagulation alone for the management of intermediate-risk pulmonary embolism. Cost-effectiveness was determined by calculating deaths averted and incremental cost-effectiveness ratios (ICER). Uncertainty was addressed by plotting cost-effectiveness planes and acceptability curves for various willingness-to-pay thresholds. The main outcome was ICER (US dollars/deaths averted).</p><p><strong>Results: </strong>In the base case analysis, derived using systemic lysis data, the cost associated with catheter-directed thrombolysis was estimated at $22,353 with a probability of survival at 1 month of 0.984. For the anticoagulation alone strategy, the cost was $25,060, and the probability of survival at 1 month was 0.958. Overall, catheter-directed thrombolysis resulted in savings of $104,089 per death averted (ICER,-$104,089 per death averted). Sensitivity analysis revealed that catheter-directed thrombolysis would no longer be cost-effective when its associated mortality is greater than 0.042. In the probabilistic analysis, at a willingness-to-pay of $100,000, catheter-directed thrombolysis had a 63% chance of being cost-effective, and in cost-effectiveness acceptability curves, it was cost-effective in 63%-78% of simulations for a willingness to pay ranging from $0 to $100,000.</p><p><strong>Conclusions: </strong>If the assumptions made in our model are shown to be accurate then CDT would be cost-effective and may lead to considerable cost savings if used where clinically appropriate.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643722","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}