Catheterization and Cardiovascular Interventions最新文献

{"title":"Factors Associated With Vessel Injury Caused by Atherectomy in the Treatment of Severely Calcified Femoropopliteal Lesion","authors":"Naoya Kurata,&nbsp;Osamu Iida,&nbsp;Yoshiteru Okina,&nbsp;Taku Toyoshima,&nbsp;Daichi Yoshii,&nbsp;Takafumi Masai,&nbsp;Yoshiharu Higuchi","doi":"10.1002/ccd.70124","DOIUrl":"10.1002/ccd.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The factors predicting vessel injury during the use of the Jetstream atherectomy system (JS) for femoropopliteal (FP) lesions have not been fully investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to identify factors associated with vessel injury when using the JS in severely calcified FP lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a single-center, retrospective observational study. A total of 57 patients with 68 FP lesions underwent endovascular therapy (EVT) using the JS between April 2024 and May 2025. Vessel injury was defined as evidence of medial or adventitial disruption on intravascular ultrasound evaluation. The primary outcome was the presence of vessel injury, and associated factors were analyzed. A secondary outcome was the impact of vessel injury on adverse events (AE).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The JS was used in 44% of popliteal artery lesions and 63% of nodular calcification lesions. Vessel injury was observed in 46% of cases. Factors associated with vessel injury included atherectomy in the popliteal lesion (odds ratio [OR]: 3.608; 95% confidence interval [CI]: 1.173–11.098; <i>p</i>  =  0.025) and the presence of nodular calcification (OR: 7.232; 95% CI: 2.105–24.846; <i>p</i>  =  0.002). Predictors significantly associated with AE included chronic total occlusion (Hazard ratio [HR]: 3.867; 95% CI: 1.049–14.284; <i>p</i> = 0.042), vessel injury (HR: 4.912; 95% CI: 1.342–17.981; <i>p</i> = 0.015), and minimum lumen area after EVT (HR: 0.884; 95% CI: 0.798–0.979; <i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study revealed that the utilization of the JS is associated with an elevated risk of vessel injury, particularly in cases involving lesions of the popliteal artery and those characterized by nodular calcification.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2686-2695"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986168","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":"Characterizing the Acute Changes in Pulmonary Capillary Wedge Pressure Associated With Transcatheter Pulmonary Valve Replacement","authors":"Catalina Vargas-Acevedo,&nbsp;Jenny E. Zablah,&nbsp;Ernesto Mejía,&nbsp;Natalie Soszyn,&nbsp;Joseph Kay,&nbsp;Gareth J. Morgan","doi":"10.1002/ccd.70129","DOIUrl":"10.1002/ccd.70129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>After transcatheter pulmonary valve replacement (TPVR), changes in left ventricular loading conditions can result in increased pulmonary capillary wedge pressure (PCWP). Recognizing this effect may allow better understanding of the physiologic response of the left ventricle (LV) as well as early identification and treatment of procedural complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Our aim was to describe the hemodynamic changes in LV filling pressures after TPVR measured by a PCWP before and after valve deployment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present a single center, retrospective cohort of patients that underwent TPVR at the University of Colorado. Outcomes considered were need for ventilatory support, prolonged length of stay and ventricular arrhythmias. Abnormal wedge physiology was defined as an elevated pre-PCWP (&gt;15 mmHg) or an increase (delta-PCWP) of at least 5 mmHg immediately after TPVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 104 patients were included with a median age at procedure of 22.5 years of age (IQR 14.3−36.8, and range 6−67). Twenty-two (21.2%) patients were determined to have abnormal wedge physiology. Patients in this group were older (median 37, IQR 22.8−51 vs. 18.5, IQR 13−32.3, <i>p</i> &lt; 0.001), with higher pre- and post-procedure right ventricular systolic and end diastolic pressures, higher mean pulmonary artery pressures and lower pre-procedure cardiac index (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An alteration in the loading conditions of the LV is among several hemodynamic changes that occur after TPVR and can manifest as an elevated PCWP. An awareness of this phenomenon and monitoring of PCWP before and after TPVR may promote the initiation of early interventions in this patient population. In the setting of medical interventions, abnormal wedge physiology was not associated with longer length of stay, ventilatory support, or early ventricular arrhythmias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2724-2733"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986050","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":"MitraClip Versus Surgery for Secondary Mitral Regurgitation: A Systematic Review and Updated Meta-Analysis","authors":"Juan Pinilla,&nbsp;Sebastian Jaramillo,&nbsp;Mariano Gallo Ruelas,&nbsp;Miguel Samaniego,&nbsp;Brijesh Baral,&nbsp;Nyree Nava,&nbsp;Ivo Queiroz,&nbsp;Fabio R. Farias,&nbsp;Philippe Garot","doi":"10.1002/ccd.70114","DOIUrl":"10.1002/ccd.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The optimal management of secondary mitral regurgitation (MR) remains uncertain, with surgical and percutaneous approaches offering alternative treatment strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare percutaneous repair with mitral transcatheter edge-to-edge repair (M-TEER) using MitraClip and surgical intervention in patients with secondary MR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched PubMed, Embase, and Cochrane for studies comparing M-TEER using MitraClip with surgery in secondary MR, reporting outcomes of interest. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using a random-effects model in R software. Heterogeneity was assessed with I² statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 studies (two randomized controlled trials and nine observational studies) comprising 1605 patients were included. The mean age was 69 years. Among them, 906 (57.7%) underwent MitraClip. Mean follow-up was 24.7 months (minimum: 6 months). The rate of MR grade ≤ 2+ at follow-up was lower in the MitraClip group compared to surgery (RR: 0.86, 95% CI: 0.78 to 0.95, <i>p</i> &lt; 0.01). No significant differences were observed in all-cause mortality (RR: 1.18, 95% CI: 0.93 to 1.49, <i>p</i> = 0.16), cardiovascular mortality (RR: 1.42, 95% CI: 0.54 to 3.68, <i>p</i> = 0.47), heart failure hospitalizations (RR: 1.55, 95% CI: 0.79 to 3.04, <i>p</i> = 0.20), or NYHA class I/II at follow-up (RR: 0.92, 95% CI: 0.83 to 1.01, <i>p</i> = 0.08).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although patients undergoing MitraClip exhibited a lower rate of residual MR ≤ 2+ at follow-up compared to those treated surgically, this did not translate into higher rates of clinical outcomes, including all-cause mortality, cardiovascular mortality, heart failure hospitalizations, or impaired functional status (NYHA classification).</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2675-2685"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986136","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":"Transcatheter Aortic Valve Replacement in Cath Lab: Moving From Exceptional to Everyday","authors":"Ashish H. Shah","doi":"10.1002/ccd.70118","DOIUrl":"10.1002/ccd.70118","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2673-2674"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985830","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":"Anomalous Single Ostial Origin of Entire Coronary Arteries From the Right Coronary Sinus: A Rare Case of ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention","authors":"Mohsen Taghavi Shavazi,&nbsp;Saeed Sadr,&nbsp;Mohamad Reza Ayoubpour,&nbsp;Soroush Mostafavi","doi":"10.1002/ccd.70128","DOIUrl":"10.1002/ccd.70128","url":null,"abstract":"<div>\u0000 \u0000 <p>This report is about managing ST-segment elevation myocardial infarction (STEMI) in a patient with a coronary anomaly of single ostial origin of entire coronary arteries from the right coronary sinus. To date, no cases have been reported of such an anatomical irregularity in a comparable clinical situation that managed with emergent revascularization. The administration of such cases, whether through primary percutaneous coronary intervention (PPCI) or emergent cardiac surgery, underscores the comprehensive understanding of uncommon anatomical variations among cardiologists.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2696-2700"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986040","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":"Successful Tip Detection-Antegrade Dissection and Re-Entry for Chronic Iatrogenic Coronary Artery Dissection Using a 6Fr Guiding Catheter: A Technical Challenge Overcome","authors":"Bayushi Eka Putra,&nbsp;Umihiko Kaneko,&nbsp;Yutaka Tadano,&nbsp;Tsutomu Fujita","doi":"10.1002/ccd.70102","DOIUrl":"10.1002/ccd.70102","url":null,"abstract":"<div>\u0000 \u0000 <p>A 57-year-old man presented with recurrent exertional angina 1 month after an unsuccessful PCI attempt elsewhere. Angiography revealed severe stenosis and a chronic dissection of the posterior lateral artery (PLA). PCI was performed via a 6 Fr right transradial guiding catheter. Initial intravascular ultrasound (IVUS) using OptiCross HD (Boston Scientific; 3.1 Fr outer diameter [OD], 20 mm transducer-to-tip distance [TTD]) confirmed guidewire placement in the subintimal space within the extensive chronic dissection. TD-ADR was successfully performed using the OptiCross HD IVUS and a low-profile Carnelian MARVEL microcatheter (1.9 Fr OD), both accommodated within the 6 Fr guide. True lumen re-entry was achieved, followed by balloon dilatation, side branch management, and successful drug-eluting stent deployment in the main vessel, confirmed by final angiography and IVUS.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2701-2707"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985863","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":"Septal Collateral Perforation Complicated by Intraventricular Septal Hematoma: A Case Report","authors":"Francesco Jeva,&nbsp;Andrea Minghini,&nbsp;Andrea Rolandi,&nbsp;Mauro De Benedictis","doi":"10.1002/ccd.70120","DOIUrl":"10.1002/ccd.70120","url":null,"abstract":"<div>\u0000 \u0000 <p>A 76-year-old man with effort angina was admitted to Cardiology Department for an elective coronary angiography (CA). Diagnostic CA revealed severely calcified three-vessel coronary artery disease (CAD) with chronic total occlusions (CTO) of the right dominant coronary artery (RCA) and of the left circumflex artery (LCX) ostium, and severe calcific stenosis of the left descending artery (LAD). An urgent percutaneous coronary intervention (PCI) to treat LAD was carried out because of ECG modifications and chest pain immediately after CA. During the procedure a septal collateral perforation occurred leading to abrupt development of a large intraventricular septal hematoma (IVSH). Urgent embolization of the distal septal branch with coils was performed using block and deliver (BAD) technique. Rapid hematoma expansion involved another proximal septal collateral. A prompt second coil embolization was carried out arresting the growth of hematoma expansion. The patient was discharged home in stable condition after close observation in Coronary Care Unit (CCU), and subsequently in a low-intensity care unit. Complete resolution of IVSH was confirmed by transthoracic echocardiogram 2 months later. Timely management of the septal perforation and close echocardiographic monitoring resulted in complete hematoma resolution and a satisfactory outcome.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2668-2672"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985769","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":"Active Side-Branch Protection Strategy for Culprit Bifurcation Lesion in STEMI Patients: The Multicenter STEMI-BIF Registry","authors":"Ahmet Güner,&nbsp;Ebru Serin,&nbsp;Regayip Zehir,&nbsp;Barış Şimşek,&nbsp;Ahmet Öz,&nbsp;Ahmet Yaşar Çizgici,&nbsp;Mert Evlice,&nbsp;Veysel Ozan Tanık,&nbsp;Abdullah Kadir Dolu,&nbsp;Mustafa Ferhat Keten,&nbsp;Mehmet Akif Erdöl,&nbsp;Ziya Apaydın,&nbsp;Berkay Serter,&nbsp;Emre Aydın,&nbsp;Merve Aydın,&nbsp;Mustafa Kamil Yemiş,&nbsp;Büşra Çörekçioğlu,&nbsp;Koray Çiloğlu,&nbsp;Abdullah Doğan,&nbsp;Hande Uysal,&nbsp;Saner Bahadır Gök,&nbsp;Ali Nural,&nbsp;Ahmet Ceyhun Cebeci,&nbsp;Ali Yaşar Kılınç,&nbsp;Ezgi Merve Çelik,&nbsp;Mustafa Sarı,&nbsp;Emre Paçacı,&nbsp;Cemalettin Akman,&nbsp;Hicaz Zencirkıran Ağuş,&nbsp;Azmican Kaya,&nbsp;Ezgi Gültekin Güner,&nbsp;Koray Demirci,&nbsp;Kaan Gökçe,&nbsp;Aybüke Şimşek,&nbsp;Mehmet Falakaoğlu,&nbsp;Fatih Furkan Bedir,&nbsp;Ali Rıza Demir,&nbsp;Sinem Deniz Çakal,&nbsp;Ahmet Arif Yalçın,&nbsp;Fatih Uzun,&nbsp;Berhan Keskin,&nbsp;İbrahim Faruk Aktürk","doi":"10.1002/ccd.70107","DOIUrl":"10.1002/ccd.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To date, the best side branch (SB) protection strategy in patients with coronary bifurcation lesions (CBLs)-related ST-segment elevation myocardial infarction (STEMI) has not yet been settled.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study sought to evaluate the clinical outcome of the jailed balloon (JBT) and jailed wire techniques (JWT) for the SB protection strategy in STEMI patients with culprit CBLs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This large-scale multicenter (<i>n</i> = 10) observational retrospective study included STEMI patients with culprit CBLs who underwent PCI with provisional stenting. The primary endpoint was major adverse cardiac events (MACE) as the combination of death from cardiac causes, target vessel myocardial infarction, or clinically driven target lesion revascularization (TLR). Propensity score-matching analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1218 consecutive patients (male: 1020 [83.7%], mean age: 57.68 ± 11.76 years) were included in this study. The study cohort was divided into two groups as JBT (<i>n</i> = 196) and JWT (<i>n</i> = 1022). The incidences of the SB intervention (21.4% vs. 36.2%, <i>p</i> &lt; 0.001) and residual stenosis of SB ≥ 70% (23.0% vs. 45.5%, <i>p</i> &lt; 0.001) were significantly lower in the JBT group compared to the JWT group. Whereas procedure time (47.21 ± 17.70 vs. 40.94 ± 13.18 min, <i>p</i> &lt; 0.001) and fluoroscopy time (15.92 ± 9.51 vs. 13.39 ± 6.69 min, <i>p</i> = 0.001) were notably higher in the JBT group than in the JWT group. The risk-adjusted midterm MACE (HR: 0.688, <i>p</i> = 0.200) and clinally driven TLR (HR: 0.566, <i>p</i> = 0.170) did not differ in individuals with culprit CBLs to protect the SB with JBT and the JWT in the propensity-matched cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study suggests that risk-adjusted MACE and TLR rates were comparable between both techniques at midterm follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2647-2660"},"PeriodicalIF":1.9,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986038","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":"Regional Variations in the Management and Outcomes of Pulmonary Embolism: A Five-Year United States Analysis","authors":"Aryan Mehta,&nbsp;Mridul Bansal,&nbsp;Vinayak Nagaraja,&nbsp;Khansa Ahmad,&nbsp;Joseph J. Ingrassia,&nbsp;J. Dawn Abbott,&nbsp;Saraschandra Vallabhajosyula","doi":"10.1002/ccd.70110","DOIUrl":"10.1002/ccd.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute pulmonary embolism (PE) is one of the most common causes of cardiovascular mortality in the United States. Significant variations in the management of various cardiovascular conditions have previously been reported, but this has been poorly elucidated for pulmonary embolism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>During 2016–2020, adult (≥ 18 years) nonelective admissions with PE, admitted to Northeast, Midwest, South, and West geographic regions were identified using the National Inpatient Sample. Outcomes of interest included in-hospital mortality, utilization of PE therapies, non-cardiac organ support, total hospitalization costs, and hospitalization duration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this 5-year duration, 904,260 admissions were identified - Northeast, Midwest, South, and West had 166,050 (18.3%), 225,680 (24.9%), 350,160 (38.7%), and 162,370 (17.9%) admissions, respectively. On average, admissions to the Northeast were less comorbid, from a higher socioeconomic status, privately insured, and more commonly admitted to urban teaching and medium-sized hospitals (all <i>p</i> &lt; 0.001). The Northeast region also had the lowest rates of definitive PE therapies except surgical thrombectomy. In comparison to the Northeast, the in-hospital mortality was higher in the South and West and lower in the Midwest region (3.1% vs 2.8% vs 3.2% vs 3.3%, <i>p</i> &lt; 0.001). However, on adjusted analysis with Northeast as a reference, in-hospital mortality was noted to be lower in the Midwest (adjusted odds ratio [aOR] 0.98, 95% confidence interval [CI] 0.67−0.84; <i>p</i> &lt; 0.001), South (aOR 0.89, 95% CI 0.80−0.98; <i>p</i> &lt; 0.05), and the West (aOR 0.88, 95% CI 0.78−0.99; <i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, we noted significant heterogeneity in the management and outcome of pulmonary embolism across various regions of the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2632-2636"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144985284","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 Outcomes of Patients Undergoing Extracorporeal Membrane Oxygenator-Assisted High-Risk Percutaneous Coronary Intervention","authors":"Aiyuan Cheng,&nbsp;Bo Wang,&nbsp;Guotao Fu,&nbsp;Chengxiang Li,&nbsp;Yi Liu,&nbsp;Fei Li,&nbsp;Qiong Wang,&nbsp;Zhiyong Yin,&nbsp;Haokao Gao,&nbsp;Chao Gao,&nbsp;Ling Tao","doi":"10.1002/ccd.70098","DOIUrl":"10.1002/ccd.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Data regarding the long-term outcomes of patients undergoing venoarterial extracorporeal membrane oxygenator (VA-ECMO) assisted high-risk percutaneous coronary intervention (PCI) and the impact of the operator experience is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to investigate the long-term outcomes of patients undergoing VA-ECMO-assisted PCI and the effect of the operator experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study was a retrospective cohort study that consecutively enrolled patients who were declined by the Heart Team for coronary artery bypass grafting (CABG) due to high surgical risk and treated with VA-ECMO-assisted PCI from November 1, 2016, to March 1, 2024, in Xijing Hospital, China. The primary endpoint was all-cause death at 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 220 patients were included. The mean age ± SD was 65.6 ± 11.4 years and the median LVEF% (IQR) was 36.0 (30.0−40.0). The mean ± SD of the SYNTAX score was 34.7 ± 6.9. The median (IQR) follow-up was 1.9 (1.3−4.9) years, and the vital status of all patients was available at 1 year. The all-cause death occurred in 56 (25.5%) of patients at 1 year. Utilizing the restricted cubic spline, the threshold to categorize an experienced operator was performing &gt; 10 cases of VA-ECMO-assisted PCI. Compared to the ≤ 10 cases group, the &gt; 10 cases group was associated with a 44% decrease in risk of all-cause death (19.8% vs. 31.5%, HR adjusted: 0.56, 95% CI: 0.33−0.97, <i>p</i> = 0.039).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VA-ECMO-assisted PCI appeared to be a feasible option for patients unsuitable for CABG. Performing &gt; 10 cases could be a threshold to categorize an experienced operator.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06713876.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"106 4","pages":"2637-2644"},"PeriodicalIF":1.9,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986145","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}