Catheterization and Cardiovascular Interventions最新文献

{"title":"Novel Transthoracic Pulmonary Valve Implantation Using Self-Expanding Salus Valve: A Prospective Study of Safety and Mid-Term Outcomes.","authors":"Ziqin Zhou, Miao Tian, Jiazichao Tu, Yong Zhang, Jian Zhuang, Shusheng Wen, Jimei Chen","doi":"10.1002/ccd.31471","DOIUrl":"https://doi.org/10.1002/ccd.31471","url":null,"abstract":"<p><strong>Background: </strong>Transcatheter pulmonary valve replacement (TPVR) has emerged as a valuable treatment for severe pulmonary regurgitation (PR). The Salus valve (Balance Medical Technology Co. Ltd., Beijing, China) represents a novel self-expanding valve stent designed for deployment through a transthoracic approach with a small subxiphoid incision.</p><p><strong>Aims: </strong>The objective of this study was to evaluate the medium-term safety and efficacy of Salus valve stents in this patient population.</p><p><strong>Methods: </strong>This prospective cohort study enrolled patients who underwent transthoracic pulmonary valve stenting at Guangdong Provincial People's Hospital from September 2021 to September 2024. Inclusion criteria included moderate-to-severe PR following RVOT reconstruction, age ≥ 14 years, and specific clinical/imaging parameters. Primary endpoints were pulmonary regurgitation fraction < 20%, freedom from reintervention at 12 months, and major adverse events (MAE). MAE were defined as death, reintervention, recurrent severe PR, worsening heart failure, cardiac arrest, new severe ventricular arrhythmias, and third-degree AV block.</p><p><strong>Results: </strong>Among 38 patients (mean age 24.08 ± 8.12 years), all procedures were successfully completed, although intraoperative valve displacement occurred in three cases. During a median follow-up period of 24 months, significant improvements were observed in right ventricular volumes: Right Ventricular End-Diastolic Volume Index (RVEDVI) decreased from 141.45 to 109.98 mL/m² and Right Ventricular End-Systolic Volume Index (RVESVI) decreased from 74.27 to 56.62 mL/m² (both p < 0.01). No mortality or need for reintervention was observed during the follow-up period. The estimated freedom from major adverse events at 36 months was 87.2%.</p><p><strong>Conclusion: </strong>The Salus valve demonstrated safety and efficacy for severe PR treatment through its transthoracic approach, which offers unique advantages in terms of direct access and immediate complication management. Longer follow-up is needed to assess long-term durability.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647437","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 Impact of Underlying Plaque Characteristics Following the Third-Generation Resorbable Magnesium Scaffold Implantation: An Intravascular OCT Assessment up to 12-Months.","authors":"Alp Aytekin, Masaru Seguchi, Erion Xhepa, Michael Haude, Adrian Wlodarczak, René J van der Schaaf, Jan Torzewski, Hector M Garcia-Garcia, Ron Waksman, Michael Joner","doi":"10.1002/ccd.31486","DOIUrl":"https://doi.org/10.1002/ccd.31486","url":null,"abstract":"<p><strong>Background: </strong>Third-generation resorbable magnesium scaffold (RMS) was developed with stronger mechanical properties and thinner struts compared to its predecessor. This study aimed to assess the influence of the OCT-derived underlying plaque characteristics on in-scaffold late lumen loss (LLL) in patients treated with RMS up to 12-months.</p><p><strong>Methods: </strong>Patients enrolled in the BIOMAG-I trial and who underwent OCT imaging before and after the index procedure were included in the current analysis. The acquired intravascular imaging data were evaluated to assess the presence of fibrous, calcific, or lipidic lesions. We calculated the proportions of each plaque feature per pullback and assessed their correlation with LLL obtained at 6- and 12-months follow-up. In addition, we investigated the potential impact of scaffold edge dissection and strut malapposition on in-scaffold LLL.</p><p><strong>Results: </strong>Eighty-four patients and 84 lesions were evaluated in the current analysis. There was no significant correlation between the underlying plaque characteristic and in-scaffold LLL at 6-months (p = 0.79 for fibrous, p = 0.88 for calcific, p = 0.67 for lipid lesions). This trend was similar at 12 months follow-up (p = 0.56 for fibrous, p = 0.75 for calcific, p = 0.69 for lipid lesions). The presence or absence of edge dissection did not influence the degree of in-scaffold - (p = 0.51 at 6-months, p = 0.68 at 12-months follow-up) or in-segment LLL (p = 0.88 at 6-months, p = 0.70 at 12-months follow-up).</p><p><strong>Conclusion: </strong>The underlying plaque characteristics, edge dissection or strut malapposition had no significant impact on in-scaffold LLL following DREAMS 3 G implantation up to 12 months. This suggests better device performance irrespective of the underlying plaque characteristics.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT04157153.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647444","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 Significance of Coronary Flow Reserve Improvement After Elective Percutaneous Coronary Intervention.","authors":"Yoshihiro Hanyu, Masahiro Hoshino, Eisuke Usui, Tomoyo Sugiyama, Yoshihisa Kanaji, Masahiro Hada, Tatsuhiro Nagamine, Kai Nogami, Hiroki Ueno, Taishi Yonetsu, Tetsuo Sasano, Tsunekazu Kakuta","doi":"10.1002/ccd.31500","DOIUrl":"https://doi.org/10.1002/ccd.31500","url":null,"abstract":"<p><strong>Background: </strong>Limited research has explored the prognostic significance of changes in coronary flow velocity reserve (CFVR), as measured by stress-transthoracic Doppler echocardiography (S-TDE), following elective percutaneous coronary intervention (PCI). This study aimed to assess whether post-PCI changes in CFVR are associated with major adverse cardiac events (MACE) and to identify baseline clinical factors that predict improvement of CFVR.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 184 patients who underwent elective FFR-guided PCI for the left anterior descending (LAD) artery. Standard pre-PCI TDE examinations and pre- and post-PCI physiological assessments using S-TDE were performed. Patients were categorized based on CFVR improvement, defined as an increase greater than the median value of CFVR changes. MACE, including all-cause death, myocardial infarction, ischemic stroke, and heart failure requiring hospitalization, was evaluated.</p><p><strong>Results: </strong>The median improvement in CFVR was 0.50 (28.8%). During a median follow-up period of 1.9 years, MACE occurred in 26 patients (14.1%). Patients without CFVR improvement had significantly worse outcomes (p = 0.029). In multivariate Cox regression analysis, both lower pre-PCI CFVR and lack of CFVR improvement were associated with poor prognosis. A multivariate logistic regression analysis identified absence of diabetes, lower pre-PCI FFR, lower pre-PCI CFVR, and longer pre-PCI deceleration time of diastolic coronary flow as predictors of CFVR increase, with an AUC of 0.814 (95% CI: 0.755-0.873).</p><p><strong>Conclusions: </strong>In patients undergoing elective FFR-guided LAD PCI, a lower pre-PCI CFVR and lack of CFVR improvement were associated with poor prognosis, whereas a comprehensive pre-PCI evaluation predicted CFVR improvement.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623550","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 After Transcatheter Aortic Valve Replacement Complicated by New-Onset Persistent Left Bundle Branch Block.","authors":"Carmen Hodel, Federico Moccetti, Stephanie Brunner, Valentin Sandoz, Lucca Loretz, Mathias Wolfrum, Stefan Toggweiler","doi":"10.1002/ccd.31491","DOIUrl":"https://doi.org/10.1002/ccd.31491","url":null,"abstract":"<p><strong>Background: </strong>Long-term data on the relevance of new-onset persistent left bundle branch block (pLBBB) after transcatheter aortic valve replacement (TAVR) are sparse. This study aimed to assess the impact of pLBBB that occurs after TAVR on mortality, hospitalisation for heart failure, new permanent pacemaker (PPM) implantation, and left ventricular ejection fraction (LV-EF).</p><p><strong>Aims: </strong>To investigate the impact of pLBBB on long-term outcomes after TAVR.</p><p><strong>Methods: </strong>After exclusion of patients with baseline conduction disorders, a pre-existing PPM, valve-in-valve treatment, or in-hospital mortality, a total of 551 patients were analysed. Patients were divided into two groups (pLBBB and no/transient LBBB) and followed over 5 years.</p><p><strong>Results: </strong>A pLBBB occurred in 85 patients (15%). Patients with pLBBB had a significantly deeper valve implantation (4.0 ± 1.8 mm vs. 3.3 ± 1.8 mm, p < 0.01). pLBBB was associated with an increased risk for hospitalisation for heart failure (HR_adjusted 1.34, 95% CI 1.01-1.76, p = 0.04), whereas all-cause mortality was not elevated. The presence of pLBBB was linked to a significant decline in LV-EF over the follow-up period (58% ± 11% to 55% ± 12%, p = 0.03). There was a trend toward more new PPM implantation but no significant difference (HR_adjusted 1.45, 95% CI 0.96-2.18, p = 0.07). A transient LBBB did not affect the studied outcomes.</p><p><strong>Conclusions: </strong>During long-term follow-up, patients with a pLBBB were more often hospitalised for heart failure, and experienced a significant reduction in LV-EF in comparison to patients with no or only transient LBBB.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623626","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":"Trends and Outcomes Following Percutaneous Coronary Intervention in Patients With Myeloproliferative Neoplasms: Insights From National Database.","authors":"Song Peng Ang, Jia Ee Chia, Chayakrit Krittanawong, Robert N Piana, Kwan Lee, Chadi Ayoub, Jr Exequiel Pineda, David Song, Debabrata Mukherjee","doi":"10.1002/ccd.31489","DOIUrl":"https://doi.org/10.1002/ccd.31489","url":null,"abstract":"<p><strong>Background: </strong>Myeloproliferative neoplasms (MPN) are associated with an increased cardiovascular risk including acute coronary syndrome. However, there is a lack of comprehensive data regarding the rate of percutaneous coronary intervention (PCI), as well as the in-hospital characteristics and outcomes for MPN patients.</p><p><strong>Aims: </strong>We aimed to evaluate the temporal trends and outcomes of PCI among patients with MPN.</p><p><strong>Methods and results: </strong>The National Inpatient Sample database from 2016 to 2020 was queried to identify all PCI hospitalizations. Temporal trends and outcomes of patients with and without MPN following PCI were analyzed. Propensity score matching (PSM) was implemented to compare outcomes between MPN and non-MPN groups. 2,237,210 PCI hospitalizations with 7560 (0.27%) patients with MPN were included in this study. Throughout the study period, the prevalence of MPN among PCI admissions remained stable (p-value for trend = 0.12). Within the MPN subgroup, essential thrombocythemia (ET) was the predominant condition (53.2). Patients with MPN had higher prevalence of cardiovascular comorbidities than non-MPN patients. Following PSM, MPNs were significantly associated with a higher risk of blood transfusions (OR: 1.66, 95% CI: 1.22-2.24, p = 0.001) and AKI (OR: 1.39, 95% CI: 1.17-1.65, p < 0.001). In contrast, the risk of in-hospital mortality (OR: 1.18, 95% CI: 0.83-1.69, p = 0.354 and bleeding (OR: 1.43, 95% CI: 0.90-2.27, p = 0.127) did not significantly differ between the two groups.</p><p><strong>Conclusions: </strong>Our study demonstrated that while the prevalence of MPN among patients undergoing PCI remained stable, those with MPN faced higher risks of bleeding, blood transfusion and acute kidney injury. Further research is warranted to explore the underlying reasons for these increased risks and to improve outcomes in this high-risk group.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623719","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":"A Young Male With SCAD: Challenging Conventional Risk Factors and Insights.","authors":"Namra Khan, Marcus St John","doi":"10.1002/ccd.31499","DOIUrl":"https://doi.org/10.1002/ccd.31499","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a relatively rare and underdiagnosed condition that can lead to acute coronary syndrome (ACS), with a notable incidence in young female patients without traditional cardiovascular risk factors. We present an unusual case of SCAD in a young male patient in the absence of common predisposing factors such as fibromuscular dysplasia (FMD), connective tissue disorders, and systemic inflammatory conditions. A 29-year-old man presenting with chest pain was diagnosed with SCAD involving the left anterior descending artery (LAD), resulting in an acute myocardial infarction (MI). Coronary angiography revealed a 100% occlusion, and successful angioplasty and stenting were performed. The patient was started on dual antiplatelet therapy along with other therapeutic approaches. Seven months post-intervention, his ejection fraction improved, and statin therapy was discontinued due to the absence of atherosclerotic disease. SCAD should be suspected in younger patients with ACS-like symptoms in the absence of traditional risk factors. Tailored medical therapy, psychological support, and comprehensive evaluation for underlying causes, such as extracoronary vascular abnormalities (EVAs), are critical to recovery and prevention of recurrence. A multidisciplinary approach, balancing conservative, and interventional strategies is essential for optimizing outcomes in SCAD.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613478","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 Post Percutaneous Coronary Intervention Fractional Flow Reserve on 5-Year Clinical Outcomes (The FFR SEARCH Study).","authors":"Frederik T W Groenland, Annemieke C Ziedses des Plantes, Tara Neleman, Alessandra Scoccia, Jari A van der Eijk, Kaneshka Masdjedi, Laurens J C van Zandvoort, Wijnand K den Dekker, Jeroen M Wilschut, Isabella Kardys, Paul Cummins, Roberto Diletti, Nicolas M Van Mieghem, Joost Daemen","doi":"10.1002/ccd.31493","DOIUrl":"https://doi.org/10.1002/ccd.31493","url":null,"abstract":"<p><strong>Background: </strong>Fractional flow reserve (FFR) following percutaneous coronary intervention (PCI) can be used to evaluate procedural success and to guide stent optimization. Several studies have demonstrated that lower FFR after stent implantation is associated with increased adverse event rates up to 2 years. However, the impact of post-PCI FFR on very long-term clinical outcome remains unknown.</p><p><strong>Methods: </strong>The FFR SEARCH study is a single-center, prospective, observational study including consecutive patients undergoing PCI with stent implantation from 2016 to 2017. FFR measurement was performed after angiographically successful PCI using a dedicated microcatheter. The primary endpoint was target vessel failure (TVF) at 5 years, a composite of cardiovascular death, target vessel myocardial infarction and target vessel revascularization. The optimal post-PCI FFR cutoff value to predict 5-year TVF was determined based on the maximum log-rank statistic.</p><p><strong>Results: </strong>Post-PCI FFR measurements were successfully performed in 959 patients. Mean age was 64.0 ± 11.9 years, 72.5% of the patients were male and 33.6% presented with ST-segment elevation myocardial infarction. The left anterior descending artery was the target vessel in 53.5%. The optimal post-PCI FFR cutoff value was ≤ 0.90. TVF occurred in 18.4% of patients with a post-PCI FFR ≤ 0.90 versus 11.6% in patients with a post-PCI FFR > 0.90 (adjusted HR 1.65 (95% CI 1.11-2.48, p = 0.014)).</p><p><strong>Conclusions: </strong>This large prospective observational study demonstrates that post-PCI FFR ≤ 0.90 is associated with a higher TVF rate at 5 years.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613480","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":"Cerebral Protection Devices in Case of Left Sided Intracardiac Thrombus: A Multicentre Experience From the Cath Lab and EP Lab.","authors":"Patrizio Mazzone, Alberto Preda, Giacomo Giovanni Boccuzzi, Andrea Montabone, Andrea Dell'Aquila, Nicolai Fierro, Alessandra Marzi, Andrea Radinovic, Arianna Giannitto, Fabrizio Ugo, Paolo Della Bella, Jan Berg","doi":"10.1002/ccd.31487","DOIUrl":"https://doi.org/10.1002/ccd.31487","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Performing a left atrial appendage occlusion (LAAO) or catheter ablation with left-sided intracardiac thrombus is considered very-high risk for periinterventional stroke. Cerebral embolic protection (CEP) devices are designed to prevent cardioembolic stroke and have been widely studied in TAVR procedures. However, their role in LAAO and catheter ablation of ventricular tachycardia (VT) or in pulmonary vein isolation (PVI) with cardiac thrombus present remains unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;to study utility and safety of CEP devices during LAAO and catheter ablation in patients with left sided intracardiac thrombus in a multicenter setting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two different CEP devices were used according to the physician's discretion: (1) a capture device consisting of two filters for the brachiocephalic and left common carotid arteries placed from a radial artery; or (2) a deflection device covering all three supra-aortic vessels placed over a femoral artery. Periprocedural and safety data from 2019 to 2023 were retrospectively obtained from procedural reports and discharge letters for all patients with left-sided intracardiac thrombus undergoing LAAO, VT ablation, or PVI under protection with a CEP device. Long-term safety data were obtained by clinical follow-up in the respective institutions and telephone consultations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sixty-five patients were enrolled in five centers in Italy. Fifty-two patients underwent LAA closure, 12 patients underwent VT ablation and one patient underwent PVI. Mean age was 73 ± 10 years and 43 (66%) were male, mean LVEF was 46 ± 13%. The location of the cardiac thrombus was the LAA in all 52 patients (100%) undergoing LAA closure whereas in patients undergoing VT ablation, thrombus was present in the LAA in five cases (42%), left ventricle (n = 6; 50%) and aortic arch (n = 1;8%). One patient developed left atrial thrombus during PVI. The capture device was used in 39 out of 65 (60%) and the deflection device in 26 out of 65 cases (40%). There were no periprocedural strokes or transitory ischemic attacks (TIA). CEP-related complications at the arterial access site were noted in 4 cases (6%) and were minor, not requiring surgery. Other periprocedural events were one transient ST-elevation caused by coronary spasm in a patient undergoing LAA closure, not related to the CEP device. There was one in-hospital death after VT ablation due to cardiogenic shock, not related to the CEP device. At long-term follow-up, one TIA and three non-cardiovascular deaths occurred with a mean follow-up time of 455 days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This is the first multicentre experience showing that LAA closure or catheter ablation with cerebral protection in patients with cardiac thrombus is feasible without thromboembolic complications. The possibility of safely performing an intervention in this high-risk setting is promising and should be teste","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603070","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":"Prospective Analysis of the Feasibility of the PASCAL System for Transcatheter Mitral Valve Repair (OneForAll-Registry).","authors":"Katharina Hellhammer, Florian Schindhelm, Matthias Riebisch, Rolf Alexander Janosi, Alexander Y Lind, Matthias Totzeck, Peter Luedike, Tienush Rassaf, Amir Abbas Mahabadi","doi":"10.1002/ccd.31468","DOIUrl":"https://doi.org/10.1002/ccd.31468","url":null,"abstract":"<p><strong>Background: </strong>Mitral valve transcatheter edge-to-edge repair (M-TEER) is increasingly applied in patients with high surgical risk. We aimed to evaluate whether the PASCAL system can be applied in an all-comers cohort irrespective of the underlying anatomy and whether technical features influence therapeutic success.</p><p><strong>Methods: </strong>In this prospective, observational study we enrolled consecutive patients (n = 80) with mitral regurgitation (MR) 3+ and 4+ scheduled for M-TEER. All patients were allocated to be treated with the PASCAL system irrespective of the underlying anatomy. Complexity of mitral valve anatomy was assessed according to the proposed complexity scale and the ESC/EACTS complexity scale. All patients underwent intraprocedural analysis of application of technical features of the PASCAL technology and 1-year follow-up.</p><p><strong>Results: </strong>M-TEER was successful in 98.8% of the patients. Reduction of MR 3+/4+ to MR≤ 2+ was achieved in 92.5%. Independent leaflet grasping was applied in 60.0% of procedures. The median number of grasping attempts was 4.0 ± 3.1 for the first device. Classification in degenerative, functional, or mixed MR did not correlate with procedure time and grasping attempts. In contrast, the presence of complexity criteria was linked with a longer procedure time (p = 0.002) and required more grasping attempts (p = 0.010).</p><p><strong>Conclusions: </strong>M-TEER with the PASCAL technology was possible in 98.8% of consecutive, all-comers patients irrespective of the underlying anatomy. Technical features were applied frequently with increasing application in complex anatomical cases. Classifications taking the anatomical complexity into account rather than the pathophysiological entity of MR seem superior to predict the technical challenges of a M-TEER procedure.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603506","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":"30-Day DAPT in Patients at High Bleeding Risk Undergoing PCI With Biodegradable-Polymer Sirolimus-Eluting Ultra-Thin Stent.","authors":"Andrea Erriquez, David M Leistner, Valeria Paradies, Rita Pavasini, Matteo Serenelli, Gianni Casella, Simone Biscaglia, Christoph Naber, Gianluca Campo, Pieter C Smits","doi":"10.1002/ccd.31481","DOIUrl":"https://doi.org/10.1002/ccd.31481","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence on the safety and efficacy of biodegradable-polymer sirolimus-eluting ultra-thin stent (BP-SES) in patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>This study aims to evaluate the clinical outcomes of HBR patients treated with BP-SES and ≤ 30-day dual antiplatelet therapy (DAPT) regimen.</p><p><strong>Methods: </strong>A systematic review was conducted to identify relevant studies involving HBR patients who underwent PCI with BP-SES (Supraflex Cruz). Individual patient-level data were extracted from the included studies. The primary endpoint was the composite of cardiovascular death, myocardial infarction, or clinically driven target lesion revascularization at 1-year. The safety endpoint was the 1-year occurrence of Bleeding Academic Research Consortium (BARC) type 3-5.</p><p><strong>Results: </strong>The study population included 1691 patients. Of these, 928 patients (55%) received a ≤ 30-day DAPT, while 763 patients (45%) received a longer DAPT regimen. In the ≤ 30-day DAPT group, primary outcome events occurred in 89 patients (9.5%, 95% CI: 7.7%-11.6%). The upper limit of the one-sided 95% CI of 11.6% was below the pre-specified non-inferiority margin of 14%. There was no significant difference in the primary endpoint between the ≤ 30-day DAPT group and the >30-day DAPT group (propensity score adjusted HR: 0.95, 95% CI: 0.67-3). Notably, the incidence of BARC 3-5 bleeding events was significantly lower in the ≤ 30-day DAPT group.</p><p><strong>Conclusions: </strong>In HBR patients treated with BP-SES, a ≤ 30-day DAPT regimen is associated with a low rate of ischemic events and a significant reduction in major bleeding events.</p><p><strong>Trial registration: </strong>PROSPERO CRD42024524208.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596181","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}