Catheterization and Cardiovascular Interventions最新文献

{"title":"Contemporary and Emerging Therapies in the Management of Refractory Angina: A Clinical Review","authors":"Alex Angers-Goulet,&nbsp;Siddhartha Mengi,&nbsp;David Garcia Labbé,&nbsp;Can Manh Nguyen,&nbsp;Jean-Michel Paradis","doi":"10.1002/ccd.70414","DOIUrl":"10.1002/ccd.70414","url":null,"abstract":"<p>Refractory angina (RA) represents a growing challenge in clinical cardiology, particularly in patients with obstructive coronary artery disease (CAD) who remain symptomatic despite optimal medical therapy and who are not candidates for revascularization. Advances in both device-based and biologic therapies have introduced promising adjunctive strategies. This review critically appraises current and investigational treatment modalities for RA in order to give clinicians an informed up to date picture and to guide them with this difficult to treat population (Figure 1). Emphasis is placed on evaluating the safety profiles, therapeutic efficacy, and the strength of clinical evidence supporting each modality. This review aims to assist clinicians in individualized decision-making for RA management.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"869-884"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746399","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 Preprocedural Anemia on Outcomes in Patients With Tricuspid Regurgitation Undergoing Transcatheter Edge-to-Edge Repair: Insights From the TRISPA Registry","authors":"Julio Echarte-Morales,&nbsp;Andrea Ruberti,&nbsp;Laura Sanchis,&nbsp;Dabit Arzamendi,&nbsp;Vanessa Moñivas,&nbsp;Fernando Chinchilla Carrasco-Chinchilla,&nbsp;Manuel Pan,&nbsp;Luis Nombela-Franco,&nbsp;Isaac Pascual,&nbsp;Tomás Benito-González,&nbsp;Ruth Pérez,&nbsp;Iván Gómez-Blázquez,&nbsp;Ignacio J. Amat-Santos,&nbsp;Ignacio Cruz-González,&nbsp;Ángel Sánchez-Recalde,&nbsp;Ana Belén Cid Álvarez,&nbsp;Manuel Barreiro-Pérez,&nbsp;Eduardo Flores Umanzor,&nbsp;Chi Hion Li,&nbsp;Maria del Trigo,&nbsp;José David Martínez-Carmona,&nbsp;Dolores Mesa,&nbsp;Pilar Jiménez,&nbsp;Pedro Cepas-Guillén,&nbsp;Pablo Avanzas,&nbsp;Felipe Fernandez-Vázquez,&nbsp;Xavier Freixa,&nbsp;Rodrigo Estévez-Loureiro","doi":"10.1002/ccd.70408","DOIUrl":"10.1002/ccd.70408","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tricuspid transcatheter edge-to-edge repair (T-TEER) is an established treatment for tricuspid regurgitation (TR) in patients at high surgical risk. Although anemia is a well-established predictor of poor outcomes in other transcatheter valvular interventions, its role in the tricuspid field remains poorly characterized.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To evaluate the clinical impact of anemia in a cohort of patients undergoing T-TEER.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 487 patients undergoing T-TEER at 15 centers between 2020 and 2025 were included. Anemia was defined as a hemoglobin level &lt; 13 g/dL in men and &lt; 12 g/dL in women. The primary outcome was the composite of all-cause mortality and heart failure hospitalization (HFH) at 2-year follow-up, with each component also evaluated separately as secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Anemia was present in 174 patients (35.7%). Compared to those without anemia, patients with baseline anemia had a higher burden of baseline comorbidities, as well as more frequent right ventricular remodeling and tricuspid annular dilatation. Rates of in-hospital clinical complications were similar between groups (<i>p</i> = 0.696), but patients with anemia had higher rates of residual TR ≥ 3+ (<i>p</i> = 0.038). The composite endpoint at 2 years (49% vs. 12%, <i>p</i> &lt; 0.001), as well as all-cause mortality (26% vs. 9%) and HFH (31% vs. 13%), were significantly higher in anemic patients. In the multivariate analysis, anemia was an independent predictor of all-cause mortality at follow-up (hazard ratio 3.03 [1.30–7.96]; <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Baseline anemia is common among patients undergoing T-TEER and is associated with increased mortality and higher TR residual degree.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"916-924"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764947","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":"Rapid Entry and Advanced Coronary Handling (REACH) Technique: A Novel Use of the Guide Extension Catheter","authors":"Peter Kayaert,&nbsp;Claudiu Ungureanu,&nbsp;Yoann Bataille,&nbsp;Bert Vandeloo,&nbsp;Pascal Vranckx","doi":"10.1002/ccd.70433","DOIUrl":"10.1002/ccd.70433","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In complex percutaneous coronary interventions, the use of multiple coronary guidewires is often required. Delivering a second guidewire can be challenging and carries inherent risks, particularly in cases involving complex anatomy or bifurcation lesions where side branch recrossing is necessary after main branch stenting. Dual-lumen catheters may be used in such scenarios; however, device removal after wire delivery typically requires a guidewire extension or, preferably, a trapping balloon, techniques that are less commonly employed by many interventionalists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The Rapid Entry and Advanced Coronary Handling (REACH) technique is proposed as an alternative approach for complex wire delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>It involves advancing a second guidewire through the cylinder of a guide extension catheter under fluoroscopic guidance, directly into the coronary segment engaged by the extension. The technique is described in detail, supported by step-by-step illustrations, a bench test, and recorded cases that demonstrate its various applications. A comprehensive overview of its advantages and limitations is provided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In selected cases, the REACH technique may represent a reproducible and potentially cost-efficient alternative to the dual-lumen catheter for complex wire delivery. While limitations exist, its simplicity and practicality make it a valuable addition to the interventional toolkit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"909-915"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764969","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 Implantation of Balloon-Expandable Valve in a Repaired Native Tricuspid Valve Without Annuloplasty Ring","authors":"Michael Yang,&nbsp;Marissa A. Munsayac,&nbsp;Steven C. Romero,&nbsp;Curtiss T. Stinis","doi":"10.1002/ccd.70342","DOIUrl":"10.1002/ccd.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Late complications of repaired congenital heart disease are increasingly common, including tricuspid stenosis and regurgitation. We present a case of a 36-year-old female with tetralogy of Fallot, 1.5 ventricle repair, and prior tricuspid repair using homograft tissue without an annuloplasty ring, who developed worsening congestive heart failure. Transesophageal echocardiogram revealed severe tricuspid stenosis and regurgitation. We performed transcatheter tricuspid valve replacement with a SAPIEN S3 Ultra RESILIA valve within a CP-covered stent. To our knowledge, this is the first implantation of the SAPIEN S3 Ultra RESILIA valve in the tricuspid position without an annuloplasty ring, and the first implantation of a balloon-expandable valve in a native tricuspid valve without extracorporeal membrane oxygenation support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"944-948"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764988","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 Prospective, Multicenter, Open Label Study Investigating the Implementation of a Standardized Algorithm for Coronary CaLcificatiOn With PlaquE Modification Using UltraSound Guidance to Improve Procedural and Clinical Outcomes (CYCLOPES): Design and Rationale of the CYCLOPES Trial","authors":"Daniel O'Callaghan,&nbsp;Rory Durand,&nbsp;Colm G. Hanratty,&nbsp;Thomas Cuisset,&nbsp;Beatriz Vaquerizo,&nbsp;Jan-Malte Sinning,&nbsp;Peter O'Kane,&nbsp;J. J. Coughlan,&nbsp;Simon Walsh,&nbsp;Róisín Colleran,&nbsp;Himanshu Rai,&nbsp;Osama Soliman,&nbsp;Emanuele Barbato,&nbsp;Barbara E. Stähli,&nbsp;Robert A. Byrne","doi":"10.1002/ccd.70424","DOIUrl":"10.1002/ccd.70424","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Moderate-to-severe calcification is present in ~20%–30% of patients undergoing coronary angiography. Coronary lesion modification is often necessary to facilitate optimal stent delivery and expansion, with several dedicated devices now approved for calcium modification before stent implantation. The CYCLOPES study aims to evaluate an intravascular ultrasound (IVUS) based calcium modification algorithm for the treatment of moderate-to-severely calcified coronary lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Analysis</h3>\u0000 \u0000 <p>CYCLOPES is a prospective, international, multi-center, observational, single-arm study. 500 patients will be enrolled at 25 centers in Europe. Patients with planned percutaneous coronary intervention (PCI) to a native coronary artery lesion with moderate-to-severe calcification will be eligible. All PCI procedures will be IVUS guided, with drug-eluting stents implanted according to the study-specific algorithm.</p>\u0000 \u0000 <p>The co-primary endpoints are the minimum stent area (MSA) at the site of maximum calcification at the end of the index procedure (as determined by core lab analysis), and target lesion failure (TLF) at 1-year post-procedure. Prespecified secondary endpoints include: the individual components of TLF at 1 month and 1 year; the MSA measured at the end of the index procedure; strategy success (defined as successful stent delivery with ≥ 80% stent expansion and complete stent apposition with no significant edge dissection and full lesion coverage with &lt; 50% plaque burden at proximal and distal references with TIMI 3 flow); as well as target vessel revascularization; target lesion revascularization; stent thrombosis; cardiovascular death; and acute kidney injury at 1 year. Coronary angiograms and IVUS images will be analyzed by an independent core Lab. Clinical follow-up will be performed at discharge, 30-days, and 1 year post PCI.</p>\u0000 \u0000 <p>Trial Registration: ClinicalTrials.gov identifier: NCT06678594.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"1018-1026"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777174","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 Sex on Residual Angina After Percutaneous Coronary Interventions","authors":"Masahiro Hada,&nbsp;Takuya Mizukami,&nbsp;Kazumasa Ikeda,&nbsp;Daniel Munhoz,&nbsp;Sofie Brouwers,&nbsp;Jeroen Sonck,&nbsp;Hitoshi Matsuo,&nbsp;Toshiro Shinke,&nbsp;Hirohiko Ando,&nbsp;Brian Ko,&nbsp;Simone Biscaglia,&nbsp;Fernando Rivero,&nbsp;Thomas Engstrøm,&nbsp;Ketina Arslani,&nbsp;Antonio Maria Leone,&nbsp;Domenico Galante,&nbsp;Lokien X. van Nunen,&nbsp;William F. Fearon,&nbsp;Evald Høj Christiansen,&nbsp;Stephane Fournier,&nbsp;Liyew Desta,&nbsp;Andy Yong,&nbsp;Julien Adjedj,&nbsp;Javier Escaned,&nbsp;Masafumi Nakayama,&nbsp;Ashkan Eftekhari,&nbsp;Frederik M. Zimmermann,&nbsp;Koshiro Sakai,&nbsp;Tatyana Storozhenko,&nbsp;Bruno R. da Costa,&nbsp;Gianluca Campo,&nbsp;Colin Berry,&nbsp;Damien Collison,&nbsp;Thomas Johnson,&nbsp;Tetsuya Amano,&nbsp;Divaka Perera,&nbsp;Allen Jeremias,&nbsp;Ziad Ali,&nbsp;Bernard De Bruyne,&nbsp;Paola Barbato,&nbsp;Sara Corradetti,&nbsp;Nikolaos Stalikas,&nbsp;Anthony Kechichian,&nbsp;Frederic Bouisset,&nbsp;Tsunekazu Kakuta,&nbsp;Nils P. Johnson,&nbsp;Carlos Collet","doi":"10.1002/ccd.70419","DOIUrl":"10.1002/ccd.70419","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sex-related differences in the clinical presentation of coronary artery disease (CAD) are well recognized. The pullback pressure gradient (PPG) characterizes pathophysiological CAD patterns as focal or diffuse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate the influence of sex on residual angina at one year after percutaneous coronary intervention (PCI), stratified by PPG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a sub-analysis of PPG Global, a multicenter, prospective, single-arm study. All patients had hemodynamically significant CAD (fractional flow reserve [FFR] ≤ 0.80) and underwent a manual FFR pullbacks to calculate PPG before PCI. Patient-reported outcomes were collected using the 7-item Seattle Angina Questionnaire (SAQ-7) at baseline and 1-year follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We included 814 patients (205 [25.2%] women and 609 [74.8%] men). Women were significantly older than men (70 ± 10 years vs. 67 ± 10 years <i>p</i> &lt; 0.001). Baseline FFR were comparable between sexes (0.68 ± 0.13 vs. 0.66 ± 0.12, <i>p</i> = 0.098), but women had a more focal CAD compared to men (PPG 0.66 ± 0.15 vs. 0.63 ± 0.15, <i>p</i> = 0.047). Post PCI-FFR was higher in women than men (0.88 ± 0.07 vs. 0.87 ± 0.07, <i>p</i> = 0.041); however, angina at 1 year was more frequent in women (SAQ angina frequency score 94 ± 12 vs. 96 ± 10, <i>p</i> = 0.041).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite having a more focal CAD pattern and achieving higher post-PCI FFR, women report more residual angina than men at 1-year follow-up.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov NCT04789317.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"987-996"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777193","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":"Temporal Trends in Coronary Physiology Testing and Intravascular Imaging Adoption in Poland (2014–2025)","authors":"Michal Hawranek,&nbsp;Artur Dziewierz,&nbsp;Marta Kałużna-Oleksy,&nbsp;Mariusz Tomaniak,&nbsp;Mamas A. Mamas,&nbsp;Valeria Paradies,&nbsp;Zenon Huczek,&nbsp;Krzysztof Malinowski,&nbsp;Zbigniew Siudak","doi":"10.1002/ccd.70439","DOIUrl":"10.1002/ccd.70439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intravascular ultrasound (IVUS), optical coherence tomography (OCT), and fractional flow reserve (FFR) improve percutaneous coronary intervention (PCI) outcomes. However, their adoption varies globally due to clinical, economic, and healthcare policy factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To analyze temporal trends in coronary physiology testing and intravascular imaging utilization in Poland from 2014 to 2025, and to evaluate the impact of national reimbursement policies and European Society of Cardiology guideline evolution on adoption patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis using data from the Polish National Registry of PCI (ORPKI), a mandatory prospective registry capturing &gt; 85% of national PCI procedures. All patients undergoing coronary angiography or PCI between January 2014 and June 2025 were included. Temporal trends were assessed using Cochran-Armitage test for trend.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2,244,689 coronary procedures, utilization of adjunctive diagnostic modalities increased significantly: FFR during coronary angiography from 1.6% to 9.2%, IVUS during PCI from 0.7% to 15.0%, and OCT during PCI from 0.2% to 1.7% (all <i>p</i> for trend &lt; 0.001). Adoption was higher in male patients, elective procedures, and complex lesions (left main coronary artery and proximal left anterior descending artery), with IVUS utilization reaching 47% in rotational atherectomy procedures by 2025. Substantial inter-center heterogeneity was observed, with high-adopting centers achieving &gt; 30% IVUS and &gt; 5% OCT utilization rates. Gini coefficient analysis revealed moderate inequality for FFR (0.32) and IVUS (0.35), but marked concentration for OCT (0.73), indicating limited diffusion across centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Coronary physiology testing and intravascular imaging utilization in Poland increased substantially over the study period, coinciding with reimbursement policy implementation and guideline updates. Despite this progress, clinical adoption remains below international standards, with persistent sex-based disparities and pronounced inter-center variability representing key targets for quality improvement initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"969-976"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764979","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 Implantation via Percutaneous Axillary Access—A UK Registry","authors":"Noman Ali,&nbsp;Michael S. Cunnington,&nbsp;Douglas Muir,&nbsp;Seth Vijayan,&nbsp;Pyotr Telyuk,&nbsp;Adnan M. Nadir,&nbsp;Mark Zorman,&nbsp;Rajesh Kharbanda,&nbsp;Daniel J. Blackman,&nbsp;Christopher J. Malkin,&nbsp;Ciprian Dospinescu,&nbsp;Arul Baradi,&nbsp;David Hildick-Smith,&nbsp;Adam Hartley,&nbsp;Iqbal Malik,&nbsp;Stephen Dorman,&nbsp;Vasileios Panoulas,&nbsp;Konstantinou Konstantinos,&nbsp;Sagar Doshi,&nbsp;Paul D. Williams","doi":"10.1002/ccd.70435","DOIUrl":"10.1002/ccd.70435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alternative access for transcatheter aortic valve implantation (TAVI) is required for the small subset of patients in whom transfemoral (TF) access is not feasible. The most commonly used alternative access route in the United Kingdom is the subclavian/axillary artery, and historically, most have been performed via surgical cutdown. Transaxillary TAVI can be undertaken via a percutaneous route. However, there exists limited data on the safety and efficacy of this technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aims to describe the UK experience of percutaneous axillary (PAx) TAVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, multicenter study included every TAVI center in the United Kingdom which had performed &gt; 10 PAx TAVI cases as of November 1, 2023. Each center provided data on all PAx cases carried out up to December 31, 2023. Procedural and clinical endpoints as well as adverse events were assessed according to Valve Academic Research Consortium (VARC)-3 definitions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine UK TAVI centers contributed data from 210 PAx cases. VARC-3 technical success was achieved in 92.4%. The incidence of major VARC-3 vascular access site complications was 7.1%, major or life-threatening VARC-3 bleeding occurred in 5.3%, a covered stent was used in 25.2%, and vascular surgical intervention was required in 3.3%. The incidence of in-hospital stroke and mortality were 7.1% and 3.3%, respectively. No statistically significant differences were observed between PAx carried out under conscious sedation (non-GA) and GA with respect to clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PAx TAVI is viable and can be performed under conscious sedation with no detriment in terms of clinical outcomes. However, the elevated risk of stroke is a concern.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"997-1004"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145777167","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":"SYNTAX Score as a Predictor of Angiographic Complexity in Stable Angina and Acute Coronary Syndrome Patients","authors":"Sohaib Ashraf,&nbsp;Amjad Mujtaba,&nbsp;Rutaba Akmal,&nbsp;Muhammad Sarmad Shahab,&nbsp;Waseem Ahmad,&nbsp;Amir Shahbaz,&nbsp;Muhammad Ahmad Imran,&nbsp;Meer Hassan Khalid,&nbsp;Sidra Ashraf,&nbsp;Muhammad Kiwan Akram,&nbsp;Usama Bin Naeem,&nbsp;Larab Kalsoom,&nbsp;Usama Farooq,&nbsp;Zonera Javed,&nbsp;Muhammad Sikandar Saleem,&nbsp;Anum Pari,&nbsp;Iqra Farooq,&nbsp;Zaryab Tahir,&nbsp;Arbaz Tahir,&nbsp;Qurrat ul Ain Iqbal,&nbsp;Ali Arshad,&nbsp;Muhammad Athar Mujtaba,&nbsp;Ifrah Batool,&nbsp;Siraj Ul Muneer,&nbsp;Sundas Rafique,&nbsp;Musa Khalil,&nbsp;Fatima Awais,&nbsp;Qazi Abdul Saboor,&nbsp;Moneeb Ashraf,&nbsp;Shoaib Ashraf","doi":"10.1002/ccd.70420","DOIUrl":"10.1002/ccd.70420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coronary angiography is the gold standard for assessing coronary artery disease (CAD), while the SYNTAX score (SxS) quantifies lesion complexity. Its prognostic value across clinical settings remains uncertain. This study compared angiographic findings in stable angina and acute coronary syndrome (ACS) using the SxS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective study was conducted at Shaikh Zayed Hospital, Lahore, over 12 months, including 156 patients undergoing coronary angiography: stable angina (<i>n</i> = 78) and ACS (<i>n</i> = 78). Patients aged 18–80 years undergoing primary PCI or elective angiography were included, excluding prior PCI or CABG. Demographic and clinical data were collected, and SxS was applied post-angiography. Data were analyzed using SPSS v.25, with <i>p</i> ≤ 0.05 considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 156 patients were enrolled (71.2% male; mean age 59.2 ± 10.6 years, BMI 27.2 ± 3.5 kg/m²), equally divided into stable angina (<i>n</i> = 78) and ACS (<i>n</i> = 78). The overall mean SxS was 26.1 ± 11.3. Comparison between groups showed no significant differences in age, BMI, sex distribution, smoking, hypertension, or diabetes (all <i>p</i> &gt; 0.05). However, dyslipidemia was more prevalent in ACS patients (<i>p</i> &lt; 0.05), and the mean SxS was significantly higher in ACS versus stable angina (28.2 ± 9.9 vs. 23.8 ± 12.4; <i>p</i> = 0.01), indicating greater angiographic complexity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The higher SxS in ACS patients indicated greater angiographic complexity, consistent with prior studies. Scores were also significantly elevated in patients with diabetes and hypertension, supporting the score's prognostic value in CAD stratification. However, the absence of clinical variables limits risk prediction. The single-center design, small sample size, lack of adjusted analyses, and absence of long-term outcomes further constrain generalizability, warranting validation in larger multicenter cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The SxS was significantly higher in ACS than stable angina, supporting its role in guiding management, particularly in patients with comorbidities. Larger multicenter studies are needed to validate its prognostic utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"949-954"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764954","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 of Transcatheter Versus Surgical Management of Coronary Artery Disease and Aortic Stenosis","authors":"Nikolaos Ktenopoulos,&nbsp;Anastasios Apostolos,&nbsp;Konstantinos Karampinos,&nbsp;Panayotis Vlachakis,&nbsp;Antonios Karanasos,&nbsp;Maria Drakopoulou,&nbsp;Andreas Synetos,&nbsp;George Latsios,&nbsp;Konstantinos Tsioufis,&nbsp;Konstantinos Toutouzas","doi":"10.1002/ccd.70416","DOIUrl":"10.1002/ccd.70416","url":null,"abstract":"&lt;p&gt;The coexistence of severe aortic stenosis (AS) and coronary artery disease (CAD) represents one of the most difficult challenges for the Heart Team. Surgical aortic valve replacement (SAVR) with concomitant coronary artery bypass grafting (CABG) has been the reference strategy. However, with the expanding indications for transcatheter aortic valve replacement (TAVR) and the increasing feasibility of percutaneous coronary intervention (PCI), the combined PCI–TAVR strategy has emerged as a less-invasive alternative option. Whether this approach presents comparable outcomes to CABG–SAVR remains uncertain.&lt;/p&gt;&lt;p&gt;This systematic review and meta-analysis were conducted in accordance with the updated PRISMA 2020 guidelines [&lt;span&gt;1&lt;/span&gt;]. The rationale and design of our project were prospectively registered in the PROSPERO database (CRD42025630603). A systematic search of the PubMed, Cochrane, and Scopus databases was conducted to identify relevant studies that reported distinct short-term outcomes for patients undergoing PCI-TAVR versus CABG-SAVR, published up to January 15, 2025. We performed a meta-analysis of nine studies (seven observational; two randomized), including 136,763 patients (PCI–TAVR: 101,529; CABG–SAVR: 35,234). The primary endpoints were 30-day all-cause mortality and stroke, and secondary endpoints included acute kidney injury (AKI), permanent pacemaker implantation (PPI), and major vascular complications.&lt;/p&gt;&lt;p&gt;Our meta-analysis showed that 30-day mortality was comparable between the two groups (RR: 0.83, 95% CI: 0.61–1.14). However, sensitivity analysis showed that exclusion of the large registry by Patlolla et al. shifted the results toward a survival benefit with PCI–TAVR (RR: 0.66, 95% CI: 0.54–0.81) [&lt;span&gt;2&lt;/span&gt;]. Stroke rates were numerically lower, but borderline statistically significant, and AKI rates were significantly lower in the PCI–TAVR group (RR: 0.85, 95% CI: 0.73–1.00, and RR: 0.56, 95% CI: 0.36–0.88, respectively). Notably, PCI–TAVR was associated with significantly higher rates of new PPI (RR: 2.05, 95% CI: 1.87–2.25). No significant difference was observed in major vascular complications between groups (Figure 1).&lt;/p&gt;&lt;p&gt;A previous meta-analysis by Talanas et al. [&lt;span&gt;3&lt;/span&gt;] also reported no significant difference in all-cause mortality between TAVR and SAVR (HR: 1.03, 95% CI: 0.95–1.11). However, its sample size was smaller (3985 vs. 3800 patients) and excluded observational studies, providing a less-powered (Central Illustration 1) analysis. Our analysis strengthens these observations by including both randomized and observational evidence across a broader population. Furthermore, the increased need for PPI after TAVR deserves emphasis. Conduction disturbances are strongly linked to the burden of aortic valve and annular calcification. Excessive calcification near the atrioventricular conduction system might compress or injure the His bundle or left bundle branch, increasing the risk of PPI. This me","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 4","pages":"885-887"},"PeriodicalIF":1.9,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12953215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746413","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}