Catheterization and Cardiovascular Interventions最新文献

{"title":"PCI for Ostial Stenosis of Left Circumflex or Left Anterior Descending Artery","authors":"Ezgi Gültekin Güner,&nbsp;Ahmet Güner,&nbsp;Veysel Ozan Tanık,&nbsp;Ebru Serin,&nbsp;Sezer Markirt,&nbsp;Mehmet Erdoğan,&nbsp;Muhammed Furkan Deniz,&nbsp;Ali Nazmi Çalık,&nbsp;Serkan Asil,&nbsp;Enes Arslan,&nbsp;Kurtuluş Karaüzüm,&nbsp;Semih Kalkan,&nbsp;Ahmet Anıl Başkurt,&nbsp;Faruk Kara,&nbsp;Ahmet Yaşar Çizgici,&nbsp;Saner Bahadır Gök,&nbsp;Özge Çebi,&nbsp;Aylin Şafak,&nbsp;Kaan Gökçe,&nbsp;Koray Çiloğlu,&nbsp;Abdullah Doğan,&nbsp;Onur Sönmez,&nbsp;Fatih Furkan Bedir,&nbsp;Ahmet Gürdal,&nbsp;Cemal Özanalp,&nbsp;Çağatay Tunca,&nbsp;Kürşat Akbuğa,&nbsp;Ali Öztürk,&nbsp;Mustafa Kırmızıgül,&nbsp;Didar Mirzamidinov,&nbsp;Cemalettin Akman,&nbsp;Furkan Durak,&nbsp;Elif Uslu,&nbsp;Serhat Agüloglu,&nbsp;Eyüp Karaer,&nbsp;Günsel Göksoylu,&nbsp;İbrahim Halil Uygun,&nbsp;Uygar Çağdaş Yüksel,&nbsp;İbrahim Faruk Aktürk,&nbsp;Kudret Keskin,&nbsp;İrfan Şahin,&nbsp;Hatice Tolunay,&nbsp;Fatih Uzun","doi":"10.1002/ccd.70670","DOIUrl":"10.1002/ccd.70670","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To date, the clinical outcome of ostial stent implantation (OSI) in patients with ostial left circumflex artery (LCX) or left anterior descending artery (LAD) lesions has not been well established. This study sought to assess the cardiovascular outcomes of the ostial stent implantation (OSI) for the ostial LAD or LCX lesions under long-term follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This large-scale, multicenter (<i>n</i> = 13) observational, retrospective study included 839 patients (men: 619 [73.8%], mean age: 61.36 ± 11.93 years) who underwent PCI with OSI for ostial LAD or LCX lesions between 2014 and 2025. The primary outcome was major adverse cardiac events (MACE), including cardiac death, target lesion revascularisation, and target vessel myocardial infarction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study cohort was divided into two groups: ostial LAD (<i>n</i> = 590) and ostial LCX (<i>n</i> = 249) revascularized with OSI. SYNTAX scores and the utilization of intravascular imaging rates were similar in both groups. Total stent length (22.79 ± 7.37 vs. 24.60 ± 7.57 mm, <i>p</i> = 0.001) was notably lower in the LCX group; however, the rate of bailout 2-stent technique (6.4 vs. 2.7%, <i>p</i> = 0.010) was significantly higher in the LCX group than in the LAD group. The risk-adjusted long-term MACE (HR: 1.591, <i>p</i> = 0.010) significantly differed in individuals with left-sided ostial lesions to revascularize with OSI. Additionally, diabetes mellitus, chronic kidney disease, intravascular imaging, reduced left ventricle ejection fraction, high SYNTAX score, statin usage, and total stent length were found to be independent predictors of MACE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This multicenter study demonstrates that the location of ostial stenosis in LCX was associated with a higher risk-adjusted MACE rate at long-term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"426-436"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148039005","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":"Renal Denervation in Cardiovascular Diseases: Mechanisms, Evidence, and Expanding Applications","authors":"Ameer Awashra,&nbsp;Haroun Neiroukh,&nbsp;Lubna Alnatour,&nbsp;Nada S. Jibril,&nbsp;Mohammed AbuBaha,&nbsp;Ahmed Emara,&nbsp;Waseem Shehadeh,&nbsp;Anwar Zahran,&nbsp;Mohamed S. Elgendy,&nbsp;Abdalhakim Shubietah,&nbsp;Ali Saad Al-Shammari,&nbsp;Yasar Sattar","doi":"10.1002/ccd.70656","DOIUrl":"10.1002/ccd.70656","url":null,"abstract":"<div>\u0000 \u0000 <p>Renal denervation (RDN) is a minimally invasive technique that disrupts renal sympathetic nerve activity, reducing sympathetic overdrive implicated in hypertension and other cardiovascular disorders. After early enthusiasm waned following SYMPLICITY HTN-3, subsequent rigorously designed trials re-established its efficacy. This review summarizes mechanistic insights, clinical evidence, and emerging applications of RDN. Data from randomized trials, meta-analyses, registries, and translational studies were evaluated to assess their safety, efficacy, and broader therapeutic potential. Recent trials (SPYRAL HTN-OFF MED, RADIANCE HTN-TRIO, RADIANCE II) show consistent and durable systolic blood pressure reductions of approximately 5–10 mmHg with excellent safety. Beyond resistant hypertension, preliminary studies suggest benefits in heart failure (HFrEF and HFpEF), atrial fibrillation when combined with pulmonary vein isolation, chronic kidney disease, and metabolic syndrome. Mechanistic data reveal improved autonomic balance, regression of left ventricular hypertrophy, and possible renal protection. Limitations include procedural variability, incomplete nerve ablation, and the lack of large outcome-based cardiovascular trials. Nevertheless, cost-effectiveness analyses and recent ESC (2024) and AHA/ACC (2025) guidelines endorse RDN as a reasonable adjunct for resistant or uncontrolled hypertension. RDN offers sustained blood pressure control with a strong safety profile. Its expanding role across cardiovascular conditions positions it as a promising adjunctive therapy. Future outcome-driven studies and standardized procedural approaches are needed to refine its place in clinical practice.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"357-375"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966921","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":"Intravascular Ultrasound in Chronic Limb-Threatening Ischemia Endovascular Revascularization: A Multidisciplinary Survey of Clinical Practices and Operator Perceptions","authors":"Marc-André d'Entremont,&nbsp;Eric A. Secemsky,&nbsp;Graham R. McClure,&nbsp;Krzysztof Kowalik,&nbsp;Laura M. Drudi,&nbsp;Samuel Lemaire-Paquette,&nbsp;Andrew D. Brown,&nbsp;Elisa Greco,&nbsp;Andrew Benko,&nbsp;Anirudh Mirakhur,&nbsp;Elie Girsowicz,&nbsp;Jane Newman,&nbsp;Jonathan Misskey,&nbsp;Simon Bérubé,&nbsp;John Harlock,&nbsp;Sanjit S. Jolly","doi":"10.1002/ccd.70665","DOIUrl":"10.1002/ccd.70665","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intravascular ultrasound (IVUS) may be beneficial for guiding endovascular revascularization in patients with chronic limb-threatening ischemia (CLTI); however, its use remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We surveyed interventional radiologists, vascular surgeons, and interventional cardiologists in the United States, Canada, and the United Kingdom using a 13-question, anonymous online questionnaire to evaluate clinical equipoise, willingness to randomize, and opinions and perceptions regarding IVUS use in patients with CLTI undergoing endovascular revascularization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 105 operators (5.7% response rate) participated in the survey: 42 interventional radiologists, 40 vascular surgeons and 23 interventional cardiologists. Operators indicated the main obstacles to adopting or expanding IVUS for endovascular revascularization were cost or lack of reimbursement (69.5%), concerns about longer procedural time (47.6%), and the absence of randomized data supporting its benefit (39.0%). Overall, 80.0% of operators agreed that a large, multicenter, randomized trial was required, and 77.1% were willing to randomize patients in such a trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this multidisciplinary survey, the identified barriers for IVUS use in CLTI revascularization were cost/non-reimbursement, increased procedural time, and lack of randomized evidence. Given respondents' clinical equipoise and willingness to randomize, large randomized controlled trials are needed to inform clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"402-408"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020397","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":"Is Imaging of a Single Vessel Sufficient to Assess Pan-Coronary Vulnerability?","authors":"Riccardo Scalamera,&nbsp;Stefano Andreaggi,&nbsp;Sekeun Kim,&nbsp;Hang Lee,&nbsp;Iris McNulty,&nbsp;Stefano Benenati,&nbsp;Rocco Vergallo,&nbsp;Italo Porto,&nbsp;Ik-Kyung Jang","doi":"10.1002/ccd.70680","DOIUrl":"10.1002/ccd.70680","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coronary atherosclerosis is a pan-coronary process. However, some studies investigated only one coronary artery and extrapolated the findings to the pan-vascular process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We utilized a three-vessel optical coherence tomography (OCT) database to investigate whether plaque features in the left anterior descending coronary artery (LAD) mirror vulnerability in the remaining coronary vessels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 131 patients who underwent OCT imaging of the LAD, left circumflex (LCx), and right coronary artery (RCA). Vulnerable features, including thin-cap fibroatheroma (TCFA), lipid-rich plaque, macrophages, microvessels, and cholesterol crystals, were evaluated in each vessel. Vulnerable features in the LAD and non-LAD vessels were correlated at patient and plaque levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the patient level, vulnerable features in the LAD correlated with those in non-LAD vessels (TCFA <i>p</i> &lt; 0.001; lipid-rich plaque <i>p</i> &lt; 0.001; macrophages <i>p</i> = 0.010; microvessels <i>p</i> = 0.012; cholesterol crystals <i>p</i> = 0.045). However, an LAD-only strategy would have missed 30%–75% of patients with vulnerable features in non-LAD vessels; the adjusted miss rates were 58.7% for TCFA, 28.2% for lipid-rich plaque, 44.3% for macrophages, 36.9% for microvessels, and 75.7% for cholesterol crystals. At the plaque level, a similar number of high-risk plaques in non-LAD arteries would have been overlooked by the LAD-only approach, with the adjusted miss rates ranging from 74.3% for cholesterol crystals to 26.7% for lipid-rich plaque.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Vulnerable plaque features in the LAD were associated with their presence in the other coronary arteries. However, a single-vessel LAD assessment would have missed a substantial proportion of patients with vulnerable features in the LCx or RCA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"459-467"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045202","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":"Intravascular Imaging-Guided Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Unprotected Left Main Stenosis","authors":"Wojciech Wańha,&nbsp;Łukasz Kuźma,&nbsp;Michał Święczkowski,&nbsp;Emil Dąbrowski,&nbsp;Sylwia Iwańczyk,&nbsp;Maciej Lesiak,&nbsp;Mariusz Kowalewski,&nbsp;Sławomir Dobrzycki,&nbsp;Paweł Kralisz,&nbsp;Adam Kowalówka,&nbsp;Maged Makhoul,&nbsp;Kamal Morshed,&nbsp;Krystian Wita,&nbsp;Radosław Gocoł,&nbsp;Damian Hudziak,&nbsp;Wojciech Wojakowski,&nbsp;José M De la Torre Hernández,&nbsp;Bernardo Cortese","doi":"10.1002/ccd.70672","DOIUrl":"10.1002/ccd.70672","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Randomized clinical trials comparing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) stenosis have indicated lower repeat revascularization after CABG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This multi-center study aimed to investigate outcomes of intravascular imaging (IVI)-guided PCI compared with CABG for treating LMCA stenosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analysis included 855 patients (396 PCI) from 18 centers. The primary composite endpoint was major adverse cardiac and cerebrovascular events (MACCE: cardiovascular death, myocardial infarction, stroke, and target vessel revascularization at 2 years). Propensity score matching (PSM) analysis was used to limit differences among the groups. Cox regression event rates were calculated for matched groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the overall cohort, no difference in MACCE was observed (HR 0.97, 95% CI 0.72–1.32, <i>p</i> = 0.84). PSM resulted in 230 pairs, with no significant differences in baseline, procedural characteristics, and SYNTAX score between the two groups. The matched cohorts had no significant differences for the primary endpoint (HR 0.85, 95% CI 0.65–1.43, <i>p</i> = 0.85). No differences for all-cause mortality rates between the two groups were found at 2 years (10% in the PCI and 11% in the CABG arm, <i>p</i> = 0.65). During follow-up, patients undergoing CABG had lower rates of myocardial infarction (8.7% vs. 14.8%, <i>p</i> = 0.04). More frequent stroke incidence was noticed (8.7% vs. 0%, <i>p</i> &lt; 0.001). There was no significant difference in the incidence of target vessel revascularization between PCI and CABG (3.91% vs. 2.61%, <i>p</i> = 0.43).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IVI-guided PCI for LMCA stenosis provides similar 2-year outcomes to CABG. Lower MACCE rates with PCI were observed in patients with lower anatomic complexity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"415-425"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148039019","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":"Impella Versus VA-ECMO in Cardiogenic Shock: An Updated Systematic Review and Meta-Analysis With Exploratory Matched-Cohort Analyses","authors":"Ahmed Elmorsy Mohamed,&nbsp;Mohamed Elnady,&nbsp;Zeyad Kholeif,&nbsp;Ameer Awashra,&nbsp;Mohamed Sobhy Elsobky,&nbsp;Amr Ahmed Ibrahim,&nbsp;Abdallah Osama Elfeky,&nbsp;Mahmoud Shams,&nbsp;Rana Rashwan,&nbsp;Imad Tahhan,&nbsp;Mohab Elnashar,&nbsp;Ranem Ayman,&nbsp;Mazen Hassanin,&nbsp;Hisham Elharty,&nbsp;Diaa Hakim","doi":"10.1002/ccd.70658","DOIUrl":"10.1002/ccd.70658","url":null,"abstract":"<div>\u0000 \u0000 <p>Observational studies comparing Impella and venoarterial extracorporeal membrane oxygenation (VA-ECMO) in cardiogenic shock have reported inconsistent findings. We performed an updated systematic review and meta-analysis, with exploratory matched-cohort analyses where directly reportable propensity score–matched event-level data were available. We searched PubMed, Scopus, Web of Science, and the Cochrane Library from inception through March 2026 for observational studies comparing Impella versus VA-ECMO in adult patients with cardiogenic shock. The primary outcome was in-hospital mortality. Secondary outcomes included all-cause mortality, ICU outcomes, access site bleeding requiring transfusion, peripheral vascular complications, renal outcomes, and stroke. Random-effects models using restricted maximum likelihood were applied. Fifteen observational studies including 22,618 patients were analyzed. In the primary crude analysis, Impella was not associated with a statistically significant difference in in-hospital mortality (RR 0.84, 95% CI 0.66−1.07; <i>p</i> = 0.15) with substantial heterogeneity (<i>I</i>² = 92.9%). However, leave-one-out analysis identified an influential registry study; its exclusion markedly reduced heterogeneity and favored Impella (<i>p</i> &lt; 0.01). In exploratory propensity score-matched analysis, Impella was also associated with lower in-hospital mortality (RR 0.69, 95% CI 0.56−0.85, <i>p</i> &lt; 0.01). Thirty-day and 6-month all-cause mortality were neutral, whereas 12-month mortality modestly favored Impella (<i>p</i> = 0.048). Sensitivity analyses similarly resolved heterogeneity and favored Impella for selected secondary outcomes, including 6-month mortality, acute kidney injury, and ischemic stroke. ICU mortality was neutral, while ICU length of stay was shorter with Impella (<i>p</i> = 0.01). Impella was also associated with lower access site bleeding requiring transfusion (<i>p</i> &lt; 0.01), peripheral vascular complications (<i>p</i> &lt; 0.01), and hemorrhagic stroke (<i>p</i> &lt; 0.01). In this updated meta-analysis of observational studies, the primary crude analysis of in-hospital mortality was neutral overall but highly heterogeneous, whereas sensitivity and exploratory matched-cohort analyses showed a more consistent association favoring Impella. Impella was also associated with lower bleeding and vascular complications and shorter ICU length of stay, although several outcomes remained sensitive to study-level influence. These findings should be interpreted cautiously given the observational design, predominance of serious risk of bias, and strong potential for confounding by indication.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"301-313"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877155","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":"Double Barrel DCB in a Giant Ostial LAD","authors":"An Shing Ang,&nbsp;Muhammad Alimi,&nbsp;Thet Khaing,&nbsp;Saket Subhash Junagade,&nbsp;Randal Jun Bang Low","doi":"10.1002/ccd.70661","DOIUrl":"10.1002/ccd.70661","url":null,"abstract":"<div>\u0000 \u0000 <p>Coronary artery ectasia is associated with adverse cardiac events. It presents significant challenges to percutaneous coronary intervention, with higher risks of no reflow. Moreover, conventional PCI strategies may not be suitable. In this case report, we showcase how we treated a patient with coronary artery ectasia and NSTEMI with a novel application of a “double-barrel” drug-coated balloon (DCB) strategy. The patient recovered well post PCI and has since remained chest pain-free. Relook at coronary angiography at 9 months showed a widely patent vessel with evidence of late lumen gain after DCB treatment. To our knowledge, this is the first reported case of such an approach.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"323-328"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937090","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":"Novel Precise Ostial and Bifurcation Stenting Using a Guide Extension Catheter: The Ostial Stenting With Guide Extension Catheter Tip Technique","authors":"Shingo Kurimoto,&nbsp;Koichi Kishi","doi":"10.1002/ccd.70666","DOIUrl":"10.1002/ccd.70666","url":null,"abstract":"<div>\u0000 \u0000 <p>Precise stenting of coronary ostial and bifurcation lesions remains technically challenging. A geographical miss can cause incomplete lesion coverage or excessive stent protrusion, compromising procedural outcomes. We developed a novel, streamlined approach utilizing a guide extension catheter, termed the Ostial Stenting with Guide Extension catheter Tip (OS-GET) technique, to enhance precision in stent placement. The OS-GET technique employs the distal tip of a guide extension catheter as a stable fluoroscopic landmark to achieve precise alignment of the proximal stent marker with the true coronary ostium. Stabilization by the guide extension catherter mitigates stent migration during balloon expansion, facilitating optimal positioning. This technique is feasible with a 6-Fr guiding system and is compatible with all contemporary stent platforms and guide extension catheters, offering high procedural versatility. This technique was applied in three representative cases: (1) left anterior descending artery (LAD) ostial stenting, (2) left circumflex artery ostial stenting with heavy calcification following intravascular lithotripsy, and (3) mid-LAD stenting distal to a large diagonal branch. In all interventions, OS-GET enabled precise stent deployment with full lesion coverage and without protrusion into the left main trunk or adjacent branches. Final angiography confirmed Thrombolysis In Myocardial Infarction (TIMI) 3 flow, while intravascular ultrasound demonstrated optimal expansion and apposition. The OS-GET technique represents a practical, reproducible, and versatile strategy for precise stent placement in complex ostial and bifurcated lesions.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"409-414"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148020421","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":"Reverse Crush Versus Culotte in Bifurcation Lesions After Provisional Stenting: Insights From the PROGRESS-BIFURCATION Registry","authors":"Eleni Kladou,&nbsp;Dimitrios Strepkos,&nbsp;Pedro E. P. Carvalho,&nbsp;Michaella Alexandrou,&nbsp;Barkin Kultursay,&nbsp;Ali Karagoz,&nbsp;Oleg Krestyaninov,&nbsp;Dmitrii Khelimskii,&nbsp;Mahmut Uluganyan,&nbsp;Korhan Soylu,&nbsp;Ufuk Yildirim,&nbsp;Kadriye O. Kilickesmez,&nbsp;Gokhan Cetinkal,&nbsp;Sefa Sural,&nbsp;Olga Mastrodemos,&nbsp;Bavana V. Rangan,&nbsp;Konstantinos Voudris,&nbsp;Noah N. Williford,&nbsp;M. Nicholas Burke,&nbsp;Yader Sandoval,&nbsp;Emmanouil S. Brilakis","doi":"10.1002/ccd.70674","DOIUrl":"10.1002/ccd.70674","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Reverse crush and culotte are commonly used strategies in case of side branch (SB) compromise after main vessel (MV) stenting during provisional bifurcation percutaneous coronary intervention (PCI).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The aim of this study is to compare the technical and procedural outcomes and safety of reverse crush versus (vs.) culotte technique in cases of SB compromise following MV stenting during provisional bifurcation PCI.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We analyzed 43 PCIs (43 patients) with SB compromise after MV stenting during provisional strategy from the PROGRESS-BIFURCATION registry that were treated with reverse crush or culotte.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Of 43 PCIs (43 patients) with SB compromise after MV stenting during the provisional strategy, 29 (67%) were treated with reverse crush and 14 (33%) with culotte. Reverse crush and culotte patients had similar baseline characteristics. Reverse crush was more likely to be used in the left anterior descending artery (LAD) and in smaller bifurcation angles (45° [37.50, 60.00] vs. 70° [45.00, 80.00], &lt;i&gt;p&lt;/i&gt; = 0.017). Culotte was more frequently used in the left main coronary artery (LMCA). Reverse crush cases had smaller proximal (3.25 [3.00, 3.50] vs. 4.00 [3.00, 5.00] mm, &lt;i&gt;p&lt;/i&gt; = 0.028) and distal (3.00 [2.50, 3.00] vs. 3.50 [3.00, 4.00] mm, &lt;i&gt;p&lt;/i&gt; = 0.013) MV diameter, smaller SB diameter (2.50 [2.25, 2.50] vs. 3.00 [2.50, 3.50] mm, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and longer proximal MV (10.00 [5.00, 20.00] vs. 5.00 [0.00, 10.00] mm, &lt;i&gt;p&lt;/i&gt; = 0.003) and SB (10.00 [8.00, 12.00] vs. 4.00 [0.00, 10.00] mm, &lt;i&gt;p&lt;/i&gt; = 0.002) lesions. SB total occlusion was a more frequent trigger for escalation to a two-stent strategy in the reverse crush group compared with the culotte group (42.3% vs. 0.0%, &lt;i&gt;p&lt;/i&gt; = 0.016). Patients treated with the reverse crush technique were less likely to require escalation to a third stenting strategy compared with those treated with culotte (4.0% vs. 21.4%, &lt;i&gt;p&lt;/i&gt; = 0.04), but had longer procedural time (102.00 [77.00, 144.00] vs. 60.00 [45.00, 110.00] min), &lt;i&gt;p&lt;/i&gt; = 0.012). There was no difference in technical (100% vs. 100%, &lt;i&gt;p&lt;/i&gt; = 1.00), procedural (96.6% vs 100%, &lt;i&gt;p&lt;/i&gt; = 1.00) success, periprocedural major adverse cardiac events (MACE) (3.4% vs. 0.0%, &lt;i&gt;p&lt;/i&gt; = 1.00) or long-term MACE (HR 0.59, 95% CI 0.12–2.92, &lt;i&gt;p&lt;/i&gt; = 0.50) between reverse crush and culotte cases.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Most cases of SB compromise during pr","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"452-458"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148045268","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 COVID-19 Infection and Vaccination on Myocarditis Incidence: A Comparative Analysis of Pre-, Peri-, and Post-Pandemic Eras","authors":"Ori Waksman,&nbsp;Waiel Abusnina,&nbsp;Brian C. Case,&nbsp;Matteo Cellamare,&nbsp;Cheng Zhang,&nbsp;Hank Rappaport,&nbsp;Vaishnavi Sawant,&nbsp;Yama Thakkar,&nbsp;Ron Waksman","doi":"10.1002/ccd.70659","DOIUrl":"10.1002/ccd.70659","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The coronavirus disease 2019 (COVID-19) pandemic introduced a surge in cardiovascular complications, with myocarditis emerging as a concern due to both direct viral effects and rare vaccine-associated events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This analysis examines the incidence and outcomes of myocarditis in patients across a large healthcare system in the Washington, DC Metropolitan Area, focusing on periods before, during, and after the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted using electronic health records from the MedStar Health System (2017−2024). Myocarditis cases were identified using ICD-10 codes, with cases stratified by pre- (2017−2019), peri- (2020−2022), and post-COVID-19 (2023−2024) pandemic periods, as well as by association with COVID-19 infection and/or vaccination. The overall incidence and inpatient mortality of myocarditis were compared over these eras.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 778 myocarditis patients admitted between January 2017 and December 2024, categorized into pre-COVID-19 (<i>n</i> = 207), peri-COVID-19 (<i>n</i> = 370), and post-COVID-19 (<i>n</i> = 201) periods. Total myocarditis incidence surged during the peri-pandemic period, peaking in 2022, and declined in 2023-2024. In the post-pandemic period, total myocarditis remained elevated and higher than in the pre-pandemic era. During the pandemic and post-pandemic periods, myocarditis patients were older, included a higher proportion of African American individuals, and had a greater burden of cardiometabolic comorbidities, compared to pre-pandemic myocarditis hospitalizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates a marked increase in myocarditis cases during the COVID-19 pandemic, driven initially by a surge in COVID-19-related myocarditis. Notably, total myocarditis cases remained elevated in the post-pandemic period compared to pre-pandemic levels. These findings, particularly the increased post-pandemic myocarditis patients, warrant further investigation into underlying risk factors and long-term outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"108 2","pages":"388-394"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966932","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}