Catheterization and Cardiovascular Interventions最新文献

{"title":"Comparing the Clinical Performance of High-Dose and Low-Dose Drug-Coated Balloons for Long Femoropopliteal Artery Disease: Results of the SATELLITE Study.","authors":"Naoki Yoshioka, Takahiro Tokuda, Akiko Tanaka, Shunsuke Kojima, Kohei Yamaguchi, Takashi Yanagiuchi, Kenji Ogata, Tatsuro Takei, Yasuhiro Morita, Tatsuya Nakama, Itsuro Morishima","doi":"10.1002/ccd.31485","DOIUrl":"https://doi.org/10.1002/ccd.31485","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have shown comparable outcomes between first-generation high-dose drug-coated balloon (HD-DCB) and second-generation low-dose drug-coated balloon (LD-DCB) for femoropopliteal artery disease. However, data about the clinical performances of these DCBs for longer lesions in real-world clinical settings are limited.</p><p><strong>Methods: </strong>In this multicenter, retrospective study, the clinical performances of the HD-DCB (IN.PACT, Medtronic, MN, USA) and the LD-DCB (Ranger, Boston, MA, USA) were assessed in cases of femoropopliteal artery disease with lesion length ≥ 150 mm. From the database, 288 lesions in 288 patients were assigned to the HD-DCB group, and 88 lesions in 88 patients were assigned to the LD-DCB group. Propensity score-matching analysis was performed to adjust for baseline patient and lesion characteristics. The primary outcome was the 2-year primary patency rate of the two types of DCBs.</p><p><strong>Results: </strong>Propensity score matching was used to extract 76 pairs with no significant intergroup differences in baseline patient and lesion characteristics. The average lesion length was 257.5 and 255.7 mm in the HD and LD-DCB groups, respectively. The 2-year primary patency rates between the HD and LD-DCB groups were comparable (68.5% vs. 60.4%; p = 0.33). There were also no significant differences in clinically driven target lesion revascularization, acute limb ischemia, major amputation, or overall survival between the two types of DCBs.</p><p><strong>Conclusion: </strong>The clinical outcomes between the HD and LD-DCBs did not significantly differ in real-world populations with severely complex lesions.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572155","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":"Future Directions of Chronic Total Occlusion Management: Identifying the Right Patient for Intervention With a Focus on Biomarkers.","authors":"Daniel A Gold, Nodari Maisuradze, Billy Joe Mullinax, Mariem A Sawan, Madeleine Barker, Elsa Hebbo, Nikoloz Shekiladze, Bryan Kindya, Wissam A Jaber, Pratik B Sandesara, Arshed A Quyyumi, William J Nicholson","doi":"10.1002/ccd.31466","DOIUrl":"https://doi.org/10.1002/ccd.31466","url":null,"abstract":"<p><p>The management of a chronic total occlusion (CTO) of a coronary artery has been a conundrum in interventional cardiology, as revascularization has not been proven to provide a mortality benefit. However, there are subgroups of patients with a CTO that have high levels of ischemia on myocardial perfusion imaging and high circulating levels of high sensitivity troponin-I (hsTn-I) and N terminal pro-brain natriuretic peptide (NT pro-BNP) that are at a particularly high-risk for adverse cardiovascular events. These high-risk subgroups of patients with a CTO may have not been well represented in prior clinical trials, and may gain a mortality benefit from revascularization of the CTO. Conversely, patients with low levels of ischemia and these biomarkers are at lower risk and may not gain a mortality benefit from revascularization of their CTO. It is important for future randomized controlled trials to investigate the efficacy of CTO PCI in patients with elevated biomarkers and high ischemic burden on myocardial perfusion imaging to determine if patients at high-risk gain a mortality benefit from revascularization.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566057","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":"Image-Derived Modeling to Assess Coronary Proximity in Patients Undergoing Transcatheter Pulmonary Valve Replacement With Self-Expanding Valves.","authors":"Yuval Barak-Corren, Vladislav Obsekov, Mudit Gupta, Christian Herz, Silvani Amin, Andras Lasso, Michael L O'Byrne, Matthew J Gillespie, Matthew A Jolley","doi":"10.1002/ccd.31469","DOIUrl":"https://doi.org/10.1002/ccd.31469","url":null,"abstract":"<p><strong>Background: </strong>The potential for coronary artery compression (CC) during transcatheter pulmonary valve replacement (TPVR) using self-expanding valves (SEV) is not fully understood, yet anecdotal reports suggest that this risk exists.</p><p><strong>Aims and methods: </strong>We performed a retrospective cohort study of patients evaluated for SEV-TPVR to evaluate the relationship between the right ventricular outflow tract (RVOT) and coronary arteries (CA). CT-derived segmentations of the RVOT and CA were created using machine learning. A 2D map of the distance between the RVOT surface and CA, in systole and diastole, was created. In the subset of patients with post-procedural CTA, the distance before and after TPVR was measured.</p><p><strong>Results: </strong>Forty-two individuals underwent screening for SEV-TPVR, of which 83% (n = 35) had SEV implanted (Harmony = 24; Alterra = 11). Median age was 22.9 years (range 12-60) and 76% had tetralogy of Fallot (TOF). There was no significant change in the distance between the RVOT and LCA between diastole and systole (p = 0.31), yet the RVOT area nearest to the LCA displaced proximally by 11 mm (IQR: 5.6-19.9) in systole. In 8 patients with pre- and post-TPVR CTA, no statistically significant differences were observed in the RVOT-to-LCA relation after intervention. The distance to the LCA was smaller in pulmonary stenosis/atresia patients than those with TOF (median distance 1.2 and 2.1 mm, respectively; p = 0.185).</p><p><strong>Conclusion: </strong>The RVOT area in closest proximity to LCA is dynamic and should be considered when planning TPVR. Special attention should be given to patients with a diagnosis of pulmonary stenosis/atresia.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566075","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":"Endovascular Thrombectomy of Arteriovenous Dialysis Access: A Feasible Treatment?","authors":"Rui Filipe Nogueira, Nuno Afonso Oliveira, Emanuel Ferreira, Luís Rodrigues","doi":"10.1002/ccd.31484","DOIUrl":"https://doi.org/10.1002/ccd.31484","url":null,"abstract":"<p><strong>Introduction: </strong>There is no single best treatment for arteriovenous vascular access thrombosis, with comparable patency rates for both surgical and endovascular treatment. This study aims to evaluate the results of endovascular thrombectomy in our center and analyze the patency rates in different groups.</p><p><strong>Material and methods: </strong>We retrospectively selected patients referred to our vascular access treatment unit due to arteriovenous access thrombosis from June 2017 to February 2022. All patients were submitted to endovascular manual thromboaspiration. Patient demographic data, comorbidities and clinical data were collected from medical records for further analysis.</p><p><strong>Results: </strong>Out of the 96 patients selected, 45 (47%) had AV grafts and 51 (53%) had AV fistulas. The mean age was 74 (±15) years and 54% were males. The overall success rate of interventions was 85.4% (n = 82), while the reintervention rate stood at 59.8% (n = 49). AV grafts exhibited superior secondary patency compared to AV fistulas (92.4% vs. 78.0% and 85.3% vs. 74.1% at 6 and 12 months, respectively; p = 0.047). Forearm fistulas demonstrated enhanced primary patency (72.7% vs. 41.5% and 58.2% vs. 23.1% at 6 and 12 months, respectively; p = 0.017), better assisted primary patency (81.8% vs. 55.8% and 81.8% vs. 42.0% at 6 and 12 months, respectively; p = 0.025), and a lower reintervention rate (27.3% vs. 63.3%; p = 0.040) compared to upper arm fistulas.</p><p><strong>Conclusions: </strong>Endovascular manual thromboaspiration seems to be an alternative technique for salvaging thrombosed vascular accesses. Forearm fistulas had the best assisted primary patency, which consolidates the rationale of giving primacy to its construction over other options.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572159","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":"Incidence and 1-Year Prognostic of Unstable Angina After High-Sensitivity Troponin Assessment.","authors":"Romain Jouen, Pierre-Alain Meunier, Lionel Moulis, Francois Roubille, Jean-Christophe Macia, Jean-Michel Berdeu, Matthieu Steinecker, Pierre Robert, Benoit Lattuca, Guillaume Cayla, Florence Leclercq","doi":"10.1002/ccd.31473","DOIUrl":"https://doi.org/10.1002/ccd.31473","url":null,"abstract":"<p><strong>Background: </strong>Incidence and prognostic of unstable angina after high-sensitivity troponin assesment is controversial.</p><p><strong>Aims: </strong>This study evaluated prognostic of a contemporary population of patients with UA defined using high sensitive T troponin (T hs-cTn) measurements and with significant coronary artery disease (CAD).</p><p><strong>Methods: </strong>Consecutive patients admitted in 2 French university centres with UA defined as clinical ischemic symptoms and T hs-cTn dosages undetectable (< 5 ng/L), non-elevated (> 14 ng/L) or mildly elevated (14-50 ng/L) were included. The primary end-point included major events at 1-year follow-up.</p><p><strong>Results: </strong>Among 1752 patients admitted for ACS between December 2021 and February 2023, 210 (12.0%) have UA and significant CAD. Mean age was 66 ± 12 years, with predominantly men (n = 143; 68.1%). Patients had undetectable (n = 4), non-elevated (n = 80) or mildly elevated and stable T hs-cTn (n = 126). History of CAD was found in 98 patients (46.6%). Percutaneous intervention was required in main patients (n = 186; 88.6%). Adverse non-fatal in-hospital event occurred in one patient. The primary outcome was achieved in 55 patients (26.2%; CI 95% [20.2-32.1]) mainly related to new ACS (n = 34, 16.2%). The level of troponin at admission (p = 0.639) was not associated with the primary outcome. In multivariate analysis, multiple risk factors (OR 1.93, [1.01-3.69], p = 0.0194), history of CAD (3.09; CI [1.63; 5.87], p = 0.0005), and tritroncular disease (OR 2.66; CI [1.24; 5.69], p = 0.0118) were significantly associated with major events at 1-year.</p><p><strong>Conclusion: </strong>Contemporary incidence of UA with significant CAD is low with few in-hospital events, but with a 1-year incidence of cardiac events high (26%), mainly related to new ACS. Improving secondary prevention may be crucial for these patients. (ID: NCT06378333).</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566117","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":"Vascular Response, Downstream Effect, and Pharmacokinetics After Sirolimus- and Paclitaxel-Coated Balloons in Porcine Coronary Arteries.","authors":"Kenji Kawai, Frank D Kolodgie, Rika Kawakami, Takao Konishi, Tatsuya Shiraki, Teruo Sekimoto, Takamasa Tanaka, Kai Shen, Renu Virmani, Aloke V Finn","doi":"10.1002/ccd.31482","DOIUrl":"https://doi.org/10.1002/ccd.31482","url":null,"abstract":"<p><strong>Background: </strong>Paclitaxel (PCB) and sirolimus-coated balloons (SCB) are major therapeutic options for coronary artery disease, but there is no direct head-to-head histological comparison of their effects during the percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>We aimed to investigate the vascular and downstream effects and drug pharmacokinetics in a porcine coronary model treated with MagicTouch-SCB (MT-SCB), Selution-SRL-SCB (SEL-SCB), Agent PCB, and plain old balloon angioplasty (POBA).</p><p><strong>Methods: </strong>Twenty-eight coronary arteries from 10 pigs were treated with one of three drug-coated balloons (DCBs) (n = 7 for each) or POBA (n = 7) with 28 days follow-up. In six pigs, histological assessment was performed for the arterial response with semi-quantified scoring. In four pigs, sirolimus and paclitaxel concentrations were measured in the coronary artery and downstream myocardium. All 10 animals were histologically assessed for downstream effects on the myocardium for distal emboli and tissue injury.</p><p><strong>Results: </strong>All DCBs showed minimal neointimal formation, but the MT-SCB and SEL-SCB showed less medial SMC loss compared to the PCB. In the histology section-based analysis of downstream myocardium, PCB showed evidence of myocyte necrosis/scarring in 21% of sections, whereas there was no evidence in the other groups (p < 0.01). POBA had the lowest downstream emboli (6%), followed by MT-SCB (15%), SEL-SCB (25%), and PCB (36%) (p = 0.02). In the pharmacokinetic analysis, paclitaxel showed higher concentration after PCB treatment compared to sirolimus after both two SCBs treatment in coronary and downstream myocardium.</p><p><strong>Conclusion: </strong>MT-SCB and SEL-SCB demonstrated less arterial injury, less downstream effect, and lower drug concentration compared to PCB during PCI.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572173","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 Diabetes on Long-Term Outcomes of Percutaneous Coronary Intervention for Coronary Bifurcation Lesions.","authors":"Subin Lim, Soon Jun Hong, Ju Hyeon Kim, Jung-Joon Cha, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Do-Sun Lim, Chang-Wook Nam","doi":"10.1002/ccd.31476","DOIUrl":"https://doi.org/10.1002/ccd.31476","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is a well-known risk factor for cardiovascular diseases, including coronary artery diseases (CAD). Complex percutaneous coronary intervention (PCI) such as PCI for bifurcation lesions often yields poor outcomes, especially in DM patients.</p><p><strong>Aims: </strong>The effect of DM on cardiovascular outcomes in bifurcation PCI was investigated in this retrospective, multicenter, observational, real-world registry of 2648 patients with coronary bifurcation lesions undergoing PCI with contemporary drug-eluting stents (DES).</p><p><strong>Methods: </strong>The primary outcome was target lesion failure (TLF), defined as a composite of cardiac death, target vessel myocardial infarction and target lesion revascularization. The adjusted outcomes were compared using 1:1 propensity score (PS) matching.</p><p><strong>Results: </strong>Overall, DM patients were more likely to be older, female, and have hypertension or chronic kidney disease. After PS matching, the cumulative incidence of the primary outcome remained higher in the DM group (7.9% vs. 5.5%, log-rank p = 0.033). In multivariable analysis, DM (HR, 1.57; 95% CI, 1.02-2.43; p = 0.040), chronic kidney disease (HR, 2.62; 95% CI, 1.27-5.38; p = 0.008), low left ventricular ejection fraction (HR, 1.92; 95% CI, 1.10-3.35; p = 0.022) and the two-stent technique (HR, 2.18; 95% CI, 1.17-4.05; p = 0.013) were independent predictors of TLF. For patients with intravascular ultrasound-guided PCI, TLF rates were similar between DM and non-DM groups (9.1% vs. 7.3%, log-rank p = 0.347).</p><p><strong>Conclusion: </strong>For patients with coronary bifurcation lesions undergoing contemporary PCI, 5-year TLF rates were worse in DM patients. Careful planning and usage of imaging devices may help ameliorate outcomes for DM patients.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566114","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 and Technical Predictors of Treatment Success After Coronary Intravascular Lithotripsy in Calcific Coronary Lesions.","authors":"Martijn J H van Oort, Brian O Bingen, Federico Oliveri, Ibtihal Al Amri, Akshay A S Phagu, Bimmer E P M Claessen, Aukelien C Dimitriu-Leen, Tessel N Vossenberg, Joelle Kefer, Hany Girgis, Frank van der Kley, J Wouter Jukema, Jose M Montero-Cabezas","doi":"10.1002/ccd.31480","DOIUrl":"https://doi.org/10.1002/ccd.31480","url":null,"abstract":"<p><strong>Background: </strong>Intravascular lithotripsy (IVL) is increasingly used to treat coronary artery calcification (CAC). This study aimed to identify clinical and procedural factors associated with IVL treatment success.</p><p><strong>Methods: </strong>This retrospective analysis included 454 patients (73 ± 9 years, 75% male) treated with IVL from the multicenter BENELUX-IVL registry (May 2019 to February 2024). Treatment success was defined as achieving residual coronary diameter stenosis < 30% and luminal gain, assessed by quantitative coronary analysis (QCA). Linear and binary logistic regression analyses were performed to identify factors associated with these outcomes.</p><p><strong>Results: </strong>The mean luminal gain was 1.9 ± 0.9 mm, and residual diameter stenosis < 30% was achieved in 354 (90%) lesions. Stenting after IVL for therapy completion (p < 0.001), intracoronary imaging (ICI) guidance (p = 0.024) and chronic total occlusions (CTOs; p < 0.001) were associated with increased luminal gain, while bifurcation lesions (p = 0.029) were associated with decreased luminal gain. Long (> 20 mm) lesions (p = 0.034) and post-IVL stenting for therapy completion (p = 0.041) were associated with a residual diameter stenosis < 30%, while aorto-ostial lesions (p = 0.014) were negatively associated with this outcome. Technical IVL parameters such as inflation pressure and number of pulses delivered were not significantly associated with treatment success.</p><p><strong>Conclusion: </strong>Stenting after IVL for therapy completion, ICI guidance and CTOs were associated with increased luminal gain, while bifurcation lesions were linked to decreased luminal gain. Long lesions and post-IVL stenting for therapy completion were associated with residual diameter stenosis < 30%, while the presence of aorto-ostial lesions was negatively associated with this outcome. Technical IVL-related procedural factors did not significantly impact treatment success.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555992","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":"Safety and Efficacy of Single Femoral Vein Puncture Technique for Double Access in Patent Foramen Ovale Closure Under ICE Guidance-A Single Center Experience of the \"Two-In-One Technique\".","authors":"Pierre Guilleminot, Mathieu Mourot, Luc Lorgis, Romain Didier, Benjamin Ferrand, Gabriel Laurent, Catherine Vergely, Charles Guenancia, Thibaut Pommier","doi":"10.1002/ccd.31479","DOIUrl":"https://doi.org/10.1002/ccd.31479","url":null,"abstract":"<p><strong>Background: </strong>In selected patient populations, percutaneous closure of patent foramen ovale has been shown to be beneficial in preventing cerebral ischaemic events. In most cases, this procedure requires echocardiographic guidance, which may be transesophageal, transthoracic or intracardiac. Intracardiac echocardiography (ICE) has the advantage of not requiring general anaesthesia but usually requires a second vascular access.</p><p><strong>Aims: </strong>The aim of this study was to evaluate the safety and efficacy of the single femoral vein puncture technique for double veinous access compared to conventional bilateral double puncture during patent foramen ovale (PFO) closure under intracardiac echocardiography (ICE) guidance.</p><p><strong>Methods: </strong>A retrospective study including all patients who underwent PFO closure under ICE guidance between January 2018 and April 2024 in University Hospital of Dijon, comparing the single puncture technique, defined as a single vascular hole for two sheaths, with those who underwent bilateral puncture. We collected baseline patient characteristics as well as intra- and post-procedural data, especially significant vascular complications (bleeding, false aneurysm, deep vein thrombosis, arteriovenous fistula) and procedural success (defined as successful placement of the prosthesis, meeting stability criteria, without embolization). In addition, patients were asked to rate the comfort of the procedure on a scale of 0 to 10 after the procedure.</p><p><strong>Results: </strong>We analyzed 179 consecutive patients, of whom 126 received a femoral vein approach using the two-in-one technique and 53 received a bilateral femoral vein puncture. PFO closure was successful in all cases regardless of group. No tamponade, device migration, or death was observed during hospitalization. Vascular complication rate was comparable (3 (1.6%) vs. 2 (3.8%); p = 0.582). In addition, the single puncture technique was associated with an increased comfort score compared with the bilateral puncture technique (9.20 ± 1.55 vs. 8.44 ± 1.93; p = 0.044), shorter procedure time (40 min [32; 50] vs. 60 min [48; 70]; p < 0.001), hospital stay duration (0.82 ± 1.02 days vs. 2.04 ± 0.83 days; p < 0.001) and fluoroscopy time (5.71 min [4.28; 8.33] vs. 9.57 min [7.42; 13.11]; p < 0.001).</p><p><strong>Conclusion: </strong>The single femoral vein puncture technique for double femoral vein access is safe and effective for PFO closure under ICE guidance. It is also associated with increased patient comfort and reduced fluoroscopy time, although large multicenter studies are needed to confirm these results.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555993","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":"Advantages of Orbital Atherectomy: A Case Series.","authors":"Atit A Gawalkar, Krishna Prasad Akkineni, Rajesh Vijayvergiya, Pragya Karki","doi":"10.1002/ccd.31474","DOIUrl":"https://doi.org/10.1002/ccd.31474","url":null,"abstract":"<p><p>Severe coronary calcification poses a significant challenge during percutaneous coronary intervention. Rotational atherectomy is widely used for calcium ablation because of its efficacy, cost-effectiveness and availability. However, orbital atherectomy (OA), with its unique design and mechanism, is the treatment of choice in certain subsets of calcific lesions. Through a case-based approach, we highlighted the unique advantages of OA in modifying calcified lesions. We illustrated three cases with heavily calcified coronary arteries where OA had to be chosen in preference to other calcium modification techniques. We also included imaging evidence to demonstrate the efficacy of OA in calcium modification. Calcific coronary lesions need a multi-pronged approach for optimal management. In certain situations like a mismatch in size between the main vessel and side branch, eccentric calcium with unfavorable wire bias and calcium in close proximity to a stented segment, OA can be used to successfully modify the calcium with lesser risk of complications.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540361","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}