Catheterization and Cardiovascular Interventions最新文献

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Incidence and Predictors of Hypoattenuated Thickening and Device-Related Thrombus at Three Months Postprocedural CT Assessment Following Left Atrial Appendage Occlusion With Amplatzer Devices—A Single-Center Cohort 左心耳Amplatzer器械闭塞术后3个月CT评估中减薄增厚和器械相关血栓的发生率及预测因素——单中心队列研究
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-09 DOI: 10.1002/ccd.70421
Pierre Guilleminot, Carole Richard, Antoine Roger, Marlène Daller, Gabriel Laurent, Catherine Vergely, Charles Guenancia, Thibaut Pommier
{"title":"Incidence and Predictors of Hypoattenuated Thickening and Device-Related Thrombus at Three Months Postprocedural CT Assessment Following Left Atrial Appendage Occlusion With Amplatzer Devices—A Single-Center Cohort","authors":"Pierre Guilleminot, Carole Richard, Antoine Roger, Marlène Daller, Gabriel Laurent, Catherine Vergely, Charles Guenancia, Thibaut Pommier","doi":"10.1002/ccd.70421","DOIUrl":"10.1002/ccd.70421","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Left atrial appendage occlusion (LAAO) has become a valuable alternative to long-term anticoagulation for stroke prevention in patients with non-valvular atrial fibrillation (AF), especially in those at high bleeding risk. Hypoattenuated thickening (HAT) and device-related thrombus (DRT) remain notable postprocedural concerns. Identifying reliable predictors is essential to optimize post-LAAO management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to assess the incidence of HAT and DRT at 3 months following percutaneous LAAO and to identify clinical, anatomical, and procedural predictors—based on CT imaging evaluation—that may guide optimization of postprocedural antithrombotic strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-center study including adult patients who underwent percutaneous LAAO with Amplatzer Amulet or ACP devices at Dijon University Hospital between April 2016 and May 2024, with available pre- and 3-month postprocedural CT scans. Baseline clinical, echocardiographic, biological, procedural, and anatomical data were collected. The primary objective was to determine the incidence and predictors of HAT and DRT at 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 102 patients (mean age 76 ± 7 years, mean CHADS-VASc 4.4 ± 1.4), HAT was observed in 25 (24%), and DRT in 3 (2.9%). Female sex and prior stroke/TIA were significantly associated with HAT occurrence. Importantly, patients discharged on dual antiplatelet therapy (DAPT) demonstrated a markedly lower incidence of HAT/DRT, suggesting a protective effect. In contrast, no anatomical parameter, including the Cressa classification, predicted thrombotic events. While Cressa morphology correlated with procedural complexity, it had no value for thrombotic risk stratification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the absence of anatomical predictors of HAT/DRT, emphasizing instead clinical determinants and the protective role of DAPT. These findings support tailoring antithrombotic therapy after LAAO according to individual clinical risk profiles, particularly in patients with prior stroke/TIA or women, who may benefit from reinforced preventive strategies. Larger multicenter studies are needed to refine postprocedural management algorithms and improve risk stratification beyond anatomical assessment.</p>\u0000 </section>\u0000 ","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"754-761"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12902733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710488","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}
引用次数: 0
Reassessing PCI Timing in High Bleeding Risk Patients: Evidence, Strategies, and Outcomes 重新评估高危出血患者的PCI时机:证据、策略和结果。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-09 DOI: 10.1002/ccd.70410
Ameer Awashra, Mohammed AbuBaha, Ahmed Emara, Ahmad Hamdan, Anwar Zahran, Mazen Ibrahem, Nadeem Khayat, Mohamed S. Elgendy, Ahmad Nouri, Mohamed Saad Rakab, Atef Akoum, Abdalhakim Shubietah
{"title":"Reassessing PCI Timing in High Bleeding Risk Patients: Evidence, Strategies, and Outcomes","authors":"Ameer Awashra,&nbsp;Mohammed AbuBaha,&nbsp;Ahmed Emara,&nbsp;Ahmad Hamdan,&nbsp;Anwar Zahran,&nbsp;Mazen Ibrahem,&nbsp;Nadeem Khayat,&nbsp;Mohamed S. Elgendy,&nbsp;Ahmad Nouri,&nbsp;Mohamed Saad Rakab,&nbsp;Atef Akoum,&nbsp;Abdalhakim Shubietah","doi":"10.1002/ccd.70410","DOIUrl":"10.1002/ccd.70410","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Percutaneous coronary intervention (PCI) in patients with high bleeding risk (HBR) presents a therapeutic challenge, requiring careful balancing of ischemic prevention and bleeding avoidance. The Academic Research Consortium High Bleeding Risk (ARC-HBR) criteria provide a standardized framework for identifying this population, yet optimal PCI timing, procedural strategies, and antithrombotic regimens remain uncertain. This review synthesizes data from randomized controlled trials, large-scale registries, and meta-analyses involving HBR patients undergoing PCI in settings including stable coronary artery disease, acute coronary syndromes (ACS), ST-elevation myocardial infarction (STEMI), post-resuscitation states, and malignancy-related thrombocytopenia. Special emphasis is placed on procedural approaches (radial vs. femoral access), device selection (drug-coated balloons, polymer-free drug-eluting stents), and dual antiplatelet therapy (DAPT) duration. Evidence supports the safety of abbreviated DAPT regimens (1–3 months) when combined with bleeding-sparing techniques and devices, with the greatest benefit observed in patients with a high ischemic burden (e.g., GRACE score &gt; 140). Early invasive management in ACS has been associated with reduced ischemic endpoints and shorter hospital stays without a significant rise in major bleeding. Conversely, delayed PCI is advisable in the presence of active bleeding, recent thrombolysis, or severe coagulopathy. Persistent limitations include underrepresentation of ARC-HBR patients in trials and lack of standardized, bleeding risk–tailored timing protocols. PCI in HBR patients can be performed safely and effectively when guided by individualized, evidence-based strategies for procedural timing and antithrombotic therapy. Future directions include integrating biomarker-driven DAPT modulation and artificial intelligence-based decision frameworks to optimize outcomes in this high-risk group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"780-794"},"PeriodicalIF":1.9,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145717201","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}
引用次数: 0
A Novel “Telescopic Locking” Technique for Precise Stent Placement in the Ostium of the Left Anterior Descending Artery 一种新颖的“套筒锁定”技术在左前降支口精确放置支架。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-08 DOI: 10.1002/ccd.70379
Kunal Mishra, Kamron Hamedi, Roberto A. Secaira, Theodore K. Lau
{"title":"A Novel “Telescopic Locking” Technique for Precise Stent Placement in the Ostium of the Left Anterior Descending Artery","authors":"Kunal Mishra,&nbsp;Kamron Hamedi,&nbsp;Roberto A. Secaira,&nbsp;Theodore K. Lau","doi":"10.1002/ccd.70379","DOIUrl":"10.1002/ccd.70379","url":null,"abstract":"<div>\u0000 \u0000 <p>Approaching percutaneous coronary intervention (PCI) of ostial left anterior descending artery (LAD) lesions has always been a unique challenge. The proximity of the ostial LAD lesion to the left main coronary artery (LMCA) and to the origin of the left circumflex (LCX) has always made treating these lesions difficult. It is often difficult to correctly place stents at these locations due to many variables, such as respiratory variation, cardiac motion, suboptimal angiographic visualization; all of which could lead to improper placement, thereby leading to possible complications involving the LMCA or LCX. There are several techniques in literature that have aimed to improve stent accuracy in this location, however most of these can be technically demanding or could anatomically be difficult to do. In this paper we introduce a novel technique which we call the “telescopic locking” method, whereby we make use of a guide extension catheter as a radiopaque maker and mechanical backstop to aid precise stent positioning at the LAD ostium. We present two cases in this paper to illustrate this technique.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"713-716"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703803","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}
引用次数: 0
Missing Device Details in Coronary Stent Dislodgment Case 冠状动脉支架脱位病例中缺少器械细节。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-08 DOI: 10.1002/ccd.70407
Marco Bernardi, Luigi Spadafora, Giuseppe Biondi-Zoccai
{"title":"Missing Device Details in Coronary Stent Dislodgment Case","authors":"Marco Bernardi,&nbsp;Luigi Spadafora,&nbsp;Giuseppe Biondi-Zoccai","doi":"10.1002/ccd.70407","DOIUrl":"10.1002/ccd.70407","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"752-753"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710500","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}
引用次数: 0
Unveiling Hidden Threats: Intravascular Ultrasound–Guided Precise Intervention for Coronary Ostium Obstruction Risk in Bicuspid Transcatheter Aortic Valve Replacement 揭示隐藏的威胁:血管内超声引导下对经导管二尖瓣主动脉瓣置换术中冠状动脉口阻塞风险的精确干预。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-08 DOI: 10.1002/ccd.70431
Binbin Cao, Shaoyi Lin, Xiaomin Chen
{"title":"Unveiling Hidden Threats: Intravascular Ultrasound–Guided Precise Intervention for Coronary Ostium Obstruction Risk in Bicuspid Transcatheter Aortic Valve Replacement","authors":"Binbin Cao,&nbsp;Shaoyi Lin,&nbsp;Xiaomin Chen","doi":"10.1002/ccd.70431","DOIUrl":"10.1002/ccd.70431","url":null,"abstract":"<div>\u0000 \u0000 <p>Coronary obstruction during transcatheter aortic valve replacement (TAVR) in bicuspid anatomy remains an unpredictable and potentially fatal complication. We report three representative bicuspid TAVR cases in which static computed tomography angiography (CTA) ratios-leaflet length relative to the sinotubular junction or coronary ostium-yielded conflicting or borderline risk signals. Intravascular ultrasound (IVUS) directly visualized dynamic coronary compromise and guided timely protective PCI. Each case highlights a distinct scenario: discordant metrics, borderline anatomy, and overt high-risk morphology. The combination of CTA and real-time IVUS provided decisive risk clarification and procedural safety. This case series underscores the limitations of static anatomic assessment and demonstrates the educational value of IVUS-guided decision-making in complex bicuspid TAVR.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"762-766"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710479","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}
引用次数: 0
Hemolysis Detected Following the Preparation and Collection of Blood in a Porcine Model Using a Syringe-Based Aspiration Thrombectomy System for Autotransfusion 在猪模型中使用基于注射器的抽吸取栓系统制备和采集血液后检测溶血。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-08 DOI: 10.1002/ccd.70402
Suhail Dohad, Mohammed M. Hoque, Jonathan H. Waters, Marc Salhanick
{"title":"Hemolysis Detected Following the Preparation and Collection of Blood in a Porcine Model Using a Syringe-Based Aspiration Thrombectomy System for Autotransfusion","authors":"Suhail Dohad,&nbsp;Mohammed M. Hoque,&nbsp;Jonathan H. Waters,&nbsp;Marc Salhanick","doi":"10.1002/ccd.70402","DOIUrl":"10.1002/ccd.70402","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autologous transfusion of filtered, unwashed blood is a technique to mitigate the effects of blood loss during mechanical thrombectomy, but the degree of hemolysis resulting from this approach and guidance for blood return in this setting is not well understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess hemolysis in aspirated and filtered porcine blood using a commercially available syringe-based aspiration thrombectomy blood return device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A large-bore, syringe-based aspiration thrombectomy blood return device was tested to assess extent of hemolysis in blood from a porcine model, following the manufacturer's instructions for use (IFU). The aspiration sequence consisted of three stages: blood was aspirated via the inferior vena cava (IVC) from a single animal using a 60-cc syringe through a 24 F catheter (stage 1), filtered through a blood return filter (stage 2), and processed through a transfusion filter (stage 3). Blood was sampled from each stage using a new 3-cc syringe and tested for hemolysis. This was repeated for five separate sequences using the same 60-cc syringe for a total of 15 samples. Plasma free hemoglobin (PFH) was measured as a hemolysis marker. Systemic samples were taken throughout to establish a control PFH value. Samples were compared to control and evaluated against the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Registry threshold of 20 mg/dL PFH for hemolysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using the blood return device, PFH levels were elevated relative to control (6.0 ± 1.8 mg/dL) in all samples, and 33.3% (5/15) of samples exceeded the 20 mg/dL INTERMACS threshold. A significant increase in mean PFH occurred across sequences (<i>p</i> &lt; 0.001), while there was a statistically nonsignificant increase in mean PFH (<i>p</i> = 0.059) across stages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Porcine blood processed through a syringe-based aspiration thrombectomy blood return device exhibited threshold-exceeding hemolysis, which increased across sequences and remained post-filtration. This study highlights the need to further assess hemolysis when returning aspirated blood to patients during thrombectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"729-735"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12902718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703792","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}
引用次数: 0
Comparison of Injection and Aspiration Performance of Multiple Microcatheters for Percutaneous Coronary Intervention 多根微导管在经皮冠状动脉介入治疗中的注射与抽吸性能比较。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-08 DOI: 10.1002/ccd.70423
Tomoaki Haga, Akihito Tanaka, Yosuke Tatami, Ryuji Kubota, Taiki Ohashi, Shinji Kaneko, Masanori Shinoda, Toyoaki Murohara
{"title":"Comparison of Injection and Aspiration Performance of Multiple Microcatheters for Percutaneous Coronary Intervention","authors":"Tomoaki Haga,&nbsp;Akihito Tanaka,&nbsp;Yosuke Tatami,&nbsp;Ryuji Kubota,&nbsp;Taiki Ohashi,&nbsp;Shinji Kaneko,&nbsp;Masanori Shinoda,&nbsp;Toyoaki Murohara","doi":"10.1002/ccd.70423","DOIUrl":"10.1002/ccd.70423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Injection and aspiration efficacy via microcatheter are important in complex percutaneous coronary intervention (PCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this study was to compare the injection and aspiration performance of different microcatheters under identical conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the injection bench test, injection volumes and times for each microcatheter were measured three times using an auto-injector. In the aspiration bench test, each microcatheter was connected to a two-way stopcock and an aspiration syringe. Times required to aspirate 5 mL (T1) and 10 mL (T2) of blood-mimicking fluid were measured. For the injection bench test, flow rates and resistance ratios were calculated, for the aspiration bench test, resistance ratios were calculated. The resistance ratio of the Finecross GT 130 cm was set as 1.0 (reference).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The fastest flow rate (0.66 mL/s) and lowest resistance ratio (0.74) in the injection test were observed with the Zizai 130 cm. Conversely, dual-lumen catheters exhibited the slowest flow rates (Sasuke and Crusade Type R: 0.14 mL/s, 0.19 mL/s) and highest resistance ratios (Sasuke and Crusade Type R: 3.43, 2.53). In the aspiration bench test, the Zizai 130 cm exhibited the shortest aspiration times (T1, 73.0 s, T2, 140.7 s) and lowest resistance ratio (average R1, R2: 0.74), whereas the Corsair Pro 135 cm exhibited the longest aspiration times (T1, 174 s, T2, 330.3 s) and highest resistance ratios (R1, 1.78, R2, 1.72; average, 1.75).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To our knowledge, this is the first comparison of injection efficacy and aspiration resistance among various microcatheters for PCI, providing practical guidance for microcatheter selection in complex PCI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"746-751"},"PeriodicalIF":1.9,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710532","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}
引用次数: 0
Prognostic Implications of Very Low-Gradient Aortic Stenosis After Transcatheter Aortic Valve Implantation: Insights From the OCEAN-TAVI Registry 经导管主动脉瓣置入术后极低梯度主动脉瓣狭窄的预后意义:来自OCEAN-TAVI注册的见解。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-07 DOI: 10.1002/ccd.70400
Daisuke Miyahara, Masaki Izumo, Taishi Okuno, Kai Takahiko, Shingo Kuwata, Masashi Koga, Yoshihiro Akashi, Shinichi Shirai, Yusuke Watanabe, Toru Naganuma, Norio Tada, Futoshi Yamanaka, Masahiko Noguchi, Hiroshi Ueno, Yohei Ohno, Hidetaka Nishina, Kensuke Takagi, Masahiko Asami, Kazuki Mizutani, Fumiaki Yashima, Toshiaki Otsuka, Masanori Yamamoto, Kentaro Hayashida
{"title":"Prognostic Implications of Very Low-Gradient Aortic Stenosis After Transcatheter Aortic Valve Implantation: Insights From the OCEAN-TAVI Registry","authors":"Daisuke Miyahara,&nbsp;Masaki Izumo,&nbsp;Taishi Okuno,&nbsp;Kai Takahiko,&nbsp;Shingo Kuwata,&nbsp;Masashi Koga,&nbsp;Yoshihiro Akashi,&nbsp;Shinichi Shirai,&nbsp;Yusuke Watanabe,&nbsp;Toru Naganuma,&nbsp;Norio Tada,&nbsp;Futoshi Yamanaka,&nbsp;Masahiko Noguchi,&nbsp;Hiroshi Ueno,&nbsp;Yohei Ohno,&nbsp;Hidetaka Nishina,&nbsp;Kensuke Takagi,&nbsp;Masahiko Asami,&nbsp;Kazuki Mizutani,&nbsp;Fumiaki Yashima,&nbsp;Toshiaki Otsuka,&nbsp;Masanori Yamamoto,&nbsp;Kentaro Hayashida","doi":"10.1002/ccd.70400","DOIUrl":"10.1002/ccd.70400","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The management of very low-gradient (LG) severe aortic stenosis (AS) remains challenging. Moreover, limited evidence exists regarding the outcomes of patients with very LG severe AS following transcatheter aortic valve implantation (TAVI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We aimed to elucidate the prognosis of patients with very LG severe AS after TAVI and the influence of flow status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were retrospectively collected from the OCEAN-TAVI multicenter registry in Japan, including patients with severe AS who underwent TAVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 7103 patients were classified into three groups based on their baseline mean pressure gradient (MPG): very LG (MPG ≤ 20 mmHg), LG (20 &lt; MPG &lt; 40 mmHg), and high-gradient (HG) (MPG ≥ 40 mmHg). The primary endpoint was a composite of all-cause mortality and hospitalization for heart failure. During a median follow-up period of 741 days, the composite endpoint was reached in 2081 patients. Patients with very LG severe AS had a higher prevalence of comorbidities. Kaplan–Meier analysis showed that very LG severe AS was associated with significantly lower event-free survival compared to that with LG and HG severe AS. Multivariable Cox regression analysis identified very LG severe AS as an independent poor prognostic indicator, regardless of the flow state. Moreover, within the very LG severe AS group, a low body mass index and myocardial infarction history were associated with worse outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that patients with very LG severe AS have worse prognoses compared to those with LG or HG severe AS following TAVI, regardless of the flow state.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"717-728"},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703791","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}
引用次数: 0
The “Fracture-Advance” Technique in Intravascular Lithotripsy for the Treatment of Severe and Tortuous Calcified Coronary Lesions “骨折提前”技术在血管内碎石治疗严重扭曲钙化冠状动脉病变中的应用。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-07 DOI: 10.1002/ccd.70367
Zhichao Fang, Xin Xue, Si Yan, Jin Zhu, Xiaoyu Yang
{"title":"The “Fracture-Advance” Technique in Intravascular Lithotripsy for the Treatment of Severe and Tortuous Calcified Coronary Lesions","authors":"Zhichao Fang,&nbsp;Xin Xue,&nbsp;Si Yan,&nbsp;Jin Zhu,&nbsp;Xiaoyu Yang","doi":"10.1002/ccd.70367","DOIUrl":"10.1002/ccd.70367","url":null,"abstract":"<div>\u0000 \u0000 <p>Intravascular lithotripsy (IVL), a novel interventional technique for coronary artery calcification, is increasingly being adopted in the clinical setting. However, advancing the IVL balloon through heavily calcified lesions remains challenging. This report describes a “fracture-advance” technique enabling progressive balloon advancement. This strategy offers a viable alternative when conventional delivery fails.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"736-739"},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703794","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}
引用次数: 0
Letter to the Editor on “Mid-Term Clinical Outcomes and Predictors of Mortality and Major Adverse Cardiovascular Events Following Cardiac Valve Replacement Surgery: A Retrospective Cohort Study From a Tertiary Center in Iran” 致编辑关于“心脏瓣膜置换术后中期临床结果和死亡率及主要不良心血管事件预测因素:来自伊朗某三级中心的回顾性队列研究”的信。
IF 1.9 3区 医学
Catheterization and Cardiovascular Interventions Pub Date : 2025-12-07 DOI: 10.1002/ccd.70391
Syed Muhammad Sabeeh, Muhammad Umer, Muhammad Yousaf
{"title":"Letter to the Editor on “Mid-Term Clinical Outcomes and Predictors of Mortality and Major Adverse Cardiovascular Events Following Cardiac Valve Replacement Surgery: A Retrospective Cohort Study From a Tertiary Center in Iran”","authors":"Syed Muhammad Sabeeh,&nbsp;Muhammad Umer,&nbsp;Muhammad Yousaf","doi":"10.1002/ccd.70391","DOIUrl":"10.1002/ccd.70391","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 3","pages":"711-712"},"PeriodicalIF":1.9,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145703797","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}
引用次数: 0
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