Catheterization and Cardiovascular Interventions最新文献

{"title":"Aortic Wall Thrombus and Stroke After Transfemoral TAVR.","authors":"Marc Bonnet, Lionel Mangin, Nathanael Frank Bayard, Sébastien Gerelli, Brahim Harbaoui","doi":"10.1002/ccd.31475","DOIUrl":"https://doi.org/10.1002/ccd.31475","url":null,"abstract":"<p><p>We present the case of a patient with significant aortic wall thrombus (AWT) who experienced a stroke after transfemoral TAVR. FLAIR MRI revealed an embolic shower. Pre- and postoperative computed tomography showed dislodgment of the AWT located in the outer curvature of the aortic arch after TAVR. This case supports the hypothesis that AWT may cause stroke by being dislodged and carried upstream toward the carotid arteries.</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":"143540362","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":"Enhanced Antegrade CTO Revascularization Strategy: Notes on a Unique Microcatheter Technology.","authors":"On Topaz","doi":"10.1002/ccd.31477","DOIUrl":"https://doi.org/10.1002/ccd.31477","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536589","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":"Management of Cardiac Implantable Electronic Devices in Patients With Severe Symptomatic Tricuspid Regurgitation-Proposed Algorithm and Selected Case Examples.","authors":"Mina M Kerolos, Kevin Lee, David M Najman, Mark D Metzl, Mark J Ricciardi","doi":"10.1002/ccd.31444","DOIUrl":"https://doi.org/10.1002/ccd.31444","url":null,"abstract":"<p><p>Severe tricuspid regurgitation (TR) is associated with significant morbidity and mortality. Management of severe TR includes treatment of the underlying cause(s), medical therapy and less commonly surgical tricuspid valve repair. Newer transcatheter tricuspid valve repair devices show promise for those patients who remain symptomatic with severe TR despite such efforts. The presence of a Cardiac Implantable Electronic Device (CIED) with leads across the tricuspid valve poses a significant challenge from both diagnostic and therapeutic standpoints. In this paper, we propose an algorithm to manage patients with CIED leads across the tricuspid valve and symptomatic TR. We include case studies to illustrate implementation of the algorithm in clinical care. Key takeaway messages: (1) CIED leads across the tricuspid valve (TV) in the setting of TR are often innocent but may be causal and/or interfere with valve imaging. (2) CIED lead extraction often does not reduce TR and is reserved for select patients. (3)Transcatheter TV interventions can be performed in the presence of CIED leads. (4) An algorithm-driven interventional cardiology, electrophysiology and advanced imaging team approach is needed to best manage TR in the setting of CIED leads.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522732","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":"Combined Mitraclip Redo and Triclip Transcatheter Edge-to-Edge Repair Using Triclip Guide Catheter: A Case Report Demonstrating Its Feasibility.","authors":"Marcelo Andrés Agüero, Walter Javier García, Jorge Alberto Baccaro, Gastón Pozzi","doi":"10.1002/ccd.31470","DOIUrl":"https://doi.org/10.1002/ccd.31470","url":null,"abstract":"<p><p>A 76-year-old female patient with a previous Mitraclip implant presented with worsening heart failure signs and symptoms. Moderate to severe Mitral regurgitation and severe Tricuspid regurgitation was diagnosed. We present a case of combined redo Mitraclip and Triclip transcatheter edge-to-edge repair using Triclip guide catheter for both procedures. Such strategy can reduce time and cost of these interventions.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522730","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":"Ticagrelor Monotherapy Following Short-Term DAPT in ACS Undergoing PCI: A Systematic Review and Meta-Analysis.","authors":"Rocio Barriga Guzman, Manuel Villegas Roberson, Larissa Teixeira, Denilsa D P Navalha, Armando Talavera, Muhammad Ahmad, Yiannis Chatzizisis, Nikolaos Spilias","doi":"10.1002/ccd.31459","DOIUrl":"https://doi.org/10.1002/ccd.31459","url":null,"abstract":"<p><strong>Background: </strong>Dual antiplatelet therapy (DAPT) for 1 year after acute coronary syndrome (ACS) in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is the standard of care. However, it is associated with a higher incidence of bleeding events. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the safety and efficacy of short-term DAPT.</p><p><strong>Aims: </strong>This study aimed to assess the relative risk of major and minor bleeding, net adverse clinical and cerebral events (NACCE), and all-cause mortality in patients with ACS undergoing PCI with DES, comparing ticagrelor-based short-term DAPT (≤ 3 months) followed by ticagrelor monotherapy for up to 12 months versus 12-month DAPT. The secondary endpoint evaluated the relative risk of complications, including myocardial infarction, stroke, stent thrombosis, repeat revascularization, and cardiovascular mortality.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Cochrane Central was conducted for eligible RCTs. A subgroup analysis of ultrashort-term DAPT (≤ 1 month) followed by ticagrelor monotherapy for up to 12 months was also performed. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model.</p><p><strong>Results: </strong>Five RCTs were included with a total of 21,407 patients. Short-term DAPT was associated with a significant reduction in major bleeding (RR 0.50; 95% CI 0.38-0.66; p < 0.01), minor bleeding (RR 0.53; 95% CI 0.35-0.80; p < 0.01), NACCE (RR 0.71; 95% CI 0.59-0.85; p < 0.01), and all-cause mortality (RR 0.78; 95% CI 0.62-0.98; p =0.04).</p><p><strong>Conclusions: </strong>Short-term DAPT followed by ticagrelor monotherapy up to 12 months was associated with a significant reduction in major and minor bleeding, NACCE, and all-cause mortality compared to 12-month DAPT. There were no significant differences in myocardial infarction, stroke, stent thrombosis, repeat revascularization, or cardiovascular mortality. Major bleeding and NACCE remained consistently reduced in the subgroup analysis.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498623","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":"Aortic Root Anatomy and Impact on New-Onset Left Bundle Branch Block After Transcatheter Aortic Valve Implantation.","authors":"Habib Layoun, Joseph Kassab, Michel Chedid El Helou, Joseph El Dahdah, Odette Iskandar, Maryam Muhammad Ali Majeed Saidan, Abdelrahman Abushouk, Toshiaki Isogai, Grant Reed, Rishi Puri, Oussama M Wazni, Amar Krishnaswamy, Serge Harb, Samir Kapadia","doi":"10.1002/ccd.31434","DOIUrl":"https://doi.org/10.1002/ccd.31434","url":null,"abstract":"<p><strong>Background: </strong>Angulation of virtual basal ring (VBR), also known as aortic annulus, in relation to sino-tubular junction (STJ) may lead to greater exposure of implanted stent to the conduction system, consequently increasing the risk of left bundle branch block (LBBB).</p><p><strong>Aims: </strong>We sough to measure the VBR-STJ angle and explore its impact on the development of LBBB post-TAVR.</p><p><strong>Methods: </strong>Patients undergoing TAVR using the Sapiens 3 valve between 2016 and 2021, without pre-TAVR conduction anomalies were included. The angle between the VBR and the ascending aorta was measured as the angle between the VBR plane and the plane of the STJ on cardiac CT, along with the annulus dimensions. TAVR implantation depth was measured on fluoroscopy images.</p><p><strong>Results: </strong>A total of 1204 patients were included, with 145 having new-onset LBBB. The VBR-STJ angle was significantly greater in the new-onset LBBB group (7.3 ± 4.7 vs. 5.9 ± 4.6, p = 0.002), and the difference in implantation depth between the levels of right and none coronary cusp (RCC and NCC) was significantly correlated with the VBR-STJ angle (r = 0.3, p = 0.03). This angle was further associated with new-onset LBBB after adjustment to patient and procedural characteristics (OR 1.08 CI: [1.04, 1.13], p < 0.001).</p><p><strong>Conclusion: </strong>Patients developing LBBB have larger VBR-STJ angle which was associated with greater depth of implantation of the TAVR valve below the RCC compared to the NCC. Precise understanding of the aortic root anatomy can help to predict onset of LBBB which in turn can inform decision-making regarding optimal way of treating aortic stenosis and may improve procedure planning.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499451","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":"Correction to “Long-Term Outcomes of DCB and DES for the Treatment of In-Stent Restenosis in Relation to the Vessel Size”","authors":"","doi":"10.1002/ccd.31453","DOIUrl":"10.1002/ccd.31453","url":null,"abstract":"<p>S. Iwańczyk, R. Wolny, R. Januszek, et al., “Long-Term Outcomes of DCB and DES for the Treatment of In-Stent Restenosis in Relation to the Vessel Size,” <i>Catheterization and Cardiovascular Interventions</i> 104, no. 6 (November 2024): 1168–1177, https://doi.org/10.1002/ccd.31225.</p><p>The affiliation of Piotr Kubler was incorrect. The correct affiliation of Piotr Kubler is: Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.</p><p>We apologize for this error.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1278"},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490902","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":"Comparison of Fractional Flow Reserve and Myocardial Perfusion Imaging in Saphenous Vein Grafts.","authors":"Roel Hoek, Ruben W de Winter, Rens T Peters, Yvemarie B O Somsen, Pepijn A van Diemen, Ruurt A Jukema, Jos W Twisk, Niels J Verouden, Alexander W den Hartog, Pieter G Raijmakers, Alexander Nap, Ibrahim Danad, Paul Knaapen","doi":"10.1002/ccd.31467","DOIUrl":"https://doi.org/10.1002/ccd.31467","url":null,"abstract":"<p><strong>Background: </strong>Revascularization decision-making for saphenous vein grafts (SVGs) relies on angiographic lesion severity estimation, as studies on fractional flow reserve (FFR) for detecting ischemia in SVGs are scarce.</p><p><strong>Aims: </strong>To compare FFR and quantitative coronary angiography (QCA) of SVGs against myocardial perfusion imaging (MPI) and to establish an optimal FFR threshold for SVGs.</p><p><strong>Methods: </strong>This cross-sectional registry study included symptomatic patients with prior coronary artery bypass grafting who underwent single-photon emission computed tomography, positron emission tomography, or stress perfusion cardiac magnetic resonance imaging and had FFR measurements of ≥ 1 SVGs. We matched the myocardial territory supplied by the SVGs to ischemia on MPI. The optimal FFR threshold for SVGs was determined using the Youden index. Diagnostic performance measures were calculated and compared for FFR (0.80 and the optimal threshold) and for QCA (diameter stenosis ≥ 50%).</p><p><strong>Results: </strong>This study included 80 patients (mean age 73 ± 7 years, 68 [85%] male) with 94 SVGs, of which 38 (40%) supplied ischemic myocardium. Areas under the curve between FFR and QCA were comparable (0.73 vs. 0.65, p = 0.181). The optimal cutoff value of FFR was 0.94. FFR ≤ 0.94 showed higher sensitivity (63%) and negative predictive value (75%) compared to FFR ≤ 0.80 (32% [p < 0.001] and 64% [p = 0.007]) and QCA (37% [p = 0.002] and 65% [p = 0.021]), but with lower specificity (75%) than FFR ≤ 0.80 (84%, p = 0.021). Positive predictive value and overall accuracy were similar across all methods.</p><p><strong>Conclusions: </strong>FFR and QCA had comparable moderate diagnostic performance for detecting SVG failure determined by MPI. The optimal FFR cutoff in SVGs is higher than 0.80, resulting in higher sensitivity and negative predictive value compared to FFR ≤ 0.80 and QCA, at the expense of reduced specificity.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482391","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 Side Branch Predilatation on Provisional Bifurcation Percutaneous Coronary Intervention Outcomes: Insights From PROGRESS-BIFURCATION Registry.","authors":"Pedro E P Carvalho, Deniz Mutlu, Dimitrios Strepkos, Michaella Alexandrou, Ozgur Selim Ser, Sandeep Jalli, Barkin Kultursay, Ali Karagoz, Oleg Krestyaninov, Dmitrii Khelimskii, Mahmut Uluganyan, Korhan Soylu, Ufuk Yildirim, Olga Mastrodemos, Bavana V Rangan, Konstantinos Voudris, M Nicholas Burke, Yader Sandoval, Emmanouil S Brilakis","doi":"10.1002/ccd.31465","DOIUrl":"https://doi.org/10.1002/ccd.31465","url":null,"abstract":"<p><strong>Background: </strong>Whether side branch (SB) predilatation should be performed in patients undergoing bifurcation percutaneous coronary interventions (PCI) remains controversial.</p><p><strong>Methods: </strong>We performed an observational cohort study across six international centers from 2013 to 2024, as part of the Prospective Global Registry of PCI in Bifurcation Lesions (PROGRESS-BIFURCATION). We analyzed procedural characteristics and in-hospital outcomes of patients undergoing provisional bifurcation PCI with and without SB lesion predilatation. Significant SB lesions were defined as those with ≥50% diameter stenosis. Multivariable adjusted hazard ratios (aHR) with 95% confidence intervals [CI] were calculated using mixed effects Cox regression.</p><p><strong>Results: </strong>Of 1042 lesions treated with provisional bifurcation PCI, 428 (41.1%) had significant SB lesions (true bifurcation lesions). Among these, 143 (33.4%) underwent predilatation. Lesions that underwent SB predilatation had longer SB lesion length (median 10.0 mm [IQR 5.0-10.0] vs. 5.0 mm [IQR 5.0-10.0], p = 0.001) and more SB diameter stenosis (median 90% [IQR 70%-95%] vs. 70% [IQR 60-90]). Technical success (95.1% vs. 87.7%; p = 0.015) and procedural success (93.7% vs. 82.8%; p = 0.003) were more common in the SB predilatation group, although the rates of crossover to a 2-stent technique were also higher in the SB predilatation group (23.1% vs. 10.9%; p < 0.001). The incidence of procedural complications (22.3% vs. 21.3%, p = 0.897) and in-hospital major adverse cardiovascular events (2.4% vs. 6.4%, p = 0.097) was similar between the groups.</p><p><strong>Conclusion: </strong>In provisional bifurcation PCI of true bifurcation lesions, SB predilatation was performed in approximately one-third and was associated with higher technical and procedural success, higher rates to crossover to a 2-stent technique, and similar incidence of in-hospital and long-term follow-up outcomes.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490903","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 Value of CT-Based 3D Computational Modeling in Left Atrial Appendage Occlusion: An In-Depth Analysis of the PRECISE LAAO Study.","authors":"Emmanuel De Cock, Stijn Lochy, Maximo Rivero-Ayerza, Mathieu Lempereur, Kristoff Cornelis, Philippe Debonnaire, Paul Vermeersch, Emma Christiaen, Ian Buysschaert","doi":"10.1002/ccd.31464","DOIUrl":"https://doi.org/10.1002/ccd.31464","url":null,"abstract":"<p><strong>Background: </strong>Standard of care (SoC) assessment based on computed tomography (CT) and/or transesophageal echocardiography is suboptimal for adequate preprocedural evaluation for left atrial appendage occlusion (LAAO). This can be improved through CT-based 3D computational modeling of the LAA-device interaction using FEops HEARTguide. This study aims to assess the decisional impact of FEops in preprocedural planning for LAAO.</p><p><strong>Methods: </strong>The PRECISE LAAO is a prospective multi-center self-controlled study evaluating the use of FEops in LAAO with Amulet. Preprocedural device size selection and degree of certainty (scale 0-10) were registered before (Decision SoC) and after accessing FEops (Decision FEops), followed by device implantation. Concordance was compared between the Decisions and the final implanted device. After the procedure, clinicians rated the subjective value of FEops on a scale from -3 (futile) to +3 (most helpful).</p><p><strong>Results: </strong>One hundred two patients were included. Decision SoC was concordant with the implanted device in 61 patients (59.8%), whereas Decision FEops was concordant in 92 (90.2%, p < 0.0001). FEops induced a size change in 35 patients, which was correct in 33 (32.4%). Certainty SoC was 6.7 ± 1.3 and increased after FEops assessment to 7.6 ± 1.3 (p < 0.0001). In the 33 patients with FEops-induced positive corrections, Certainty SoC was lower (6.2 ± 1.5, suggesting a more complex procedure) and increased to 7.2 ± 1.2 with FEops (p = 0.004). Clinicians rated FEops as helpful (subjective score ≥ 1) in 90.2% of cases.</p><p><strong>Conclusions: </strong>CT-based computational modeling using FEops has a positive decisional impact in LAAO, inducing a change in Amulet size selection in almost one out of three patients and increasing procedural confidence. Trials Trial Registration: NCT04640051.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482390","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}