Catheterization and Cardiovascular Interventions最新文献

{"title":"Microcatheter tip fracture and acute vessel occlusion rescued with subintimal tracking and re-entry: Move the tip","authors":"Giangiacomi Francesco MD,&nbsp;Mircoli Luca MD,&nbsp;Tumminello Gabriele MD,&nbsp;Carugo Stefano MD","doi":"10.1002/ccd.31264","DOIUrl":"10.1002/ccd.31264","url":null,"abstract":"<p>The development of microcatheters capable of advancing through long, calcified, and tortuous vessels, produced an increase in the success rate of complex percutaneous coronary interventions. However, the aggressive manipulation of these materials may lead to potentially severe and threatening complications. We present a case of Turnpike Spiral (Teleflex) tip fracture, which caused an acute occlusion of the proximal right coronary artery. The coronary artery was tortuous and had two heavily calcified lesions in the proximal segment, uncrossable to both small angioplasty balloons and standard microcatheters. After the incarceration of the tip of the Turnpike Spiral in the calcium, it got fractured during the attempt of removing it from the vessel. This led to ST-segment elevation and patient instability. Due to the impossibility of advancing a second guidewire into the true lumen, we decided to proceed to antegrade dissection and re-entry using the scratch-and-go and subintimal tracking and re-entry technique. We placed a guide-extension and we used a Gaia II (Asahi Intecc) to enter the subintimal space and advance over the fractured tip. The wire was exchanged for a Gladius MG (Asahi Intecc), which re-entered the true lumen at the level of the acute margin of the heart. Intravascular ultrasound was used to confirm the re-entry point, and three drug eluting stents were placed. In this way we rapidly restored the flow in the right coronary artery, and we prevented a myocardial infarction.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1220-1224"},"PeriodicalIF":2.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458778","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":"Long-term outcomes of DCB and DES for the treatment of in-stent restenosis in relation to the vessel size","authors":"Sylwia Iwańczyk MD, PhD,&nbsp;Rafał Wolny MD,&nbsp;Rafał Januszek MD, PhD,&nbsp;Robert J. Gil MD, PhD,&nbsp;Bernardo Cortese MD,&nbsp;Piotr Kubler MD, PhD,&nbsp;Wojciech Wojakowski MD, PhD,&nbsp;Marek Grygier MD, PhD,&nbsp;Maciej Lesiak MD, PhD,&nbsp;Wojciech Wańha MD, PhD","doi":"10.1002/ccd.31225","DOIUrl":"10.1002/ccd.31225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Percutaneous coronary intervention (PCI) with drug-coated balloons (DCB) or drug-eluting stents (DES) are well-established treatments for in-stent restenosis, however little is known about the impact of vessel size on the outcomes. The study aimed to evaluate the efficacy and safety profile of DCB versus DES in DES in-stent restenosis depending on the vessel size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients with DES in-stent restenosis who underwent PCI between January 2010 and February 2018 entered the registry with a long-term follow-up. Patients who received DCB at the index procedure were compared with those who received DES in three subgroups depending on the vessel size (≤2.5 mm; 2.5–3.5 mm; &gt;3.5 mm). Data were analyzed using propensity score matching and Kaplan-Meier estimator plots.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1,374 patients with DES in-stent restenosis, 615 were treated with DES and 759 with DCB. After propensity score matching, we analyzed 752 patients in the DES and DCB groups at a long-term follow-up. The risk of DOCE did not differ significantly between the DES and DCB groups, both in the overall population (HR 0.85; 95%CI [0.58; 1.26], log-rank <i>p</i> = 0.41) and when divided into small (HR 0.84; 95%CI [0.36; 1.95], log-rank <i>p</i> = 0.70), medium-sized (HR 0.90; 95%CI [0.49; 1.65], log-rank <i>p</i> = 0.73), and large-sized (HR 0.81; 95%CI [0.42; 1.53], log-rank <i>p</i> = 0.50) coronary arteries. The incidence of all-cause death was significantly higher in the overall DES population (HR 4.03; 95%CI [2.40; 6.79], log-rank <i>p</i> &lt; 0.001) and subgroup of small (HR 5.54; 95%CI [1.80; 17.02], log-rank <i>p</i> = 0.003), medium-sized (HR 4.37; 95%CI [1.92; 9.94], log-rank <i>p</i> = 0.009) and large-sized coronary arteries (HR 3.26; 95%CI [1.35; 7.86], log-rank <i>p</i> = 0.02).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DES and DCB strategies are comparable methods of treating ISR regardless of the diameter of the treated vessel in a long-term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1168-1177"},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388326","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 iatrogenic ascending aortic dissection after percutaneous intervention of chronic total occlusion.","authors":"Ahmad Safdar, Laura Young, Jaikirshan Khatri","doi":"10.1002/ccd.31262","DOIUrl":"https://doi.org/10.1002/ccd.31262","url":null,"abstract":"<p><strong>Background: </strong>This study highlights the prevalence and conservative management strategies of iatrogenic ascending aortic dissection after percutaneous intervention (PCI) of chronic total occlusion (CTO).</p><p><strong>Methods: </strong>Retrospective analysis on patients who underwent CTO PCI from one medical center from 2020 to 2022 was performed by two operators. Data was obtained from the Prospective Global Registry for the Study of CTO database.</p><p><strong>Results: </strong>Out of 318 patients, there were six reported cases of iatrogenic ascending aortic dissection. The causes of dissection included guiding catheter trauma, antegrade injection, two retrograde injection, and two cases of balloon rupture after lithotripsy. IVUS-guided stenting of the coronary back to the origin to seal the entry of the dissection flap occurred in two patients. All patients had a conservative management approach. No patient had to undergo urgent surgery.</p><p><strong>Conclusion: </strong>While the incidence remains rare, complications, including aortic dissection, are more frequent in CTO PCI as compared to non-CTO PCI. IVUS can be used to complete coronary intervention so long as the patient remains clinically and hemodynamically stable. Patients should have formal imaging with either transesophageal echocardiogram or computed tomography angiography. The outcomes of patients who experience iatrogenic aortic dissection during CTO PCI with stable coronary disease seem to be better than in patients with acute coronary syndrome.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388327","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":"ProGlide-AngioSeal versus ProGlide-FemoSeal for vascular access hemostasis posttranscatheter aortic valve implantation","authors":"Mohamed Samy MD,&nbsp;Martin Landt MD,&nbsp;Nader Mankerious MD,&nbsp;Arief Kurniadi MD,&nbsp;Sultan Alotaibi MD, MSc,&nbsp;Ralph Toelg MD,&nbsp;Mohamed Abdel-Wahab MD,&nbsp;Holger Nef MD,&nbsp;Abdelhakim Allali MD,&nbsp;Gert Richardt MD,&nbsp;Karim Elbasha MD","doi":"10.1002/ccd.31259","DOIUrl":"10.1002/ccd.31259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The hybrid strategy combining plug-based and suture-based vascular closure devices (VCD) was introduced as a promising technique for vascular access hemostasis after transcatheter aortic valve implantation (TAVI) with satisfactory outcomes. However, data comparing two plug-based VCDs each in the combination with a suture-based VCD, namely ProGlide/AngioSeal (P/AS) with ProGlide/FemoSeal (P/FS) VCDs, is still lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To compare the 30-day outcome of the hybrid strategy using P/AS versus P/FS for vascular access site closure after TAVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective single-center observational study included 608 patients recruited from a prospective TAVI registry between 2016 and 2022. The composite endpoint was defined as any VCD-related major vascular complications and/or bleeding more than type 1 according to Valve Academic Research Consortium criteria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The current study reported a significantly higher rate of composite endpoint in P/AS group, which was driven by a higher rate of major bleeding (5.4% vs. 1.4%, <i>p</i> = 0.036). We also found a higher rate of VCD-related minor bleeding in P/AS group (16.3% vs. 8.1%, <i>p</i> = 0.013). Successful access site hemostasis was achieved in 71.7% of P/AS group versus 83.1% in P/FS group (<i>p</i> = 0.006). The presence of anterior wall calcification at the access site was significantly associated with the composite endpoint (adj odds ratio 2.49; 95% confidence interval (1.08–5.75), <i>p</i> = 0.032).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The hybrid strategy for large bore vascular access closure using P/FS showed a potentially better 30-day outcomes compared with P/AS. The presence of anterior calcification at the access site carries a significant risk of VCD-related complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1251-1259"},"PeriodicalIF":2.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388328","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":"Coagulation after transcatheter aortic valve replacement: Still a black box?","authors":"Dr. N. Patrick Mayr MD, FACC,&nbsp;Dr. Yousuke Taniguchi MD","doi":"10.1002/ccd.31258","DOIUrl":"10.1002/ccd.31258","url":null,"abstract":"&lt;p&gt;Pioneering roots of transcatheter aortic valve replacement (TAVR) date back to the early 1990s when Andersen and colleagues first presented their prototype of a transcatheter valve. Cribier achieved a clinical breakthrough by implanting a transcatheter aortic valve in a critically ill patient in 2002. Since then, TAVR has become a routine therapy for elderly patients with acquired aortic valve stenosis. For this procedure, sufficient periprocedural anticoagulation is mandatory. The implantation of potentially thrombogenic material into the cardiovascular system harbors the risk of thrombotic events, including stroke or bioprosthetic valve thrombosis, to name just a few.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Despite significant technical advances since the introduction of transfemoral TAVR, vascular bleeding complications still occur.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Finding the right balance between thrombosis and bleeding after the procedure is equally important. Thrombin, antithrombin, fibrinogen, and platelets play a vital role in the coagulation cascade. The course of these factors is essential to understand changes in coagulation after TAVR.&lt;/p&gt;&lt;p&gt;In the current issue of this journal, Katayama and colleagues have addressed this topic in a prospective single-center observational study.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Almost half of the initial 539 patients were excluded to finally analyze a clean patient cohort, and the most frequent valve types (balloon-expandable and self-expandable) were used. Thrombin-antithrombin complex (TAT) and Fibrin degradation products (FDP) were used as surrogate parameters for changes in the coagulation system.&lt;/p&gt;&lt;p&gt;TAT is a coagulation marker and is evidence of increased thrombin formation or thrombosis. Conversely, FDP is a marker for fibrinolysis. Finally, the drop of platelets was observed over time.&lt;/p&gt;&lt;p&gt;Interestingly, a dynamic shift of coagulation status, such as a marked increase of the TAT, was observed in the very early phase after TAVR (first hour). Simultaneously—and with a high correlation to the TAT peak—a significant drop of platelets was seen. It is well known that platelet drop occurs after TAVI&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;; however, the mechanism is not clearly understood. Especially the higher TAT levels and more significant platelet drop in patients with balloon-expandable transcatheter valves require further investigation. In contrast to the dynamic changes of TAT, FDP levels increased more gradually and consistently in both valve types.&lt;/p&gt;&lt;p&gt;This study has provided insights into the coagulation system and platelets after TAVR; nevertheless, open questions remain. The authors hypothesize that the drop in platelet count may be due to mechanical destruction, overconsumption, or rapid shear stress. However, other studies have additionally shown a significant drop in hemoglobin levels during and in the early period after the procedure.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; However, this drop may also be caused by bleeding or hemodilut","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1322-1323"},"PeriodicalIF":2.1,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31258","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388325","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":"Safety, efficacy, and optical coherence tomography insights into intravascular lithotripsy for the modification of noneruptive calcified nodules.","authors":"Okasha Tahir, Syed Ibad Ali, Fatima Zehra, Laiba Shamim, Muhammad Umar","doi":"10.1002/ccd.31260","DOIUrl":"https://doi.org/10.1002/ccd.31260","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371059","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":"Chronic total occlusion percutaneous coronary intervention of anomalous coronary arteries: insights from the PROGRESS CTO registry","authors":"Gustavo M. Hirata MD,&nbsp;Athanasios Rempakos MD,&nbsp;A. Walker Boyd MD,&nbsp;Michaella Alexandrou MD,&nbsp;Deniz Mutlu MD,&nbsp;James W. Choi MD,&nbsp;Paul Poommipanit MD,&nbsp;Jaikirshan J. Khatri MD,&nbsp;Laura Young MD,&nbsp;Rhian Davies DO, MS,&nbsp;Sevket Gorgulu MD,&nbsp;Farouc A. Jaffer MD, PhD,&nbsp;Raj Chandwaney MD,&nbsp;Brian Jefferson MD,&nbsp;Basem Elbarouni MD,&nbsp;Lorenzo Azzalini MD, PhD, MSc,&nbsp;Kathleen E. Kearney MD,&nbsp;Khaldoon Alaswad MD,&nbsp;Mir B. Basir DO,&nbsp;Oleg Krestyaninov MD,&nbsp;Dmitrii Khelimskii MD,&nbsp;Nazif Aygul MD,&nbsp;Nidal Abi-Rafeh MD,&nbsp;Ahmed ElGuindy MD,&nbsp;Omer Goktekin MD,&nbsp;Bavana V. Rangan BDS, MPH,&nbsp;Olga C. Mastrodemos BA,&nbsp;Ahmed Al-Ogaili MD,&nbsp;Yader Sandoval MD,&nbsp;M. Nicholas Burke MD,&nbsp;Emmanouil S. Brilakis MD,&nbsp;Jarrod D. Frizzell MD","doi":"10.1002/ccd.31248","DOIUrl":"10.1002/ccd.31248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is limited information about the frequency and outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in anomalous coronary arteries (ACA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined the clinical and angiographic characteristics and procedural outcomes of CTO PCI in ACA among 14,173 patients who underwent 14,470 CTO PCIs at 46 US and non-US centers between 2012 and 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 14,470 CTO PCIs, 36 (0.24%) were CTO PCIs in an ACA. ACA patients had similar baseline characteristics as those without an ACA. The type of ACA in which the CTO lesion was found were as follows: anomalous origin of the right coronary artery (ARCA) (17, 48.5%), anomalous origin of left circumflex coronary artery (9, 25.7%), left anterior descending artery and left circumflex artery with separate origins (4, 11.4%), anomalous origin of the left anterior descending artery (2, 5.7%), dual left anterior descending artery (2, 5.7%) and woven coronary artery 1 (2.8%). The Japan CTO score was similar between both groups (2.17 ± 1.32 vs 2.38 ± 1.26, <i>p</i> = 0.30). The target CTO in ACA patients was more likely to have moderate/severe tortuosity (44% vs 28%, <i>p</i> = 0.035), required more often use of retrograde approach (27% vs 12%, <i>p</i> = 0.028), and was associated with longer procedure (142.5 min vs 112.00 min [74.0, 164.0], <i>p</i> = 0.028) and fluoroscopy (56 min [40, 79 ml] vs 42 min [25, 67], <i>p</i> = 0.014) time and higher contrast volume (260 ml [190, 450] vs 200 ml [150, 300], <i>p</i> = 0.004) but had similar procedural (91.4% vs 85.6%, <i>p</i> = 0.46) and technical (91.4% vs 87.0%, <i>p</i> = 0.59) success. No major adverse cardiac events (MACE) were seen in ACA patients (0% [0] vs 1.9% [281] in non-ACA patients, <i>p</i> = 1.00). Two coronary perforations were reported in ACA CTO PCI (<i>p</i> = 0.7 vs. non-ACA CTO PCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CTO PCI of ACA comprise 0.24% of all CTO PCIs performed in the PROGRESS CTO registry and was associated with higher procedural complexity but similar technical and procedural success rates and similar MACE compared with non-ACA CTO PCI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1148-1158"},"PeriodicalIF":2.1,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371058","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":"One-month DAPT after biodegradable-polymer everolimus-eluting stent implantation in women at high-bleeding risk: Insights from the POEM trial","authors":"Matteo Maurina MD,&nbsp;Carlo Andrea Pivato MD,&nbsp;Vijay Kunadian MD,&nbsp;Luca Testa MD, PhD,&nbsp;Carlo Briguori MD, PhD,&nbsp;Andrea Pacchioni MD,&nbsp;Alessia Chiara Latini MD,&nbsp;Nicola Cesani MD,&nbsp;Raffale Piccolo MD, PhD,&nbsp;Carmine Musto MD, PhD,&nbsp;Gennaro Sardella MD,&nbsp;Ciro Indolfi MD,&nbsp;Damiano Regazzoli MD,&nbsp;Valeria Paradies MD,&nbsp;Giulio Stefanini MD, PhD, MSc","doi":"10.1002/ccd.31255","DOIUrl":"10.1002/ccd.31255","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We conducted a prespecified subanalysis of the POEM trial to assess the association between sex and clinical outcomes following a short 1-month dual-antiplatelet-therapy (DAPT) period after percutaneous coronary intervention (PCI) with bioresorbable polymer everolimus-eluting stent (BP-EES) among patients at high bleeding risk (HBR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Shortening the DAPT period after PCI is an effective bleeding avoidance strategy with contemporary drug-eluting stents. Whether sex affects the risk of adverse events following PCI is still debated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients at HBR undergoing PCI with BP-EES were enrolled and treated with 1-month DAPT. If anticoagulation was needed, study participants received an oral anticoagulant (OAC) in addition to a P2Y₁₂ inhibitor for 1 month, followed by OAC only thereafter. The primary endpoint was a composite of cardiac death, myocardial infarction, or definite/probable stent thrombosis at 12 months. We report sex-based outcomes of patients included in the POEM study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We enrolled 129 (29.1%) women and 314 (70.9%) men. Women were older, with lower hemoglobin levels, and worse renal function. Accordingly, they had a trend for a greater number of HBR criteria fulfilled and a higher PARIS bleeding score. However, they were not at a significantly higher risk for the primary endpoint (men vs. women: 5.17% vs. 3.94%; HR 1.30; 95% CI: 0.48-3.54, <i>p</i> = 0.61), or any of the hemorrhagic and ischemic secondary endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This prespecified subanalysis of the POEM trial suggests that 1-month DAPT following PCI with BP-EES may be a safe and effective therapeutic strategy for women at HBR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1129-1138"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31255","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364553","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":"Use of sirolimus-coated balloon in de novo coronary lesions; long-term clinical outcomes from a multi-center real-world population","authors":"Sandeep Basavarajaiah MD, FESC,&nbsp;Vinoda Sharma MD, MRCP,&nbsp;Alessandro Sticchi MD,&nbsp;Gianluca Caiazzo MD, PhD,&nbsp;Filiberto Fausto Mottola MD,&nbsp;Bhagya Harindi Loku Waduge MBBS,&nbsp;Sampath Athukorala MD, MRCP,&nbsp;Mazaya Fawazy MD, MRCP,&nbsp;Luca Testa MD,&nbsp;Antonio Colombo MD","doi":"10.1002/ccd.31244","DOIUrl":"10.1002/ccd.31244","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;Sirolimus-coated balloon (SCB), a relatively novel technology appears attractive due to the drug properties (safety and efficacy) and sirolimus remains the drug of choice in stents. However, there is limited data long-term data on SCB. In this study, we have explored the clinical outcomes following the use of SCB in de-novo lesions from a real-world practice.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To report long-term clinical outcomes following the use of Siroliumus coated balloon in de novo lesions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods and Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We analyzed all patients treated with an SCB in de novo lesions between 2016 and 2023 at four high-volume centers in UK and Italy. The outcomes measured included cardiac death, target vessel myocardial infarction (TVMI), target lesion revascularization (TLR) and major adverse cardiac events (MACE).&lt;/p&gt;\u0000 \u0000 &lt;p&gt;During the study period, 771 patients had SCB in de novo lesions. Diabetes mellitus was noted in 36% of patients (&lt;i&gt;n&lt;/i&gt; = 280), of which 14% (&lt;i&gt;n&lt;/i&gt; = 108) were insulin dependent. Fifteen percent (&lt;i&gt;n&lt;/i&gt; = 117) had chronic kidney disease, Fifty-two percent (&lt;i&gt;n&lt;/i&gt; = 398) of cases were in the setting acute coronary syndrome (ACS) and of which 51 cases (7%) were ST-segment elevation myocardial infarction. Small vessels (&lt;3.0 mm) accounted for 78% (&lt;i&gt;n&lt;/i&gt; = 601) of cases and 76% (&lt;i&gt;n&lt;/i&gt; = 584) were long lesions (&lt;span&gt;&lt;/span&gt;&lt;math&gt;\u0000 &lt;semantics&gt;\u0000 &lt;mrow&gt;\u0000 \u0000 &lt;mrow&gt;\u0000 &lt;mo&gt;≥&lt;/mo&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;/mrow&gt;\u0000 &lt;annotation&gt; &lt;math altimg=\"urn:x-wiley:15221946:media:ccd31244:ccd31244-math-0001\" wiley:location=\"equation/ccd31244-math-0001.png\" display=\"inline\" xmlns=\"http://www.w3.org/1998/Math/MathML\"&gt;&lt;mrow&gt;&lt;mrow&gt;&lt;mo&gt;unicode{x02265}&lt;/mo&gt;&lt;/mrow&gt;&lt;/mrow&gt;&lt;/math&gt;&lt;/annotation&gt;\u0000 &lt;/semantics&gt;&lt;/math&gt;20 mm). The mean diameter of SCB was 2.6 ± 0.4 mm and the mean length was 25 ± 10.39 mm. Bailout stenting following SCB was required in 9% lesions (&lt;i&gt;n&lt;/i&gt; = 67).&lt;/p&gt;\u0000 \u0000 &lt;p&gt;During the median follow-up 640 days, total death occurred in 39 (5%) patients and of which, cardiac death occurred in 10 patients (1.3%). TVMI occurred in 20 patients (2.6%). TLR and TVR were 5.6% and 5.8% respectively. The overall MACE rate was 8%. We had no documented case of acute vessel closure.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The results from this long-term follow-up in a real-world","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1159-1167"},"PeriodicalIF":2.1,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364554","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":"Challenges in the diagnosis and management of dry tamponade","authors":"Jasleen Tiwana MD,&nbsp;Kathleen E. Kearney MD,&nbsp;William L. Lombardi MD,&nbsp;Lorenzo Azzalini MD, PhD, MSc","doi":"10.1002/ccd.31241","DOIUrl":"10.1002/ccd.31241","url":null,"abstract":"<p>Dry tamponade is a rare complication of percutaneous coronary intervention. It encompasses a heterogenous pathophysiology and is used to describe hemodynamic compromise secondary to a coronary artery perforation, without free-flowing fluid in the pericardium. Tamponade physiology can result from compressive epicardial, intramyocardial, subepicardial hematomas, or dissecting intramyocardial hematomas. The diagnosis of dry tamponade requires hemodynamic derangement in the context of a compressive hematoma as demonstrated by imaging. Although echocardiography can often help identify dry tamponade, additional studies including right heart catheterization, computed tomography, or cardiac magnetic resonance imaging can inform the exact mechanism and help guide management. This article describes a case of dry tamponade, reviews the existing literature on the topic, and offers expert recommendations on diagnosis and management.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1228-1240"},"PeriodicalIF":2.1,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361188","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}