Catheterization and Cardiovascular Interventions最新文献

{"title":"Structural Heart Disease Interventions. Year in Review 2023–2024","authors":"Konstantinos Marmagkiolis,&nbsp;Jaime Caballero,&nbsp;Stefanos Votsis,&nbsp;Vlasis Ninios,&nbsp;Mehmet Cilingiroglu,&nbsp;Konstantinos Dean Boudoulas,&nbsp;Cezar Iliescu","doi":"10.1002/ccd.31436","DOIUrl":"10.1002/ccd.31436","url":null,"abstract":"<div>\u0000 \u0000 <p>In 2023–2024, there was a surge in research on structural heart disease. This review aims to provide a comprehensive overview of the field for both general and interventional cardiologists, especially those with a keen interest in structural heart interventions. It summarizes the most important randomized controlled trials, meta-analyses, retrospective analyses, data registries, and noteworthy late-breaking studies unveiled at prominent cardiology conferences.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1196-1203"},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254695","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":"Lack of Racial Disparities in Cangrelor Therapy in Patients Presenting With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention","authors":"Waiel Abusnina,&nbsp;Kalyan R. Chitturi,&nbsp;Abhishek Chaturvedi,&nbsp;Lior Lupu,&nbsp;Dan Haberman,&nbsp;Matteo Cellamare,&nbsp;Vaishnavi Sawant,&nbsp;Cheng Zhang,&nbsp;Itsik Ben-Dor,&nbsp;Lowell F. Satler,&nbsp;Hayder D. Hashim,&nbsp;Brian C. Case,&nbsp;Ron Waksman","doi":"10.1002/ccd.31442","DOIUrl":"10.1002/ccd.31442","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cangrelor is an intravenous P2Y12 receptor antagonist that exerts rapid and potent antiplatelet effects. It is associated with a reduction in the indcidence of ischemic events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of our study was to investigate the racial disparities and their impact on outcomes among patients with ACS who were treated with cangrelor during PCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the data of patients with ACS who were treated with cangrelor during PCI at our center from 2018 to 2023 and divided between African American (AA) and Caucasian patients. The primary safety outcome was in-hospital thrombolysis in myocardial infarction (TIMI) major bleeding. The primary efficacy outcome was in-hospital major adverse cardiac events (MACE), defined as a composite of cardiac death, MI, or stroke. Multivariate regression analysis was performed to assess the primary outcomes after controlling for differences in baseline characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1181 patients who received cangrelor during PCI for ACS, including 616 AA and 565 Caucasian patients. AA patients were significantly younger (61 ± 13 vs. 64 ± 12 years; <i>p</i> &lt; 0.001) and had higher rates of hypertension, diabetes mellitus, and end-stage renal disease requiring dialysis. There were no significant differences between AA and Caucasian patients regarding in-hospital TIMI major bleeding (odds ratio [OR]: 0.55; 95% confidence interval [CI]: 0.16–1.88<i>; p</i> = 0.343) and in-hospital MACE (OR: 1.82; 95% CI: 0.71–4.69<i>; p</i> = 0.212) after controlling for relevant baseline differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>No racial disparities were observed with regard to the administration of cangrelor during PCI in patients presenting with ACS, and cangrelor was not associated with increased bleeding for AA patients as compared to Caucasian patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1188-1195"},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188431","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":"Sex Differences in Patients Presenting With ST-Segment Elevation Myocardial Infarction and Nonobstructive Coronary Arteries","authors":"Mehmet Yildiz,&nbsp;Madison Pico,&nbsp;Timothy D. Henry,&nbsp;Seth Bergstedt,&nbsp;Larissa Stanberry,&nbsp;Jenny Chambers,&nbsp;Ananya Shah,&nbsp;Lucas Volpenhein,&nbsp;Rebekah Lantz,&nbsp;Ross F. Garberich,&nbsp;Frank V. Aguirre,&nbsp;Santiago Garcia,&nbsp;Scott W. Sharkey,&nbsp;Odayme Quesada","doi":"10.1002/ccd.31438","DOIUrl":"10.1002/ccd.31438","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sex differences in ST-segment elevation myocardial infarction (STEMI) due to obstructive coronary artery disease (CAD) are well-established, but limited research exists on sex differences in STEMI patients with nonobstructive coronary arteries (MINOCA) and MINOCA mimickers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 8560 consecutive STEMI patients, enrolled in the Midwest STEMI Consortium from 2003 to 2020. Patients with non-obstructive CAD were classified into MINOCA (defined as &lt; 50% coronary artery stenosis and confirmed or suspected coronary artery plaque disruption, epicardial coronary spasm, or coronary embolism/thrombosis) and MINOCA mimickers (takotsubo cardiomyopathy, myocarditis, or non-ischemic cardiomyopathy). The primary outcome was 5-year all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 8560 patients, 409 (4.8%) had non-obstructive CAD, including 120 (1.4%) MINOCA and 289 (3.4%) MINOCA mimickers. Females were more likely to have MINOCA and MINOCA mimickers (49.2% and 56.4%, respectively). There were no significant sex differences in in-hospital or 5-year mortality in MINOCA, but females with MINOCA mimickers had higher unadjusted 5-year mortality (HR 2.90, 95% CI 1.53−5.53). After adjusting for age and comorbidities, the long-term mortality risk was similar between sexes (adjusted HR 1.16, 95% CI: 0.61−2.24). Females with obstructive CAD had higher 5-year mortality in unadjusted models (HR 1.66, 95% CI 1.48, 1.86), but the difference was not significant after adjustment (adjusted HR 1.1, 95% CI: 0.98−1.24).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings highlight important sex-based differences in the prevalence, treatment, and long-term outcomes of STEMI patients with MINOCA, MINOCA mimickers, and obstructive CAD. Despite clinical disparities, mortality risks were similar across sexes after adjusting for comorbidities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1204-1213"},"PeriodicalIF":2.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188433","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":"Saline-Enhanced Optical Coherence Tomography (OCT) and Combined Orbital Atherectomy and Intravascular Lithotripsy in Complex Right Coronary Artery Stenosis With Chronic Kidney Disease","authors":"Zubair Naeem-Shaukat,&nbsp;Javed Ehtisham,&nbsp;Naeem Shaukat,&nbsp;Ayman Helal","doi":"10.1002/ccd.31441","DOIUrl":"10.1002/ccd.31441","url":null,"abstract":"<div>\u0000 \u0000 <p>Managing coronary artery disease (CAD) in patients with chronic kidney disease (CKD) poses significant challenges, particularly in reducing contrast volume to prevent worsening renal function. We present the case of a 67-year-old male with an initial presentation of inferior STEMI and 2:1 Mobitz Type II AV block, who underwent successful primary percutaneous coronary intervention (PPCI) for a thrombotic occlusion in the right coronary artery (RCA) then staged procedure for calcium modification and stenting. This report highlights two key aspects of the procedure: using saline instead of contrast for optical coherence tomography (OCT) to minimize contrast exposure, and and employing combination of orbital atherectomy followed by intravascular lithotripsy (IVL) for calcium modification in a heavily calcified lesion. The case underscores the importance of individualized procedural strategies to optimize outcomes in patients with complex coronary anatomy and comorbid CKD. In conclusion, using saline-enhanced OCT provides adequate imaging and helps to minimize contrast use to prevent kidney injury while the combined use of orbital atherectomy and IVL allowed for optimal calcium modification, enabling excellent stent deployment in a severely calcified coronary disease.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1183-1187"},"PeriodicalIF":2.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122323","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 Occlusion on Patient Outcomes After Bifurcation Percutaneous Coronary Intervention","authors":"Dimitrios Strepkos,&nbsp;Michaella Alexandrou,&nbsp;Deniz Mutlu,&nbsp;Pedro E. P. Carvalho,&nbsp;Ozgur S. Ser,&nbsp;Sandeep Jalli,&nbsp;Konstantinos Voudris,&nbsp;M. Nicholas Burke,&nbsp;Yader Sandoval,&nbsp;Emmanouil S. Brilakis","doi":"10.1002/ccd.31439","DOIUrl":"10.1002/ccd.31439","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The outcomes and characteristics of patients with side branch occlusion (SBO) after bifurcation percutaneous coronary intervention (PCI) have received limited study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We compared the procedural characteristics and outcomes of patients with and without SBO among 933 provisional bifurcation PCIs performed in 803 patients at six centers between 2014 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of SBO was 13% (<i>n</i> = 121). SBO patients had lower rates of hypertension, prior coronary artery bypass graft surgery (CABG), and prior PCI but higher angiographic complexity, with higher prevalence of left anterior descending artery stenoses, smaller side branch diameter and more severe side branch diameter stenoses. SBO patients were more likely to convert from provisional to two-stent strategies (24.8% vs 6.0%, <i>p</i> &lt; 0.001), and to require plaque modification (39.7% vs 17.5%, <i>p</i> &lt; 0.001) and side branch percutaneous transluminal coronary angioplasty (PTCA) (25.6% vs 12.9%, <i>p</i> &lt; 0.001). SBO patients had lower technical (78.5% vs 96.2%, <i>p</i> &lt; 0.001) and procedural (73.5% vs 92.2%, <i>p</i> &lt; 0.001) success and similar in-hospital major adverse cardiovascular events (MACE), but higher dissection rates (7.1% vs 2.0%, <i>p</i> = 0.007). Patients with untreated SBO had similar in-hospital MACE with untreated SBO patients. During a median follow-up of 1,095 days patients with treated SBO (83.9%, <i>n</i> = 94) had lower follow-up MACE (hazard ratio [HR]: 0.29, 95% confidence intervals [CI]: 0.10, 0.84, <i>p</i> = 0.023) and mortality (HR: 0.22, CI: 0.065, 0.755, <i>p</i> = 0.016) compared with patients with untreated SBO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>SBO occurs in 13% of provisional PCIs. SBO patients had more complex coronary lesions and worse follow-up clinical outcomes if the SBO was left untreated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1142-1148"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078188","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":"Serial Change and Clinical Impact of Irregular Protrusion in Lesions With Chronic Coronary Syndrome","authors":"Naotaka Okamoto,&nbsp;Isamu Mizote,&nbsp;Takayuki Ishihara,&nbsp;Daisuke Nakamura,&nbsp;Tatsusya Shiraki,&nbsp;Naoki Itaya,&nbsp;Takuya Tsujimura,&nbsp;Mitsuyoshi Takahara,&nbsp;Shungo Hikosou,&nbsp;Toshiaki Mano,&nbsp;Takahumi Ueno,&nbsp;Masami Nishino,&nbsp;Shinsuke Nanto,&nbsp;Yasushi Sakata","doi":"10.1002/ccd.31430","DOIUrl":"10.1002/ccd.31430","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The changes over time and effects on long-term clinical outcomes beyond 1 year of irregular protrusion (IP) in chronic coronary syndrome (CCS) remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to assess the time-dependent change and long-term clinical impact of IP in CCS lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a post hoc analysis of COLLABORATION study, which was a multicenter, prospective, observational study conducted from July 2018 to February 2020, assessing 1- and 12-month serial vessel responses after stent implantation using OCT and coronary angioscopy. Time-dependent change in the presence of IP was evaluated using the serial OCT examinations. The cumulative 3-year incidence of TLR was compared between the lesions with and without IP, as well as between those with and without residual IP at 1 month.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 107 lesions, IP was detected in post-OCT pullbacks in 38 (35.5%) lesions. Out of the 38 lesions, IP remained in 9 (23.7%) lesions at 1 month and existed in 2 (5.3%) lesions at 12 months. The cumulative 3-year incidence of TLR was significantly higher in IP group than in non-IP group (13.6% vs. 3.0%, <i>p</i> = 0.04). Similarly, it was significantly higher in lesions with residual IP at 1 month than those without (33.3% vs. 4.3%, <i>p</i> &lt; 0.01). All residual IP at 1 month were composed of angioscopic yellow plaques and red thrombi.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The presence of IP decreased over time, but approximately one-fourth of IP remained at 1 month. IP and residual IP at 1 month were important post-stent OCT findings leading to long-term TLR in patients with CCS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1149-1160"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078336","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":"Long-Term Impact of Early Subclinical Leaflet Thrombosis After Transcatheter Aortic Valve Implantation","authors":"Juri Iwata,&nbsp;Kentaro Hayashida,&nbsp;Ryo Arita,&nbsp;Tomonari Moriizumi,&nbsp;Akiyoshi Kajino,&nbsp;Shingo Sakata,&nbsp;Toshinobu Ryuzaki,&nbsp;Keitaro Shinada,&nbsp;Hikaru Tsuruta,&nbsp;Yoshitake Yamada,&nbsp;Jungo Kato,&nbsp;Tatsuo Takahashi,&nbsp;Masataka Yamazaki,&nbsp;Masahiro Jinzaki,&nbsp;Hideyuki Shimizu,&nbsp;Masaki Ieda","doi":"10.1002/ccd.31435","DOIUrl":"10.1002/ccd.31435","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hypoattenuated leaflet thickening (HALT) after transcatheter aortic valve implantation (TAVI) detected on multidetector computed tomography (MDCT) is considered leaflet thrombosis. However, its impact on long-term clinical outcomes remains unclear. This study aimed to investigate the impact of early HALT detection after TAVI on long-term clinical outcomes and structural valve deterioration beyond 6 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Of the 672 consecutive patients who underwent TAVI between 2013 and 2018, 448 were treated with either SAPIEN XT or SAPIEN 3 and underwent MDCT analysis within 30 days after TAVI. MDCT results and echocardiographic data were analyzed annually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HALT was detected in 68 (15.2%) of 448 eligible patients within 30 days after TAVI. No significant difference in effective orifice area was observed by echocardiography within 30 days after TAVI between the HALT and the non-HALT groups in SAPIEN XT (HALT vs. non-HALT: 1.62 ± 0.66 cm² vs. 1.72 ± 0.43 cm²; <i>p</i> = 0.26) and in SAPIEN 3 (1.42 ± 0.35 cm² vs. 1.45 ± 0.34 cm²; <i>p</i> = 0.63). No significant differences in all-cause mortality (52.9% vs. 60.0%; hazard ratio (HR): 1.19; 95% confidence interval (CI): 0.83−1.70; <i>p</i> = 0.3), stroke incidence (5.9% vs. 7.1%; HR: 1.06; 95% CI: 0.08−13.7; <i>p</i> = 0.97), heart failure rehospitalization (10.3% vs. 15.0%; HR: 2.3; 95% CI: 0.89−5.99; <i>p</i> = 0.09), and structural valve deterioration (14.7% vs. 17.9%; HR: 0.89; 95% CI: 0.45−1.73; <i>p</i> = 0.73) were observed between the HALT and the non-HALT groups during the median follow-up of 1872 (interquartile range; 1203−2468) days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HALT within 30 days was not associated with clinical outcomes or hemodynamic performance during long-term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1161-1170"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31435","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078211","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":"The Role of IVUS in Coronary Complications","authors":"Fabrizio Ugo,&nbsp;Marco Franzino,&nbsp;Gianluca Massaro,&nbsp;Ludovica Maltese,&nbsp;Chiara Cavallino,&nbsp;Mohamed Abdirashid,&nbsp;Daniela Benedetto,&nbsp;Francesco Costa,&nbsp;Francesco Rametta,&nbsp;Giuseppe Massimo Sangiorgi","doi":"10.1002/ccd.31433","DOIUrl":"10.1002/ccd.31433","url":null,"abstract":"<div>\u0000 \u0000 <p>Intravascular ultrasound (IVUS) is an essential tool in the diagnostic and therapeutic management of coronary artery disease. In daily practice, IVUS is particularly useful for plaque characterization, optimizing stent implantation, and identifying the cause of in-stent restenosis. In acute coronary syndromes, it helps to detect culprit lesions that are not clearly visible on angiography and plays a key role in the diagnostic algorithm for myocardial infarction with non-obstructive coronary arteries (MINOCA). Additionally, IVUS is frequently used in complex and calcified lesions to guide optimal plaque modification strategies and improve procedural and long term outcomes. Beyond these common applications, IVUS is crucial in managing coronary complications, such as coronary dissection, perforation, intramural hematoma, and side-branch occlusion. In these challenging cases, IVUS allows us to overcome some of the limitations of angiography. This review explores the role of IVUS in bail out situations, offering practical tips and techniques for navigating coronary complications and improving procedural success in a safer and more refined manner.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1171-1182"},"PeriodicalIF":2.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122324","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":"Transcatheter Stenting to Restore Cross-Sectional Area of Extracardiac Fontan Conduits","authors":"Neil D. Patel,&nbsp;Edris Saadat,&nbsp;Patrick M. Sullivan,&nbsp;Andrew L. Cheng,&nbsp;Cheryl Takao,&nbsp;Darren P. Berman","doi":"10.1002/ccd.31432","DOIUrl":"10.1002/ccd.31432","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reduction in cross-sectional area (CSA) of extracardiac Fontan conduits (EFC) is a known complication of the Fontan operation. Relief of obstruction is crucial for optimal Fontan physiology. The aim of this study is to describe technical aspects and outcomes of EFC stenting and short-term follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective study was performed of patients who underwent stent implantation in EFCs with reduced CSA from July 2011 to February 2024. The expected conduit CSA was calculated based on the implanted EFC diameter. The minimum CSA before and after stent implantation was calculated. The minimum EFC diameter and CSA were compared pre- and post-intervention. Data are presented as median [interquartile range].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-five patients with reduced EFC CSA underwent stent implantation (median age: 13.3 [12.5, 16.8] years, median weight: 49.5 [41.6, 65.4] kg). Forty-seven (72.3%) catheterizations were performed for routine surveillance. In the 63 patients with a known original EFC size, the median reduction in EFC CSA was 36.0 [29,46] %. The minimum CSA was significantly smaller than the expected CSA (157.2 [133.7, 180.1] mm² vs. 254.5 [254.5, 254.5] mm², <i>p</i> &lt; 0.0001). Including all patients the minimum EFC diameter and CSA were 12.5 [11.6, 13.4] mm and 153.8 [133.7, 179.7] mm², respectively. Following stent placement EFC diameter and CSA improved to 16.8 [16.2, 17.8] mm (<i>p</i> &lt; 0.0001) and 234.8 [223.4, 269.2] mm² (<i>p</i> &lt; 0.0001), respectively. The EFC CSA was 96.8 [89.2, 108.4] % of the expected CSA based on the original EFC diameter. In 24 (36.9%) patients the EFC CSA following stent placement was greater than the expected CSA. There were nine complications in total, of which two were related to EFC stenting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stent implantation can safely and effectively restore EFC CSA. In select cases, conduits can be expanded beyond the stated diameter.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1134-1141"},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063922","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 Healing After Biodegradable Polymer Sirolimus-Eluting Versus Durable Polymer Everolimus-Eluting Stents in Chronic Total Occlusions","authors":"Geng Wang,&nbsp;Yi Li,&nbsp;Wen Lu,&nbsp;Yawei Xu,&nbsp;Xi Su,&nbsp;Shaoliang Chen,&nbsp;Yang Li,&nbsp;Yaling Han,&nbsp;the TARGET CTO OCT substudy Investigators","doi":"10.1002/ccd.31423","DOIUrl":"10.1002/ccd.31423","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Biodegradable polymer stents may reduce the risk of neoatherosclerosis and stent thrombosis. Limited data is available for biodegradable polymer sirolimus-eluting stent (BP-SES) and durable polymer drug-eluting stents (DP-EES) in chronic total occlusions (CTO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study was to evaluate healing patterns of BP-SES versus DP-EES in CTO at 3 and 13 months based on optical coherence tomography (OCT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The TARGET-CTO study is a prospective, multicenter, randomized noninferiority controlled trial for BP-SES compared to DP-EES in CTO. In the current predefined subanalysis, 44 consecutive patients underwent OCT follow-up at 3 and 13 months. The primary endpoint was mean neo-intimal thickness at 3 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 3 months, mean neo-intimal thickness was 47.6 ± 15.7 µm in BP-SES and 62.5 ± 37.3 µm in DP-EES (<i>p</i> = 0.384), meeting the noninferiority for BP-SES (<i>p</i>_{noninferiority} &lt; 0.001). Mean neo-intimal thickness at 13 months was 76.4 ± 34.1 µm in BP-SES and 106.6 ± 54.9 µm in DP-EES (<i>p</i> = 0.086). No significant differences in strut coverage were observed at 3 or 13 months. At 13 months significantly higher percentages of frames with layered neo-intima and neoatherosclerosis were observed in DP-EES compared to BP-SES (<i>p</i> = 0.015 and <i>p</i> = 0.021, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BP-SES was noninferior to DP-EES in terms of neo-intimal thickness at 3 months and healing responses at 3-month follow-up were comparable. At 13 months, less advanced neoatherosclerosis patterns were observed in BP-SES as compared to DP-EES.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"105 5","pages":"1124-1133"},"PeriodicalIF":2.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058309","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}