Catheterization and Cardiovascular Interventions最新文献

{"title":"Combined strategy of device-based contrast minimization and urine flow rate-guided hydration to prevent acute kidney injury in high-risk patients undergoing coronary interventional procedures","authors":"Luca Paolucci MD,&nbsp;Francesca De Micco MD,&nbsp;Mario Scarpelli MD,&nbsp;Amelia Focaccio MD,&nbsp;Valeria Cavaliere MD,&nbsp;Carlo Briguori MD, PhD","doi":"10.1002/ccd.31229","DOIUrl":"10.1002/ccd.31229","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Contrast-associated acute kidney injury (CA-AKI) is a major complication following coronary procedures. We aimed to evaluate the effectiveness of a combination of urine flow rate-(UFR) guided hydration (RenalGuard^TM) and device-based contrast media (CM) reduction (DyeVert^TM) in CA-AKI prevention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Stable high-risk patients undergoing coronary procedures with the use of DyeVert^TM and RenalGuard^TM were prospectively included (<i>Combined</i> group) and matched with a similar cohort of patients treated only with RenalGuard^TM in whom CM volume was controlled by operator-dependent strategies (<i>Control</i> group). CA-AKI was defined as a serum creatinine increase ≥0.3 mg/dL at 48 h.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 55 patients were enrolled and matched with comparable controls. Patients in the <i>Combined</i> group were exposed to a lower CM dose (<i>Control</i>: 55 [30–90] mL vs. <i>Combined</i>: 42.1 [24.9–59.4] mL; <i>p </i>= 0.024). A significant interaction was found between treatment allocation and serum creatinine changes (<i>p </i>= 0.048). CA-AKI occurred in five (9.1%) patients in the <i>Combined</i> group and in 14 (25.4%) patients in the <i>Control</i> group (OR 0.29, 95% CI [0.09–0.88]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A combined strategy of device-based CM reduction plus UFR-guided hydration is superior to operator-dependent CM sparing strategies plus UFR-guided hydration in preventing CA-AKI in high-risk patient.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1204-1210"},"PeriodicalIF":2.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253532","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":"Comparative long-term efficacy and safety of two paclitaxel-coated balloons with different coating strategies for the treatment of drug-eluting coronary stent restenosis","authors":"Tobias Koch MD,&nbsp;Tobias Lenz MD,&nbsp;Tobias Rheude MD,&nbsp;Salvatore Cassese MD, PhD,&nbsp;Erion Xhepa MD, PhD,&nbsp;Michael Joner MD,&nbsp;Julinda Mehilli MD,&nbsp;Heribert Schunkert MD,&nbsp;Adnan Kastrati MD,&nbsp;Sebastian Kufner MD","doi":"10.1002/ccd.31228","DOIUrl":"10.1002/ccd.31228","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We previously showed non-inferiority of a low-dose paclitaxel-coated balloon (PCB) with citrate excipient (Agent PCB) as compared to normal-dose iopromide excipient (SeQuent Please PCB) in terms of angiographic and clinical endpoints at 12 months. The long-term clinical efficacy and safety of Agent PCB is not defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>262 patients (323 DES-ISR lesions) were enrolled in this study and treated with either Agent PCB (125 patients, 151 lesions) in the ISAR-DESIRE 3a trial or with SeQuent Please PCB (137 patients, 172 lesions) in the setting of the randomized ISAR-DESIRE 3 trial with similar in- and exclusion criteria serving as historical control arm. The follow-up period was extended to 7 years. The efficacy and safety endpoints of this analysis were target-lesion revascularization (TLR), death, myocardial infarction (MI) and target lesion thrombosis (TLT) at 7 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 7 years, 206 patients (78.6%) were alive. The risks of TLR (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 0.87–1.90; <i>p</i> = 0.205), death (HR: 1.38, 95% CI: 0.82-2.35; <i>p</i> = 0.227), MI (HR: 1.10, 95% CI: 0.39–3.15; <i>p</i> = 0.852) and TLT (HR: 2.18, 95% CI: 0.20–24.10; <i>p</i> = 0.523) were comparable between Agent PCB and SeQuent PCB. Multivariate analysis showed comparable risks of TLR, death and MI between both PCB devices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients treated for DES-ISR by angioplasty with Agent PCB and SeQuent Please PCB, there was no statistically significant difference in TLR at 7 years. Randomized trials with standardized lesion preparation and long-term follow-up are warranted to further evaluate comparative efficacy of both devices. (ClinicalTrials. gov Identifier: NCT02367495).</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"909-917"},"PeriodicalIF":2.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31228","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253569","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":"Outcomes of transcatheter closure for coronary artery fistulas with or without aneurysm: A comparative study","authors":"Peijian Wei MD,&nbsp;Zuo Pu MD,&nbsp;Jeffrey S. K. Chan MBChB, MPH,&nbsp;Yihang Li MM,&nbsp;Liang Xu MD,&nbsp;Junyi Wan MD,&nbsp;Fengwen Zhang MD,&nbsp;Gary Tse MD, PhD,&nbsp;Shouzheng Wang MD,&nbsp;Wenbin Ouyang MD,&nbsp;Gejun Zhang MD,&nbsp;Fang Fang MD,&nbsp;Xiangbin Pan MD, PhD","doi":"10.1002/ccd.31235","DOIUrl":"10.1002/ccd.31235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coronary Artery Fistulas (CAFs) Patients with aneurysm may face severe complications, necessitating prompt treatment. However, data on the outcomes of transcatheter closure in CAFs patients with aneurysm are notably scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included all consecutive CAFs patients who underwent transcatheter closure at Fuwai Hospital from January 2010 to December 2023. Patients were divided into two groups based on the presence of aneurysm, and baseline characteristics, anatomical features, and transcatheter closure outcomes were further compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study ultimately included 104 patients, consisting of 56 in the aneurysm group and 48 in the non-aneurysm group. Patients in the aneurysm group were younger [39.79 (16.35) versus 50.69 (13.31) years, <i>p</i> &lt; 0.001] and more frequently present with heart murmurs (21.43% vs. 6.25%, <i>p</i> = 0.03). Multivariate logistic regression indicated that a larger fistula diameter and the presence of CCFs are independent risk factors for the presence of aneurysm in CAF patients. The procedural success rate (75% vs. 75%, <i>P</i> = 1), fistula recanalization rate (11.11% vs. 16.67%, <i>p</i> = 0.42), and reintervention rate (3.7% vs. 6.25%, <i>p</i> = 0.89) were similar between the aneurysm and non-aneurysm groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A larger fistula diameters and the presence of coronary-cameral fistulas are independent risk factors for the occurrence of aneurysms in patients with CAFs. The outcomes of transcatheter closure are comparable for CAFs patients with and without aneurysm, though post-closure thrombosis within the fistula appears to be more common in patients with aneurysm.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"990-998"},"PeriodicalIF":2.1,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253570","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":"Selective embolization with autologous fat to treat massive bleeding secondary to percutaneous renal biopsy","authors":"Fabio Solis-Jiménez MD, MSc,&nbsp;Alexandra Perez-Zamorano MD,&nbsp;Guering Eid-Lidt MD,&nbsp;Gian Manuel Jimenez-Rodriguez MD, MSc","doi":"10.1002/ccd.31224","DOIUrl":"10.1002/ccd.31224","url":null,"abstract":"<p>Bleeding following a percutaneous renal biopsy is a complication that can be life-threatening. Embolization of the bleeding artery is a procedure that can limit the damage; however, embolization devices can be costly or not immediately available. This is why we present the case of a 25-year-old man with a history of multiple thromboses who underwent a renal biopsy due to suspected systemic lupus erythematosus. Five days after the procedure, he developed hypovolemic shock. A CT scan was performed due to suspected hemorrhage and showed active bleeding at the renal biopsy site. Since embolization devices were not immediately available, selective embolization of the bleeding artery was successfully performed using autologous fat. It is known that embolization with coils is the most frequently used interventional procedure to stop bleeding secondary to renal biopsies. However, embolization with autologous fat is a proven technique to stop bleeding in coronary perforations. In this case, we adapted this technique to treat an actively bleeding renal artery secondary to a renal biopsy. Based on this case, we consider that this technique may be an alternative when coil embolization is not available.</p>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"1008-1011"},"PeriodicalIF":2.1,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31224","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253574","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":"Age-related structural remodelling of the coronary circulation","authors":"Daniel Faria MD, PhD,&nbsp;Marco Lombardi MD, PhD,&nbsp;Nina van der Hoeven MD, PhD,&nbsp;Alejandro Travieso MD, PhD,&nbsp;Julius C. Heemelaar MD, PhD,&nbsp;Sukhjinder S. Nijjer MD, PhD,&nbsp;Hernán Mejía-Rentería MD, PhD,&nbsp;Guus A. de Waard MD, PhD,&nbsp;Sayan Sen MD, PhD,&nbsp;Tim P. van de Hoef MD, PhD,&nbsp;Ricardo Petraco MD, PhD,&nbsp;Mauro Echavarría-Pinto MD, PhD,&nbsp;Jan J. Piek MD, PhD,&nbsp;Justin E. Davies MD, PhD,&nbsp;Niels van Royen MD, PhD,&nbsp;Javier Escaned MD, PhD","doi":"10.1002/ccd.31223","DOIUrl":"10.1002/ccd.31223","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While it is broadly accepted that ageing is associated with impairment of coronary microvascular function, little is known about the underlying mechanisms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>We investigated age-related changes in coronary microvascular structure in patients with stable angina without epicardial coronary stenoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In an analysis of the IDEAL registry, a total of 165 vessels without coronary stenosis were interrogated with combined pressure/Doppler guidewires. We calculated diastolic microvascular conductance (DMVC) and backward expansion wave (BEW), and compared them between age tertiles. We calculated the prevalence of CMD, defined by reduced coronary flow reserve (CFR), and the prevalence of low BEW and low DMVC in each group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The three study groups were defined as having 37–53, 54–66, and 67–77 years of age, respectively. Oldest (3rd tertile) patients showed lower hyperemic flow velocity (46.7 ± 14.4 vs. 45.1 ± 12.4 vs. 38.4 ± 11.5 cm s⁻¹, <i>p</i> = 0.019), lower DMVC (1.90 ± 0.71 vs. 1.44 ± 0.56 vs. 1.37 ± 0.67 cm s⁻¹ mmHg⁻¹, <i>p</i> &lt; 0.001) and lower BEW intensity (5.9 [2.9–8.4] vs. 4.8 [2.9–6.8] vs. 4.4 [3.4–6.3] × 10⁶ W m⁻² s⁻¹, <i>p</i> = 0.094). Older age was independently associated with lower BEW intensity (<i>B</i>: −0.10, 95% confidence interval [CI]: −0.17 to −0.09, <i>p</i> = 0.021) and DMVC (<i>B</i>: −0.25 95% CI: −0.45 to −0.09, <i>p</i> = 0.027). In patients with CFR &lt; 2.5, the prevalence of BEW intensity and DMVC below the 25th percentile increased with age (25.0% vs. 52.0% vs. 72.7%, <i>p</i> = 0.010).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ageing is independently associated with structural microcirculatory remodeling that is reflected in BEW intensity and DMVC measurements, and with an increased prevalence of structural CMD. These results are important to understand non-obstructive mechanisms of myocardial ischemia in the elderly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"968-979"},"PeriodicalIF":2.1,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253577","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 intra-vascular imaging in patients undergoing intravascular lithotripsy: Insights from the COIL registry","authors":"Bilal Bawamia MD,&nbsp;Michał Kuzemczak MD, PhD,&nbsp;Janusz Lipiecki MD, PhD,&nbsp;Jacek Legutko MD, PhD,&nbsp;Johan Bennett MD, PhD,&nbsp;Joseph Dens MD,&nbsp;Mohammad Alkhalil DPhil, MRCP","doi":"10.1002/ccd.31227","DOIUrl":"10.1002/ccd.31227","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The role of intra-coronary imaging in patients with stent failure undergoing intravascular lithotripsy (IVL) is unclear. We aimed to assess clinical outcomes in patients undergoing IVL treatment for stent failure stratified according to the use of intra-coronary imaging and lesion complexity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a pre-specified subgroup analysis of patients who were included in the coronary intravascular lithotripsy in patients with stent failure (COIL) registry (international multi-centre study assessing IVL treatment for stent failure in 6 European centres). A complex lesion was defined if IVL treatment was used in the left main, true bifurcation, long lesion, or coupled with athero-ablative therapy. The primary endpoint was the composite of cardiac death, spontaneous myocardial infarction, or target vessel revascularization (TVR) at 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 102 patients analyzed, of whom 27 (26%) patients had complex anatomy. The use of intra-coronary imaging following IVL in stent failure was more frequent in patients with complex versus Noncomplex anatomy (56% vs. 31%, <i>p</i> = 0.022). IVL treatment was effective in both groups, however, patients with complex anatomy had worse clinical outcomes (30% vs. 11%, <i>p</i> = 0.02), driven by a higher rate of TVR (26% vs. 8%, <i>p</i> = 0.017). In the complex group, patients who underwent intracoronary imaging post intervention had lower event rate compared to those without imaging (13% vs. 50%, <i>p</i> = 0.038).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In patients undergoing IVL treatment for stent failure with complex coronary anatomy, the use of intra-coronary imaging was associated with fewer adverse events compared to angiography guided intervention.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"891-898"},"PeriodicalIF":2.1,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253572","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":"Efficacy and safety of the VASCADE® MVP venous vascular closure device in patients undergoing percutaneous left atrial appendage occlusion with WATCHMAN","authors":"Hafez Golzarian DO,&nbsp;Katherine T. Graebel MD,&nbsp;Rachel Bailey DO,&nbsp;Michael B. Widmer DO,&nbsp;Arielle Thiel RN,&nbsp;Gerri Hempfling CNP,&nbsp;Michael Otto PA,&nbsp;Todd Otto PA,&nbsp;Sandeep M. Patel FACC, FSCAI, RPVI","doi":"10.1002/ccd.31209","DOIUrl":"10.1002/ccd.31209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The VASCADE MVP venous vascular closure system is commonly used for percutaneous venotomy closure in catheter-based procedures utilizing sheath sizes 6-12 French. However, its application with larger sheaths such as ones required in left atrial appendage occlusion (LAAO) has yet to be explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study compared the efficacy and safety of VASCADE MVP versus conventional Figure-of-8 sutures (Fo8) for femoral venotomy closure in patients undergoing Watchman LAAO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective analysis included patients who underwent post-LAAO femoral venotomy closure with either VASCADE MVP or Fo8 sutures. The primary efficacy endpoint was time to hemostasis (TTH). Primary safety endpoints were 30-day access site-related readmissions and major complications. Minor access-site-related complications were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>107 patients underwent post-LAAO femoral venotomy closure with VASCADE MVP, of which 101 were successful (94.4%). 99 patients underwent conventional closure with Fo8 sutures and supplemental manual pressure. Baseline characteristics were similar between groups. TTH was significantly shorter with VASCADE MVP (152.9 vs. 335.8 s, <i>p</i> = 0.001). Major safety outcomes were comparable. However, the conventional group experienced a higher incidence of ecchymosis (16.2% vs 4.7%, <i>p</i> = 0.007) and 30-day all-cause readmission (18.2% vs 8.4%, <i>p</i> = 0.038).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>VASCADE MVP significantly reduced TTH compared to Fo8 sutures after LAAO. While demonstrating a similar safety profile, VASCADE MVP may offer a more efficient approach to femoral vein closure in this patient population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 6","pages":"1260-1266"},"PeriodicalIF":2.1,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268853","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":"The effect of hydrostatic pressure on invasive coronary pressure measurements: Comparison with [15O]H2O-positron emission tomography flow data","authors":"Adriaan Wilgenhof MD,&nbsp;Ruurt A. Jukema MD,&nbsp;Roel S. Driessen MD, PhD,&nbsp;Ibrahim Danad MD, PhD,&nbsp;Pieter G. Raijmakers MD, PhD,&nbsp;Niels van Royen MD, PhD,&nbsp;Lokien X. van Nunen MD, PhD,&nbsp;Carlos Collet MD, PhD,&nbsp;Guus A. de Waard MD, PhD,&nbsp;Paul Knaapen MD, PhD","doi":"10.1002/ccd.31215","DOIUrl":"10.1002/ccd.31215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Fractional flow reserve (FFR) has emerged as the invasive gold standard for assessing vessel-specific ischemia. However, FFR measurements are influenced by the hydrostatic effect, which might adversely impact the assessment of ischemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to investigate the impact of hydrostatic pressure on FFR measurements by correcting for the height and comparing FFR with [¹⁵O]H₂O positron emission tomography (PET)-derived relative flow reserve (RFR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 206 patients were included in this analysis. Patients underwent coronary computed tomography angiography (CCTA), [¹⁵O]H₂O PET, and invasive coronary angiography with routine FFR in every epicardial artery. Height differences between the aortic guiding catheter and distal pressure sensor were quantified on CCTA images. An FFR ≤ 0.80 was considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found a reclassification in 7% of the coronary arteries. Notably, 11% of left anterior descending (LAD) arteries were reclassified from hemodynamically significant to nonsignificant. Conversely, 6% of left circumflex (Cx) arteries were reclassified from nonsignificant to significant. After correcting for the hydrostatic pressure effect, the correlation between FFR and PET-derived RFR increased significantly from <i>r</i> = 0.720 to <i>r</i> = 0.786 (<i>p</i> = 0.009). The average magnitude of correction was +0.05 FFR units in the LAD, −0.03 in the Cx, and −0.02 in the right coronary artery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hydrostatic pressure has a small but clinically relevant influence on FFR measurements obtained with a pressure wire. Correcting for this hydrostatic error significantly enhances the correlation between FFR and PET-derived RFR.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"980-989"},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.31215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183592","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 impact of stroke and bleeding on mortality and quality of life during the first year after TAVI: A POPular TAVI subanalysis","authors":"Puck J. A. van Nuland,&nbsp;Dirk Jan van Ginkel MD,&nbsp;Daniel C. Overduin MD,&nbsp;Willem L. Bor MD,&nbsp;Jorn Brouwer MD, PhD,&nbsp;Vincent J. Nijenhuis MD, PhD,&nbsp;Joyce Peper PhD,&nbsp;Arnoud W. J. van't Hof MD, PhD,&nbsp;Pieter A. Vriesendorp MD, PhD,&nbsp;Jurriën M. ten Berg MD, PhD","doi":"10.1002/ccd.31218","DOIUrl":"10.1002/ccd.31218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bleeding and stroke are frequent complications after transcatheter aortic valve implantation (TAVI). The mortality risk associated with these events has been reported before, but data regarding their impact on health-related quality of life (QoL) is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the impact of bleeding and stroke occurring within 30 days after TAVI, on mortality and QoL during the first year after TAVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>POPular TAVI was a randomized clinical trial that evaluated the addition of clopidogrel to aspirin or oral anticoagulation in patients undergoing TAVI. Besides clinical outcomes, QoL was assessed using the Short Form-12 and EuroQoL Five Dimensions questionnaires before, and at 3, 6, and 12 months after TAVI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Major or life-threatening bleeding occurred in 81 patients (8.3%) and was associated with an increased risk of death (hazard ratio [HR] 1.95 [95% confidence interval (CI) 1.00–3.79]); minor bleeding occurred in 104 patients (10.6%) and was not associated with mortality (HR 0.75 [95% CI 0.30–1.89]). Stroke occurred in 35 patients (3.6%) and was associated with an increased risk of death (HR 2.90 [95% CI 1.23–6.83]). Mean mental component summary (MCS-12) scores over time were lower in patients with major or life-threatening bleeding (<i>p</i> = 0.01), and similar in patients with minor bleeding, compared to patients without bleeding; mean physical component summary (PCS-12) scores, EQ-5D index, and visual analog scale (VAS) were similar between those patients. Mean MCS-12 scores were lower in patients with stroke (<i>p</i> = 0.01), mean PCS-12, EQ-5D index, and VAS were similar compared to patients without stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Major or life-threatening bleeding and stroke were associated with an increased risk of death and decreased mental QoL in the first year after TAVI.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"1107-1118"},"PeriodicalIF":2.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183593","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 commissural alignment on the hemodynamic performance of supra-annular self-expandable transcatheter aortic valves","authors":"Ignacio J. Amat-Santos MD, PhD, FESC,&nbsp;Javier Gómez-Herrero MD,&nbsp;Pablo Pinon MD,&nbsp;Luis Nombela-Franco MD, PhD,&nbsp;Raúl Moreno MD, PhD,&nbsp;Antonio J. Munoz-García MD,&nbsp;Alfredo Redondo MD,&nbsp;Antonio Gómez-Menchero MD, PhD,&nbsp;Itziar Gómez-Salvador MD,&nbsp;J. Alberto San Román MD, PhD","doi":"10.1002/ccd.31201","DOIUrl":"10.1002/ccd.31201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hemodynamic impact of commissural alignment (CA) with self-expandable transcatheter aortic valves (TAVR) has not been investigated yet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine hemodynamic impact of CA with self-expandable TAVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Multicentric ambispective study comparing patients who underwent self-expandable TAVR in seven centers with the Evolut Pro/Pro+ (EP) (Medtronic) and Acurate neo2 (AN2) (Boston Scientific) with and without CA strategies. The degree of commissural misalignment (CMA) was assessed by computed tomography/angiography and 1-year transvalvular gradients/regurgitation evaluated by echocardiography. A matched comparison according to annular dimensions/eccentricity, prosthesis size/type, and baseline left ventricular function and gradients was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 557 patients, mean age 80.7 ± 6.6 years, 61.4% men, and STS score of 4.3 ± 3.1% were analyzed. A CA technique was attempted in 215 patients (38.6%), including 113 patients with AN2 and 102 patients with EP. None/mild CMA was found in 158 (73.5% vs. 43.6% if no CA attempted, <i>p</i> &lt; 0.001) with no differences between devices (AN2:75.2%; EP:71.6%, <i>p</i> = 0.545). Patients with moderate/severe CMA had a greater aortic peak gradient (22.3 ± 8.7 vs. 19.7 ± 8.5, <i>p</i> = 0.001), significantly greater progression of both peak (<i>p</i> = 0.002) and mean gradients (<i>p</i> = 0.001) after matching, and higher rate of central aortic regurgitation (1.2% vs. 0.4%, <i>p</i> = 0.005) at 1-year, but not a greater proportion of patients with mean gradient ≥ 10 mmHg.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of CA strategies significantly reduced the rate of CMA for the self-expandable TAVR devices ACN2 and EP which was associated to lower transvalvular gradients and intra-prosthetic regurgitation progression at 1-year although no criteria of structural deterioration were met at this follow up. Clinicaltrials.org: NCT05097183.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"104 5","pages":"1060-1070"},"PeriodicalIF":2.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183594","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}