Catheterization and Cardiovascular Interventions最新文献

{"title":"Cardiovascular Outcomes of Drug-Coated Balloon Versus Drug-Eluting Stents for Femoropopliteal Peripheral Arterial Disease Interventions: A Meta-Regression Analysis","authors":"Yasar Sattar,&nbsp;Mohammad Hamza,&nbsp;Mansi Oberoi,&nbsp;Neel Patel,&nbsp;Nouraldeen Manasrah,&nbsp;Yasemin Bahar,&nbsp;Rana Usman Anwar,&nbsp;Sadaf Fakhra,&nbsp;Shazia Aziz,&nbsp;Moinuddin Syed,&nbsp;Ramesh Daggubati,&nbsp;Vikrant Jagadeesan,&nbsp;Timir K. Paul,&nbsp;Mamas A. Mamas,&nbsp;Islam Y. Elgendy,&nbsp;Subhash Banerjee,&nbsp;M. Chadi Alraies","doi":"10.1002/ccd.70557","DOIUrl":"10.1002/ccd.70557","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Outcomes comparing drug-coated balloons (DCB) versus drug-eluting stents (DES) have not been sufficiently studied in femoropopliteal peripheral arterial disease (PAD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This meta-analysis aims to compare outcomes of DES versus DCBs in femoropopliteal PAD and uses regression to rule out effect modifiers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online literature search was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis search strategy from inception till November 2022. <i>STATA v.17</i> was used for statistical analysis to calculate odds ratios and for univariate meta-regression to rule out effect modifiers, including baseline characteristics and comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of eight studies with 1261 patients underwent femoropopliteal peripheral arterial intervention (DCB, <i>n</i> = 670; DES, <i>n</i> = 591). There was no difference in the primary outcome of all-cause mortality and primary patency at 1 year and 2 years between DCB and DES. One-year clinically-driven target lesion revascularization (CD-TLR) was significantly lower in the DCB group (OR: 0.68; 95% CI = 0.47–0.98; <i>p</i> = 0.04); however, no significant difference was found in 2-year CD-TLR. Regarding secondary outcomes' analysis, major amputation, procedural success, and post-procedure ankle-brachial index (ABI) failed to reach statistical significance. Univariate meta-regression results showed no effect modification based on demographics, comorbidities, and lesion characteristics (<i>p</i> &gt; 0.05) for all outcomes except 1-year CD-TLR and major amputation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was no significant difference in all-cause mortality and primary patency between DCB and DES for up to 2 years. DCB was associated with lower CD-TLR at 1 year, which was lost at 2 years of follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2275-2286"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625151","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":"Prognostic Impact of Baseline Anemia on Outcomes After Elective PCI in Men: A US Retrospective Cohort Study","authors":"Abdalhakim Shubietah,&nbsp;Mohamed S. Elgendy,&nbsp;Mohamed Saad Rakab,&nbsp;Ahmed Ahmed,&nbsp;Batoul Abusalah,&nbsp;Mohamed R. Murad,&nbsp;Belal Mohamed Hamed,&nbsp;Hamza A. Abdul-Hafez,&nbsp;Ahmed Emara,&nbsp;Qutaiba Qafisheh,&nbsp;Elsayed Balbaa,&nbsp;Ameer Awashra,&nbsp;Ahmed Mansour,&nbsp;Ahmed Elbataa,&nbsp;Abdalrahman Assaassa,&nbsp;Mohammed Mhanna","doi":"10.1002/ccd.70583","DOIUrl":"10.1002/ccd.70583","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is unclear whether preprocedural anemia independently affects outcomes after elective PCI in men with stable CAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using the TriNetX US Collaborative Network, we identified adult men undergoing first-time elective PCI (2016–2024) and compared those with hemoglobin &lt; 13 g/dL (1–7 days pre-PCI) to non-anemic controls. Propensity-score matching produced two balanced cohorts (<i>n</i> = 1424). Outcomes at 7 days, 30 days, 6 months, and 12 months were analyzed with univariate and multivariable Cox models. Residual confounding was assessed with falsification endpoints and E-values, and multiplicity with Bonferroni and Benjamini–Hochberg adjustments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After propensity-score matching, 7-day outcomes were similar between groups. At 30 days, anemia was associated with higher risks of AKI (HR 1.92; 95% CI 1.35–2.72) and major bleeding (HR 2.49; 95% CI 1.48–4.19); however, the 30-day association with all-cause hospitalization (HR 1.32; 95% CI 1.05–1.66) did not remain statistically significant after multiplicity adjustment. At 6 months, anemia was linked to higher risks of AKI (HR 2.34; 95% CI 1.84–2.97), mortality (HR 2.63; 95% CI 1.63–4.26), hospitalization (HR 1.56; 95% CI 1.34–1.80), major bleeding (HR 3.28; 95% CI 2.34–4.61), and transfusion (HR 5.47; 95% CI 3.31–9.06); the association with MACE (HR 1.37; 95% CI 1.10–1.70) was sensitive to multiplicity adjustment (significant under false-discovery-rate control but not Bonferroni). At 12 months, anemia remained associated with higher risks of AKI (HR 1.96; 95% CI 1.60–2.41), mortality (HR 1.88; 95% CI 1.31–2.70), hospitalization (HR 1.41; 95% CI 1.23–1.62), major bleeding (HR 2.16; 95% CI 1.66–2.81), and transfusion (HR 3.35; 95% CI 2.31–4.85); the association with MACE (HR 1.26; 95% CI 1.03–1.53) did not persist after multiplicity adjustment. Each 1 g/dL increase in hemoglobin was associated with lower risks of AKI and transfusion in univariate Cox models, with similar directionality after adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In men undergoing first-time elective PCI for stable CAD, baseline anemia was associated with higher 12-month risks of AKI, major bleeding, transfusion, hospitalization, and death—especially with recent (≤ 1 year) bleeding or transfusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2198-2213"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611584","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 HALP Score and Its Association With Coronary Collateral Circulation Development in Chronic Total Occlusion Patients","authors":"Cuma Süleymanoğlu,&nbsp;Fuat Polat,&nbsp;Emre Paçacı,&nbsp;Sait Terzi","doi":"10.1002/ccd.70613","DOIUrl":"10.1002/ccd.70613","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Coronary collateral circulation plays a crucial compensatory role in patients with chronic total occlusion (CTO) by providing alternative blood flow pathways. The HALP score (hemoglobin, albumin, lymphocyte, and platelet) integrates systemic inflammation and nutritional status, but its relationship with collateral development in CTO patients remains unexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the association between HALP score and coronary collateral circulation quality assessed by Werner classification in CTO patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included 240 consecutive CTO patients who underwent coronary angiography. HALP score was calculated using the formula: hemoglobin (g/L) × albumin (g/L) × lymphocytes (/μL)/platelets (/μL). Collateral circulation was graded using the Werner classification (CC0-CC3), with good collateral defined as a CC score ≥ 2. Correlation analysis, ROC curve analysis, and multivariate logistic regression were performed to assess the relationship between HALP score and collateral circulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median HALP score was 4.20 (IQR: 2.68−5.68). A significant positive correlation was observed between HALP score and Werner grade (<i>r</i> = 0.807, <i>p</i> &lt; 0.001, <i>R</i>² = 0.652). Median HALP scores increased progressively across Werner grades: CC0 (1.62), CC1 (3.20), CC2 (4.80), and CC3 (7.70). In multivariate analysis, the HALP score was significantly associated with good collateral circulation (OR: 3.762, 95% CI: 2.182−6.486, <i>p</i> &lt; 0.001). The optimal cutoff of 3.509 demonstrated good diagnostic performance with 90.7% sensitivity and 66.7% specificity (AUC: 0.885).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HALP score is significantly associated with coronary collateral circulation development in CTO patients. This simple, cost-effective biomarker appears promising for risk stratification in this population based on this preliminary analysis, though prospective validation is needed before clinical application.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2261-2274"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625280","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":"Near-Infrared Spectroscopy-Guided Directional Coronary Atherectomy for Left Main Bifurcation: Effective Modification of Lipid-Rich Plaque","authors":"Yusuke Miura,&nbsp;Norihito Nakamura,&nbsp;Sho Torii,&nbsp;Kohei Koyama","doi":"10.1002/ccd.70609","DOIUrl":"10.1002/ccd.70609","url":null,"abstract":"<div>\u0000 \u0000 <p>Directional coronary atherectomy (DCA) is an attractive option for treating bifurcation lesions, particularly when a stentless strategy is considered; however, the clinical significance of the qualitative characteristics of post-DCA residual plaque remains unclear. We report a case of a 72-year-old male undergoing percutaneous coronary intervention for a left main coronary artery (LMCA) true bifurcation lesion, in whom near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) revealed a high lipid burden. To avoid side-branch compromise, NIRS-IVUS-guided DCA was performed from the LMCA to the left anterior descending artery, observing the progressive reduction of lipid-rich plaque in real time. Adequate lumen enlargement and qualitative plaque improvement enabled a stentless strategy using drug-eluting balloons. At 7-month follow-up, angiography showed no restenosis, and NIRS-IVUS demonstrated preserved lumen dimensions and further reduction of lipid burden. This case highlights the utility of NIRS-IVUS-guided DCA in optimizing treatment decisions for bifurcation lesions by enabling real-time assessment of plaque composition and residual vulnerability, in addition to conventional indicators, including plaque burden and % plaque area.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2230-2233"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611582","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":"Differential Predictors of Severe Versus Milder Radial Artery Spasm: Insights From a Large Contemporary Distal Radial Access Cohort","authors":"Yi-Ching Lin,&nbsp;Yung-Cheng Chen,&nbsp;Chung-Ming Tu,&nbsp;Yi-Yao Chang,&nbsp;Jung-Cheng Hsu,&nbsp;Yen-Wen Wu,&nbsp;Ai-Hsien Li","doi":"10.1002/ccd.70598","DOIUrl":"10.1002/ccd.70598","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radial artery spasm remains a frequent procedural challenge in transradial intervention; however, its predictors may differ for severe and milder forms of spasm. This distinction is poorly characterized, particularly in contemporary distal radial access (dRA) populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Hereby we intend to approach the predictors of these two types of radial artery spasm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective single-center study enrolled 291 consecutive patients planned to undergo dRA (successful in 282 [96.9%] and converted to conventional access [cRA] in nine [3.1%] patients). Spasm was systematically graded via completion angiography using a 4-point scale (0: &lt; 30%, 1: 30%−50%, 2: 50%−70%, 3: &gt; 70% narrowing). Multivariable logistic regression was used to identify the independent predictors of severe spasm (&gt; 70%) and any spasm (≥ 30%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Severe spasms occurred in 91 patients (31.3%), and spasms in 226 patients (77.7%). The predictor profiles differed substantially according to severity. For severe spasms, the independent predictors were younger age (OR: 0.949 per year; 95% CI: 0.926–0.973; <i>p</i> &lt; 0.001), lower body mass index (BMI (OR: 0.915 per kg/m², 95% CI: 0.863–0.970; <i>p</i> = 0.003), and absence of diabetes (OR: 0.495, 95% CI: 0.253–0.970; <i>p</i> = 0.040). For any spasm, the predictors were: female sex (OR: 2.34, 95% CI: 1.15–4.761.15−4.76; <i>p</i> = 0.019), younger age (OR: 0.973, 95% CI: 0.947–0.999; <i>p</i> = 0.043), and interventional procedures (OR: 2.55, 95% CI: 1.11–5.87; <i>p</i> = 0.028). The study was not designed or powered to compare access sites (dRA vs. cRA) because of the extreme cohort imbalance (<i>n</i> = 9 cRA). These findings may enable operators to tailor prophylactic measures based on patient-specific risk profiles. No vascular rupture or radial artery occlusion was observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a contemporary dRA cohort, the predictors of radial artery spasm differed according to severity. While younger age is a universal risk factor, severe spasm is uniquely associated with lower BMI and non-diabetic status, whereas milder spasms are linked to female sex and procedural complexity. These findings may enable operators to tailor prophylactic measures based on patient-specific risk profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2186-2194"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611606","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":"IVUS-Guided Rescue of Catheter-Induced Left Main Coronary Artery Dissection","authors":"Haşim Tüner,&nbsp;Fuat Polat,&nbsp;İmran Önür,&nbsp;Özge Özden Kayhan,&nbsp;Ömer Göktekin","doi":"10.1002/ccd.70584","DOIUrl":"10.1002/ccd.70584","url":null,"abstract":"<div>\u0000 \u0000 <p>Catheter-induced left main coronary artery (LMCA) dissection is a rare but life-threatening complication of coronary angiography requiring rapid recognition and expert management. We report a 72-year-old hypertensive female who developed a National Heart, Lung, and Blood Institute (NHLBI) Type-F dissection of the LMCA extending into both the left anterior descending (LAD) and circumflex (LCx) arteries during guiding catheter engagement for left coronary angiography. The dissection resulted in abrupt LAD occlusion with TIMI 0 flow and acute ST-segment elevation. Intravascular ultrasound (IVUS) revealed that both guidewires had inadvertently tracked into the false lumen, a finding that would have led to catastrophic outcomes if unrecognized. Under real-time IVUS guidance, the operator successfully redirected the wire into the true LAD lumen, followed by drug-eluting stent deployment from LMCA to LAD with proximal optimization technique (POT), LCx balloon angioplasty to decompress the subintimal hematoma, and final kissing balloon inflation restoring TIMI-III flow in both vessels. The patient remained hemodynamically stable and was asymptomatic at 6-month follow-up. This case underscores the critical and potentially life-saving role of IVUS in achieving true-lumen re-entry and successful percutaneous management of complex LMCA dissections without the need for emergency surgical intervention.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2257-2260"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625284","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":"An Old Problem, an Old Device, but Perhaps a New Indication? Intra-Aortic Balloon Counterpulsation for Intracoronary Thrombus","authors":"A. Yan,&nbsp;D. Brieger,&nbsp;H. C. Lowe","doi":"10.1002/ccd.70602","DOIUrl":"10.1002/ccd.70602","url":null,"abstract":"<div>\u0000 \u0000 <p>A case is presented of ST-elevation myocardial infarction without shock, due to right coronary artery thrombotic occlusion, in which the unusual step was taken with the use of an intra-aortic balloon pump (IABP) following coronary intervention, which was associated with prevention of further ischemia, angiographic evidence of thrombus resolution, and maintained TIMI 3 flow, in a patient with limited other apparent options. Further investigation into this strategy might be considered.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2195-2197"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611588","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":"Acute Stent Thrombosis During Glycoprotein IIb/IIIa Inhibitor Infusion","authors":"Barbara Zdzierak,&nbsp;Artur Dziewierz,&nbsp;Krystian Gruszka,&nbsp;Tomasz Rakowski","doi":"10.1002/ccd.70603","DOIUrl":"10.1002/ccd.70603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 <p>Acute stent thrombosis (ST) represents an infrequent but critical complication occurring within 24 h post-percutaneous coronary intervention (PCI). It is most associated with inadequate antiplatelet therapy, stent underexpansion, or malapposition. We report the case of a patient with acute coronary syndrome treated with PCI under optical coherence tomography guidance, who developed recurrent chest pain and ST-segment elevation 7 h after the initial procedure. Urgent coronary angiography revealed acute ST within the newly implanted stent, despite intravascular imaging-guided PCI and optimal antiplatelet therapy. The most probable cause was an untreated, hemodynamically significant stenosis at the crux of the right coronary artery, distal to the implanted stent. This critical downstream lesion impaired coronary flow, leading to stasis within the long proximal stent and creating a highly prothrombotic environment, ultimately overwhelming even potent glycoprotein IIb/IIIa inhibition. Post-dilatation of the distal coronary stenosis resulted in improved coronary flow and complete resolution of symptoms, with no recurrence observed during the remainder of the hospitalization. Optimization of PCI using intracoronary imaging and adequate antiplatelet therapy is essential for reducing the incidence of acute ST. However, untreated residual stenoses that significantly impair distal flow may also play a pivotal role in ST formation and should be addressed during the primary procedure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2252-2256"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625078","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":"Mechanical Circulatory Support Use in Chronic Total Occlusion Percutaneous Coronary Intervention: A Systematic Review","authors":"Mattia Basile,&nbsp;Giuseppe Vadalà,&nbsp;Jon Zubiaur,&nbsp;Alfredo R. Galassi,&nbsp;Guillermo Galeote,&nbsp;Roberto Garbo,&nbsp;Claudiu Ungureanu,&nbsp;Daniel Tébar-Márquez,&nbsp;Manfredi Arioti,&nbsp;Ariana Gonzálvez-García,&nbsp;Kambis Mashayekhi,&nbsp;Borja Rivero-Santana,&nbsp;Mohaned Egred,&nbsp;Santiago Jiménez-Valero,&nbsp;Emmanouil S. Brilakis,&nbsp;Raúl Moreno,&nbsp;Alfonso Jurado-Román","doi":"10.1002/ccd.70589","DOIUrl":"10.1002/ccd.70589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mechanical circulatory support (MCS) during percutaneous coronary intervention (PCI) remains controversial, particularly in high-risk procedures such as chronic total occlusion PCI (CTO-PCI), and real-world data on its frequency, patient selection, and outcomes are limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess the frequency of MCS use during CTO-PCI, to describe the clinical and procedural characteristics of supported patients, and to synthesize the available outcome data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251044868). PubMed, Scopus, and the Cochrane Library were systematically searched.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies were included in the qualitative synthesis. Reported rates of MCS use during CTO-PCI ranged from 0.7% to 6.4%. MCS was used more frequently in elderly patients and those with diabetes mellitus, chronic kidney disease, impaired left ventricular systolic function, greater anatomical complexity, and in procedures employing a retrograde approach. Across studies, procedural and clinical outcomes were consistently more favorable when MCS was implanted prophylactically rather than used as urgent rescue therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, MCS use during CTO-PCI is infrequent and largely reserved for selected high-risk cases. In patients with a meaningful anticipated risk of hemodynamic instability, prophylactic implantation should be considered. Prospective multicenter studies are needed to refine indications and assess cost-effectiveness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2139-2149"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597483","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":"Technical Success and Adverse Events Associated With Percutaneous Carotid Artery Access for Transcatheter Procedures in Infants","authors":"Michael L. O'Byrne,&nbsp;Andrew C. Glatz,&nbsp;Mudit Gupta,&nbsp;Jie Tang,&nbsp;Christopher L. Smith,&nbsp;Yoav Dori,&nbsp;Jonathan J. Rome,&nbsp;Matthew J. Gillespie,&nbsp;Ryan Callahan","doi":"10.1002/ccd.70601","DOIUrl":"10.1002/ccd.70601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Demand for transcatheter interventions in small neonates continues to increase. Percutaneous carotid artery access can facilitate intervention by providing a more direct wire course and/or potentially reduce morbidity associated with femoral artery access in very small patients. To our knowledge, there remains limited information on the technical success and adverse events associated with carotid access in this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center retrospective case series was performed of infants undergoing carotid access between January 6, 2020, and September 30, 2025, for catheterization procedures, describing the patients, procedures, and outcomes of these procedures, including protocolized ultrasound evaluation of carotid access sites and incidence of vascular and neurological complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, 105 procedures using PCA were performed in 77 individual patients at median age of 10 days (IQR: 5−63) and median weight 3.2 kg (IQR: 2.8−3.9) for stent angioplasty of the ductus arteriosus in 84%, intervention on surgical shunts in 9%, and balloon aortic valvuloplasty in 5%. One hundred percent of procedures were technically successful. There were no neurological complications. Vascular ultrasound was performed in all subjects. Pseudoaneurysms occurred after two cases, and in one case, surgical repair was performed. Follow-up imaging was available in 74% of subjects with no pathology identified after a median follow-up of 218 days (IQR: 94−761). Similarly, no clinical events attributable to carotid access were seen during clinical follow-up (median: 785 days, IQR: 330−1336).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PCA can be used to facilitate a range of transcatheter interventions, including repeated access in the same vessel. Adverse events were very rare, and no neurological complications were seen in short term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 7","pages":"2214-2222"},"PeriodicalIF":1.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611622","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}