{"title":"经导管主动脉瓣置换术后经皮冠状动脉介入治疗中延长丝引导导管置换的可行性。","authors":"Makoto Saigan, Masaki Miyasaka, Daishi Tazawa, Momo Kosuga, Manabu Maeda, Yun Teng, Natsuko Satomi, Yuta Kobayashi, Masaki Nakashima, Yusuke Enta, Yoshiko Munehisa, Yukihiro Hayatsu, Norio Tada","doi":"10.1007/s12928-025-01159-w","DOIUrl":null,"url":null,"abstract":"<p><p>Percutaneous coronary intervention (PCI) after transcatheter aortic valve replacement (TAVR) is technically challenging because of the presence of the transcatheter heart valve (THV), which complicates coronary artery engagement. Owing to their flexibility, diagnostic catheters (DCs) facilitate coronary access, but require subsequent exchange to guiding catheters (GCs) for PCI. The feasibility of using an extension wire (EW) to facilitate DC-to-GC exchange in this context remains unexplored. A retrospective analysis was conducted at our institution, examining 11 PCI cases performed after TAVR between January 6, 2020, and June 1, 2024, in which an EW was employed to transition from a DC to a GC. Clinical, angiographic, and procedural data were reviewed. Procedural success was defined as a successful DC-to-GC exchange and completion of PCI. DC-to-GC exchange using an EW was successfully achieved in all 11 cases (100%). Revascularization was achieved in 10/11 cases (91%). The lesions were uniformly classified as American College of Cardiology/American Heart Association Type B2/C. The GCs included Judkins-type in 7/11 cases (64%) and backup-type in 4/11 cases (36%). The THV types included SAPIEN in 6/11 cases (55%), Evolut in 3/11 cases (27%), and Navitor in 2/11 cases (18%). A 6Fr GC was utilized in 10/11 cases (91%), and rotational atherectomy was performed in 1/11 cases (9%). The use of an EW to facilitate the transition from DC to GC in PCI after TAVR resulted in high procedural success, providing a feasible approach for addressing complex lesions and optimizing procedural outcomes.</p>","PeriodicalId":9439,"journal":{"name":"Cardiovascular Intervention and Therapeutics","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Feasibility of guiding catheter exchange using extension wire in percutaneous coronary intervention after transcatheter aortic valve replacement.\",\"authors\":\"Makoto Saigan, Masaki Miyasaka, Daishi Tazawa, Momo Kosuga, Manabu Maeda, Yun Teng, Natsuko Satomi, Yuta Kobayashi, Masaki Nakashima, Yusuke Enta, Yoshiko Munehisa, Yukihiro Hayatsu, Norio Tada\",\"doi\":\"10.1007/s12928-025-01159-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Percutaneous coronary intervention (PCI) after transcatheter aortic valve replacement (TAVR) is technically challenging because of the presence of the transcatheter heart valve (THV), which complicates coronary artery engagement. Owing to their flexibility, diagnostic catheters (DCs) facilitate coronary access, but require subsequent exchange to guiding catheters (GCs) for PCI. The feasibility of using an extension wire (EW) to facilitate DC-to-GC exchange in this context remains unexplored. A retrospective analysis was conducted at our institution, examining 11 PCI cases performed after TAVR between January 6, 2020, and June 1, 2024, in which an EW was employed to transition from a DC to a GC. Clinical, angiographic, and procedural data were reviewed. Procedural success was defined as a successful DC-to-GC exchange and completion of PCI. DC-to-GC exchange using an EW was successfully achieved in all 11 cases (100%). Revascularization was achieved in 10/11 cases (91%). The lesions were uniformly classified as American College of Cardiology/American Heart Association Type B2/C. The GCs included Judkins-type in 7/11 cases (64%) and backup-type in 4/11 cases (36%). The THV types included SAPIEN in 6/11 cases (55%), Evolut in 3/11 cases (27%), and Navitor in 2/11 cases (18%). A 6Fr GC was utilized in 10/11 cases (91%), and rotational atherectomy was performed in 1/11 cases (9%). The use of an EW to facilitate the transition from DC to GC in PCI after TAVR resulted in high procedural success, providing a feasible approach for addressing complex lesions and optimizing procedural outcomes.</p>\",\"PeriodicalId\":9439,\"journal\":{\"name\":\"Cardiovascular Intervention and Therapeutics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Intervention and Therapeutics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12928-025-01159-w\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Intervention and Therapeutics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12928-025-01159-w","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Feasibility of guiding catheter exchange using extension wire in percutaneous coronary intervention after transcatheter aortic valve replacement.
Percutaneous coronary intervention (PCI) after transcatheter aortic valve replacement (TAVR) is technically challenging because of the presence of the transcatheter heart valve (THV), which complicates coronary artery engagement. Owing to their flexibility, diagnostic catheters (DCs) facilitate coronary access, but require subsequent exchange to guiding catheters (GCs) for PCI. The feasibility of using an extension wire (EW) to facilitate DC-to-GC exchange in this context remains unexplored. A retrospective analysis was conducted at our institution, examining 11 PCI cases performed after TAVR between January 6, 2020, and June 1, 2024, in which an EW was employed to transition from a DC to a GC. Clinical, angiographic, and procedural data were reviewed. Procedural success was defined as a successful DC-to-GC exchange and completion of PCI. DC-to-GC exchange using an EW was successfully achieved in all 11 cases (100%). Revascularization was achieved in 10/11 cases (91%). The lesions were uniformly classified as American College of Cardiology/American Heart Association Type B2/C. The GCs included Judkins-type in 7/11 cases (64%) and backup-type in 4/11 cases (36%). The THV types included SAPIEN in 6/11 cases (55%), Evolut in 3/11 cases (27%), and Navitor in 2/11 cases (18%). A 6Fr GC was utilized in 10/11 cases (91%), and rotational atherectomy was performed in 1/11 cases (9%). The use of an EW to facilitate the transition from DC to GC in PCI after TAVR resulted in high procedural success, providing a feasible approach for addressing complex lesions and optimizing procedural outcomes.
期刊介绍:
Cardiovascular Intervention and Therapeutics (CVIT) is an international journal covering the field of cardiovascular disease and includes cardiac (coronary and noncoronary) and peripheral interventions and therapeutics. Articles are subject to peer review and complete editorial evaluation prior to any decision regarding acceptability. CVIT is an official journal of The Japanese Association of Cardiovascular Intervention and Therapeutics.