Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.005
Ahmed Al-Ogaili , Gauravpal S. Gill , Emmanouil S. Brilakis
Complications of percutaneous coronary intervention (PCI) can lead to significant morbidity and mortality. In-depth understanding of the mechanisms and management options of these complications as well as timely recognition and action can sometimes be lifesaving. In this review we discuss the mechanisms, prevention methods, diagnosis, and management of three major PCI complications: a) perforation b) acute vessel closure, and c) equipment loss.
{"title":"Complications of percutaneous coronary intervention","authors":"Ahmed Al-Ogaili , Gauravpal S. Gill , Emmanouil S. Brilakis","doi":"10.1016/j.pcad.2024.12.005","DOIUrl":"10.1016/j.pcad.2024.12.005","url":null,"abstract":"<div><div>Complications of percutaneous coronary intervention (PCI) can lead to significant morbidity and mortality. In-depth understanding of the mechanisms and management options of these complications as well as timely recognition and action can sometimes be lifesaving. In this review we discuss the mechanisms, prevention methods, diagnosis, and management of three major PCI complications: a) perforation b) acute vessel closure, and c) equipment loss.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 80-93"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.003
Aashish Gupta , Oscar Maitas , Rajan A.G. Patel
Coronary artery in-stent restenosis (ISR) is driven by neointimal hyperplasia and neo‐atherosclerosis in previously placed stents. Drug eluting stents (DES) have been adopted as first line therapy for the initial episode of ISR. However, recurrent ISR has limited durable salvage options. In this article we review the pathophysiology, incidence, and management options of recurrent DES- ISR.
{"title":"Recurrent drug eluting stent, in-stent restenosis (DES-ISR): Epidemiology, pathophysiology & treatment","authors":"Aashish Gupta , Oscar Maitas , Rajan A.G. Patel","doi":"10.1016/j.pcad.2024.12.003","DOIUrl":"10.1016/j.pcad.2024.12.003","url":null,"abstract":"<div><div>Coronary artery in-stent restenosis (ISR) is driven by neointimal hyperplasia and neo‐atherosclerosis in previously placed stents. Drug eluting stents (DES) have been adopted as first line therapy for the initial episode of ISR. However, recurrent ISR has limited durable salvage options. In this article we review the pathophysiology, incidence, and management options of recurrent DES- ISR.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 68-74"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.001
Jarrod Frizzell, Dean J. Kereiakes
The presence and severity of calcified coronary plaque negatively impacts angiographic and clinical outcomes following percutaneous coronary intervention (PCI). Severe coronary calcification is associated with suboptimal stent delivery, deployment, apposition and expansion which can lead to in-stent restenosis and/or thrombosis. Severe coronary calcification is associated with incremental hazard for adverse clinical events, including death, during 5–10 years following PCI despite the use of new generation drug- eluting stents. Multiple technologies including high-pressure noncompliant and modified (cutting/scoring) balloons, atheroablative technologies (laser, rotational or orbital atherectomy), and more recently, intravascular lithotripsy have been used to modify calcified plaque and facilitate optimal coronary stent implantation. Intravascular imaging is critically important to determine the extent and distribution (superficial or deep) of coronary calcification and to aid selection and sequence for use of calcium modifying technologies. Unfortunately, large scale randomized comparative trials of calcium modifying technologies are limited and the relative safety and effectiveness of these modalities is poorly defined. Recent mechanistic and clinical data supporting the use of plaque modifying technologies are reviewed to provide insights into their optimal use.
{"title":"Calcified plaque modification during percutaneous coronary revascularization","authors":"Jarrod Frizzell, Dean J. Kereiakes","doi":"10.1016/j.pcad.2024.12.001","DOIUrl":"10.1016/j.pcad.2024.12.001","url":null,"abstract":"<div><div>The presence and severity of calcified coronary plaque negatively impacts angiographic and clinical outcomes following percutaneous coronary intervention (PCI). Severe coronary calcification is associated with suboptimal stent delivery, deployment, apposition and expansion which can lead to in-stent restenosis and/or thrombosis. Severe coronary calcification is associated with incremental hazard for adverse clinical events, including death, during 5–10 years following PCI despite the use of new generation drug- eluting stents. Multiple technologies including high-pressure noncompliant and modified (cutting/scoring) balloons, atheroablative technologies (laser, rotational or orbital atherectomy), and more recently, intravascular lithotripsy have been used to modify calcified plaque and facilitate optimal coronary stent implantation. Intravascular imaging is critically important to determine the extent and distribution (superficial or deep) of coronary calcification and to aid selection and sequence for use of calcium modifying technologies. Unfortunately, large scale randomized comparative trials of calcium modifying technologies are limited and the relative safety and effectiveness of these modalities is poorly defined. Recent mechanistic and clinical data supporting the use of plaque modifying technologies are reviewed to provide insights into their optimal use.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 39-52"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.006
Imad Bagh , Rajan A.G. Patel
Revascularization has been demonstrated to be clearly superior to medical therapy for significant unprotected left main coronary artery (LMCA) disease. Coronary artery bypass graft surgery (CABG) has a class 1 indication in both the American and European society guidelines for the treatment of LMCA disease. However, for the population of patients who are declined CABG after a heart team evaluation, percutaneous coronary interventional (PCI) may be an efficacious alternative. This review summarizes the data on percutaneous coronary intervention of distal left main coronary artery disease including the various contemporary techniques and associated challenges.
{"title":"Unprotected distal left main percutaneous intervention","authors":"Imad Bagh , Rajan A.G. Patel","doi":"10.1016/j.pcad.2024.12.006","DOIUrl":"10.1016/j.pcad.2024.12.006","url":null,"abstract":"<div><div>Revascularization has been demonstrated to be clearly superior to medical therapy for significant unprotected left main coronary artery (LMCA) disease. Coronary artery bypass graft surgery (CABG) has a class 1 indication in both the American and European society guidelines for the treatment of LMCA disease. However, for the population of patients who are declined CABG after a heart team evaluation, percutaneous coronary interventional (PCI) may be an efficacious alternative. This review summarizes the data on percutaneous coronary intervention of distal left main coronary artery disease including the various contemporary techniques and associated challenges.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 53-59"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.06.008
Mohamad Riad Abouzid , Ankit Vyas , Ibrahim Kamel , Junaid Anwar , Shorouk Elshafei , Venkat Subramaniam , William Bennett , Carl J. Lavie , Chima Nwaukwa , Christopher J. White , Rajan A.G. Patel
Introduction
Critical limb-threatening ischemia (CLTI) is a severe manifestation of peripheral artery disease (PAD) that can lead to limb amputation and significantly reduce quality of life. In addition to guideline-directed medical therapy (GDMT), endovascular therapy and surgical revascularization are the two revascularization options for CLTI. In recent years, there has been an ongoing debate about the best approach for CLTI patients. The purpose of this meta-analysis is to examine the current evidence and compare the clinical outcomes of endovascular therapy and surgical revascularization for CLTI.
Methods
We conducted a systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) for studies comparing the outcomes of endovascular therapy versus surgery in patients with CLTI. The primary outcomes were major adverse limb events (MALE) and major adverse cardiovascular events (MACE), while secondary outcomes included risk of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure, and length of hospital stay. Pooled data was analyzed using the fixed-effect model or the random-effect model in Review Manager 5.3. The Newcastle-Ottawa Scale and Cochrane risk of bias assessment tool were used to assess the bias of included studies.
Results
A total of 16 studies (47,609 patients) were included in this meta-analysis. The overall effect favors surgery over endovascular intervention in terms of MALE [odds ratio (OR) 1.13, 95% CI (1.01–1.28), P = 0.04]. Endovascular therapy is associated with lower MACE rates compared to surgery [OR 0.62, 95% CI (0.51–0.76), P < 0.00001]. Furthermore, the risk of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure as well as the length of hospital stay was lower for endovascular intervention. Finally, there was no statistically significant difference in 30-day mortality between the two groups [OR 0.94, 95% CI 0.79–1.12, P = 0.52; Fig. 3i], and the pooled studies were homogeneous [P = 0.39; I2 = 5%].
Conclusion
Surgery may be the preferred treatment option for CLTI patients, as it is associated with a lower risk of MALE than endovascular therapy. However, endovascular therapy may be associated with a lower risk of MACE and lower rates of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure, and shorter hospital stays. There was no statistically significant difference in 30-day mortality between the two groups. Ultimately, the decision to use endovascular therapy or surgery as the primary treatment strategy should be based on a multi-disciplinary team approach with careful consideration of patient characteristics and anatomy.
导言：危重肢体缺血（CLTI）是外周动脉疾病（PAD）的一种严重表现，可导致肢体截肢并显著降低生活质量。除指南指导的药物治疗（GDMT）外，血管内治疗和手术血管重建是治疗 CLTI 的两种血管重建方案。近年来，关于 CLTI 患者的最佳治疗方法一直存在争议。本荟萃分析的目的是研究现有证据，并比较血管内治疗和手术血管重建治疗 CLTI 的临床效果：我们对电子数据库（PubMed、Embase、Cochrane Library 和 Web of Science）进行了系统性检索，比较了血管内治疗与手术治疗 CLTI 患者的疗效。主要结果是肢体主要不良事件（MALE）和心血管主要不良事件（MACE），次要结果包括出血风险、伤口并发症、再入院、计划外再次手术、急性肾功能衰竭和住院时间。汇总数据使用Review Manager 5.3中的固定效应模型或随机效应模型进行分析。采用纽卡斯尔-渥太华量表和 Cochrane 偏倚风险评估工具评估纳入研究的偏倚：本荟萃分析共纳入16项研究（47 609名患者）。就MALE而言，手术治疗优于血管内介入治疗[几率比（OR）1.13，95% CI (1.01-1.28)，P = 0.04]。与手术相比，血管内治疗的 MACE 发生率更低[OR 0.62，95% CI (0.51-0.76)，P 结论：手术可能是CLTI患者的首选治疗方案，因为与血管内治疗相比，手术的MALE风险更低。然而，血管内治疗可能与较低的MACE风险、较低的出血率、伤口并发症、再入院、计划外再次手术、急性肾功能衰竭和较短的住院时间有关。两组患者的 30 天死亡率在统计学上没有明显差异。最终，决定使用血管内治疗还是手术作为主要治疗策略，应基于多学科团队的方法，并仔细考虑患者的特征和解剖结构。
{"title":"Comparing the efficacy and safety of endovascular therapy versus surgical revascularization for critical limb-threatening ischemia: A systematic review and Meta-analysis","authors":"Mohamad Riad Abouzid , Ankit Vyas , Ibrahim Kamel , Junaid Anwar , Shorouk Elshafei , Venkat Subramaniam , William Bennett , Carl J. Lavie , Chima Nwaukwa , Christopher J. White , Rajan A.G. Patel","doi":"10.1016/j.pcad.2024.06.008","DOIUrl":"10.1016/j.pcad.2024.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Critical limb-threatening ischemia (CLTI) is a severe manifestation of peripheral artery disease (PAD) that can lead to limb amputation and significantly reduce quality of life. In addition to guideline-directed medical therapy (GDMT), endovascular therapy and surgical revascularization are the two revascularization options for CLTI. In recent years, there has been an ongoing debate about the best approach for CLTI patients. The purpose of this meta-analysis is to examine the current evidence and compare the clinical outcomes of endovascular therapy and surgical revascularization for CLTI.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) for studies comparing the outcomes of endovascular therapy versus surgery in patients with CLTI. The primary outcomes were major adverse limb events (MALE) and major adverse cardiovascular events (MACE), while secondary outcomes included risk of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure, and length of hospital stay. Pooled data was analyzed using the fixed-effect model or the random-effect model in Review Manager 5.3. The Newcastle-Ottawa Scale and Cochrane risk of bias assessment tool were used to assess the bias of included studies.</div></div><div><h3>Results</h3><div>A total of 16 studies (47,609 patients) were included in this meta-analysis. The overall effect favors surgery over endovascular intervention in terms of MALE [odds ratio (OR) 1.13, 95% CI (1.01–1.28), <em>P</em> = 0.04]. Endovascular therapy is associated with lower MACE rates compared to surgery [OR 0.62, 95% CI (0.51–0.76), <em>P</em> < 0.00001]. Furthermore, the risk of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure as well as the length of hospital stay was lower for endovascular intervention. Finally, there was no statistically significant difference in 30-day mortality between the two groups [OR 0.94, 95% CI 0.79–1.12, <em>P</em> = 0.52; Fig. 3i], and the pooled studies were homogeneous [<em>P</em> = 0.39; I2 = 5%].</div></div><div><h3>Conclusion</h3><div>Surgery may be the preferred treatment option for CLTI patients, as it is associated with a lower risk of MALE than endovascular therapy. However, endovascular therapy may be associated with a lower risk of MACE and lower rates of bleeding, wound complications, readmission, unplanned reoperation, acute renal failure, and shorter hospital stays. There was no statistically significant difference in 30-day mortality between the two groups. Ultimately, the decision to use endovascular therapy or surgery as the primary treatment strategy should be based on a multi-disciplinary team approach with careful consideration of patient characteristics and anatomy.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 126-135"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.10.007
Zaid Al Jebaje, Ahmad Jabri, Tushar Mishra, Adnan Halboni, Asem Ayyad, Anas Alameh, Rama Ellauzi, Francisco B. Alexandrino, Khaldoon Alaswad, Mir Babar Basir
As the field of percutaneous coronary intervention grows in volume, expertise, and available tools, interventional cardiologists are increasingly performing more complex and higher-risk coronary artery procedures. Mechanical circulatory support devices, previously used only in urgent situations, are now being utilized as supplementary tools to enhance outcomes in elective complex cases. This shift has sparked significant discussions about patient and device selection, as well as the potential risks involved. In this article, we explore the various devices and their distinct features. Additionally, we also introduce algorithms for device selection, placement and weaning to help guide physicians during their care for their high-risk PCI patients.
{"title":"Use of mechanical circulatory support in high-risk percutaneous coronary interventions","authors":"Zaid Al Jebaje, Ahmad Jabri, Tushar Mishra, Adnan Halboni, Asem Ayyad, Anas Alameh, Rama Ellauzi, Francisco B. Alexandrino, Khaldoon Alaswad, Mir Babar Basir","doi":"10.1016/j.pcad.2024.10.007","DOIUrl":"10.1016/j.pcad.2024.10.007","url":null,"abstract":"<div><div>As the field of percutaneous coronary intervention grows in volume, expertise, and available tools, interventional cardiologists are increasingly performing more complex and higher-risk coronary artery procedures. Mechanical circulatory support devices, previously used only in urgent situations, are now being utilized as supplementary tools to enhance outcomes in elective complex cases. This shift has sparked significant discussions about patient and device selection, as well as the potential risks involved. In this article, we explore the various devices and their distinct features. Additionally, we also introduce algorithms for device selection, placement and weaning to help guide physicians during their care for their high-risk PCI patients.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 60-67"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.002
Salman S. Allana , Keerthi Gondi , Amit Goyal , Saraschandra Vallabhajosyula
The retrograde approach to chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly contributed to the success rates of CTO PCI. It is usually performed in complex CTO lesions, in which the antegrade approach is not feasible or fails. In this article we discuss the steps to perform retrograde CTO PCI and its complications and success rates. Considering the moderate to high success rates of the retrograde approach in the hands of experienced operators and higher complication rates than antegrade only procedures, optimizing the safety of retrograde CTO PCI is of paramount importance.
{"title":"Retrograde approach to chronic total occlusion percutaneous coronary interventions- Technique and outcomes","authors":"Salman S. Allana , Keerthi Gondi , Amit Goyal , Saraschandra Vallabhajosyula","doi":"10.1016/j.pcad.2024.12.002","DOIUrl":"10.1016/j.pcad.2024.12.002","url":null,"abstract":"<div><div>The retrograde approach to chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has significantly contributed to the success rates of CTO PCI. It is usually performed in complex CTO lesions, in which the antegrade approach is not feasible or fails. In this article we discuss the steps to perform retrograde CTO PCI and its complications and success rates. Considering the moderate to high success rates of the retrograde approach in the hands of experienced operators and higher complication rates than antegrade only procedures, optimizing the safety of retrograde CTO PCI is of paramount importance.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 28-38"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.007
Kais Hyasat , Chieh-Shou Su , Ajay J. Kirtane , Margaret McEntegart
Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention. In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.
{"title":"The efficacy of revascularization in ischemic cardiomyopathy","authors":"Kais Hyasat , Chieh-Shou Su , Ajay J. Kirtane , Margaret McEntegart","doi":"10.1016/j.pcad.2024.12.007","DOIUrl":"10.1016/j.pcad.2024.12.007","url":null,"abstract":"<div><div>Ischemic cardiomyopathy (ICM) is characterized by myocardial dysfunction due to myocardial ischemia, associated with the presence of significant coronary artery disease (CAD). We provide a comprehensive review of the current evidence for coronary revascularization in ICM, including consideration of the different modalities of coronary artery bypass grafting and percutaneous coronary intervention. In addition to a contemporary assessment of the literature, we aim to provide real-world insights and perspectives to guide clinical decision-making in this heterogeneous and complex patient population.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 105-112"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.pcad.2024.12.009
Kaushik Darbha , Vincent J. Long , Caleb M. Lowe , Edem J. Abotsi , Antony Anandaraj , Arnold H. Seto
Vascular access for coronary, peripheral, and structural interventions has changed significantly over the past two decades. The evolving demand for both large-bore access for valvular interventions and mechanical support devices, and for safer access for coronary interventions, in patients with comorbidities have driven progress in these areas. This review will provide an overview of the techniques of arterial access in the femoral, forearm (radial and ulnar), and alternative (transcarotid, transaxillary, and transcaval) locations based on the latest evidence and experience.
{"title":"Vascular access: Femoral, radial and large-bore alternative access","authors":"Kaushik Darbha , Vincent J. Long , Caleb M. Lowe , Edem J. Abotsi , Antony Anandaraj , Arnold H. Seto","doi":"10.1016/j.pcad.2024.12.009","DOIUrl":"10.1016/j.pcad.2024.12.009","url":null,"abstract":"<div><div>Vascular access for coronary, peripheral, and structural interventions has changed significantly over the past two decades. The evolving demand for both large-bore access for valvular interventions and mechanical support devices, and for safer access for coronary interventions, in patients with comorbidities have driven progress in these areas. This review will provide an overview of the techniques of arterial access in the femoral, forearm (radial and ulnar), and alternative (transcarotid, transaxillary, and transcaval) locations based on the latest evidence and experience.</div></div>","PeriodicalId":21156,"journal":{"name":"Progress in cardiovascular diseases","volume":"88 ","pages":"Pages 2-19"},"PeriodicalIF":5.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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