Pub Date : 2026-01-02DOI: 10.1016/j.carrev.2025.12.026
Adham Ramadan, Michael Megaly
{"title":"Editorial: Intravascular brachytherapy for in-stent restenosis: The role of vessel size.","authors":"Adham Ramadan, Michael Megaly","doi":"10.1016/j.carrev.2025.12.026","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.12.026","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.carrev.2025.12.027
Grant W Reed, Evan H Whitehead
{"title":"Editorial: ICE versus TEE: Redefining image guidance for left atrial appendage occlusion.","authors":"Grant W Reed, Evan H Whitehead","doi":"10.1016/j.carrev.2025.12.027","DOIUrl":"https://doi.org/10.1016/j.carrev.2025.12.027","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.04.013
Lin Wang , Luca Paolucci , Angela McInerney , Fernando Alfonso , David del Val , Enrico Cerrato , Juan Garcia de Lara , Eduardo Pinar , Armando Perez de Prado , Salvatore Brugaletta , Andrea Ruberti , Manel Sabaté , Héctor Cubero Gallego , Beatriz Vaquerizo , Alfonso Jurado-Román , Ferdinando Varbella , Marcelo Jimenez , Artemio Garcia Escobar , José María de la Torre , Ignacio Amat Santos , Nieves Gonzalo
Background
The effectiveness of intravascular lithotripsy (IVL) in terms of anatomical and physiological results in different subtypes of calcifications is unknown.
Methods
Lesions treated with IVL-percutaneous coronary intervention (PCI) were stratified according to hemodynamic pattern (focal/diffuse) and calcification phenotypes (concentric/eccentric). All lesions were analyzed with optical coherence tomography (OCT), OCT-based fractional flow reserve (OFR) and quantitative flow ratio (QFR). The outcomes were post-PCI OFR/QFR values, minimal stent area (MSA) and angio-derived index of microvascular resistance (Angio-IMR).
Results
88 lesions were included. All parameters significantly increased during PCI. Diffuse lesions showed lower post-PCI values of OFR (focal = 0.92 (0.89–0.95) vs diffuse = 0.88 (0.85–0.91), P < 0.01), QFR (focal = 0.94 (0.89–0.98) vs diffuse = 0.87 (0.85–0.90); P < 0.01) and MSA (focal = 6.40 (5.80–7.10) mm2 vs diffuse = 5.40 (4.80–6.00) mm2, P = 0.02). Angio-IMR changes were comparable between the two groups. No differences were evident between concentric and eccentric lesions for any outcomes assessed.
Conclusions
Diffuse lesions were associated with suboptimal anatomical and physiological results following IVL-PCI, while no differences were evident between concentric and eccentric calcification phenotypes.
{"title":"Impact of lesion hemodynamic pattern and calcium morphology on the functional efficacy of coronary intravascular lithotripsy","authors":"Lin Wang , Luca Paolucci , Angela McInerney , Fernando Alfonso , David del Val , Enrico Cerrato , Juan Garcia de Lara , Eduardo Pinar , Armando Perez de Prado , Salvatore Brugaletta , Andrea Ruberti , Manel Sabaté , Héctor Cubero Gallego , Beatriz Vaquerizo , Alfonso Jurado-Román , Ferdinando Varbella , Marcelo Jimenez , Artemio Garcia Escobar , José María de la Torre , Ignacio Amat Santos , Nieves Gonzalo","doi":"10.1016/j.carrev.2025.04.013","DOIUrl":"10.1016/j.carrev.2025.04.013","url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness of intravascular lithotripsy (IVL) in terms of anatomical and physiological results in different subtypes of calcifications is unknown.</div></div><div><h3>Methods</h3><div>Lesions treated with IVL-percutaneous coronary intervention (PCI) were stratified according to hemodynamic<span> pattern (focal/diffuse) and calcification phenotypes (concentric/eccentric). All lesions were analyzed with optical coherence tomography<span> (OCT), OCT-based fractional flow reserve (OFR) and quantitative flow ratio (QFR). The outcomes were post-PCI OFR/QFR values, minimal stent area (MSA) and angio-derived index of microvascular resistance (Angio-IMR).</span></span></div></div><div><h3>Results</h3><div>88 lesions were included. All parameters significantly increased during PCI. Diffuse lesions showed lower post-PCI values of OFR (focal = 0.92 (0.89–0.95) vs diffuse = 0.88 (0.85–0.91), <em>P</em> < 0.01), QFR (focal = 0.94 (0.89–0.98) vs diffuse = 0.87 (0.85–0.90); P < 0.01) and MSA (focal = 6.40 (5.80–7.10) mm<sup>2</sup> vs diffuse = 5.40 (4.80–6.00) mm<sup>2</sup>, <em>P</em> = 0.02). Angio-IMR changes were comparable between the two groups. No differences were evident between concentric and eccentric lesions for any outcomes assessed.</div></div><div><h3>Conclusions</h3><div>Diffuse lesions were associated with suboptimal anatomical and physiological results following IVL-PCI, while no differences were evident between concentric and eccentric calcification phenotypes.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 1-8"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.04.008
Michał Piotrowski , Julia Izabela Karpierz , Jakub Batko , Marian Burysz , Krzysztof Bartuś
Background
Patent foramen ovale and atrial septal defect are among the most common congenital heart diseases. When they are symptomatic, either pharmacologic or percutaneous/surgical treatment should be considered. The aim of this study was to investigate the post-approval complication profiles of the Gore Cardioform and Gore Helex devices based on the Manufacturer and User Facility Device Experience database.
Methods
A search of the Manufacturer and User Facility Device Experience Database was performed to identify reports of complications following the closure of atrial septal defects with Gore devices. 401 reports met inclusion criteria, including 204 patients with Gore Cardioform Septal Occluder, 146 patients with Gore Cardioform ASD Occluder, and 51 patients with Gore Helex Septal Occluder.
Results
The number of adverse events related to device problems contributed to 51.4 % of reported complications (n = 206), which mostly consisted of embolism of the device (n = 140). There were 3 reported cases of death, with 2 linked to device embolization. Most reports concerned devices sized 25 and 30 mm although only 313 reports (78.1 %) had information about size available. 54 cases of pericardial effusion and 14 cases of perforation were reported. Multiple postoperative arrhythmias were reported (n = 80), with the majority of them being atrial fibrillation (n = 39) or heart block (n = 18).
Conclusions
No cardiac erosions linked to Gore devices were found throughout our analysis, supporting earlier literature findings. The investigated devices and their sizes varied in terms of complication profiles.
{"title":"Atrial septal defect and patent foramen ovale closure- complication profile of approved Gore Occluders","authors":"Michał Piotrowski , Julia Izabela Karpierz , Jakub Batko , Marian Burysz , Krzysztof Bartuś","doi":"10.1016/j.carrev.2025.04.008","DOIUrl":"10.1016/j.carrev.2025.04.008","url":null,"abstract":"<div><h3>Background</h3><div>Patent foramen ovale<span> and atrial septal defect<span> are among the most common congenital heart diseases. When they are symptomatic, either pharmacologic or percutaneous/surgical treatment should be considered. The aim of this study was to investigate the post-approval complication profiles of the Gore Cardioform and Gore Helex devices based on the Manufacturer and User Facility Device Experience database.</span></span></div></div><div><h3>Methods</h3><div>A search of the Manufacturer and User Facility Device Experience Database was performed to identify reports of complications following the closure of atrial septal defects with Gore devices. 401 reports met inclusion criteria, including 204 patients with Gore Cardioform Septal Occluder, 146 patients with Gore Cardioform ASD Occluder, and 51 patients with Gore Helex Septal Occluder.</div></div><div><h3>Results</h3><div>The number of adverse events related to device problems contributed to 51.4 % of reported complications (<em>n</em> = 206), which mostly consisted of embolism of the device (<em>n</em><span> = 140). There were 3 reported cases of death, with 2 linked to device embolization<span>. Most reports concerned devices sized 25 and 30 mm although only 313 reports (78.1 %) had information about size available. 54 cases of pericardial effusion and 14 cases of perforation were reported. Multiple postoperative arrhythmias were reported (</span></span><em>n</em> = 80), with the majority of them being atrial fibrillation (<em>n</em> = 39) or heart block (<em>n</em> = 18).</div></div><div><h3>Conclusions</h3><div>No cardiac erosions linked to Gore devices were found throughout our analysis, supporting earlier literature findings. The investigated devices and their sizes varied in terms of complication profiles.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 84-90"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.05.025
Robert S. Dieter , Robert S. Dieter II , Elizabeth G. Dieter
{"title":"Expanding the differential for a bounding popliteal artery pulsation on physical exam","authors":"Robert S. Dieter , Robert S. Dieter II , Elizabeth G. Dieter","doi":"10.1016/j.carrev.2025.05.025","DOIUrl":"10.1016/j.carrev.2025.05.025","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 127-128"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.08.002
Flavio L. Ribichini
{"title":"Editorial: Renal denervation for kidney-related pain syndromes: a clue in search of proofs","authors":"Flavio L. Ribichini","doi":"10.1016/j.carrev.2025.08.002","DOIUrl":"10.1016/j.carrev.2025.08.002","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 21-22"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.04.004
Jason Z. Li , Connor P. Oates , Meredith Njus , Rachel Barish , Susan O'Donoghue , Farooq H. Sheikh
Background
The risk factors for developing arrhythmias, prognostic implications, and value of implantable cardioverter defibrillators (ICD) are poorly understood in patients with cardiac amyloidosis (CA).
Methods
A single-center retrospective analysis was performed of consecutive patients diagnosed with or referred for cardiac amyloidosis at our center from 2/2010–4/2023.
Results
A total of 186 patients were diagnosed with CA (AL-CA: 18.3%; ATTR-CA: 81.2%). Atrial fibrillation (AF) occurred in 61.8%, atrial flutter (AFL) in 24.7%, and sustained ventricular tachycardia (VT) in 6.5% of patients with CA. AF and AFL occurred more commonly in patients with ATTR-CA than AL-CA (AF: 66.9% vs 38.2%; p = 0.002; AFL: 28.5% vs 8.8%; p = 0.017). On univariate analysis, QRS duration >120 ms (OR 4.22; 95% CI 1.21–14.64; p = 0.023) and left ventricular end diastolic diameter (OR 3.94; 95% CI 1.45–10.66; p = 0.007) were associated with the development of sustained VT in patients with CA. Incidence of sustained VT in patients with CA was independently associated with increased risk of mortality (HR 2.22; 95% CI 1.10–4.50; p = 0.027), however, ICD implantation was not associated with improved survival (HR 0.59; 95% CI 0.32–1.08; p = 0.090).
Conclusion
Atrial and ventricular arrhythmias are common in CA. Characteristics of adverse electrical and structural remodeling are associated with the development of sustained VT, which was independently associated with increased mortality in this population. ICD therapy was not associated with improved survival.
背景：在心脏淀粉样变性（CA）患者中，发生心律失常的危险因素、预后意义和植入式心律转复除颤器（ICD）的价值尚不清楚。方法：对2010年2月至2023年4月在本中心诊断为或转诊为心脏淀粉样变性的连续患者进行单中心回顾性分析。结果：共186例患者被诊断为CA (AL-CA: 18.3%；ATTR-CA: 81.2%)。房颤（AF）发生率为61.8%，心房扑动（AFL）发生率为24.7%，持续性室性心动过速（VT）发生率为6.5%。AF和AFL在atr -CA患者中比AL-CA患者更常见(AF: 66.9% vs 38.2%；p = 0.002；AFL: 28.5% vs 8.8%；p = 0.017)。单因素分析，QRS持续时间>120 ms (OR 4.22；95% ci 1.21-14.64；p = 0.023)和左室舒张末期内径(OR 3.94；95% ci 1.45-10.66；p = 0.007)与CA患者持续性室速的发生相关。CA患者持续性室速的发生率与死亡风险增加独立相关(HR 2.22；95% ci 1.10-4.50；p = 0.027)，然而，ICD植入与生存改善无关(HR 0.59；95% ci 0.32-1.08；p = 0.090)。结论：房性和室性心律失常在CA中很常见。不良电重构和结构重构的特征与持续性VT的发展有关，这与该人群死亡率的增加独立相关。ICD治疗与生存率的提高无关。
{"title":"Atrial and ventricular arrhythmias in patients with cardiac amyloidosis: Incidence, risk factors, and prognostic implications","authors":"Jason Z. Li , Connor P. Oates , Meredith Njus , Rachel Barish , Susan O'Donoghue , Farooq H. Sheikh","doi":"10.1016/j.carrev.2025.04.004","DOIUrl":"10.1016/j.carrev.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div><span>The risk factors for developing arrhythmias, prognostic implications, and value of </span>implantable cardioverter defibrillators<span> (ICD) are poorly understood in patients with cardiac amyloidosis (CA).</span></div></div><div><h3>Methods</h3><div>A single-center retrospective analysis was performed of consecutive patients diagnosed with or referred for cardiac amyloidosis at our center from 2/2010–4/2023.</div></div><div><h3>Results</h3><div><span>A total of 186 patients were diagnosed with CA (AL-CA: 18.3%; ATTR-CA: 81.2%). Atrial fibrillation<span> (AF) occurred in 61.8%, atrial flutter<span> (AFL) in 24.7%, and sustained ventricular tachycardia (VT) in 6.5% of patients with CA. AF and AFL occurred more commonly in patients with ATTR-CA than AL-CA (AF: 66.9% vs 38.2%; </span></span></span><em>p</em> = 0.002; AFL: 28.5% vs 8.8%; <em>p</em><span> = 0.017). On univariate analysis, QRS duration >120 ms (OR 4.22; 95% CI 1.21–14.64; </span><em>p</em> = 0.023) and left ventricular end diastolic diameter (OR 3.94; 95% CI 1.45–10.66; <em>p</em> = 0.007) were associated with the development of sustained VT in patients with CA. Incidence of sustained VT in patients with CA was independently associated with increased risk of mortality (HR 2.22; 95% CI 1.10–4.50; <em>p</em> = 0.027), however, ICD implantation was not associated with improved survival (HR 0.59; 95% CI 0.32–1.08; <em>p</em> = 0.090).</div></div><div><h3>Conclusion</h3><div>Atrial and ventricular arrhythmias are common in CA. Characteristics of adverse electrical and structural remodeling are associated with the development of sustained VT, which was independently associated with increased mortality in this population. ICD therapy was not associated with improved survival.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 93-99"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.05.017
Georges Ephrem
{"title":"Editorial: Keeping them honest MAUDE! But can we do better?","authors":"Georges Ephrem","doi":"10.1016/j.carrev.2025.05.017","DOIUrl":"10.1016/j.carrev.2025.05.017","url":null,"abstract":"","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 91-92"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.carrev.2025.02.015
Robert F. Storey , Kambiz Hassan , Anna L. Meyer , Thomas Eberle , Nikolaas deNeve , Matthias Thielmann , Martin H. Bernardi , Nandor Marczin , Ulf Guenther , Bernd Panholzer , Heinrich Maechler , Steven Hunter , Marijana Matejic-Spasic , Daniel Wendt , Efthymios N. Deliargyris , Michael Schmoeckel
Objectives
Severe perioperative bleeding occurs in over 30 % of patients on ticagrelor undergoing isolated coronary artery bypass grafting (i-CABG) before completing the recommended 3-day washout. Intraoperative ticagrelor removal with a polymer bead hemoadsorption device is an approved therapy that may reduce perioperative bleeding.
Methods
The current analysis from the international Safe and Timely Antithrombotic Removal (STAR) registry reports outcomes with intraoperative hemoadsorption in patients on ticagrelor undergoing i-CABG before completing the recommended washout. Bleeding was assessed by the Universal Definition of Perioperative Bleeding (UDPB) definition.
Results
102 patients (63.8 ± 10.1 years, 81.2 % male) underwent i-CABG at mean time from last dose (TLD) of 22.8 ± 14.6 h. Groups were created based on TLD to CABG: Group-1 (G1): <24 h (n = 61; TLD 12.6 ± 6.5 h); Group-2 (G2): 24-72 h (n = 41; 37.2 ± 10.1 h). G1 was higher risk than G2 based on EuroSCORE-II (median: 4.2 % vs. 1.7 %, p = 0.006) and emergency indication (66.1 % vs. 12.2 %, p < 0.001). Operation and cardiopulmonary bypass durations were similar (G1: 4.3 ± 1.5 h and 94.9 ± 37.1 min vs. G2: 4.4 ± 1 h and 94.7 ± 36.1 min, p = ns). Severe bleeding (UDPB≥3) and re-operations for bleeding were more frequent in G1 vs. G2 (14.8 % vs. 2.4 %, p = 0.047, and 8.2 % vs. 0 %, p = 0.08, respectively). Any transfusion of red blood cells or platelets was also more frequent in G1 vs. G2 (45.9 % vs. 26.8 %, p = 0.05 and 59.0 % vs. 34.1 %, p = 0.014, respectively).
Conclusions
Intraoperative ticagrelor removal may help reduce ticagrelor-related bleeding in patients undergoing i-CABG before completing the 3-day washout. High risk emergency procedures within the first 24 h of last ticagrelor dose have an increased bleeding risk.
{"title":"Early CABG with intraoperative hemoadsorption in patients on ticagrelor: Real-world data from the international Safe and Timely Antithrombotic Removal (STAR) registry","authors":"Robert F. Storey , Kambiz Hassan , Anna L. Meyer , Thomas Eberle , Nikolaas deNeve , Matthias Thielmann , Martin H. Bernardi , Nandor Marczin , Ulf Guenther , Bernd Panholzer , Heinrich Maechler , Steven Hunter , Marijana Matejic-Spasic , Daniel Wendt , Efthymios N. Deliargyris , Michael Schmoeckel","doi":"10.1016/j.carrev.2025.02.015","DOIUrl":"10.1016/j.carrev.2025.02.015","url":null,"abstract":"<div><h3>Objectives</h3><div>Severe perioperative bleeding occurs in over 30 % of patients on ticagrelor undergoing isolated coronary artery bypass grafting (i-CABG) before completing the recommended 3-day washout. Intraoperative ticagrelor removal with a polymer bead hemoadsorption device is an approved therapy that may reduce perioperative bleeding.</div></div><div><h3>Methods</h3><div>The current analysis from the international Safe and Timely Antithrombotic Removal (STAR) registry reports outcomes with intraoperative hemoadsorption in patients on ticagrelor undergoing i-CABG before completing the recommended washout. Bleeding was assessed by the Universal Definition of Perioperative Bleeding (UDPB) definition.</div></div><div><h3>Results</h3><div>102 patients (63.8 ± 10.1 years, 81.2 % male) underwent i-CABG at mean time from last dose (TLD) of 22.8 ± 14.6 h. Groups were created based on TLD to CABG: Group-1 (G1): <24 h (<em>n</em> = 61; TLD 12.6 ± 6.5 h); Group-2 (G2): 24-72 h (<em>n</em> = 41; 37.2 ± 10.1 h). G1 was higher risk than G2 based on EuroSCORE-II (median: 4.2 % vs. 1.7 %, <em>p</em> = 0.006) and emergency indication (66.1 % vs. 12.2 %, <em>p</em> < 0.001). Operation and cardiopulmonary bypass durations were similar (G1: 4.3 ± 1.5 h and 94.9 ± 37.1 min vs. G2: 4.4 ± 1 h and 94.7 ± 36.1 min, p = ns). Severe bleeding (UDPB≥3) and re-operations for bleeding were more frequent in G1 vs. G2 (14.8 % vs. 2.4 %, <em>p</em> = 0.047, and 8.2 % vs. 0 %, <em>p</em> = 0.08, respectively). Any transfusion of red blood cells or platelets was also more frequent in G1 vs. G2 (45.9 % vs. 26.8 %, <em>p</em> = 0.05 and 59.0 % vs. 34.1 %, <em>p</em> = 0.014, respectively).</div></div><div><h3>Conclusions</h3><div>Intraoperative ticagrelor removal may help reduce ticagrelor-related bleeding in patients undergoing i-CABG before completing the 3-day washout. High risk emergency procedures within the first 24 h of last ticagrelor dose have an increased bleeding risk.</div></div><div><h3>Clinical trial registry number</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>: NCT05077124.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 50-56"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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