Cardiovascular Revascularization Medicine最新文献

英文中文

Percutaneous renal denervation in the management of kidney-related pain syndromes: a case series 经皮肾去神经支配治疗肾相关疼痛综合征：一个病例系列。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.04.041

K.A. Saville , V.J.M. Zeijen , R. Zietse , M. Salih , D.A. Hesselink , J. Daemen

Introduction

Positive effects on pain reduction following renal denervation (RDN) have been described in patients with kidney-related pain syndromes, yet data on the safety and efficacy of redo RDN procedures are limited.

Methods

Consecutive patients with a history of chronic loin pain, hypertension and preserved renal function (eGFR ≥40 ml/min) scheduled for RDN were included. Changes in perceived pain, opioid and antihypertensive medication use, and blood pressure were prospectively assessed 3 months after each procedure.

Results

Two patients presented with a history of Autosomal Dominant Polycystic Kidney Disease (n = 2) and one with Loin Pain Hematuria Syndrome (n = 1). Two patients underwent a redo RDN. After the initial procedures, a reduction in perceived pain, along with a 50 % and 75 % reduction in the daily dosage of opioids, was observed in two patients. One patient showed no reduction in perceived pain or opioid use and underwent a redo procedure after 3 years, again with no reduction in perceived pain or opioid use. One patient who initially responded returned at 2 years with recurrent symptoms and underwent a redo procedure. After 3 months, a significant improvement in pain and opioid use was observed. Mean 24-hour systolic blood pressure decreased in all patients and after each procedure with a mean decrease of 12 mmHg. No adverse events were observed.

Conclusion

In hypertensive patients with kidney-related pain syndromes, percutaneous RDN may be considered as an alternative treatment option to reduce pain severity and improve blood pressure control. Redo procedures may be considered in patients with recurrent symptoms after an initial response.

导读：肾相关疼痛综合征患者行肾去神经支配（RDN）后疼痛减轻的积极作用已有报道，但重行肾去神经支配（RDN）手术的安全性和有效性数据有限。方法：纳入有慢性腰痛、高血压和保留肾功能（eGFR≥40 ml/min）计划进行RDN的连续患者。每次手术后3个月前瞻性评估感知疼痛、阿片类药物和抗高血压药物使用以及血压的变化。结果：2例患者有常染色体显性多囊肾病病史（n = 2）， 1例患者有腰痛血尿综合征（n = 1）。2例患者重做RDN。初步治疗后，两名患者的疼痛感减轻，阿片类药物的日剂量分别减少了50%和75%。一名患者感觉疼痛或阿片类药物的使用没有减少，并在3年后进行了重做手术，再次没有减少感觉疼痛或阿片类药物的使用。一名最初有反应的患者在2年后出现复发症状并接受了重做手术。3个月后，观察到疼痛和阿片类药物使用的显著改善。所有患者的平均24小时收缩压均下降，每次手术后平均下降12 mmHg。未观察到不良事件。结论：对于合并肾相关性疼痛综合征的高血压患者，经皮RDN可作为减轻疼痛严重程度和改善血压控制的替代治疗选择。初次缓解后症状复发的患者可考虑重做手术。

{"title":"Percutaneous renal denervation in the management of kidney-related pain syndromes: a case series","authors":"K.A. Saville , V.J.M. Zeijen , R. Zietse , M. Salih , D.A. Hesselink , J. Daemen","doi":"10.1016/j.carrev.2025.04.041","DOIUrl":"10.1016/j.carrev.2025.04.041","url":null,"abstract":"<div><h3>Introduction</h3><div>Positive effects on pain reduction following renal denervation (RDN) have been described in patients with kidney-related pain syndromes, yet data on the safety and efficacy of redo RDN procedures are limited.</div></div><div><h3>Methods</h3><div>Consecutive patients with a history of chronic loin pain, hypertension and preserved renal function (eGFR ≥40 ml/min) scheduled for RDN were included. Changes in perceived pain, opioid and antihypertensive medication use, and blood pressure were prospectively assessed 3 months after each procedure.</div></div><div><h3>Results</h3><div>Two patients presented with a history of Autosomal Dominant Polycystic Kidney Disease (<em>n</em> = 2) and one with Loin Pain Hematuria Syndrome (<em>n</em> = 1). Two patients underwent a redo RDN. After the initial procedures, a reduction in perceived pain, along with a 50 % and 75 % reduction in the daily dosage of opioids, was observed in two patients. One patient showed no reduction in perceived pain or opioid use and underwent a redo procedure after 3 years, again with no reduction in perceived pain or opioid use. One patient who initially responded returned at 2 years with recurrent symptoms and underwent a redo procedure. After 3 months, a significant improvement in pain and opioid use was observed. Mean 24-hour systolic blood pressure decreased in all patients and after each procedure with a mean decrease of 12 mmHg. No adverse events were observed.</div></div><div><h3>Conclusion</h3><div>In hypertensive patients with kidney-related pain syndromes, percutaneous RDN may be considered as an alternative treatment option to reduce pain severity and improve blood pressure control. Redo procedures may be considered in patients with recurrent symptoms after an initial response.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 15-20"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988230","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}

引用次数: 0

The role of Pulmonary Artery Pulsatility Index to assess the outcomes following catheter directed therapy in patients with intermediate-to-high and high-risk pulmonary embolism 肺动脉搏动指数在评估导管引导治疗中高、高危肺栓塞患者预后中的作用

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.02.002

Mario Iannaccone , Sylwia Sławek-Szmyt , Marco Gamardella , Federica Fumarola , Riccardo Mangione , Daniele Savio , Filippo Russo , Giacomo Boccuzzi , Aleksander Araszkiewicz , Alaide Chieffo

Background

The clinical impact of catheter-directed therapy (CDT) for pulmonary embolism (PE) on right ventricular function and procedural outcomes remains undefined.

Methods

This observational retrospective study included consecutive patients who underwent CDT for PE at San Giovanni Bosco Hospital, Italy, and First Department of Cardiology, Poznan University Clinical Hospital, Poland, between 2021 and 2023. Clinical characteristics, PE risk stratification, pre and post-interventional invasive pulmonary artery pressure (PAP), and Pulmonary Artery Pulsatility Index (PAPi) were collected. The primary endpoint was in-hospital death.

Results

Among 165 patients (53 % male, mean age 63 ± 5.6 years), 65.6 % had multiple PE risk factors. 32.7 % were classified as high-risk (HR) PE, and 67.3 % as intermediate-high risk (IHR). Treatments included transcatheter thrombolysis (17 %), FlowTriever device (10 %), and Indigo Cath8 or Lightning 12 device (73 %), with 7 % requiring ECMO support. In IHR patients, mean PAP significantly decreased from 31.7 ± 7.1 to 23.4 ± 6.1 mmHg (p < 0.01) and PAPi from 3.1 ± 0.1 to 2.9 ± 0.1 (p < 0.01). HR patients had no significant changes in PAP or PAPi overall, but those who survived without events showed significant reductions in PAP (29.1 ± 8.7 to 23.8 ± 5.5, p < 0.02) and increases in PAPi (1.5 ± 0.6 to 2.0 ± 0.5, p < 0.01). In the HR group, a delta PAPi >0.45 predicted positive outcomes with 65.7 % sensitivity and 75 % specificity (AUC 0.83).

Conclusion

CDT for PE significantly impacts PAP and PAPi in acute PE patients. Normalization of PAPi in IHR patients and its increase in HR patients may indicate procedural success and right ventricular recovery. Hemodynamic changes could serve as important markers for procedural efficacy and outcome assessment in these groups.

背景：导管定向治疗（CDT）对肺栓塞（PE）的右心室功能和手术结果的临床影响尚不明确。方法：这项观察性回顾性研究纳入了2021年至2023年间在意大利San Giovanni Bosco医院和波兰波兹南大学临床医院第一心脏科接受CDT治疗PE的连续患者。收集临床特征、PE危险分层、介入前后有创肺动脉压（PAP）、肺动脉搏动指数（PAPi）。主要终点是院内死亡。结果：165例患者（男性53%，平均年龄63±5.6岁）中，65.6%存在多种PE危险因素。高危PE （HR）占32.7%，中高危PE （IHR）占67.3%。治疗包括经导管溶栓（17%）、FlowTriever装置（10%）和Indigo Cath8或Lightning 12装置（73%），其中7%需要ECMO支持。在IHR患者中，平均PAP从31.7±7.1显著下降到23.4±6.1 mmHg (p 0.45预测阳性结果，敏感性为65.7%，特异性为75% （AUC 0.83）。结论：PE CDT对急性PE患者PAP和PAPi有显著影响。IHR患者的PAPi正常化和HR患者的PAPi升高可能表明手术成功和右心室恢复。血流动力学变化可作为手术疗效和疗效评估的重要指标。

{"title":"The role of Pulmonary Artery Pulsatility Index to assess the outcomes following catheter directed therapy in patients with intermediate-to-high and high-risk pulmonary embolism","authors":"Mario Iannaccone , Sylwia Sławek-Szmyt , Marco Gamardella , Federica Fumarola , Riccardo Mangione , Daniele Savio , Filippo Russo , Giacomo Boccuzzi , Aleksander Araszkiewicz , Alaide Chieffo","doi":"10.1016/j.carrev.2025.02.002","DOIUrl":"10.1016/j.carrev.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>The clinical impact of catheter-directed therapy (CDT) for pulmonary embolism<span> (PE) on right ventricular function and procedural outcomes remains undefined.</span></div></div><div><h3>Methods</h3><div><span>This observational retrospective study included consecutive patients who underwent CDT for PE at San Giovanni Bosco Hospital, Italy, and First Department of Cardiology, Poznan University Clinical Hospital, Poland, between 2021 and 2023. Clinical characteristics, PE </span>risk stratification<span><span>, pre and post-interventional invasive pulmonary artery pressure (PAP), and Pulmonary Artery </span>Pulsatility Index (PAPi) were collected. The primary endpoint was in-hospital death.</span></div></div><div><h3>Results</h3><div>Among 165 patients (53 % male, mean age 63 ± 5.6 years), 65.6 % had multiple PE risk factors. 32.7 % were classified as high-risk (HR) PE, and 67.3 % as intermediate-high risk (IHR). Treatments included transcatheter thrombolysis (17 %), FlowTriever device (10 %), and Indigo Cath8 or Lightning 12 device (73 %), with 7 % requiring ECMO support. In IHR patients, mean PAP significantly decreased from 31.7 ± 7.1 to 23.4 ± 6.1 mmHg (p < 0.01) and PAPi from 3.1 ± 0.1 to 2.9 ± 0.1 (p < 0.01). HR patients had no significant changes in PAP or PAPi overall, but those who survived without events showed significant reductions in PAP (29.1 ± 8.7 to 23.8 ± 5.5, p < 0.02) and increases in PAPi (1.5 ± 0.6 to 2.0 ± 0.5, p < 0.01). In the HR group, a delta PAPi >0.45 predicted positive outcomes with 65.7 % sensitivity and 75 % specificity (AUC 0.83).</div></div><div><h3>Conclusion</h3><div><span>CDT for PE significantly impacts PAP and PAPi in acute PE patients. Normalization of PAPi in IHR patients and its increase in HR patients may indicate procedural success and right ventricular recovery. </span>Hemodynamic changes could serve as important markers for procedural efficacy and outcome assessment in these groups.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 57-61"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399282","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}

引用次数: 0

Intravascular ultrasound guidance for complex high-risk indicated procedures in underrepresented patient populations registry: Rationale and study design of the prospective observational IVUS CHIP UPP registry 在代表性不足的患者群体登记中，血管内超声指导复杂高危手术：前瞻性观察性IVUS CHIP UPP登记的基本原理和研究设计。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.06.027

Ernest Spitzer , Ximena S. Paredes , J. Dawn Abbott , Wayne B. Batchelor , Joost Daemen , Jan G.P. Tijssen , David E. Kandzari

Background

Intravascular ultrasound (IVUS) guidance during percutaneous coronary intervention (PCI) of complex coronary lesions is currently recommended by international guidelines. Complex coronary anatomy is observed in up to one third of the patients undergoing coronary interventions and is associated with worse clinical outcomes. Data on lesion characteristics and outcomes are scarce in census-defined minority groups.

Methods/design

The Intravascular Ultrasound Guidance for Complex High-Risk Indicated Procedures in Underrepresented Patient Populations (UPP) Registry is a prospective, observational, multicenter, single-arm study describing the safety and efficacy of IVUS-guided PCI in approximately 1010 subjects who self-identify within a demographic minority and undergo complex high-risk procedures. Criteria for optimal stenting include final minimal stent area (MSA) >5 mm² or MSA >90 % of the distal reference lumen, plaque burden <50 % within 5 mm proximal or distal to stent edges, and absence of edge dissections involving the media and > 3 mm in length. The primary endpoint of target-vessel failure is a composite of cardiac death, target vessel myocardial infarction, or clinically indicated target-vessel revascularization at 1 year. Secondary endpoints include the individual components of the primary end point as well as procedural and imaging endpoints.

Summary

The IVUS CHIP UPP Registry is the first prospective investigation of procedural and clinical outcomes related to an IVUS-guided PCI for management of complex coronary lesions among minority patient populations in the United States.

背景：目前国际指南推荐在复杂冠状动脉病变经皮冠状动脉介入治疗（PCI）时血管内超声（IVUS）引导。在接受冠状动脉介入治疗的患者中，多达三分之一的患者存在复杂的冠状动脉解剖结构，这与较差的临床结果有关。在人口普查定义的少数群体中，关于病变特征和结果的数据很少。方法/设计：在代表性不足的患者群体（UPP）登记中，血管内超声指导复杂高风险指征手术是一项前瞻性、观察性、多中心、单臂研究，描述了ivus引导的PCI在大约1010名自认为属于人口统计学少数群体并接受复杂高风险手术的受试者中的安全性和有效性。最佳支架植入术的标准包括最终最小支架面积(MSA) >5 mm2或MSA >远端参考管腔的90%，斑块负荷长度为3 mm。靶血管衰竭的主要终点是心源性死亡、靶血管心肌梗死或1年后临床指示的靶血管重建术的复合终点。次要终点包括主要终点的各个组成部分以及手术终点和成像终点。摘要：IVUS CHIP UPP注册是美国少数患者中IVUS引导下PCI治疗复杂冠状动脉病变的程序和临床结果的第一个前瞻性调查。

{"title":"Intravascular ultrasound guidance for complex high-risk indicated procedures in underrepresented patient populations registry: Rationale and study design of the prospective observational IVUS CHIP UPP registry","authors":"Ernest Spitzer , Ximena S. Paredes , J. Dawn Abbott , Wayne B. Batchelor , Joost Daemen , Jan G.P. Tijssen , David E. Kandzari","doi":"10.1016/j.carrev.2025.06.027","DOIUrl":"10.1016/j.carrev.2025.06.027","url":null,"abstract":"<div><h3>Background</h3><div>Intravascular ultrasound<span> (IVUS) guidance during percutaneous coronary intervention (PCI) of complex coronary lesions is currently recommended by international guidelines. Complex coronary anatomy is observed in up to one third of the patients undergoing coronary interventions and is associated with worse clinical outcomes. Data on lesion characteristics and outcomes are scarce in census-defined minority groups.</span></div></div><div><h3>Methods/design</h3><div>The Intravascular Ultrasound Guidance for Complex High-Risk Indicated Procedures in Underrepresented Patient Populations (UPP) Registry is a prospective, observational, multicenter, single-arm study describing the safety and efficacy of IVUS-guided PCI in approximately 1010 subjects who self-identify within a demographic minority and undergo complex high-risk procedures. Criteria for optimal stenting include final minimal stent area (MSA) >5 mm<sup>2</sup> or MSA >90 % of the distal reference lumen, plaque burden <50 % within 5 mm proximal or distal to stent edges, and absence of edge dissections involving the media and > 3 mm in length. The primary endpoint of target-vessel failure is a composite of cardiac death, target vessel myocardial infarction, or clinically indicated target-vessel revascularization at 1 year. Secondary endpoints include the individual components of the primary end point as well as procedural and imaging endpoints.</div></div><div><h3>Summary</h3><div>The IVUS CHIP UPP Registry is the first prospective investigation of procedural and clinical outcomes related to an IVUS-guided PCI for management of complex coronary lesions among minority patient populations in the United States.</div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 42-49"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498406","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}

引用次数: 0

Editorial: Impact of coronary intravascular lithotripsy on modern coronary revascularization 编辑：冠状动脉血管内碎石术对现代冠状动脉血运重建的影响。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.06.026

Wah Wah Htun

引用次数: 0

Transcatheter treatment of tricuspid regurgitation: A state-of-the-art review 经导管治疗三尖瓣反流：最新进展。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.06.029

Claudio Sanfilippo , Marco Frazzetto , Michela Bonanni , Andrea Matteucci , Laura Anna Leo , Ridha Umar , Giuseppe Imperatore , Paulo de Coelho Castro , Guilherme Attizzani , Giuseppe Massimo Sangiorgi , Carmelo Grasso , Corrado Tamburino

Recent advancements in transcatheter techniques for the treatment of severe tricuspid regurgitation (TR) have introduced minimally invasive therapies with significantly lower risk profiles compared to traditional surgical approaches. Despite this progress, the latest European guidelines still recommend surgery as the “gold standard” for severe primary and secondary TR, particularly during left heart surgery or in cases with right ventricular dilation. However, surgical interventions are associated with high mortality and morbidity rates, making them less desirable for high-risk patients. As a result, transcatheter tricuspid valve interventions (TTVI) have emerged as promising alternatives, reshaping treatment paradigms. Among these, the tricuspid edge-to-edge repair (T-TEER) technique, using devices like the TriClip and PASCAL, has demonstrated significant clinical benefits, including improved valve function, symptom relief, and quality of life. While the TRI-SCORE and TRIVALVE risk scores help guide patient selection, further research is needed to refine outcomes across diverse clinical settings. Additionally, newer technologies like transcatheter valve replacement (TTVR) offer viable solutions for patients with complex anatomies. TTVR, exemplified by the EVOQUE valve, has shown promise in reducing TR and improving functional status, though it carries risks such as bleeding and pacemaker implantation. Moreover, heterotopic valve implantation, such as the TricValve, provides a less invasive option for symptom management, although it does not address the underlying valve pathology. Overall, the expanding range of transcatheter treatments is providing safer, effective alternatives for high-risk patients, with ongoing research critical to optimizing outcomes.

经导管技术治疗严重三尖瓣反流（TR）的最新进展引入了微创治疗，与传统手术方法相比，其风险显著降低。尽管取得了这些进展，最新的欧洲指南仍然推荐手术作为严重原发性和继发性TR的“金标准”，特别是在左心手术或右室扩张的情况下。然而，手术干预与高死亡率和发病率相关，使其不适合高危患者。因此，经导管三尖瓣介入治疗（TTVI）已成为有希望的替代方案，重塑了治疗范式。其中，使用TriClip和PASCAL等设备的三尖瓣边缘到边缘修复（T-TEER）技术已显示出显着的临床益处，包括改善瓣膜功能，症状缓解和生活质量。虽然TRI-SCORE和TRIVALVE风险评分有助于指导患者选择，但需要进一步的研究来完善不同临床环境下的结果。此外，像经导管瓣膜置换术（TTVR）这样的新技术为复杂解剖结构的患者提供了可行的解决方案。以EVOQUE瓣膜为代表的TTVR在减少TR和改善功能状态方面表现出了希望，尽管它存在出血和起搏器植入等风险。此外，异位瓣膜植入，如TricValve，为症状管理提供了一种侵入性较小的选择，尽管它不能解决潜在的瓣膜病理。总的来说，不断扩大的经导管治疗范围为高风险患者提供了更安全、有效的替代方案，正在进行的研究对优化结果至关重要。

{"title":"Transcatheter treatment of tricuspid regurgitation: A state-of-the-art review","authors":"Claudio Sanfilippo , Marco Frazzetto , Michela Bonanni , Andrea Matteucci , Laura Anna Leo , Ridha Umar , Giuseppe Imperatore , Paulo de Coelho Castro , Guilherme Attizzani , Giuseppe Massimo Sangiorgi , Carmelo Grasso , Corrado Tamburino","doi":"10.1016/j.carrev.2025.06.029","DOIUrl":"10.1016/j.carrev.2025.06.029","url":null,"abstract":"<div><div><span>Recent advancements in transcatheter techniques for the treatment of severe tricuspid regurgitation (TR) have introduced </span>minimally invasive therapies<span><span><span> with significantly lower risk profiles compared to traditional surgical approaches. Despite this progress, the latest European guidelines still recommend surgery as the “gold standard” for severe primary and secondary TR, particularly during left heart surgery or in cases with right ventricular dilation. However, surgical interventions are associated with high mortality and morbidity rates, making them less desirable for high-risk patients. As a result, transcatheter tricuspid valve<span> interventions (TTVI) have emerged as promising alternatives, reshaping treatment paradigms. Among these, the tricuspid edge-to-edge repair (T-TEER) technique, using devices like the TriClip and PASCAL, has demonstrated significant clinical benefits, including improved valve function, symptom relief, and quality of life<span>. While the TRI-SCORE and TRIVALVE risk scores help guide patient selection, further research is needed to refine outcomes across diverse clinical settings. Additionally, newer technologies like transcatheter valve replacement (TTVR) offer viable solutions for patients with complex anatomies. TTVR, exemplified by the EVOQUE valve, has shown promise in reducing TR and improving functional status, though it carries risks such as bleeding and </span></span></span>pacemaker implantation. Moreover, </span>heterotopic valve implantation, such as the TricValve, provides a less invasive option for symptom management, although it does not address the underlying valve pathology. Overall, the expanding range of transcatheter treatments is providing safer, effective alternatives for high-risk patients, with ongoing research critical to optimizing outcomes.</span></div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 129-135"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568001","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}

引用次数: 0

Transcatheter aortic valve replacement in small aortic annuli: A propensity-matched comparison between intra-annular self-expanding valves and balloon-expandable valves 经导管主动脉瓣置换术治疗小主动脉环：环内自膨胀瓣膜与球囊膨胀瓣膜的倾向匹配比较

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.05.009

Danial Ahmad , Michel Pompeu Sá , Dustin Kliner , Derek Serna-Gallegos , Catalin Toma , Amber Makani , David West , Yisi Wang , Floyd Thoma , Takuya Ogami , Irsa Hasan , Ibrahim Sultan

Background

Specific transcatheter aortic valve replacement (TAVR) valve superiority is not established in the small aortic annulus (SAA) population. We sought to compare clinical and echocardiographic characteristics between patients with a SAA who underwent TAVR with either intra-annular self-expanding valves (SEV) or balloon-expandable valves (BEV).

Methods

This was an observational, retrospective analysis (2013−2023). SAA was defined as an aortic annulus diameter < 23 mm (maximum) and annulus area ≤ 430 mm². Unmatched and propensity-score matched (PSM) populations were compared.

Results

We identified 663 patients with SAA who underwent TAVR with SEV (n = 106) or BEV (n = 557). The PSM cohort (96 pairs) was predominantly female (90.6 % and 87.5 %) with a median age of 82.5 and 81.0 years. No statistically significant differences were observed in VARC-3 outcomes (periprocedural mortality, technical success, device success, clinical efficacy). Higher rates of residual mean gradients >20 mmHg were seen in the BEV group at 30 days (SEV 2.1 % vs BEV 21.9 %, P < 0.001) as well as lower median values of indexed effective orifice area (SEV 0.9 vs 0.6 cm²/m²). Severe PPM was also more common in the BEV group (SEV 5.2 % vs BEV 21.9 %, P = 0.002). At 2 years, differences in the rates of all-cause death (SE 11.9 % vs BE 17.1 %, P_log-rank = 0.6794) and stroke (SEV 3.4 % vs BEV 10.2 %, P = 0.7055) were not statistically significant.

Conclusions

Intra-annular SEV presented better hemodynamics compared to BEV; however, survival and incidence of stroke were comparable between the groups at 2 years. Potential risk of nonstructural valve deterioration with BEV needs further investigation with longer follow-up.

背景：特异性经导管主动脉瓣置换术（TAVR）在小主动脉环（SAA）人群中的优势尚未确立。我们试图比较接受TAVR的SAA患者的临床和超声心动图特征，无论是环内自扩瓣膜（SEV）还是球囊可扩瓣膜（BEV）。方法：采用观察性、回顾性分析（2013-2023）。SAA定义为主动脉环直径2。不匹配和倾向分数匹配（PSM）人群进行比较。结果：我们发现663例SAA患者接受了伴有SEV （n = 106）或BEV （n = 557）的TAVR。PSM队列（96对）以女性为主（90.6%和87.5%），中位年龄分别为82.5岁和81.0岁。在VARC-3结局（围手术期死亡率、技术成功、器械成功、临床疗效）方面没有观察到统计学上的显著差异。在30天，BEV组观察到较高的残余平均梯度率bb0 20 mmHg （SEV 2.1% vs BEV 21.9%, P 2/m2）。严重PPM在BEV组中也更为常见（SEV 5.2% vs BEV 21.9%, P = 0.002）。2年时，全因死亡率（SE 11.9% vs BE 17.1%, Plog-rank = 0.6794）和卒中（SEV 3.4% vs BEV 10.2%, P = 0.7055）的差异无统计学意义。结论：与BEV相比，环内SEV具有更好的血流动力学；然而，两组在2年时的生存率和卒中发生率是相当的。BEV非结构性瓣膜恶化的潜在风险需要进一步调查，随访时间更长。

{"title":"Transcatheter aortic valve replacement in small aortic annuli: A propensity-matched comparison between intra-annular self-expanding valves and balloon-expandable valves","authors":"Danial Ahmad , Michel Pompeu Sá , Dustin Kliner , Derek Serna-Gallegos , Catalin Toma , Amber Makani , David West , Yisi Wang , Floyd Thoma , Takuya Ogami , Irsa Hasan , Ibrahim Sultan","doi":"10.1016/j.carrev.2025.05.009","DOIUrl":"10.1016/j.carrev.2025.05.009","url":null,"abstract":"<div><h3>Background</h3><div>Specific transcatheter aortic valve replacement (TAVR) valve superiority is not established in the small aortic annulus (SAA) population. We sought to compare clinical and echocardiographic characteristics between patients with a SAA who underwent TAVR with either intra-annular self-expanding valves (SEV) or balloon-expandable valves (BEV).</div></div><div><h3>Methods</h3><div>This was an observational, retrospective analysis (2013−2023). SAA was defined as an aortic annulus diameter < 23 mm (maximum) and annulus area ≤ 430 mm<sup>2</sup>. Unmatched and propensity-score matched (PSM) populations were compared.</div></div><div><h3>Results</h3><div>We identified 663 patients with SAA who underwent TAVR with SEV (<em>n</em> = 106) or BEV (<em>n</em> = 557). The PSM cohort (96 pairs) was predominantly female (90.6 % and 87.5 %) with a median age of 82.5 and 81.0 years. No statistically significant differences were observed in VARC-3 outcomes (periprocedural mortality, technical success, device success, clinical efficacy). Higher rates of residual mean gradients >20 mmHg were seen in the BEV group at 30 days (SEV 2.1 % vs BEV 21.9 %, <em>P</em> < 0.001) as well as lower median values of indexed effective orifice area (SEV 0.9 vs 0.6 cm<sup>2</sup>/m<sup>2</sup>). Severe PPM was also more common in the BEV group (SEV 5.2 % vs BEV 21.9 %, <em>P</em> = 0.002). At 2 years, differences in the rates of all-cause death (SE 11.9 % vs BE 17.1 %, P<sub>log-rank</sub> = 0.6794) and stroke (SEV 3.4 % vs BEV 10.2 %, <em>P</em> = 0.7055) were not statistically significant.</div></div><div><h3>Conclusions</h3><div>Intra-annular SEV presented better hemodynamics<span> compared to BEV; however, survival and incidence of stroke were comparable between the groups at 2 years. Potential risk of nonstructural valve deterioration with BEV needs further investigation with longer follow-up.</span></div></div>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":"82 ","pages":"Pages 78-83"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081332","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}

引用次数: 0

Critique of the OPTIMIS study on magnesium-based bioresorbable scaffolds 镁基生物可吸收支架的OPTIMIS研究述评。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.08.009

Çağrı Zorlu, Sefa Erdi Ömür

引用次数: 0

Editorial: The vulnerable patient: Frailty in pulmonary embolism patients 社论：易受伤害的病人：肺栓塞病人的虚弱。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.10.014

Edward Koifman , Tomer Stahi

引用次数: 0

Refining the prognostic role of red cell distribution width in TAVR patients 完善TAVR患者红细胞分布宽度的预后作用。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.05.020

Artur Dziewierz

引用次数: 0

Editorial: Refining the hemocompatibility paradigm in AMI-cardiogenic shock: Insights from an early Impella 5+ experience with DAPT and bivalirudin 编辑：完善ami心源性休克的血液相容性范例：来自DAPT和比伐鲁定早期5+的经验。

IF 1.9 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Revascularization Medicine

Pub Date : 2026-01-01 DOI: 10.1016/j.carrev.2025.08.015

Ezequiel J. Molina

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Cardiovascular Revascularization Medicine

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀