首页 > 最新文献

Journal of the Society for Cardiovascular Angiography & Interventions最新文献

英文 中文
Socioeconomic Disparities in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Cardiomyopathy 酒精性室间隔消融术治疗肥厚性心肌病患者的社会经济差异
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.103788
Sivaram Neppala MD , Salman Abdul Basit MD , Himaja Dutt Chigurupati MD , Prakash Upreti MD , Soumya Kambalapall MD , Abdullah Naveed Muhammad MD , Yasemin Bahar MD , M. Chadi Alraies MD

Background

Alcohol septal ablation (ASA) effectively treats select patients with hypertrophic obstructive cardiomyopathy (HOCM). Our study analyzes socioeconomic and geographic factors' influence on post-ASA outcomes to improve patient care and accessibility.

Methods

Using the National Inpatient Sample (2016-2021) and International Classification of Diseases 10th Revision codes, we identified patients with a primary diagnosis of HOCM who underwent ASA. Study populations were categorized into 3 groups based on the poverty income ratio. The primary outcome was in-hospital complications following the procedure. Secondary outcomes included length of stay, hospitalization costs, and disposition status.

Results

Of 8585 patients who underwent ASA, 45.3% were from low SES backgrounds. Medicare was the primary payer, with treatments predominantly occurring in urban teaching hospitals for elective procedures in the southern region. Low and middle-SES patients showed higher rates of in-hospital mortality, sudden cardiac arrest, and increased pacemaker placements compared to high-SES groups. They experienced more extended hospital stays, which was associated with higher hospitalization costs and more transfers to skilled nursing facilities than high SES patients (all P < .05). However, other complications, such as acute stroke and acute kidney injury, showed no significant differences among the groups.

Conclusions

Lower and middle socioeconomic HOCM patients who underwent ASA face higher in-hospital mortality, more sudden cardiac arrests, increased pacemaker placements, and more extended hospital stays compared to higher socioeconomic patients, highlighting the need for standardized outcomes for all ASA patients.
背景:酒精室间隔消融术(ASA)可有效治疗肥厚性阻塞性心肌病(HOCM)患者。我们的研究分析了社会经济和地理因素对asa后结果的影响,以改善患者的护理和可及性。方法使用国家住院患者样本(2016-2021)和国际疾病分类第10次修订代码,我们确定了初步诊断为HOCM并接受ASA的患者。根据贫困收入比将研究人群分为三组。主要结果是手术后的院内并发症。次要结局包括住院时间、住院费用和处置状况。结果8585例ASA患者中,45.3%来自低社会经济地位背景。医疗保险是主要付款人,治疗主要在南部地区的城市教学医院进行选择性手术。与高ses组相比,中低ses组患者表现出更高的住院死亡率、心脏骤停和起搏器放置率。与高SES患者相比,他们经历了更长的住院时间,这与更高的住院费用和更多的转移到熟练护理机构相关(均P <; 0.05)。然而,其他并发症,如急性中风和急性肾损伤,组间无显著差异。结论:与社会经济水平较高的患者相比,接受ASA的慢速和中等社会经济水平的HOCM患者面临更高的住院死亡率、更多的心脏骤停、更多的起搏器放置和更长的住院时间,这突出了对所有ASA患者进行标准化结局的需求。
{"title":"Socioeconomic Disparities in Patients Undergoing Alcohol Septal Ablation for Hypertrophic Cardiomyopathy","authors":"Sivaram Neppala MD ,&nbsp;Salman Abdul Basit MD ,&nbsp;Himaja Dutt Chigurupati MD ,&nbsp;Prakash Upreti MD ,&nbsp;Soumya Kambalapall MD ,&nbsp;Abdullah Naveed Muhammad MD ,&nbsp;Yasemin Bahar MD ,&nbsp;M. Chadi Alraies MD","doi":"10.1016/j.jscai.2025.103788","DOIUrl":"10.1016/j.jscai.2025.103788","url":null,"abstract":"<div><h3>Background</h3><div>Alcohol septal ablation (ASA) effectively treats select patients with hypertrophic obstructive cardiomyopathy (HOCM). Our study analyzes socioeconomic and geographic factors' influence on post-ASA outcomes to improve patient care and accessibility.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample (2016-2021) and International Classification of Diseases 10th Revision codes, we identified patients with a primary diagnosis of HOCM who underwent ASA. Study populations were categorized into 3 groups based on the poverty income ratio. The primary outcome was in-hospital complications following the procedure. Secondary outcomes included length of stay, hospitalization costs, and disposition status.</div></div><div><h3>Results</h3><div>Of 8585 patients who underwent ASA, 45.3% were from low SES backgrounds. Medicare was the primary payer, with treatments predominantly occurring in urban teaching hospitals for elective procedures in the southern region. Low and middle-SES patients showed higher rates of in-hospital mortality, sudden cardiac arrest, and increased pacemaker placements compared to high-SES groups. They experienced more extended hospital stays, which was associated with higher hospitalization costs and more transfers to skilled nursing facilities than high SES patients (all <em>P</em> &lt; .05). However, other complications, such as acute stroke and acute kidney injury, showed no significant differences among the groups.</div></div><div><h3>Conclusions</h3><div>Lower and middle socioeconomic HOCM patients who underwent ASA face higher in-hospital mortality, more sudden cardiac arrests, increased pacemaker placements, and more extended hospital stays compared to higher socioeconomic patients, highlighting the need for standardized outcomes for all ASA patients.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 103788"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533002","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
One Biomarker to Rule Them All? 一种生物标志物可以统治一切?
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.104006
Alexander G. Truesdell MD , Holger Thiele MD
{"title":"One Biomarker to Rule Them All?","authors":"Alexander G. Truesdell MD ,&nbsp;Holger Thiele MD","doi":"10.1016/j.jscai.2025.104006","DOIUrl":"10.1016/j.jscai.2025.104006","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 104006"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533013","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
Radial to Peripheral Intervention: A Paradigm Shift 径向向外周干预:一种范式转变
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.104012
Srinivasa Potluri MD, Mohamad Bader Abo Hajar MD, Joseph Suhail Jebain MD
{"title":"Radial to Peripheral Intervention: A Paradigm Shift","authors":"Srinivasa Potluri MD,&nbsp;Mohamad Bader Abo Hajar MD,&nbsp;Joseph Suhail Jebain MD","doi":"10.1016/j.jscai.2025.104012","DOIUrl":"10.1016/j.jscai.2025.104012","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 104012"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533019","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
Impact of Uninterrupted Versus Interrupted Oral Anticoagulation on 30-Day Outcomes Following Coronary Angiography 不间断与间断口服抗凝对冠状动脉造影后30天预后的影响
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.103988
Ting-Yu Wang MD , Robin Jacob MD , Leah Puglisi MS , Curtiss T. Stinis MD

Background

The rising prevalence of patients undergoing coronary angiography who require oral anticoagulation (OAC) presents a challenge in periprocedural management. While current North American guidelines advise OAC interruption before nonemergent coronary angiography, the impact of continuation vs interruption on outcomes remains unclear.

Methods

This retrospective study included patients who underwent elective outpatient transradial coronary angiography from August 1, 2018, to March 20, 2023 at a tertiary medical center. The primary end point included 30-day outcomes of hematoma, pseudoaneurysm, perforation, arteriovenous fistula, compartment syndrome, and stroke or transient ischemic attack.

Results

Of the 470 patients, 225 patients (48%) continued OAC (uninterrupted group), and 245 patients (52%) had OAC stopped periprocedurally (interrupted group). There were no differences in baseline demographic characteristics and clinical characteristics. The uninterrupted group trended toward higher rates of warfarin use (17.3% vs 10.6%) and lower rates of rivaroxaban use (13.3% vs 20.4%; P = .031). The interrupted group had higher rates of conversion to the alternate radial access (6.1% vs 1.8%; P =.019) and percutaneous coronary intervention (46.5% vs 24.0%; P < .001). No significant differences were found between the interrupted and uninterrupted groups with respect to 30-day rates of hematoma (2.9% vs 4.0%; P = .495), pseudoaneurysm (0.8% vs 0%; P = .5), and stroke or transient ischemic attack (1.2% vs 0.4%; P = .625), respectively. No perforations, arteriovenous fistula, or compartment syndrome were observed at 30 days.

Conclusions

In this institutional registry of patients who underwent elective outpatient transradial coronary angiography, an uninterrupted OAC strategy was not associated with higher rates of 30-day complications.
背景:接受冠状动脉造影的患者中需要口服抗凝剂(OAC)的患者越来越多,这对围手术期管理提出了挑战。虽然目前的北美指南建议在非急诊冠状动脉造影前中断OAC,但继续与中断对结果的影响尚不清楚。方法回顾性研究纳入2018年8月1日至2023年3月20日在三级医疗中心接受选择性门诊经桡动脉冠状动脉造影的患者。主要终点包括血肿、假性动脉瘤、穿孔、动静脉瘘、隔室综合征、中风或短暂性脑缺血发作的30天结局。结果470例患者中,225例(48%)患者继续OAC(不间断组),245例(52%)患者围手术期停止OAC(中断组)。基线人口学特征和临床特征无差异。不间断组华法林使用率较高(17.3% vs 10.6%),利伐沙班使用率较低(13.3% vs 20.4%; P = 0.031)。中断组有更高的转行率(6.1% vs 1.8%; P = 0.019)和经皮冠状动脉介入治疗(46.5% vs 24.0%; P < 0.001)。在30天血肿发生率(2.9% vs 4.0%, P = .495)、假性动脉瘤发生率(0.8% vs 0%, P = .5)和中风或短暂性脑缺血发作发生率(1.2% vs 0.4%, P = .625)方面,中断组和不间断组之间没有显著差异。30天未观察到穿孔、动静脉瘘或隔室综合征。结论:在接受选择性门诊经桡动脉冠状动脉造影的患者的机构登记中,不间断的OAC策略与30天并发症的高发生率无关。
{"title":"Impact of Uninterrupted Versus Interrupted Oral Anticoagulation on 30-Day Outcomes Following Coronary Angiography","authors":"Ting-Yu Wang MD ,&nbsp;Robin Jacob MD ,&nbsp;Leah Puglisi MS ,&nbsp;Curtiss T. Stinis MD","doi":"10.1016/j.jscai.2025.103988","DOIUrl":"10.1016/j.jscai.2025.103988","url":null,"abstract":"<div><h3>Background</h3><div>The rising prevalence of patients undergoing coronary angiography who require oral anticoagulation (OAC) presents a challenge in periprocedural management. While current North American guidelines advise OAC interruption before nonemergent coronary angiography, the impact of continuation vs interruption on outcomes remains unclear.</div></div><div><h3>Methods</h3><div>This retrospective study included patients who underwent elective outpatient transradial coronary angiography from August 1, 2018, to March 20, 2023 at a tertiary medical center. The primary end point included 30-day outcomes of hematoma, pseudoaneurysm, perforation, arteriovenous fistula, compartment syndrome, and stroke or transient ischemic attack.</div></div><div><h3>Results</h3><div>Of the 470 patients, 225 patients (48%) continued OAC (uninterrupted group), and 245 patients (52%) had OAC stopped periprocedurally (interrupted group). There were no differences in baseline demographic characteristics and clinical characteristics. The uninterrupted group trended toward higher rates of warfarin use (17.3% vs 10.6%) and lower rates of rivaroxaban use (13.3% vs 20.4%; <em>P</em> = .031). The interrupted group had higher rates of conversion to the alternate radial access (6.1% vs 1.8%; <em>P</em> =.019) and percutaneous coronary intervention (46.5% vs 24.0%; <em>P</em> &lt; .001). No significant differences were found between the interrupted and uninterrupted groups with respect to 30-day rates of hematoma (2.9% vs 4.0%; <em>P</em> = .495), pseudoaneurysm (0.8% vs 0%; <em>P</em> = .5), and stroke or transient ischemic attack (1.2% vs 0.4%; <em>P</em> = .625), respectively. No perforations, arteriovenous fistula, or compartment syndrome were observed at 30 days.</div></div><div><h3>Conclusions</h3><div>In this institutional registry of patients who underwent elective outpatient transradial coronary angiography, an uninterrupted OAC strategy was not associated with higher rates of 30-day complications.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 103988"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532995","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
SCAI Door to Lactate Clearance (SCAI DLC) Cardiogenic Shock Initiative: Definition, Hypothesis, and Call to Action 乳酸门清除(SCAI DLC)心源性休克:定义、假设和行动呼吁
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.103996
Srihari S. Naidu MD, MSCAI , Sandeep Nathan MD, MSc, FSCAI , Mir B. Basir DO, FSCAI , David A. Baran MD, FSCAI , Jeffrey A. Marbach MBBS, MS, FSCAI , Cindy L. Grines MD, MSCAI
{"title":"SCAI Door to Lactate Clearance (SCAI DLC) Cardiogenic Shock Initiative: Definition, Hypothesis, and Call to Action","authors":"Srihari S. Naidu MD, MSCAI ,&nbsp;Sandeep Nathan MD, MSc, FSCAI ,&nbsp;Mir B. Basir DO, FSCAI ,&nbsp;David A. Baran MD, FSCAI ,&nbsp;Jeffrey A. Marbach MBBS, MS, FSCAI ,&nbsp;Cindy L. Grines MD, MSCAI","doi":"10.1016/j.jscai.2025.103996","DOIUrl":"10.1016/j.jscai.2025.103996","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 103996"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533018","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
Angiography-Derived Versus Coronary Guidewire-Derived Index of Microcirculatory Resistance in Patients With Ischemia With Nonobstructive Coronary Arteries 非阻塞性冠状动脉缺血患者血管造影术与冠状动脉导丝术的微循环阻力指数比较
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.103872
Ethan Loftspring MD , Peter Zhang MD , William Beaty MD , Anaïs Hausvater MD , Amanda Joa BS , Kenneth L. Harkin , Claudia Serrano-Gomez MD , Ayman Farid MD , Lindsay Elbaum MD , Jeffrey S. Berger MD, MS , Harmony R. Reynolds MD , Nathaniel R. Smilowitz MD, MS

Background

Coronary function testing (CFT) during invasive coronary angiography is guideline-recommended to identify coronary microvascular dysfunction (CMD) in patients with ischemia with nonobstructive coronary arteries (INOCA). Wire-free, angiography-derived index of microcirculatory resistance (IMRangio) measurements have been developed to simplify assessment for CMD. We assessed the validity of IMRangio compared with the conventional index of microcirculatory resistance (IMR) in a cohort of individuals with INOCA.

Methods

This single-center observational study prospectively enrolled adults aged >18 years who were referred for clinically indicated invasive coronary angiography for the evaluation of chest discomfort or an anginal equivalent and had no coronary artery lesions with ≥50% stenosis. Participants underwent invasive CFT using bolus thermodilution techniques to determine IMR and coronary flow reserve (CFR) in the left anterior descending artery. IMRangio was calculated retrospectively, blinded to CFT results. CMD was defined by IMR ≥25 or CFR <2.5.

Results

Among 122 enrolled participants with INOCA (median age 62 years, 77% women), the median IMR in the left anterior descending artery was 20 (13-27), CFR was 3.95 (2.5-4.7), and 54 participants (44%) had CMD. IMRangio did not correlate with IMR (r = 0.1; P = .14). Mean IMRangio was not different among patients with and without IMR ≥25 (P = .21). IMRangio ≥25 had a sensitivity of 44% and a specificity of 53% in identifying participants with CMD. In sensitivity analyses among participants with cineangiography at 10 to 15 frames per second (r = 0.37; P = .02) and limited to participants with both optimal angiographic view and frame rates ≥10 (r = 0.48; P = .03), we observed weak positive correlations between IMRangio and IMR.

Conclusions

In patients with INOCA, correlations between IMRangio and IMR were poor. IMRangio appears unreliable for identifying CMD in patients with INOCA.
背景:指南推荐在有创冠状动脉造影期间进行冠状动脉功能检测(CFT),以识别非阻塞性冠状动脉(INOCA)缺血患者的冠状动脉微血管功能障碍(CMD)。无导线、血管造影衍生的微循环阻力指数(IMRangio)测量已被开发,以简化CMD的评估。我们评估了IMRangio与常规微循环阻力指数(IMR)在一组INOCA患者中的有效性。方法:这项单中心观察性研究前瞻性地招募了18岁的成年人,他们被推荐进行临床指征的有创冠状动脉造影,以评估胸部不适或心绞痛,并且没有冠状动脉病变,狭窄程度≥50%。参与者使用大剂量热稀释技术进行有创CFT,以确定左前降支的IMR和冠状动脉血流储备(CFR)。IMRangio回顾性计算,对CFT结果不知情。以IMR≥25或CFR≥2.5定义CMD。结果122名患者(中位年龄62岁,77%为女性),左前降支中位IMR为20 (13-27),CFR为3.95(2.5-4.7),54名患者(44%)患有CMD。IMRangio与IMR无相关性(r = 0.1; P = 0.14)。平均IMRangio在IMR≥25的患者和未IMR≥25的患者之间无差异(P = .21)。IMRangio≥25识别CMD患者的敏感性为44%,特异性为53%。在以每秒10到15帧的速度进行血管造影的参与者(r = 0.37, P = 0.02)和以最佳血管造影视角和帧率≥10的参与者(r = 0.48, P = 0.03)进行的敏感性分析中,我们观察到IMRangio和IMR之间存在弱正相关。结论在inova患者中,IMRangio与IMR相关性较差。IMRangio在识别inova患者的CMD方面似乎不可靠。
{"title":"Angiography-Derived Versus Coronary Guidewire-Derived Index of Microcirculatory Resistance in Patients With Ischemia With Nonobstructive Coronary Arteries","authors":"Ethan Loftspring MD ,&nbsp;Peter Zhang MD ,&nbsp;William Beaty MD ,&nbsp;Anaïs Hausvater MD ,&nbsp;Amanda Joa BS ,&nbsp;Kenneth L. Harkin ,&nbsp;Claudia Serrano-Gomez MD ,&nbsp;Ayman Farid MD ,&nbsp;Lindsay Elbaum MD ,&nbsp;Jeffrey S. Berger MD, MS ,&nbsp;Harmony R. Reynolds MD ,&nbsp;Nathaniel R. Smilowitz MD, MS","doi":"10.1016/j.jscai.2025.103872","DOIUrl":"10.1016/j.jscai.2025.103872","url":null,"abstract":"<div><h3>Background</h3><div>Coronary function testing (CFT) during invasive coronary angiography is guideline-recommended to identify coronary microvascular dysfunction (CMD) in patients with ischemia with nonobstructive coronary arteries (INOCA). Wire-free, angiography-derived index of microcirculatory resistance (IMR<sub>angio</sub>) measurements have been developed to simplify assessment for CMD. We assessed the validity of IMR<sub>angio</sub> compared with the conventional index of microcirculatory resistance (IMR) in a cohort of individuals with INOCA.</div></div><div><h3>Methods</h3><div>This single-center observational study prospectively enrolled adults aged &gt;18 years who were referred for clinically indicated invasive coronary angiography for the evaluation of chest discomfort or an anginal equivalent and had no coronary artery lesions with ≥50% stenosis. Participants underwent invasive CFT using bolus thermodilution techniques to determine IMR and coronary flow reserve (CFR) in the left anterior descending artery. IMR<sub>angio</sub> was calculated retrospectively, blinded to CFT results. CMD was defined by IMR ≥25 or CFR &lt;2.5.</div></div><div><h3>Results</h3><div>Among 122 enrolled participants with INOCA (median age 62 years, 77% women), the median IMR in the left anterior descending artery was 20 (13-27), CFR was 3.95 (2.5-4.7), and 54 participants (44%) had CMD. IMR<sub>angio</sub> did not correlate with IMR (r = 0.1; <em>P</em> = .14). Mean IMR<sub>angio</sub> was not different among patients with and without IMR ≥25 (<em>P</em> = .21). IMR<sub>angio</sub> ≥25 had a sensitivity of 44% and a specificity of 53% in identifying participants with CMD. In sensitivity analyses among participants with cineangiography at 10 to 15 frames per second (r = 0.37; <em>P</em> = .02) and limited to participants with both optimal angiographic view and frame rates ≥10 (r = 0.48; <em>P</em> = .03), we observed weak positive correlations between IMR<sub>angio</sub> and IMR.</div></div><div><h3>Conclusions</h3><div>In patients with INOCA, correlations between IMR<sub>angio</sub> and IMR were poor. IMR<sub>angio</sub> appears unreliable for identifying CMD in patients with INOCA.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 103872"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532989","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
Clinical Outcomes of Coronary Artery Perforation Treated With Covered Stents: The Impact of Intravascular Ultrasound Guidance in a Contemporary Cohort 覆盖支架治疗冠状动脉穿孔的临床结果:血管内超声引导对当代队列的影响
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.103919
Omar Sami Abdelhai MD , Ahmad Jabri MD , Sant Kumar MD , Ahmed Ghoneem MD , David Gelovani MD , Adnan Halboni MD , Mohammad Memon MD , John Major MD , Parsa Kamalipour MD , Ismail Jiazuldin MD , Brittany Fuller MD , Brian O’Neill MD , Herbert D. Aronow MD, MPH , Mir Babar Basir DO , William W. O’Neill MD , Mohammad Alqarqaz MD

Background

Coronary artery perforation (CAP) during percutaneous coronary intervention carries significant morbidity and mortality; however, data are limited regarding the specific role of intravascular ultrasound (IVUS) in evaluating and guiding management after CAP occurs and whether this approach improves clinical outcomes.

Methods

This study consisted of a retrospective analysis of all patients who underwent percutaneous coronary intervention and experienced CAP treated with covered stents at a single tertiary care hospital between December 2014 and January 2024. The primary outcome was target vessel revascularization (TVR). Secondary outcomes included mortality, myocardial infarction, in-stent restenosis, and emergency cardiac surgery. Multivariable logistic regression was used to assess the association between IVUS and outcomes.

Results

Between 2014 and January 2024, 127 cases of CAP treated using covered stents were identified. Of these, 34 patients (26.8%) underwent IVUS-guided covered stent optimization, whereas 93 patients (73.2%) did not undergo IVUS. Patients in the IVUS group were older (75.1 ± 8.4 vs 61.0 ± 10.3 years; P < .001) and predominantly women (55.9% vs 31.2%; P = .020). The IVUS was more frequently used for left anterior descending artery perforations (64.7% vs 36.6%; P = .009). IVUS was associated with a reduced risk of TVR during an average follow-up of 60.3 months (adjusted odds ratio, 0.04; 95% CI, 0.02-0.56; P = .031). Other outcomes, including mortality and repeat myocardial infarction, were similar between the 2 groups.

Conclusions

The use of IVUS in patients requiring covered stents for CAP treatment, despite higher procedural complexity and a higher prevalence of severe perforations, was associated with significantly reduced TVR. This suggests a potential role for IVUS in improving clinical outcomes following CAP.
背景:冠状动脉穿孔(CAP)在经皮冠状动脉介入治疗中具有显著的发病率和死亡率;然而,关于血管内超声(IVUS)在CAP发生后评估和指导治疗中的具体作用以及该方法是否改善临床结果的数据有限。方法回顾性分析2014年12月至2024年1月在一家三级医院接受经皮冠状动脉介入治疗和覆盖支架治疗的所有患者。主要终点是靶血管重建术(TVR)。次要结局包括死亡率、心肌梗死、支架内再狭窄和紧急心脏手术。采用多变量logistic回归评估IVUS与预后之间的关系。结果2014年至2024年1月,共发现有盖支架治疗CAP病例127例。其中,34例(26.8%)患者接受了IVUS引导下的覆盖支架优化,93例(73.2%)患者未接受IVUS。IVUS组患者年龄较大(75.1±8.4岁vs 61.0±10.3岁;P < 0.001),以女性为主(55.9% vs 31.2%; P = 0.020)。IVUS更常用于左前降支穿孔(64.7% vs 36.6%; P = 0.009)。在平均60.3个月的随访期间,IVUS与TVR风险降低相关(校正优势比为0.04;95% CI为0.02-0.56;P = 0.031)。其他结果,包括死亡率和重复心肌梗死,在两组之间相似。结论:尽管有较高的操作复杂性和较高的严重穿孔发生率,但在需要覆盖支架进行CAP治疗的患者中使用IVUS可显著降低TVR。这表明IVUS在改善CAP后临床结果中的潜在作用。
{"title":"Clinical Outcomes of Coronary Artery Perforation Treated With Covered Stents: The Impact of Intravascular Ultrasound Guidance in a Contemporary Cohort","authors":"Omar Sami Abdelhai MD ,&nbsp;Ahmad Jabri MD ,&nbsp;Sant Kumar MD ,&nbsp;Ahmed Ghoneem MD ,&nbsp;David Gelovani MD ,&nbsp;Adnan Halboni MD ,&nbsp;Mohammad Memon MD ,&nbsp;John Major MD ,&nbsp;Parsa Kamalipour MD ,&nbsp;Ismail Jiazuldin MD ,&nbsp;Brittany Fuller MD ,&nbsp;Brian O’Neill MD ,&nbsp;Herbert D. Aronow MD, MPH ,&nbsp;Mir Babar Basir DO ,&nbsp;William W. O’Neill MD ,&nbsp;Mohammad Alqarqaz MD","doi":"10.1016/j.jscai.2025.103919","DOIUrl":"10.1016/j.jscai.2025.103919","url":null,"abstract":"<div><h3>Background</h3><div>Coronary artery perforation (CAP) during percutaneous coronary intervention carries significant morbidity and mortality; however, data are limited regarding the specific role of intravascular ultrasound (IVUS) in evaluating and guiding management after CAP occurs and whether this approach improves clinical outcomes.</div></div><div><h3>Methods</h3><div>This study consisted of a retrospective analysis of all patients who underwent percutaneous coronary intervention and experienced CAP treated with covered stents at a single tertiary care hospital between December 2014 and January 2024. The primary outcome was target vessel revascularization (TVR). Secondary outcomes included mortality, myocardial infarction, in-stent restenosis, and emergency cardiac surgery. Multivariable logistic regression was used to assess the association between IVUS and outcomes.</div></div><div><h3>Results</h3><div>Between 2014 and January 2024, 127 cases of CAP treated using covered stents were identified. Of these, 34 patients (26.8%) underwent IVUS-guided covered stent optimization, whereas 93 patients (73.2%) did not undergo IVUS. Patients in the IVUS group were older (75.1 ± 8.4 vs 61.0 ± 10.3 years; <em>P</em> &lt; .001) and predominantly women (55.9% vs 31.2%; <em>P</em> = .020). The IVUS was more frequently used for left anterior descending artery perforations (64.7% vs 36.6%; <em>P</em> = .009). IVUS was associated with a reduced risk of TVR during an average follow-up of 60.3 months (adjusted odds ratio, 0.04; 95% CI, 0.02-0.56; <em>P</em> = .031). Other outcomes, including mortality and repeat myocardial infarction, were similar between the 2 groups.</div></div><div><h3>Conclusions</h3><div>The use of IVUS in patients requiring covered stents for CAP treatment, despite higher procedural complexity and a higher prevalence of severe perforations, was associated with significantly reduced TVR. This suggests a potential role for IVUS in improving clinical outcomes following CAP.</div></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 103919"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145532992","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
Mechanical Circulatory Support as a Bridge to Transcatheter Aortic Valve Replacement in Cardiogenic Shock 机械循环支持作为经导管主动脉瓣置换术治疗心源性休克的桥梁
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.103925
Ali A. Khan BSPH , Mohamed Barghout MD , Ahmed Elkaryoni MD , Hafiz M. Imran MD , Paul C. Gordon MD , Barry L. Sharaf MD , J. Dawn Abbott MD , Saraschandra Vallabhajosyula MD, MSc , Mohamad Alkhouli MD , Marwan Saad MD, PhD
{"title":"Mechanical Circulatory Support as a Bridge to Transcatheter Aortic Valve Replacement in Cardiogenic Shock","authors":"Ali A. Khan BSPH ,&nbsp;Mohamed Barghout MD ,&nbsp;Ahmed Elkaryoni MD ,&nbsp;Hafiz M. Imran MD ,&nbsp;Paul C. Gordon MD ,&nbsp;Barry L. Sharaf MD ,&nbsp;J. Dawn Abbott MD ,&nbsp;Saraschandra Vallabhajosyula MD, MSc ,&nbsp;Mohamad Alkhouli MD ,&nbsp;Marwan Saad MD, PhD","doi":"10.1016/j.jscai.2025.103925","DOIUrl":"10.1016/j.jscai.2025.103925","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 103925"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533000","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
Expanding the Role of Mechanical Circulatory Support in Transcatheter Aortic Valve Replacement for Cardiogenic Shock 扩大机械循环支持在经导管主动脉瓣置换术治疗心源性休克中的作用
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.104010
Dan Haberman MD , Uri Landes MD , Jacob George MD
{"title":"Expanding the Role of Mechanical Circulatory Support in Transcatheter Aortic Valve Replacement for Cardiogenic Shock","authors":"Dan Haberman MD ,&nbsp;Uri Landes MD ,&nbsp;Jacob George MD","doi":"10.1016/j.jscai.2025.104010","DOIUrl":"10.1016/j.jscai.2025.104010","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 104010"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533001","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
Ambulatory Surgery Centers for Coronary Angiography and Percutaneous Coronary Intervention: Modeled Savings for Medicare and Beneficiaries 冠状动脉造影和经皮冠状动脉介入的门诊手术中心:医疗保险和受益人的模拟储蓄
Pub Date : 2025-11-01 DOI: 10.1016/j.jscai.2025.104007
Pranav Puri MD, Charles D. Miks MD, Vikram Sharma MD
{"title":"Ambulatory Surgery Centers for Coronary Angiography and Percutaneous Coronary Intervention: Modeled Savings for Medicare and Beneficiaries","authors":"Pranav Puri MD,&nbsp;Charles D. Miks MD,&nbsp;Vikram Sharma MD","doi":"10.1016/j.jscai.2025.104007","DOIUrl":"10.1016/j.jscai.2025.104007","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"4 11","pages":"Article 104007"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145533024","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
期刊
Journal of the Society for Cardiovascular Angiography & Interventions
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1