Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102154
Saraschandra Vallabhajosyula MD, MSc , Spencer B. King III MD , John S. Douglas MD , H. V. ('Skip') Anderson MD , J. Jeffrey Marshall MD
{"title":"The Emory-Gruentzig Days—Birth of a New Field","authors":"Saraschandra Vallabhajosyula MD, MSc , Spencer B. King III MD , John S. Douglas MD , H. V. ('Skip') Anderson MD , J. Jeffrey Marshall MD","doi":"10.1016/j.jscai.2024.102154","DOIUrl":"10.1016/j.jscai.2024.102154","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102154"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102147
Left atrial appendage closure devices reduce the risk of stroke in patients with nonvalvular atrial fibrillation while avoiding the risks associated with therapeutic anticoagulation. This significant value comes with additional unique risks associated with device implantation or surgical closure. We discuss an uncommon complication of Watchman device (Boston Scientific) implantation wherein an asymptomatic fistulous connection developed between the left atrial appendage and the left circumflex artery. Additionally, we review other documented cases of left atrial appendage fistulas and current management approaches for iatrogenic fistulous connections associated with procedural left atrial appendage closure.
{"title":"Left Circumflex Fistula After Watchman Implantation: A Case Report of Left Atrial Appendage Closure Complication","authors":"","doi":"10.1016/j.jscai.2024.102147","DOIUrl":"10.1016/j.jscai.2024.102147","url":null,"abstract":"<div><p>Left atrial appendage closure devices reduce the risk of stroke in patients with nonvalvular atrial fibrillation while avoiding the risks associated with therapeutic anticoagulation. This significant value comes with additional unique risks associated with device implantation or surgical closure. We discuss an uncommon complication of Watchman device (Boston Scientific) implantation wherein an asymptomatic fistulous connection developed between the left atrial appendage and the left circumflex artery. Additionally, we review other documented cases of left atrial appendage fistulas and current management approaches for iatrogenic fistulous connections associated with procedural left atrial appendage closure.</p></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102147"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277293032401370X/pdfft?md5=7bc805c225fd842d63cc9ac126971628&pid=1-s2.0-S277293032401370X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102020
We present the case of an 82-year-old woman with persistent fatigue, exertional dyspnea, and dizziness related to a paravalvular leak following a self-expanding transcatheter aortic valve replacement. Successful closure was performed using a steerable sheath to negotiate a vascular plug closure device through the self-expanding valve structure.
{"title":"Paravalvular Leak Closure After Self-Expanding Transcatheter Aortic Valve Replacement Using a Steerable Sheath","authors":"","doi":"10.1016/j.jscai.2024.102020","DOIUrl":"10.1016/j.jscai.2024.102020","url":null,"abstract":"<div><p>We present the case of an 82-year-old woman with persistent fatigue, exertional dyspnea, and dizziness related to a paravalvular leak following a self-expanding transcatheter aortic valve replacement. Successful closure was performed using a steerable sheath to negotiate a vascular plug closure device through the self-expanding valve structure.</p></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102020"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324011311/pdfft?md5=a4918652232eb6fc8d86b9fda04a59be&pid=1-s2.0-S2772930324011311-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102072
In this case report, we explore a novel technique to remove an embolized Watchman device (Boston Scientific) into the thoracic aorta endovascularly. The technique involves a wire + snare combination that is threaded through the metal struts of the Watchman. This combination technique along with the threading provides increased stability during removal and decreases the risk of the Watchman slipping from the devices and causing further embolization. Further work is required to elucidate the efficacy of this technique in other scenarios.
{"title":"Embolized Watchman Removal With Modified Hangman Technique","authors":"","doi":"10.1016/j.jscai.2024.102072","DOIUrl":"10.1016/j.jscai.2024.102072","url":null,"abstract":"<div><p>In this case report, we explore a novel technique to remove an embolized Watchman device (Boston Scientific) into the thoracic aorta endovascularly. The technique involves a wire + snare combination that is threaded through the metal struts of the Watchman. This combination technique along with the threading provides increased stability during removal and decreases the risk of the Watchman slipping from the devices and causing further embolization. Further work is required to elucidate the efficacy of this technique in other scenarios.</p></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102072"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324012766/pdfft?md5=b33c0ecb1d3b5d16e375fe41dfb07961&pid=1-s2.0-S2772930324012766-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102169
{"title":"Pitfalls in Coronary Physiological Testing: Beware of the “Accordion” Effect With Wire-Based Physiological Testing!","authors":"","doi":"10.1016/j.jscai.2024.102169","DOIUrl":"10.1016/j.jscai.2024.102169","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102169"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324014649/pdfft?md5=761c426a6baf7f97c9b9e41ae0bd3e8b&pid=1-s2.0-S2772930324014649-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141396409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.101937
{"title":"Computed Tomography Geometry of Extremely Undersized SAPIEN 3 Transcatheter Aortic Valves With Balloon Overfilling","authors":"","doi":"10.1016/j.jscai.2024.101937","DOIUrl":"10.1016/j.jscai.2024.101937","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 101937"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324008329/pdfft?md5=38ccd5de224209ae35765016c4276507&pid=1-s2.0-S2772930324008329-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102168
{"title":"Early Experience of 3-Dimensional Intracardiac Echocardiography in Transcatheter Tricuspid Interventions","authors":"","doi":"10.1016/j.jscai.2024.102168","DOIUrl":"10.1016/j.jscai.2024.102168","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102168"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324014637/pdfft?md5=7ed80c3aa6e20c9007a7be6e1ad7afe9&pid=1-s2.0-S2772930324014637-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141393291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/S2772-9303(24)01647-8
{"title":"Cover","authors":"","doi":"10.1016/S2772-9303(24)01647-8","DOIUrl":"10.1016/S2772-9303(24)01647-8","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102258"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324016478/pdfft?md5=66829588f3ab4c7ee4ee5e02e054f406&pid=1-s2.0-S2772930324016478-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142012440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.101981
Background
Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI).
Methods
Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score—low (≤22), intermediate (23-32), and high (≥33). Procedural and clinical outcomes out to 90 days were compared between groups. Multivariable regression analysis was used to assess the impact of SYNTAX I score on major adverse cardiovascular and cerebrovascular events (MACCE) at 90 days.
Results
A total of 850 subjects with core laboratory–adjudicated SYNTAX I scores were identified (low: n = 310; intermediate: n = 256; high: n = 284). Patients with high SYNTAX I scores were older than those with low or intermediate SYNTAX I scores (72.7 vs 69.7 vs 70.1 years, respectively; P < .01). After adjustment for covariates, high SYNTAX I score remained a significant predictor of 90-day MACCE (hazard ratio [HR], 2.14; 95% CI, 1.42-3.69; P < .01 vs low), whereas intermediate SYNTAX I score was not (HR, 0.92; 95% CI, 0.47-1.77; P = .80 vs low). These findings persisted after adjustment for post-PCI SYNTAX I score.
Conclusions
A high SYNTAX I score was associated with higher rates of 90-day MACCE in patients who underwent Impella-assisted HRPCI. Further research is needed to understand the patient and procedural factors driving this finding.
背景与SYNTAX I评分较低的患者相比，SYNTAX I评分较高的复杂冠状动脉疾病患者接受经皮冠状动脉介入治疗（PCI）的预后较差。本研究旨在评估使用Impella的机械循环支持是否能减轻SYNTAX I评分对高风险经皮冠状动脉介入治疗（HRPCI）后预后的影响。方法利用PROTECT III研究的数据，将2017年3月至2020年3月期间接受Impella辅助HRPCI的患者根据SYNTAX I评分分为3个队列--低分（≤22分）、中分（23-32分）和高分（≥33分）。比较了各组 90 天内的手术和临床结果。采用多变量回归分析评估了SYNTAX I评分对90天内主要不良心脑血管事件（MACCE）的影响。结果 共确定了850名经核心实验室判定为SYNTAX I评分的受试者（低：n = 310；中：n = 256；高：n = 284）。SYNTAX I 高分患者的年龄比 SYNTAX I 低分或中分患者大（分别为 72.7 岁 vs 69.7 岁 vs 70.1 岁；P < .01）。调整协变量后，SYNTAX I 高分仍是 90 天 MACCE 的重要预测因素（危险比 [HR]，2.14；95% CI，1.42-3.69；P < .01 vs 低分），而 SYNTAX I 中分则不是（HR，0.92；95% CI，0.47-1.77；P = .80 vs 低分）。结论 在接受 Impella 辅助 HRPCI 的患者中，SYNTAX I 高分与较高的 90 天 MACCE 发生率相关。需要进一步研究以了解导致这一结果的患者和手术因素。
{"title":"Association of Preprocedural SYNTAX Score With Outcomes in Impella-Assisted High-Risk Percutaneous Coronary Intervention","authors":"","doi":"10.1016/j.jscai.2024.101981","DOIUrl":"10.1016/j.jscai.2024.101981","url":null,"abstract":"<div><h3>Background</h3><p>Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI).</p></div><div><h3>Methods</h3><p>Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score—low (≤22), intermediate (23-32), and high (≥33). Procedural and clinical outcomes out to 90 days were compared between groups. Multivariable regression analysis was used to assess the impact of SYNTAX I score on major adverse cardiovascular and cerebrovascular events (MACCE) at 90 days.</p></div><div><h3>Results</h3><p>A total of 850 subjects with core laboratory–adjudicated SYNTAX I scores were identified (low: n = 310; intermediate: n = 256; high: n = 284). Patients with high SYNTAX I scores were older than those with low or intermediate SYNTAX I scores (72.7 vs 69.7 vs 70.1 years, respectively; <em>P</em> < .01). After adjustment for covariates, high SYNTAX I score remained a significant predictor of 90-day MACCE (hazard ratio [HR], 2.14; 95% CI, 1.42-3.69; <em>P</em> < .01 vs low), whereas intermediate SYNTAX I score was not (HR, 0.92; 95% CI, 0.47-1.77; <em>P</em> = .80 vs low). These findings persisted after adjustment for post-PCI SYNTAX I score.</p></div><div><h3>Conclusions</h3><p>A high SYNTAX I score was associated with higher rates of 90-day MACCE in patients who underwent Impella-assisted HRPCI. Further research is needed to understand the patient and procedural factors driving this finding.</p></div>","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 101981"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324010524/pdfft?md5=a7c134878a25568f2c5dc4af27c55265&pid=1-s2.0-S2772930324010524-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-01DOI: 10.1016/j.jscai.2024.102238
Matthew T. Finn MSc, MD
{"title":"Comparative Effectiveness of Thrombectomy Devices in Deep Vein Thrombosis: A Step Forward","authors":"Matthew T. Finn MSc, MD","doi":"10.1016/j.jscai.2024.102238","DOIUrl":"10.1016/j.jscai.2024.102238","url":null,"abstract":"","PeriodicalId":73990,"journal":{"name":"Journal of the Society for Cardiovascular Angiography & Interventions","volume":"3 8","pages":"Article 102238"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772930324016181/pdfft?md5=cd819f611cbf8ae15f1e92da47fd7f39&pid=1-s2.0-S2772930324016181-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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