Chala Fekadu Oljira, Erik JS Packer, Håvard Dalen, Tom Roar Omdal, Rune Haaverstad, Adane Petros, Dejuma Yadeta, Eskindir Loha, Thomas Dolven, Hans Martin Flade, Arne Skagseth, Nigussie Bogale
Background
Percutaneous mitral commissurotomy (PMC) of mitral stenosis is routinely performed by the Inoue balloon technique (IBT) which may be challenging with respect to valvular crossing. Using a novel wire-assisted method (WAM) may improve feasibility and time efficiency.
Aims
In a randomized clinical trial, we compared the feasibility and time consumption by WAM and IBT.
Methods
Twenty mitral stenosis patients with a Wilkins score ≤10 were randomized 1:1 to IBT (n = 11) or WAM (n = 9). All procedures were performed under general anesthesia and optimized by in-field and transesophageal echocardiographic guiding. The IBT balloon catheter was inserted over the coiled wire, and the stylet was used to advance it to the mitral valve, while WAM was performed by advancing a commercially available balloon over a stiff coiled wire placed in the left ventricle. 1st endpoint was time from interatrial septal puncture to balloon inflation, and 2nd outcomes were failure to double mitral valve area or severe mitral regurgitation.
Results
Mean ± SD age was 28 ± 7 years (80% women) with all in NYHA class II or III. Symptom duration was median (IQR) 7 (4.8) years, Wilkins score was 8.8 ± 0.9, and mitral inflow gradient was 15.6 ± 4.6 mmHg. Procedural time (1st endpoint) was 14.4 ± 3.4 min and 21.8 ± 8.3 min in WAM and IBT, respectively (p = 0.020). Three patients in each group did not double the valve area by PMC, and no procedure was complicated by severe mitral regurgitation.
Conclusions
WAM significantly reduced the time from interatrial septal crossing to first balloon inflation during equally optimized PMC in severe mitral stenosis patients compared to IBT.
{"title":"Novel Wire-Assisted Mitral Commissurotomy Reduces Valve Crossing Time Compared to Inoue-Balloon Technique of Treating Mitral Stenosis, Randomized Controlled Trial (CROSSVal)","authors":"Chala Fekadu Oljira, Erik JS Packer, Håvard Dalen, Tom Roar Omdal, Rune Haaverstad, Adane Petros, Dejuma Yadeta, Eskindir Loha, Thomas Dolven, Hans Martin Flade, Arne Skagseth, Nigussie Bogale","doi":"10.1002/ccd.70343","DOIUrl":"10.1002/ccd.70343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Percutaneous mitral commissurotomy (PMC) of mitral stenosis is routinely performed by the Inoue balloon technique (IBT) which may be challenging with respect to valvular crossing. Using a novel wire-assisted method (WAM) may improve feasibility and time efficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In a randomized clinical trial, we compared the feasibility and time consumption by WAM and IBT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty mitral stenosis patients with a Wilkins score ≤10 were randomized 1:1 to IBT (<i>n</i> = 11) or WAM (<i>n</i> = 9). All procedures were performed under general anesthesia and optimized by in-field and transesophageal echocardiographic guiding. The IBT balloon catheter was inserted over the coiled wire, and the stylet was used to advance it to the mitral valve, while WAM was performed by advancing a commercially available balloon over a stiff coiled wire placed in the left ventricle. 1st endpoint was time from interatrial septal puncture to balloon inflation, and 2nd outcomes were failure to double mitral valve area or severe mitral regurgitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean ± SD age was 28 ± 7 years (80% women) with all in NYHA class II or III. Symptom duration was median (IQR) 7 (4.8) years, Wilkins score was 8.8 ± 0.9, and mitral inflow gradient was 15.6 ± 4.6 mmHg. Procedural time (1st endpoint) was 14.4 ± 3.4 min and 21.8 ± 8.3 min in WAM and IBT, respectively (<i>p</i> = 0.020). Three patients in each group did not double the valve area by PMC, and no procedure was complicated by severe mitral regurgitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>WAM significantly reduced the time from interatrial septal crossing to first balloon inflation during equally optimized PMC in severe mitral stenosis patients compared to IBT.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"297-303"},"PeriodicalIF":1.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70343","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yader Sandoval, Pedro Carvalho, Victor Cheng, Joao Cavalcante, Lorenzo Azzalini, Sandeep Jalli, Michaella Alexandrou, Deniz Mutlu, Dimitrios Strepkos, Eleni Kladou, Bavana V. Rangan, M. Nicholas Burke, John Lesser, Emmanouil S. Brilakis
In patients with chronic total occlusions (CTO), percutaneous coronary intervention (PCI) often has modest success rates unless performed by experienced centers and operators. Coronary computed tomography angiography (CCTA) guidance can enhance the success rates of CTO PCI. Its application, however, is limited due to the lack of expertise among interventional cardiologists in CCTA analysis, logistical barriers, and insufficient multidisciplinary collaboration. This review explores the emerging role of novel artificial intelligence (AI)-based platforms in facilitating CTO detection and pre-procedural CTO PCI planning, which enables interventional cardiologists to perform CCTA analysis without having advanced imaging training. Additionally, we provide a guide on how to use these tools and discuss the future implications of utilizing CCTA for CTO diagnosis and PCI planning.
{"title":"Artificial Intelligence Enhanced Analysis of Coronary CT Angiography to Facilitate Chronic Total Occlusion Percutaneous Coronary Intervention","authors":"Yader Sandoval, Pedro Carvalho, Victor Cheng, Joao Cavalcante, Lorenzo Azzalini, Sandeep Jalli, Michaella Alexandrou, Deniz Mutlu, Dimitrios Strepkos, Eleni Kladou, Bavana V. Rangan, M. Nicholas Burke, John Lesser, Emmanouil S. Brilakis","doi":"10.1002/ccd.70312","DOIUrl":"10.1002/ccd.70312","url":null,"abstract":"<div>\u0000 \u0000 <p>In patients with chronic total occlusions (CTO), percutaneous coronary intervention (PCI) often has modest success rates unless performed by experienced centers and operators. Coronary computed tomography angiography (CCTA) guidance can enhance the success rates of CTO PCI. Its application, however, is limited due to the lack of expertise among interventional cardiologists in CCTA analysis, logistical barriers, and insufficient multidisciplinary collaboration. This review explores the emerging role of novel artificial intelligence (AI)-based platforms in facilitating CTO detection and pre-procedural CTO PCI planning, which enables interventional cardiologists to perform CCTA analysis without having advanced imaging training. Additionally, we provide a guide on how to use these tools and discuss the future implications of utilizing CCTA for CTO diagnosis and PCI planning.</p>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"395-406"},"PeriodicalIF":1.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Methodological Considerations in Assessing Intra-Aortic Balloon Pump Use in Non–Cardiogenic Shock Acute Coronary Syndrome","authors":"Farhan Majeed, Meerab Ali khan, Haider Ali","doi":"10.1002/ccd.70339","DOIUrl":"10.1002/ccd.70339","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"275-276"},"PeriodicalIF":1.9,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Konrad A. J. van Beek, Sarosh Khan, Haroun Butt, Jesse P. A. Demandt, Rob Eerdekens, Daimy M. M. Dillen, Thomas R. Keeble, Richard Good, Colin Berry, Thomas Engström, Jasmine M. Madsen, Keith G. Oldroyd, Branko Beleslin, Bernard de Bruyne, Sara Corradetti, Ole Fröbert, Kenneth Mangion, Koen Teeuwen, Marcel van't Veer, Nico H. J. Pijls, Pim A. L. Tonino, Luuk C. Otterspoor, Mohamed El Farissi
Background
Microvascular injury (MVI) increases the risk of heart failure and mortality in patients with ST-elevation myocardial infarction (STEMI). Therefore, it is important to detect these patients at an early stage for additional (experimental) therapies to improve outcomes. Currently, there are no methods to diagnose MVI in STEMI patients before reperfusion. The objective of this study was to assess the invasively measured infarct-related absolute myocardial resistance (Rinfarction) to predict MVI before reperfusion. Cardiac magnetic resonance imaging (CMR) characterizes MVI, in the forms of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) with IMH being at the “extreme” end of the injury spectrum.
Methods
In this substudy of the EURO-ICE trial, Rinfarction was calculated as the change in distal coronary pressure during saline infusion in the occluded culprit artery, divided by the flow rate of the infused saline. The primary endpoint was to assess the diagnostic performance of Rinfarction to predict MVO on CMR performed at 2–7 days. The secondary endpoint was a composite of all-cause mortality or hospitalization for heart failure up to 5 years.
Results
A total of 82 patients were included. The area under the Receiver-Operating Characteristic curve of Rinfarction to predict MVO and IMH was 0.84 and 0.78, respectively. The optimal cut-off value for both MVO and IMH was 1000 Wood units (WU). The composite endpoint of all-cause mortality or hospitalization for heart failure occurred in 15.6% and 2.3% in the Rinfarction ≥ 1000 WU and Rinfarction < 1000 WU groups, respectively (p = 0.06).
Conclusions
Rinfarction is able to predict MVI in STEMI before reperfusion and may serve as a tool in future trials to select patients that might benefit most from experimental therapies.
{"title":"Infarct-Related Myocardial Resistance Before Reperfusion in Patients With Acute Myocardial Infarction to Predict Microvascular Injury and Clinical Outcomes","authors":"Konrad A. J. van Beek, Sarosh Khan, Haroun Butt, Jesse P. A. Demandt, Rob Eerdekens, Daimy M. M. Dillen, Thomas R. Keeble, Richard Good, Colin Berry, Thomas Engström, Jasmine M. Madsen, Keith G. Oldroyd, Branko Beleslin, Bernard de Bruyne, Sara Corradetti, Ole Fröbert, Kenneth Mangion, Koen Teeuwen, Marcel van't Veer, Nico H. J. Pijls, Pim A. L. Tonino, Luuk C. Otterspoor, Mohamed El Farissi","doi":"10.1002/ccd.70338","DOIUrl":"10.1002/ccd.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Microvascular injury (MVI) increases the risk of heart failure and mortality in patients with ST-elevation myocardial infarction (STEMI). Therefore, it is important to detect these patients at an early stage for additional (experimental) therapies to improve outcomes. Currently, there are no methods to diagnose MVI in STEMI patients before reperfusion. The objective of this study was to assess the invasively measured infarct-related absolute myocardial resistance (<i>R</i><sub>infarction</sub>) to predict MVI before reperfusion. Cardiac magnetic resonance imaging (CMR) characterizes MVI, in the forms of microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) with IMH being at the “extreme” end of the injury spectrum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this substudy of the EURO-ICE trial, R<sub><i>infarction</i></sub> was calculated as the change in distal coronary pressure during saline infusion in the occluded culprit artery, divided by the flow rate of the infused saline. The primary endpoint was to assess the diagnostic performance of R<sub><i>infarction</i></sub> to predict MVO on CMR performed at 2–7 days. The secondary endpoint was a composite of all-cause mortality or hospitalization for heart failure up to 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 82 patients were included. The area under the Receiver-Operating Characteristic curve of <i>R</i><sub>infarction</sub> to predict MVO and IMH was 0.84 and 0.78, respectively. The optimal cut-off value for both MVO and IMH was 1000 Wood units (WU). The composite endpoint of all-cause mortality or hospitalization for heart failure occurred in 15.6% and 2.3% in the <i>R</i><sub>infarction</sub> ≥ 1000 WU and <i>R</i><sub>infarction</sub> < 1000 WU groups, respectively (<i>p</i> = 0.06).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>R</i><sub>infarction</sub> is able to predict MVI in STEMI before reperfusion and may serve as a tool in future trials to select patients that might benefit most from experimental therapies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"279-287"},"PeriodicalIF":1.9,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145515463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ignacio J. Amat-Santos, Sara Blasco-Turrión, Mario García-Gómez, Cristhian Aristizabal
Background
Torrential tricuspid regurgitation (TR) in inoperable patients remains a major therapeutic challenge. Transcatheter tricuspid valve replacement (TTVR) is emerging as a definitive option, but many patients fail anatomical screening.
Aims
To assess through a clinical case the feasibility of transcatheter edge-to-edge repair (TEER) as potential strategy to transform a patient deemed non-candidate to TTVR into a good candidate.
Methods
We report how a 79-year-old man with torrential TR, chronic kidney disease, permanent atrial fibrillation, prior surgical aortic valve replacement, and a dual-chamber pacemaker who was rejected for TTVR after comprehensive screeningdue to large tricuspid annulus became good candidate to TTVR after TEER.
Results
TEER was performed with implantation of two devices and initial symptomatic and hemodynamic improvement. Three weeks later, the patient deteriorated, and detachment of one of the devices from the lateral leaflet was demonstrated with recurrent massive TR. TTVR could be performed thanks to the reduction of the neo-annular size and the anchor in the failing TEER device. This case illustrates both the limits of TEER in end-stage TR and the conceptual role of TEER as a temporizing or remodeling strategy that may, in selected patients, reshape leaflet coaptation and annular geometry sufficiently to enable subsequent TTVR.
Conclusions
TEER may serve as a bridge-to-TTVR in anatomically marginal candidates, stabilizing patients clinically and modifying valve geometry to meet device-specific criteria. Prospective evaluation is warranted to define which anatomical substrates can benefit from this staged strategy.
{"title":"Tricuspid Transcatheter Edge-to-Edge Repair as a Bridge in Tricuspid Regurgitation Deemed Non-Candidate to Transcatheter Tricuspid Valve Replacement","authors":"Ignacio J. Amat-Santos, Sara Blasco-Turrión, Mario García-Gómez, Cristhian Aristizabal","doi":"10.1002/ccd.70333","DOIUrl":"10.1002/ccd.70333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Torrential tricuspid regurgitation (TR) in inoperable patients remains a major therapeutic challenge. Transcatheter tricuspid valve replacement (TTVR) is emerging as a definitive option, but many patients fail anatomical screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess through a clinical case the feasibility of transcatheter edge-to-edge repair (TEER) as potential strategy to transform a patient deemed non-candidate to TTVR into a good candidate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We report how a 79-year-old man with torrential TR, chronic kidney disease, permanent atrial fibrillation, prior surgical aortic valve replacement, and a dual-chamber pacemaker who was rejected for TTVR after comprehensive screeningdue to large tricuspid annulus became good candidate to TTVR after TEER.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TEER was performed with implantation of two devices and initial symptomatic and hemodynamic improvement. Three weeks later, the patient deteriorated, and detachment of one of the devices from the lateral leaflet was demonstrated with recurrent massive TR. TTVR could be performed thanks to the reduction of the neo-annular size and the anchor in the failing TEER device. This case illustrates both the limits of TEER in end-stage TR and the conceptual role of TEER as a temporizing or remodeling strategy that may, in selected patients, reshape leaflet coaptation and annular geometry sufficiently to enable subsequent TTVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TEER may serve as a bridge-to-TTVR in anatomically marginal candidates, stabilizing patients clinically and modifying valve geometry to meet device-specific criteria. Prospective evaluation is warranted to define which anatomical substrates can benefit from this staged strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"243-247"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Colombo, Dario Carbonaro, Mingzi Zhang, Chi Shen, Ramtin Gharleghi, Ankush Kapoor, Claudio Chiastra, Nigel Jepson, Mark Webster, Susann Beier
Background
Complex coronary bifurcation lesions remain challenging in percutaneous coronary intervention, with stent design and deployment strategy influencing clinical outcomes.
Aims
This study compares the mechanical and hemodynamic performance of the ultrathin-strut Orsiro and thin-strut Xience Sierra stent in provisional side branch (PSB) and double kissing crush (DKC) techniques.
Methods
We used finite element analyses of bifurcation stent deployment to assess malapposition, ostium clearance, and arterial wall stress for both techniques. Computational fluid dynamics simulations quantified the luminal exposure to low time-averaged endothelial shear stress (TAESS < 0.4 Pa) and high shear rates (> 1000 s⁻¹).
Results
In PSB, Orsiro showed higher malapposition (13.0% vs. 9.6%) but improved SB ostium clearance (77% vs. 64%) and lower low-TAESS exposure (30.3% vs. 33.6%) compared to Xience. Orsiro also produced higher arterial wall stresses, particularly during kissing balloon inflation. In DKC, differences in malapposition and ostium clearance diminished between stents, though Orsiro retained a hemodynamic advantage with lower low-TAESS (28.2% vs. 36.3%).
Conclusions
Stent design influenced outcomes more strongly in PSB, where anatomical interaction and platform-specific behavior impacted both structural and hemodynamic results. In DKC, procedural complexity minimized those differences, making the stenting technique the primary performance driver. Nonetheless, Orsiro consistently preserved more favorable flow conditions. These findings highlight the need to match device selection with lesion characteristics in PSB, while in DKC, optimizing procedural steps may have a greater impact than the choice of stent platform.
{"title":"Are Ultrathin Stents Optimal for Bifurcation Lesions? Insights From Computational Modeling of Provisional and DK-Crush Techniques","authors":"Andrea Colombo, Dario Carbonaro, Mingzi Zhang, Chi Shen, Ramtin Gharleghi, Ankush Kapoor, Claudio Chiastra, Nigel Jepson, Mark Webster, Susann Beier","doi":"10.1002/ccd.70329","DOIUrl":"10.1002/ccd.70329","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Complex coronary bifurcation lesions remain challenging in percutaneous coronary intervention, with stent design and deployment strategy influencing clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study compares the mechanical and hemodynamic performance of the ultrathin-strut Orsiro and thin-strut Xience Sierra stent in provisional side branch (PSB) and double kissing crush (DKC) techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used finite element analyses of bifurcation stent deployment to assess malapposition, ostium clearance, and arterial wall stress for both techniques. Computational fluid dynamics simulations quantified the luminal exposure to low time-averaged endothelial shear stress (TAESS < 0.4 Pa) and high shear rates (> 1000 s⁻¹).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In PSB, Orsiro showed higher malapposition (13.0% vs. 9.6%) but improved SB ostium clearance (77% vs. 64%) and lower low-TAESS exposure (30.3% vs. 33.6%) compared to Xience. Orsiro also produced higher arterial wall stresses, particularly during kissing balloon inflation. In DKC, differences in malapposition and ostium clearance diminished between stents, though Orsiro retained a hemodynamic advantage with lower low-TAESS (28.2% vs. 36.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Stent design influenced outcomes more strongly in PSB, where anatomical interaction and platform-specific behavior impacted both structural and hemodynamic results. In DKC, procedural complexity minimized those differences, making the stenting technique the primary performance driver. Nonetheless, Orsiro consistently preserved more favorable flow conditions. These findings highlight the need to match device selection with lesion characteristics in PSB, while in DKC, optimizing procedural steps may have a greater impact than the choice of stent platform.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"258-272"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor: Minimum Lumen Area Indexed to Left Ventricular Mass to Identify Functionally Significant Left Main Coronary Stenoses","authors":"Garzeen Ghaffar","doi":"10.1002/ccd.70336","DOIUrl":"10.1002/ccd.70336","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"273-274"},"PeriodicalIF":1.9,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to the Editor Concerning the Article: “Comparative Outcomes of Drug-Eluting Balloons Versus Drug-Eluting Stents in Patients With Diabetes Undergoing PPCI”","authors":"Wenjin Yuan, Wenfeng Li, Jun Luo, Dandan Zhang","doi":"10.1002/ccd.70317","DOIUrl":"10.1002/ccd.70317","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"241-242"},"PeriodicalIF":1.9,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Several studies have reported the effectiveness of drug-coated balloon (DCB) for femoropopliteal (FP) chronic total occlusion (CTO).
Aims
The EAGLE study aimed to investigate the real-world clinical outcomes of DCB for FP CTO lesions at 3 years. Four risk factors for 1-year restenosis were considered: hemodialysis, chronic limb-threatening ischemia, restenosis lesion, and no dual antiplatelet therapy use.
Methods
This retrospective multicenter registry analyzed 359 limbs of 318 patients who underwent endovascular therapy with DCB for FP CTO between July 2017 and February 2021. The primary outcome was 3-year primary patency. Secondary outcomes were 3-year rates of freedom from: clinically driven target lesion revascularization (CD-TLR); re-occlusion; acute limb ischemia (ALI). Three-year clinical outcomes, based on four 1-year restenosis risk factors, were investigated using Cox proportional hazards regression models.
Results
The 3-year rate of primary patency was 47.9% (95% confidence interval: 42.2%−54.4%), whereas the corresponding rates of freedom from CD-TLR, re-occlusion, and ALI were 61.9% (56.4%−68.0%), 77.5% (72.3%−83.1%), and 96.4% (94.3%−98.5%), respectively. The bailout stent rate was 8.9%. Risk factor accumulation was associated with a lower rate of 3-year freedom from restenosis. Primary patency rates were 47.9% overall, with subgroup results of 65.2% (no risk factors), 47.1% (one risk factor), and 29.8% (two or more).
Conclusions
Outcomes of DCB for FP CTOs of patients without restenosis factors at 1 year were acceptable, but 3-year patency was low in patients with multiple risk factors. Freedom from CD-TLR, re-occlusion, and ALI outcomes were acceptable.
{"title":"Three Year Clinical Outcomes of Drug-Coated Balloons in Patients With Femoropopliteal Chronic Total Occlusion: Results From the Multicenter EAGLE Study","authors":"Naoki Hayakawa, Mitsuyoshi Takahara, Tatsuya Nakama, Kazunori Horie, Kazuki Tobita, Shinsuke Mori, Yo Iwata, Kenji Suzuki, Hiromi Miwa, Yasuyuki Tsuchida, Shinya Ichihara, Shunichi Kushida","doi":"10.1002/ccd.70332","DOIUrl":"10.1002/ccd.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several studies have reported the effectiveness of drug-coated balloon (DCB) for femoropopliteal (FP) chronic total occlusion (CTO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The EAGLE study aimed to investigate the real-world clinical outcomes of DCB for FP CTO lesions at 3 years. Four risk factors for 1-year restenosis were considered: hemodialysis, chronic limb-threatening ischemia, restenosis lesion, and no dual antiplatelet therapy use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective multicenter registry analyzed 359 limbs of 318 patients who underwent endovascular therapy with DCB for FP CTO between July 2017 and February 2021. The primary outcome was 3-year primary patency. Secondary outcomes were 3-year rates of freedom from: clinically driven target lesion revascularization (CD-TLR); re-occlusion; acute limb ischemia (ALI). Three-year clinical outcomes, based on four 1-year restenosis risk factors, were investigated using Cox proportional hazards regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 3-year rate of primary patency was 47.9% (95% confidence interval: 42.2%−54.4%), whereas the corresponding rates of freedom from CD-TLR, re-occlusion, and ALI were 61.9% (56.4%−68.0%), 77.5% (72.3%−83.1%), and 96.4% (94.3%−98.5%), respectively. The bailout stent rate was 8.9%. Risk factor accumulation was associated with a lower rate of 3-year freedom from restenosis. Primary patency rates were 47.9% overall, with subgroup results of 65.2% (no risk factors), 47.1% (one risk factor), and 29.8% (two or more).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Outcomes of DCB for FP CTOs of patients without restenosis factors at 1 year were acceptable, but 3-year patency was low in patients with multiple risk factors. Freedom from CD-TLR, re-occlusion, and ALI outcomes were acceptable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"248-257"},"PeriodicalIF":1.9,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145498080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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