Catheterization and Cardiovascular Interventions最新文献

英文中文

Re: Comparison of In-Hospital Complication Rates After Transcatheter Aortic Valve Replacement in Patients With Bicuspid Versus Tricuspid Aortic Valves: A Retrospective Cohort Study 回顾性队列研究：二尖瓣与三尖瓣主动脉瓣经导管置换术后住院并发症发生率的比较。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-09 DOI: 10.1002/ccd.70316

Meerab Ali Khan, Hussnain Bilal

引用次数: 0

Immediate and Midterm Efficacy and Safety of Intravascular Lithotripsy for Calcified In-Stent Restenosis: A Systematic Review and Meta-Analysis 血管内碎石术治疗钙化支架内再狭窄的近期和中期疗效和安全性：一项系统综述和荟萃分析。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-07 DOI: 10.1002/ccd.70296

Rifqi Rizkani Eri, Sania Zahrani, Prasetyo Andriono, Todung D. A. Silalahi

Background

In-stent restenosis (ISR) remains a major challenge in coronary revascularization, especially in lesions with heavy calcification, where recurrence rates are high. The lack of data on newer treatment options often creates dilemmas for both physicians and patients. Intravascular lithotripsy (IVL) is a relatively new technique that has shown promise in managing calcified ISR. This meta-analysis aims to evaluate the procedural success and clinical outcomes of IVL in this setting.

Methods

Following PRISMA 2020 guidelines, a systematic search was conducted on PubMed, ScienceDirect, and SCOPUS. Studies reporting procedural success and major adverse cardiovascular events (MACE) of IVL for calcified ISR during follow-up were included. The Newcastle-Ottawa Scale was used to assess study quality. Data analysis was performed using RevMan 5.4.0 and SPSS v25.

Results

Five studies with a total of 207 patients and 212 lesions treated were analyzed. Acute procedural success was 85% (95% CI 0.76–0.91, I² = 42.0%). At 1-year follow-up, major adverse cardiac events (MACE) included myocardial infarction (MI) in 6% of patients (95% CI 0.02–0.16, I² = 52.5%), target lesion revascularization in 13% (95% CI 0.08–0.20, I² = 45.8%), and cardiac death in 4% (95% CI 0.02–0.08, I² = 0.0%). The rate of periprocedural MI was 1.5% (95% CI 0.01-0.05, I² = 0.0%), while no reflow phenomenon was 0.5% (95% CI 0.01-0.06, I² = 0.0%), with no other procedural complication occured. The overall incidence of MACE was 16% (95% CI 0.07–0.33, I² = 69.8%).

Conclusion

IVL shows potential as a treatment option for for calcified-ISR, demonstrating high acute procedural success and acceptable 1-year clinical outcomes. The 1-year TLR (13%) and MACE (16%) rates compare favorably with historical data for non-IVL strategies. Further large-scale, controlled studies with longer follow-up are needed to further validate its long-term safety and effectiveness.

背景：支架内再狭窄（ISR）仍然是冠状动脉血运重建术的主要挑战，特别是在重钙化病变中，其复发率很高。缺乏更新治疗方案的数据常常给医生和患者造成两难境地。血管内碎石术（IVL）是一种相对较新的治疗钙化ISR的技术。本荟萃分析旨在评估IVL在这种情况下的手术成功率和临床结果。方法：按照PRISMA 2020指南，在PubMed、ScienceDirect和SCOPUS上进行系统检索。研究报告了在随访期间IVL治疗钙化ISR的手术成功和主要不良心血管事件（MACE）。纽卡斯尔-渥太华量表用于评估研究质量。数据分析采用RevMan 5.4.0软件和SPSS v25软件。结果：我们分析了5项研究共207例患者和212个病变。急性手术成功率为85% （95% CI 0.76-0.91, I²= 42.0%）。在1年的随访中，主要心脏不良事件（MACE）包括6%的患者心肌梗死（95% CI 0.02-0.16, I²= 52.5%），13%的患者靶区血运重建术（95% CI 0.08-0.20, I²= 45.8%），4%的患者心源性死亡（95% CI 0.02-0.08, I²= 0.0%）。术中心肌梗死发生率为1.5% (95% CI 0.01 ~ 0.05, I2 = 0.0%)，无血流回流现象发生率为0.5% (95% CI 0.01 ~ 0.06, I2 = 0.0%)，无其他手术并发症发生。MACE的总发生率为16% （95% CI 0.07-0.33, I²= 69.8%）。结论：IVL作为钙化isr的治疗选择具有潜力，具有较高的急性手术成功率和可接受的1年临床结果。1年TLR（13%）和MACE（16%）率与非ivl策略的历史数据相比有利。需要进一步的大规模、长期随访的对照研究来进一步验证其长期安全性和有效性。

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引用次数: 0

Balloon Over-the-Wire Opposing Support (BOOST) Technique: The Sawah-Sabry Approach for Retrieval of a Stuck Retrograde Microcatheter in Chronic Total Occlusion PCI—A Case Report 球囊线上反向支撑（BOOST）技术：Sawah-Sabry方法在慢性pci全闭塞中取出被卡的逆行微导管- 1例报告。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-07 DOI: 10.1002/ccd.70320

Ahmed Mohsen Elsawah, Mohamed Sabry Elhadainy

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) remains one of the most technically demanding areas in interventional cardiology, and although the retrograde approach has improved procedural success, rare complications such as retrograde microcatheter (MC) entrapment present a serious challenge with limited bailout options. We report the case of a 67-year-old male farmer with diabetes mellitus and hypertension who presented with refractory typical chest pain and a failed right coronary artery CTO PCI 3 months earlier. His J-CTO score was 4, with a prior failed attempt, blunt stump, and severe angulation. A retrograde Gaia 2nd wire successfully crossed the distal cap and entered the antegrade guiding catheter; however, the retrograde MC became entrapped at a heavily calcified bend, forming a complete LAD–RCA loop and resisting conventional retrieval maneuvers. A novel bailout strategy, the Balloon Over-the-wire Opposing Support (BOOST) Technique—Sawah-Sabry Approach—was applied using an antegrade 2.5 × 20 mm balloon advanced within the MC to generate forward counterforce, combined with minimal retrograde traction and GuideLiner support. The MC was gradually released and retrieved safely, allowing successful implantation of three drug-eluting stents with restoration of TIMI III flow.

慢性全闭塞（CTO）经皮冠状动脉介入治疗（PCI）仍然是介入心脏病学中技术要求最高的领域之一，尽管逆行方法提高了手术成功率，但罕见的并发症，如逆行微导管（MC）夹持，在有限的救援选择下提出了严重的挑战。我们报告一位67岁男性农民，患有糖尿病和高血压，3个月前出现难治性典型胸痛和右冠状动脉CTO PCI失败。他的J-CTO评分为4分，之前的尝试失败，残肢钝，角度严重。逆行盖亚第二针成功穿过远端帽，进入顺行引导导管；然而，逆行的MC被困在严重钙化的弯曲处，形成一个完整的LAD-RCA环，并抵抗常规的恢复操作。采用了一种新颖的救援策略，气球线上反支持（BOOST）技术- sawah - sabry方法，在MC内放置一个顺行2.5 × 20毫米的气球来产生正向反力，结合最小的逆行牵引力和GuideLiner支持。MC逐渐释放并安全回收，使三个药物洗脱支架植入成功，TIMI III血流恢复。

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引用次数: 0

Transcatheter Aortic Valve Replacement in Patients With Hypertrophic Obstructive Cardiomyopathy: Toward a Precision-Guided Approach 肥厚性梗阻性心肌病患者的经导管主动脉瓣置换术：一种精确引导的方法。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-07 DOI: 10.1002/ccd.70306

Rafael Alessandro Ferreira Gomes, Eduardo Pessoa de Melo, Jorge Augusto Nunes Guimarães

引用次数: 0

“Mid-Term Efficacy and Safety of Mechanical Circulatory Support in High-Risk Elective Chronic Total Occlusion Percutaneous Coronary Intervention: A Prospective Propensity-Matched Cohort Study” 机械循环支持在高风险选择性慢性全闭塞经皮冠状动脉介入治疗中的中期疗效和安全性：一项前瞻性倾向匹配队列研究。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-06 DOI: 10.1002/ccd.70321

Fahad Raja Khan, Abid Ullah, Kamran Aslam

引用次数: 0

Comment on: “Outcome of Delayed Peripheral Revascularization After Acute Limb Thrombotic Ischemia: A Case Report” 评论：“急性肢体血栓性缺血后延迟外周血运重建的结果：1例报告”。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-06 DOI: 10.1002/ccd.70319

Burak Bozkurt, Ozan Ertürk, İnanç Yeşilkaya, Mehmet Erdem Memetoğlu

引用次数: 0

“Temporal Changes in Transvalvular Pressure Gradients in Balloon-Expandable and Self-Expanding Transcatheter Aortic Valves” 球囊扩张和自扩张经导管主动脉瓣经瓣压力梯度的时间变化。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-06 DOI: 10.1002/ccd.70322

Sanhia Maheshwari

引用次数: 0

Predictors of Variability in Coronary Flow Reserve and Microvascular Resistance Measurement Using the Bolus Thermodilution Technique 冠状动脉血流储备变异性的预测因素和微血管阻力测量使用大剂量热稀释技术。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-06 DOI: 10.1002/ccd.70301

Jason Galo, Aziz Maksoud, Samit Shah, Olga Toleva, Yuhei Kobayashi, Akl C. Fahed, Evan Shlofmitz, Alok Sharma, Jorn op den Buijs, Joia Spinelli, Richard Rapoza, Brian Bergmark, Hayder Hashim

Background

Bolus thermodilution is the most commonly used invasive assessment for coronary microvascular dysfunction (CMD). However, variability in thermodilution transit time measurements (TTM) affects calculated Coronary Flow Reserve (CFR) and Index of Microvascular Resistance (IMR) values. This study determined variables associated with transit time variability and quantified confidence intervals for the range of measured CFR and IMR values.

Methods

The CoroFlow Cardiovascular System (Coroventis, Sweden) and PressureWire™ X Guidewire (Abbott) were used to collect 2541 TTM from 259 vessels at 14 US sites included in the FlowLab Study. Correlations with baseline patient and procedural variables were determined by both linear and mixed linear models. Mixed linear models with the physician or vessel as the random effect were computed. Monte Carlo simulations of CFR and IMR were performed to determine 95% confidence intervals for thresholds of 2.5 for CFR and 25 for IMR.

Results

Mixed linear analysis with vessel as the random effect provided the best model fit (R² = 0.948). In this model, RCA vessel location (p < 0.001) and pressure sensor distance < 5 cm (p < 0.005) were significantly associated with transit time. Monte Carlo simulations identified a “gray zone” range of 2.1–3.1 for CFR and 19–31 for IMR.

Conclusions

Minimizing variability in invasive CMD assessment is essential for improving diagnostic accuracy and guiding clinical decision-making as testing becomes more widespread. In this study, target vessel choice (RCA) and pressure sensor placement were identified as key modifiable sources of transit time variability. Clinically applicable confidence intervals around CFR and IMR values were defined.

背景：大剂量热稀释是冠状动脉微血管功能障碍（CMD）最常用的侵入性评估方法。然而，热稀释传递时间测量值（TTM）的变异性影响计算的冠状动脉血流储备（CFR）和微血管阻力指数（IMR）值。本研究确定了与传输时间变异性相关的变量，并量化了测量CFR和IMR值范围的置信区间。方法：使用CoroFlow心血管系统（Coroventis，瑞典）和PressureWire™X Guidewire （Abbott）从FlowLab研究中包括的14个美国地点的259个血管中收集2541个TTM。通过线性和混合线性模型确定与基线患者和程序变量的相关性。以医师或血管为随机效应计算混合线性模型。对CFR和IMR进行蒙特卡罗模拟，以确定CFR阈值为2.5和IMR阈值为25的95%置信区间。结果：以血管为随机效应的混合线性分析模型拟合最佳（R2 = 0.948）。结论：随着有创性CMD评估的普及，将可变性最小化对于提高诊断准确性和指导临床决策至关重要。在这项研究中，目标容器选择（RCA）和压力传感器的放置被确定为传输时间可变性的关键可修改源。在CFR和IMR值周围定义临床适用的置信区间。

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引用次数: 0

Letter to the Editor: Femoral Access-Assisted Balloon Trapping: A Novel Approach to Managing Kinked Catheter During Transradial Coronary Intervention—A Case Report 致编辑的信：经桡动脉冠状动脉介入治疗中，股骨通道辅助球囊捕获：一种处理导管扭结的新方法——一例报告。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-05 DOI: 10.1002/ccd.70308

Mohsin Tariq, Suleman Arshad, Taha Yahya, Syed Ali Raza Zaidi

引用次数: 0

A Streamline Strategy for Indication and Length of Telemetry Monitoring After TAVR TAVR术后遥测监测指示和时间的简化策略。

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Catheterization and Cardiovascular Interventions

Pub Date : 2025-11-05 DOI: 10.1002/ccd.70299

Antonin Fournier, Pierre Robert, Benoit Lattuca, Claire Duflos, Maël-Morvan Duroyon, Jean-Christophe Macia, Laurent Schmutz, Matthieu Steinecker, Jean-Michel Berdeu, Thomas Gandet, Jean Luc Pasquie, François Roubille, Guillaume Cayla, Florence Leclercq

Background

Both indication and length of ECG telemetry monitoring (TM) after transcatheter aortic valve replacement (TAVR) are not well defined.

Aims

We hypothesize that a targeted strategy for monitoring conductive disorders (CD) post-TAVR can reduce the need and duration of in-hospital TM without compromising safety.

Methods

We prospectively evaluated consecutive patients undergoing transfemoral TAVR between February 2023 and September 2024. Intensive care unit (ICU) transfer for TM was considered when previous right bundle branch block or when new or worsening CD. TM duration was standardized, from 24 to 48 h. The primary endpoint was incidence of severe CD, defined as symptomatic or requiring medical intervention, occurring outside the ICU, at 1-month follow-up.

Results

Among 250 patients included (mean age: 80.53 ± 6.86 years), 138 (55.20%) required TM, mainly due to new left bundle branch block (n = 64, 44.80%). By respecting the protocol, the primary endpoint was achieved for three patients (1.20%, 95% CI: 0.31; 3.77), all related to post-discharge CD occurring after Day 6 and requiring permanent pacemaker implantation (PPI). There were no deaths and no severe in-hospital CD outside the ICU. The PPI rate was 16.80%. The mean ICU length of stay was 1.34 days. Absence of TM was associated with shorter mean global hospitalization duration (1.43 vs. 2.93 days, p < 0.001).

Conclusion

Selective indication and length of TM after TAVR is possible with no in-hospital events, no deaths, and a low rate of rhythmic events after hospital discharge, confirming the safety of this in-hospital strategy. Nearly half of the patients did not require TM, and very short global and ICU lengths were observed.

背景：经导管主动脉瓣置换术（TAVR）后心电图遥测监测（TM）的适应症和持续时间尚不明确。目的：我们假设有针对性地监测tavr后传导障碍（CD）的策略可以在不影响安全性的情况下减少住院TM的需求和持续时间。方法：我们前瞻性评估了2023年2月至2024年9月期间连续接受经股TAVR的患者。当先前的右束分支阻滞或新的或恶化的CD时，考虑转移到TM的重症监护病房（ICU）。TM持续时间标准化，从24到48小时。主要终点是在1个月的随访中重症CD的发生率，定义为有症状或需要医疗干预，发生在ICU以外。结果：纳入的250例患者（平均年龄：80.53±6.86岁）中，138例（55.20%）需要TM，主要原因是新发左束支阻滞（n = 64, 44.80%）。通过遵守该方案，3例患者（1.20%,95% CI: 0.31; 3.77）达到了主要终点，所有患者都与出院后第6天发生的CD有关，需要永久性起搏器植入（PPI）。无死亡病例，ICU外无严重的院内CD。PPI为16.80%。ICU平均住院时间1.34天。结论：TAVR术后选择性TM的适应证和时间长度是可能的，无院内事件，无死亡，出院后节律性事件发生率低，证实了这种院内策略的安全性。近一半的患者不需要TM，观察到的总长度和ICU长度都很短。

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