Syed Ali Raza Zaidi, Taha Yahya, Suleman Arshad, Meer Hassan Khalid
{"title":"“Letter to the Editor: Paclitaxel-Coated Balloons for Femoropopliteal Artery Disease Treatment in French Patients: A Longitudinal Observational Study”","authors":"Syed Ali Raza Zaidi, Taha Yahya, Suleman Arshad, Meer Hassan Khalid","doi":"10.1002/ccd.70314","DOIUrl":"10.1002/ccd.70314","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"134-135"},"PeriodicalIF":1.9,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145447050","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}
Hamza Lodhi, Houman Khalili, Arthur Pavlovsky, Guilherme Attizzani, Sameer Saleem, Sajjad Haider, Mohammad Abdul-Waheed, Muhammad Akbar, Mohammed Kazimuddin, Amr E. Abbas
Background
Transcatheter aortic valve replacement (TAVR) is a rapidly expanding option for patients with severe aortic stenosis. TAVR has been shown to improve both survival and quality of life. However, the relationship between post-TAVR echocardiographic gradient and quality of life has not been well studied or compared in self-expanding (SEVs) and balloon expandable (BEVs) valves.
Aims
To explore correspondence of post-TAVR echocardiographic gradients and quality of life outcomes.
Methods
In a multicenter retrospective registry of patients undergoing TAVR the relationship between discharge mean gradient (MG) on transthoracic echocardiography (TTE) and quality-of-life scores using Kansas City Cardiomyopathy Questionnaire (KCCQ) was examined at 1 month and 1 year.
Results
During the study period, complete data for 1 month KCCQ and discharge MG data was available in 1093 patients from two high volume institutions. These included 410 (37%) SEVs and 683 (63%) BEVs. At discharge, after adjusting for baseline variables, MG was lower with SEV compared to BEV (8.5 ± 4.7 mmHg vs. 10.6 ± 4.9 mmHg, p < 0.001), however change in KCCQ score was similar for both (31.1 ± 21.8 [SEV] vs. 31.7 ± 22.9 [BEVs], p = 0.68). In the combined cohort, discharge MG was not associated with improvement in 1-month or 1-year KCCQ and did not predict change in 1-month or 1-year NYHA class. Patients with higher NYHA classifications exhibited smaller changes in KCCQ scores from baseline at 30 days. (p < 0.001).
Conclusion
In this study of TAVR patients, echocardiogram-derived MG at discharge was not associated with quality-of-life improvement as determined by change in KCCQ or NYHA class at 1 month or 1 year.
背景：经导管主动脉瓣置换术（TAVR）是严重主动脉瓣狭窄患者迅速扩大的选择。TAVR已被证明可以提高生存率和生活质量。然而，tavr后超声心动图梯度与生活质量之间的关系尚未得到很好的研究或比较自扩（sev）和球囊可扩（bev）瓣膜。目的：探讨tavr术后超声心动图梯度与生活质量的对应关系。方法：在TAVR患者的多中心回顾性登记中，使用堪萨斯城心肌病问卷（KCCQ）检查1个月和1年的经胸超声心动图（TTE）出院平均梯度（MG）与生活质量评分之间的关系。结果：在研究期间，来自两家高容量机构的1093例患者获得了1个月的完整KCCQ数据和出院MG数据。其中包括410辆（37%）纯电动汽车和683辆（63%）纯电动汽车。出院时，在调整基线变量后，与BEV相比，SEV的MG较低（8.5±4.7 mmHg vs. 10.6±4.9 mmHg）。结论：在这项TAVR患者的研究中，出院时超声心动图得出的MG与生活质量改善无关，这是通过1个月或1年的KCCQ或NYHA分级的变化来确定的。
{"title":"Relationship of Hemodynamic Improvement and Quality of Life Outcomes After Transcatheter Aortic Valve Replacement","authors":"Hamza Lodhi, Houman Khalili, Arthur Pavlovsky, Guilherme Attizzani, Sameer Saleem, Sajjad Haider, Mohammad Abdul-Waheed, Muhammad Akbar, Mohammed Kazimuddin, Amr E. Abbas","doi":"10.1002/ccd.70281","DOIUrl":"10.1002/ccd.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve replacement (TAVR) is a rapidly expanding option for patients with severe aortic stenosis. TAVR has been shown to improve both survival and quality of life. However, the relationship between post-TAVR echocardiographic gradient and quality of life has not been well studied or compared in self-expanding (SEVs) and balloon expandable (BEVs) valves.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore correspondence of post-TAVR echocardiographic gradients and quality of life outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a multicenter retrospective registry of patients undergoing TAVR the relationship between discharge mean gradient (MG) on transthoracic echocardiography (TTE) and quality-of-life scores using Kansas City Cardiomyopathy Questionnaire (KCCQ) was examined at 1 month and 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, complete data for 1 month KCCQ and discharge MG data was available in 1093 patients from two high volume institutions. These included 410 (37%) SEVs and 683 (63%) BEVs. At discharge, after adjusting for baseline variables, MG was lower with SEV compared to BEV (8.5 ± 4.7 mmHg vs. 10.6 ± 4.9 mmHg, <i>p</i> < 0.001), however change in KCCQ score was similar for both (31.1 ± 21.8 [SEV] vs. 31.7 ± 22.9 [BEVs], <i>p</i> = 0.68). In the combined cohort, discharge MG was not associated with improvement in 1-month or 1-year KCCQ and did not predict change in 1-month or 1-year NYHA class. Patients with higher NYHA classifications exhibited smaller changes in KCCQ scores from baseline at 30 days. (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study of TAVR patients, echocardiogram-derived MG at discharge was not associated with quality-of-life improvement as determined by change in KCCQ or NYHA class at 1 month or 1 year.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"70-75"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433670","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}
Mian Zain Hayat, Meer Hassan Khalid, Muhammad Ahmad, Ahmad Furqan Anjum
{"title":"Comment on “Impact of Lactate Levels on Admission in STEMI Patients With Cardiogenic Shock Treated With IMPELLA”","authors":"Mian Zain Hayat, Meer Hassan Khalid, Muhammad Ahmad, Ahmad Furqan Anjum","doi":"10.1002/ccd.70295","DOIUrl":"10.1002/ccd.70295","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"86-87"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433648","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}
Zhifeng Yao, You Zhou, Jiasheng Yin, Yizhe Wu, Li Shen, Hao Lu, Jianying Ma, Juying Qian, Zheyong Huang, Junbo Ge
Background
Drug-coated balloons are emerging as an important approach for the treatment of coronary bifurcation lesions (CBL).
Aims
This study aimed to evaluate the efficacy and safety of a novel paclitaxel-coated balloon (PCB), which used propyl gallate (PG) as the excipient, in treating the side branch of de novo CBL.
Methods
In this multicenter, randomized, non-inferiority trial, 236 patients across 17 centers were 1:1 randomized to the PG-based PCB or iohexol-based PCB groups. After stent deployment in the main vessel, the side branch was dilated with the allocated PCB. Angiographic follow-up was planned at 9 months and clinical follow-up at 12 months. The primary endpoint was diameter stenosis (DS) in the side branch during the angiographic follow-up.
Results
DS in the side branch was 21.3 ± 23.8% in the PG group versus 21.7 ± 24.3% in the control group (p = 0.198). After adjustment for centers, the difference of DS between the PG group and the control group was −0.11% (95% confidence interval, −6.84% to 6.62%), meeting the prespecified non-inferiority margin of 7%. Clinical outcomes at 12 months were comparable between groups.
Conclusions
The PG-based PCB demonstrated non-inferior efficacy and safety in comparison with the iohexol-based PCB for side branch treatment in de novo CBL. The PG-based PCB could be used as a therapeutic alternative in CBL revascularization.
{"title":"A Novel Propyl Gallate-Based Paclitaxel-Coated Balloon for the Side Branch Treatment in Coronary Bifurcation Lesions","authors":"Zhifeng Yao, You Zhou, Jiasheng Yin, Yizhe Wu, Li Shen, Hao Lu, Jianying Ma, Juying Qian, Zheyong Huang, Junbo Ge","doi":"10.1002/ccd.70290","DOIUrl":"10.1002/ccd.70290","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Drug-coated balloons are emerging as an important approach for the treatment of coronary bifurcation lesions (CBL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This study aimed to evaluate the efficacy and safety of a novel paclitaxel-coated balloon (PCB), which used propyl gallate (PG) as the excipient, in treating the side branch of de novo CBL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter, randomized, non-inferiority trial, 236 patients across 17 centers were 1:1 randomized to the PG-based PCB or iohexol-based PCB groups. After stent deployment in the main vessel, the side branch was dilated with the allocated PCB. Angiographic follow-up was planned at 9 months and clinical follow-up at 12 months. The primary endpoint was diameter stenosis (DS) in the side branch during the angiographic follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DS in the side branch was 21.3 ± 23.8% in the PG group versus 21.7 ± 24.3% in the control group (<i>p</i> = 0.198). After adjustment for centers, the difference of DS between the PG group and the control group was −0.11% (95% confidence interval, −6.84% to 6.62%), meeting the prespecified non-inferiority margin of 7%. Clinical outcomes at 12 months were comparable between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The PG-based PCB demonstrated non-inferior efficacy and safety in comparison with the iohexol-based PCB for side branch treatment in de novo CBL. The PG-based PCB could be used as a therapeutic alternative in CBL revascularization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"91-100"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440509","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}
Vinícius Martins Rodrigues Oliveira, Lucas M. Barbosa
{"title":"Are We Missing the Forest for the Trees? How Bayesian Meta-Analysis Could Reshape Evidence in Cardiology","authors":"Vinícius Martins Rodrigues Oliveira, Lucas M. Barbosa","doi":"10.1002/ccd.70298","DOIUrl":"10.1002/ccd.70298","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"88-90"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440463","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}
Agostino Spano', Ole De Backer, Ignacio J. Amat-Santos, Marouane Boukhris, Adrien Jossart, Jacques Auslender, Giuseppe Colletti, Mihai Cocoi, Claudiu Ungureanu
Background
Suture-mediated closure using the ProGlide system can fail during transfemoral transcatheter aortic valve implantation (TAVR) in patients with heavily calcified femoral arteries, complicating vascular access management.
Methods
We describe a case series of three TAVR procedure in which ProGlide pre-closure failed due to calcified plaques impairing footplate apposition, despite accurate ultrasound-guided puncture. Then, a bailout strategy involving femoral angioplasty via a secondary vascular access, the Fem-PREP (Femoral Preparation for Preclosure) technique, was employed to improve vessel compliance and luminal diameter.
Results
The Fem-PREP technique provided minimal space required for adequate ProGlide footplate mobility, reducing plaque interference and enabling successful suture deployment in all cases without vascular complications.
Conclusions
Targeted femoral angioplasty using Fem-PREP may overcome one of the key mechanical limitation associated with pre-closure failure in calcified femoral arteries, offering a simple and effective adjunctive technique in selected TAVR patients.
{"title":"Angioplasty-Assisted, Suture-Mediated Vascular Closure Enabling Percutaneous Transfemoral TAVR in Case of a Diseased Puncture Site. The FEM-PREP Technique","authors":"Agostino Spano', Ole De Backer, Ignacio J. Amat-Santos, Marouane Boukhris, Adrien Jossart, Jacques Auslender, Giuseppe Colletti, Mihai Cocoi, Claudiu Ungureanu","doi":"10.1002/ccd.70285","DOIUrl":"10.1002/ccd.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Suture-mediated closure using the ProGlide system can fail during transfemoral transcatheter aortic valve implantation (TAVR) in patients with heavily calcified femoral arteries, complicating vascular access management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We describe a case series of three TAVR procedure in which ProGlide pre-closure failed due to calcified plaques impairing footplate apposition, despite accurate ultrasound-guided puncture. Then, a bailout strategy involving femoral angioplasty via a secondary vascular access, the Fem-PREP (Femoral Preparation for Preclosure) technique, was employed to improve vessel compliance and luminal diameter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Fem-PREP technique provided minimal space required for adequate ProGlide footplate mobility, reducing plaque interference and enabling successful suture deployment in all cases without vascular complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Targeted femoral angioplasty using Fem-PREP may overcome one of the key mechanical limitation associated with pre-closure failure in calcified femoral arteries, offering a simple and effective adjunctive technique in selected TAVR patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"61-69"},"PeriodicalIF":1.9,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433636","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}
Traditional percutaneous coronary intervention (PCI) relies on two-dimensional X-ray imaging, but this does not allow depth perception and complicates precise manipulation of the guidewire. Our purpose was to develop a novel method for guidewire manipulation by establishing stereoscopic perception in coronary angiography (CAG), as described in our previous study, and thereby improve the precision and success rate of PCI.
Methods
Based on establishment of stereo perception in CAG, we used digital subtraction angiography (DSA) with gantry rotation and simulation with UG NX software to determine the orientation of the guidewire tip and the relative positions of the true lumen and false lumen. We then performed verification using a highly realistic 3D-printed transparent silicone model of the human heart and coronary arteries. By manipulating the guidewire in various branches of the model of the coronary artery, we identified the directional torque of wire rotation and simulated this using UG NX software. A preliminary trial with unidirectional rotation was conducted in which one interventionist performed 60 guidewire manipulations (30 before and 30 after training) in a 3D-printed heart model to quantify changes in directional accuracy.
Results
The results confirmed that the orientation of the distal tip of the guidewire and the relative positions of the true and false lumens were accurately determined using DSA with gantry rotation and simulation with UG NX software. We also validated the consistency of rotational torque within the coronary artery lumen, irrespective of vessel twisting and deformation. The preliminary trial demonstrated a higher success rate (93.3% vs. 60%, p < 0.01) after training.
Conclusion
Our novel method significantly improved the accuracy of guidewire manipulation in an in vitro model. This method therefore has the potential to enhance PCI outcome, and warrants further examination by clinical trials.
背景：传统的经皮冠状动脉介入治疗（PCI）依赖于二维x线成像，但这不能实现深度感知，并且使导丝的精确操作复杂化。我们的目的是开发一种新的方法，通过在冠状动脉造影（CAG）中建立立体感知来操纵导丝，从而提高PCI的准确性和成功率。方法：在CAG立体感知建立的基础上，采用龙门旋转数字减影血管造影（DSA）， UG NX软件进行模拟，确定导丝尖端的方位以及真腔和假腔的相对位置。然后，我们使用高度逼真的3d打印透明硅胶人体心脏和冠状动脉模型进行验证。通过对冠状动脉模型各分支导丝的操作，确定导丝旋转的定向扭矩，并利用UG NX软件进行仿真。进行了一项单向旋转的初步试验，其中一名介入医生在3d打印的心脏模型中进行了60次导丝操作（训练前30次，训练后30次），以量化方向精度的变化。结果：采用龙门旋转DSA及UG NX软件进行仿真，证实了导丝远端方向及真假腔相对位置的准确确定。我们还验证了冠状动脉管腔内旋转扭矩的一致性，无论血管扭曲和变形如何。初步试验显示了更高的成功率（93.3% vs. 60%） p结论：我们的新方法显著提高了体外模型导丝操作的准确性。因此，该方法具有提高PCI疗效的潜力，值得临床试验进一步检验。
{"title":"Guidewire Manipulation Based on Establishment of Stereo Perception in Percutaneous Coronary Intervention","authors":"Miao Chen, Huiqiang Zhao, Xiantao Song","doi":"10.1002/ccd.70287","DOIUrl":"10.1002/ccd.70287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traditional percutaneous coronary intervention (PCI) relies on two-dimensional X-ray imaging, but this does not allow depth perception and complicates precise manipulation of the guidewire. Our purpose was to develop a novel method for guidewire manipulation by establishing stereoscopic perception in coronary angiography (CAG), as described in our previous study, and thereby improve the precision and success rate of PCI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on establishment of stereo perception in CAG, we used digital subtraction angiography (DSA) with gantry rotation and simulation with UG NX software to determine the orientation of the guidewire tip and the relative positions of the true lumen and false lumen. We then performed verification using a highly realistic 3D-printed transparent silicone model of the human heart and coronary arteries. By manipulating the guidewire in various branches of the model of the coronary artery, we identified the directional torque of wire rotation and simulated this using UG NX software. A preliminary trial with unidirectional rotation was conducted in which one interventionist performed 60 guidewire manipulations (30 before and 30 after training) in a 3D-printed heart model to quantify changes in directional accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results confirmed that the orientation of the distal tip of the guidewire and the relative positions of the true and false lumens were accurately determined using DSA with gantry rotation and simulation with UG NX software. We also validated the consistency of rotational torque within the coronary artery lumen, irrespective of vessel twisting and deformation. The preliminary trial demonstrated a higher success rate (93.3% vs. 60%, <i>p</i> < 0.01) after training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our novel method significantly improved the accuracy of guidewire manipulation in an in vitro model. This method therefore has the potential to enhance PCI outcome, and warrants further examination by clinical trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"76-85"},"PeriodicalIF":1.9,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145433677","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}
Saverio Continisio, Andrea R. Munafò, Carolina Montonati, Riccardo Terzi, Emiliano Boldi, Alfonso Ielasi, Claudio Montalto, Francesco Soriano, Jacopo A. Oreglia, Federico De Marco, Antonio Silvestro, Tommaso Fabris, Edwin Ho, Francesco Saia, Giuseppe Tarantini, Cosmo Godino, Francesco Maisano, Gilbert H. L. Tang, Azeem Latib, Andrea Scotti
Background
Transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) is increasingly performed in younger patients with long life expectancy. However, limited data exist on the durability of transcatheter heart valves (THVs).
Aims
The aim of the present work is to compare the long-term durability of balloon-expandable (BEV) and self-expanding (SEV) THVs after TAVR.
Methods
Electronic databases were searched up to May 2025 for studies reporting on the long-term durability of THVs in patients undergoing TAVR with a minimum follow-up of 5 years. Pooled odds ratios (ORs) with 95% confidence interval (CI) were used as summary statistics and were calculated using a random-effects model. Co-primary endpoints were moderate and severe structural valve deterioration (SVD) and the occurrence of all-cause bioprosthetic valve failure (BVF). All-cause death was the secondary endpoint.
Results
A total of 22 studies and 12,131 patients undergoing TAVR were included: 52.5% of patients (n = 6362) received BEV, 47.5% (n = 5769) SEV. An old-generation THV was used in 84.5% of cases. At a median follow-up of 7 (5−8.3) years, the overall pooled estimates of moderate/severe SVD and BVF were 7% (5−9) and 4% (3−5), respectively. Patients treated with a BEV experienced a higher rate of SVD (OR: 2.09; 95% CI: 1.58−2.75; p < 0.001) and BVF (OR: 1.61; 95% CI: 1.10−2.36; p = 0.014); no difference was observed in terms of all-cause death.
Conclusions
At long-term follow-up after TAVR, patients receiving a BEV experienced higher rates of moderate/severe SVD and of BVF compared to those having a SEV. However, no significant differences between the two THV designs were observed on the clinical endpoint of all-cause death.
{"title":"Long-Term Durability of Balloon-Expandable Versus Self-Expanding Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis","authors":"Saverio Continisio, Andrea R. Munafò, Carolina Montonati, Riccardo Terzi, Emiliano Boldi, Alfonso Ielasi, Claudio Montalto, Francesco Soriano, Jacopo A. Oreglia, Federico De Marco, Antonio Silvestro, Tommaso Fabris, Edwin Ho, Francesco Saia, Giuseppe Tarantini, Cosmo Godino, Francesco Maisano, Gilbert H. L. Tang, Azeem Latib, Andrea Scotti","doi":"10.1002/ccd.70294","DOIUrl":"10.1002/ccd.70294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcatheter aortic valve replacement (TAVR) for aortic stenosis (AS) is increasingly performed in younger patients with long life expectancy. However, limited data exist on the durability of transcatheter heart valves (THVs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of the present work is to compare the long-term durability of balloon-expandable (BEV) and self-expanding (SEV) THVs after TAVR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Electronic databases were searched up to May 2025 for studies reporting on the long-term durability of THVs in patients undergoing TAVR with a minimum follow-up of 5 years. Pooled odds ratios (ORs) with 95% confidence interval (CI) were used as summary statistics and were calculated using a random-effects model. Co-primary endpoints were moderate and severe structural valve deterioration (SVD) and the occurrence of all-cause bioprosthetic valve failure (BVF). All-cause death was the secondary endpoint.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 22 studies and 12,131 patients undergoing TAVR were included: 52.5% of patients (<i>n</i> = 6362) received BEV, 47.5% (<i>n</i> = 5769) SEV. An old-generation THV was used in 84.5% of cases. At a median follow-up of 7 (5−8.3) years, the overall pooled estimates of moderate/severe SVD and BVF were 7% (5−9) and 4% (3−5), respectively. Patients treated with a BEV experienced a higher rate of SVD (OR: 2.09; 95% CI: 1.58−2.75; <i>p</i> < 0.001) and BVF (OR: 1.61; 95% CI: 1.10−2.36; <i>p</i> = 0.014); no difference was observed in terms of all-cause death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At long-term follow-up after TAVR, patients receiving a BEV experienced higher rates of moderate/severe SVD and of BVF compared to those having a SEV. However, no significant differences between the two THV designs were observed on the clinical endpoint of all-cause death.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"48-60"},"PeriodicalIF":1.9,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145411373","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}
Magdalena Cuman, Gernot Buheitel, Peter Ewert, Stanimir Georgiev
Background
Congenital aortic coarctation in neonates and children can be managed with transcatheter stent implantation, but this approach raises the issue of how to accommodate the fixed stent structure within the growing vessel.
Case Summary
A 15-month-old boy, born prematurely with critical aortic coarctation, was treated at 1 week of age with the implantation of a coronary stent. Subsequently, multiple stent dilatations were needed to adapt it to the growing aortic vessel. At 3 months the patient underwent balloon dilation with the simultaneous implantation of a second stent, and after 1 year an ultra-high-pressure balloon dilatation with intentional fracture of the coronary stent was performed.
Discussion
To overcome the problem of stenting a growing vessel, intentional stent fracture (ISF) with ultrahigh-pressure (UHP) balloon has been introduced and applied in a limited number of patients. In piglet models, the ISF technique was associated with a significant incidence of complications, which were preventable (with the exception of stent fragment embolization) by performing pre-stenting before ISF.
{"title":"Intentional Stent Fracture to Accommodate Growth After Coarctation Stenting in an 860-g Neonate","authors":"Magdalena Cuman, Gernot Buheitel, Peter Ewert, Stanimir Georgiev","doi":"10.1002/ccd.70291","DOIUrl":"10.1002/ccd.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital aortic coarctation in neonates and children can be managed with transcatheter stent implantation, but this approach raises the issue of how to accommodate the fixed stent structure within the growing vessel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Summary</h3>\u0000 \u0000 <p>A 15-month-old boy, born prematurely with critical aortic coarctation, was treated at 1 week of age with the implantation of a coronary stent. Subsequently, multiple stent dilatations were needed to adapt it to the growing aortic vessel. At 3 months the patient underwent balloon dilation with the simultaneous implantation of a second stent, and after 1 year an ultra-high-pressure balloon dilatation with intentional fracture of the coronary stent was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>To overcome the problem of stenting a growing vessel, intentional stent fracture (ISF) with ultrahigh-pressure (UHP) balloon has been introduced and applied in a limited number of patients. In piglet models, the ISF technique was associated with a significant incidence of complications, which were preventable (with the exception of stent fragment embolization) by performing pre-stenting before ISF.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"34-37"},"PeriodicalIF":1.9,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccd.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403719","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}
Muhammad Ahmad, Meer Hassan Khalid, Ahmad Furqan Anjum
{"title":"Letter to the Editor: “Expanding the Scope of Pigtail-Assisted Transradial Access: The Need for Comparative and Multicenter Evidence”","authors":"Muhammad Ahmad, Meer Hassan Khalid, Ahmad Furqan Anjum","doi":"10.1002/ccd.70293","DOIUrl":"10.1002/ccd.70293","url":null,"abstract":"","PeriodicalId":9650,"journal":{"name":"Catheterization and Cardiovascular Interventions","volume":"107 1","pages":"40-41"},"PeriodicalIF":1.9,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403715","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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