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Mashup Score: 35
BACKGROUND: Stent underexpansion is a significant challenge in percutaneous coronary intervention, critically impacting patient outcomes. While excimer laser coronary angioplasty (ELCA) and intravascular lithotripsy (IVL) are increasingly used to address this issue, their full impact on the integrity of drug-eluting stents remains unclear, raising concerns about their safety and efficacy. METHODS: This in vitro study assessed the effects of ELCA and IVL on the structural integrity of drug-eluting stents using scanning electron microscopy. Nine stents, 5 Onyx Frontier (with durable circumferential polymer coating) and 4 Cre8 (polymer-free), were implanted in a 3-dimensional coronary artery simulator following standardized protocols. After implantation, treatments with saline-ELCA, contrast-ELCA, IVL, and high-pressure balloon dilatation were applied. A comprehensive evaluation of the stent surface was performed at 60-fold magnification. RESULTS: Scanning electron microscopy analysis rev
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet
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Mashup Score: 22
BACKGROUND: Lipid content in untreated nonobstructive coronary artery lesions is associated with adverse clinical outcomes, and residual in-stent or stent edge lipid may worsen outcomes after percutaneous coronary intervention (PCI). METHODS: Near-infrared spectroscopy-intravascular ultrasound was performed before and after PCI in patients with myocardial infarction. We evaluated the impact of lipid assessed by near-infrared spectroscopy (maximal lipid core burden index over 4 mm [maxLCBI4mm]) along with intravascular ultrasound information including residual plaque burden on in-stent or edge-related major adverse cardiac events (MACE) in de novo PCI-treated culprit coronary artery lesions. The primary end point was culprit lesion-related MACE (CL-MACE), defined as cardiac death, myocardial infarction, or unstable or progressive angina either requiring revascularization or with rapid lesion progression and classified as in-stent or stent edge–related. RESULTS: During a median follow-up
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet-
More reason to Image? Lipid burden and culprit lesion outcomes. A PROSPECT II Substudy @DavidErlinge @ller_kj54329 @greggwstone @FrobertOle @ziadalinyc @MichaelMaeng1 @MaeharaAkiko #cardiotwitter #IVUS #stent #AHAJournals https://t.co/rUTUk43pSh https://t.co/B59FSJ5HMB
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Mashup Score: 19
BACKGROUND: Lipid content in untreated nonobstructive coronary artery lesions is associated with adverse clinical outcomes, and residual in-stent or stent edge lipid may worsen outcomes after percutaneous coronary intervention (PCI). METHODS: Near-infrared spectroscopy-intravascular ultrasound was performed before and after PCI in patients with myocardial infarction. We evaluated the impact of lipid assessed by near-infrared spectroscopy (maximal lipid core burden index over 4 mm [maxLCBI4mm]) along with intravascular ultrasound information including residual plaque burden on in-stent or edge-related major adverse cardiac events (MACE) in de novo PCI-treated culprit coronary artery lesions. The primary end point was culprit lesion-related MACE (CL-MACE), defined as cardiac death, myocardial infarction, or unstable or progressive angina either requiring revascularization or with rapid lesion progression and classified as in-stent or stent edge–related. RESULTS: During a median follow-up
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet-
More reason to Image? Lipid burden and culprit lesion outcomes. A PROSPECT II Substudy @DavidErlinge @ller_kj54329 @greggwstone @FrobertOle @ziadalinyc @MichaelMaeng1 @MaeharaAkiko #cardiotwitter #IVUS #stent #AHAJournals https://t.co/rUTUk43pSh https://t.co/B59FSJ5HMB
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Mashup Score: 6Prognostic Value of Murray Law-Based QFR (μQFR)-Guided Virtual PCI in Patients With Physiological Ischemia | Circulation: Cardiovascular Interventions - 2 month(s) ago
BACKGROUND: Quantitative flow ratio (QFR)-based virtual percutaneous coronary intervention (PCI) is associated with improved post-PCI physiological results. Murray law-based QFR (μQFR) is a new method for physiological assessment that has higher feasibility and efficiency. The purpose of this study was to investigate the performance of μQFR-guided virtual PCI in improving post-PCI outcomes. METHODS: The QUITE RIGHT study (Quantitative Flow Ratio Virtual Stenting and Angiography Guided Percutaneous Coronary Intervention) is a prospective, multicenter, blinded, randomized, controlled superiority study. Eligible patients were randomized 1:1 to either the μQFR-guided virtual PCI group or the angiography-guided PCI group. The primary end point was the proportion of the target vessels with a post-PCI μQFR ≥0.90, accepted as an optimal post-PCI physiological outcome. RESULTS: A total of 622 patients with 666 vessels were enrolled. The optimal physiological outcome was reached more often in th
Source: www.ahajournals.orgCategories: General Medicine News, Cardiology News and JournTweet-
How can we get it right? QFR-guided virtual PCI versus Angiography-guided PCI. The QUITE RIGHT study #cardiotwitter #AHAJournals https://t.co/YxRihppR20 https://t.co/y5ZLmnrlgr
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Mashup Score: 8
BACKGROUND: The role of left atrial appendage occlusion (LAAO) in patients without previous atrial fibrillation (AF) is not established. This meta-analysis was conducted on patients with normal sinus rhythm who underwent cardiac surgery, with and without concomitant LAAO, to evaluate its effect on the incidence of cerebrovascular accidents (CVAs). METHODS: A systematic review was conducted from inception until December 2023 for randomized and propensity-score studies comparing CVA in patients without AF undergoing cardiac surgery with or without LAAO. RESULTS: Six studies met our inclusion criteria with a total of 4130 patients: 2146 in the LAAO group and 1984 in the no-LAAO group. The risk ratio of postoperative AF was 1.05 (95% CI, 0.86–1.28); P=0.628. The CVA rates at 5 years were 6.8±1.0% in the no-LAAO group and 4.3±0.8% in the LAAO group (log-rank P=0.021). The Cox regression analysis for CVA in patients undergoing LAAO reported a hazard ratio of 0.65 (95% CI, 0.45–0.94); P=0.022
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet-
Is there a role for LAAO in cardiac surgical patients without atrial fibrillation? @Takotsubo91 @SSicouri @MarcGerdisch @BaselRamlawiMD #ACCFIT #cardiotwitter #AHAJournals https://t.co/ACUZshg1uP https://t.co/I68ZrxynN7
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Mashup Score: 38
BACKGROUND: SAPIEN3 (S3) is a ubiquitous redo–transcatheter aortic valve (TAV) replacement alternative for degenerated Evolut valves, but S3 sizing for S3-in-Evolut remains unclear. We sought to compare the impact of in vivo computed tomography (CT)-sizing on redo-TAV feasibility for S3-in-Evolut with traditional bench-sizing. METHODS: CT scans of 290 patients treated using Evolut R/PRO/PRO+ between July 2015 and December 2021 were analyzed. S3-in-Evolut was simulated using S3 outflow/neoskirt plane (NSP) at node-6, -5, and -4. CT-sizing for S3 was determined by averaging 4 areas of the Evolut stent frame at NSP level and 3 nodes below. Redo-TAV was deemed feasible if the NSP was below the coronaries, or the narrowest valve (virtual S3)-to-aorta distance was >4 mm. Risk of prosthesis-patient mismatch was estimated using predicted indexed-effective orifice area. RESULTS: Compared with bench-sizing, CT-sizing yielded smaller S3 size in 82% at node-6, 81% at node-5, and 84% at node-4. Fac
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet-
In-vivo CT sizing versus bench-sizing for S3-in-Evolut valves and redo TAV @Miho_Fukui_ @SyedZaidMD @mryburns @Koike41161477 @JoaoLCavalcante @psorajja @bapat_savrtavr @MHIF_Heart #TAVR #TAVI #cardiotwitter #AHAJournals https://t.co/pPf5G6Gt3p https://t.co/5W7VTzWvro
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Mashup Score: 8
BACKGROUND: Failure to rescue (FTR) describes in-hospital mortality following a procedural complication and has been adopted as a quality metric in multiple specialties. However, FTR has not been studied for percutaneous coronary intervention (PCI) complications. METHODS: This is a retrospective study of patients undergoing PCI from the American College of Cardiology National Cardiovascular Data Registry’s CathPCI Registry between April 1, 2018, and June 30, 2021. PCI complications evaluated were significant coronary dissection, coronary artery perforation, vascular complication, significant bleeding within 48 hours, new cardiogenic shock, and tamponade. Secular trends for FTR were evaluated with descriptive analysis, and hospital-level variation and clinical predictors were analyzed with logistic regression. RESULTS: Among 2 196 661 patients undergoing PCI at 1483 hospitals, 3.5% had at least 1 PCI complication. In-hospital mortality occurred more frequently following a complication c
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet-
How frequently can a #PCI complication not be rescued? Insights from the NCDR Registry @TYWangMD @Ravi_Hira_MD @rwyeh @akashkataruka @Jakeadoll #stent #cardiotwitter #AHAJournals https://t.co/llWadimHQU https://t.co/nwzXUvoecM
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Mashup Score: 78Enhancing Guidewire Efficacy for Trans-radial Access: The EAGER Randomized Controlled Trial | Circulation: Cardiovascular Interventions - 3 month(s) ago
Background: The 1.5mm ‘Baby J’ hydrophilic narrow J tipped wire is a development of the standard 0.035” 3mm J tipped peripheral guidewire, designed to improve efficiency of transradial coronary procedures by safely navigating small caliber radial arteries to the aorta. There is currently a lack of evidence comparing the procedural success and safety of different peripheral guidewires used in transradial cardiac procedures. We compared the efficacy and safety of a narrow J tipped hydrophilic 0.035” wire (intervention – Radifocus™ ‘Baby J’ guidewire, TERUMO Co., Tokyo, Japan). versus standard fixed core (FC) 0.035” J wire (control). Methods: Investigator initiated, blinded, Australian, multicenter randomized trial in patients undergoing clinically indicated coronary angiography and/or PCI. Randomized 1:1 via sealed envelope method to use either the control or the intervention guidewire. The primary endpoint (technical success) was defined as gaining aortic root access with the randomized
Source: www.ahajournals.orgCategories: General Medicine News, Cardiology News and JournTweet-
Can we enhance guidewire efficacy for trans-radial access? The EAGER Randomized Controlled Trial published simultaneously with the presentation at #ESCCongress https://t.co/vdTybNm5tV @tomjford @DrAdamBland @ESCAdvocacy @ESC_Lavinia #AHAJournals #Cardiotwitter #RadialFirst https://t.co/VVRW9WiH0w
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Mashup Score: 15Composite Pulmonary Embolism Shock Score and Risk of Adverse Outcomes in Patients With Pulmonary Embolism | Circulation: Cardiovascular Interventions - 3 month(s) ago
BACKGROUND: In hemodynamically stable patients with acute pulmonary embolism (PE), the Composite Pulmonary Embolism Shock (CPES) score predicts normotensive shock. However, it is unknown if CPES predicts adverse clinical outcomes. The objective of this study was to determine whether the CPES score predicts in-hospital mortality, resuscitated cardiac arrest, or hemodynamic deterioration. METHODS: Patients with acute intermediate-risk PE admitted from October 2016 to July 2019 were included. CPES was calculated for each patient. The primary outcome was a composite of in-hospital mortality, resuscitated cardiac arrest, or hemodynamic decompensation. Secondary outcomes included individual components of the primary outcome. The association of CPES with primary and secondary outcomes was evaluated. RESULTS: Among the 207 patients with intermediate-risk PE (64.7% with intermediate-high risk PE), 29 (14%) patients had a primary outcome event. In a multivariable model, a higher CPES score was a
Source: www.ahajournals.orgCategories: General Medicine News, Cardiology News and JournTweet-
Stratification of intermediate-risk PE. Composite Pulmonary Embolism Shock (CPES) Score and Adverse Clinical Outcome @jameshorowitzmd @CardsNYC @haisummaqsood @robertshiuzhang @SripalBangalore #cardiotwitter #AHAJournals https://t.co/IyS8uXujRZ https://t.co/CJBUjkgJ7r
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Mashup Score: 16Comparing Management Strategies in Patients With Clot-in-Transit | Circulation: Cardiovascular Interventions - 3 month(s) ago
BACKGROUND: Clot-in-transit is associated with high mortality, but optimal management strategies remain uncertain. The aim of this study was to compare the outcomes of different treatment strategies in patients with clot-in-transit. METHODS: This is a retrospective study of patients with documented clot-in-transit in the right heart on echocardiography across 2 institutions between January 2020 and October 2023. The primary outcome was a composite of in-hospital mortality, resuscitated cardiac arrest, or hemodynamic decompensation. RESULTS: Among 35 patients included in the study, 10 patients (28.6%) received anticoagulation alone and 2 patients (5.7%) received systemic thrombolysis, while 23 patients (65.7%) underwent catheter-based therapy (CBT; 22 mechanical thrombectomy and 1 catheter-directed thrombolysis). Over a median follow-up of 30 days, 9 patients (25.7%) experienced the primary composite outcome. Compared with anticoagulation alone, patients who received CBT or systemic thr
Source: www.ahajournals.orgCategories: General Medicine News, CardiologistsTweet-
Clot-in-Transit. Catheter based thrombectomy reduces adverse clinical outcomes compared to anticoagulation @SripalBangalore @jameshorowitzmd @CardsNYC @haisummaqsood @robertshiuzhang #PERT #cardiotwitter #AHAJournals https://t.co/HzVN3foUMn https://t.co/mLVQQrAFhp
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Excimer laser angioplasty and intravascular lithotripsy effects on drug-eluting stent integrity. An in-vitro electron microscopy study @Borjaibanez1 @foroic @AJuradoRoman @Borja.Riversa #cardiotwitter #AHAJournals https://t.co/nNZXOiOn6g https://t.co/etTDf19Ct1