Catheterization And Cardiovascular Interventions[JOURNAL]
Sun
200 papers
Short Versus Extended Duration of Triple Antithrombotic Therapy After Percutaneous Coronary Intervention in Patients Requiring Oral Anticoagulation: A Retrospective Single-Center Study.
Kurpad KP, Vorla M, Bin-Farooq T … +5 more , Mehta R, Adoni N, Kanakadandi UB, Moussa ID, Mehta SS
Catheter Cardiovasc Interv · 2026 May · PMID 42219807 · Publisher ↗
BACKGROUND: Balancing ischemic and bleeding risks in patients undergoing percutaneous coronary intervention (PCI) who require anticoagulation remains a clinical challenge. While dual antithrombotic therapy (DAT) with a P...
BACKGROUND: Balancing ischemic and bleeding risks in patients undergoing percutaneous coronary intervention (PCI) who require anticoagulation remains a clinical challenge. While dual antithrombotic therapy (DAT) with a P2Y12 inhibitor and an oral anticoagulant reduces long-term bleeding risk, the optimal duration of triple antithrombotic therapy (TAT) in the immediate post-procedural phase is uncertain. AIMS: We aimed to evaluate clinical outcomes of short-duration ({7 days) of TAT to extended-duration (≥ 7 days) of triple therapy following PCI. METHODS: We conducted a retrospective observational study of 172 patients who underwent PCI. Of these, 109 received TAT for < 7 days, and 63 received TAT for ≥ 7 but < 28 days. The primary outcome was a composite endpoint of cardiovascular mortality, myocardial infarction, target lesion revascularization, and definite or probable stent thrombosis at 1 year. Secondary outcomes were gastrointestinal bleeding (BARC > 3) and intracranial hemorrhage. RESULTS: There were no statistically significant differences between the two groups in composite outcome (cardiovascular mortality, myocardial infarction, target vessel revascularization, or stent thrombosis at 1 year). Similarly, rates of major bleeding events did not differ significantly between the groups. CONCLUSION: Early de-escalation of TAT (within 7 days) demonstrated similar clinical outcomes to longer durations (< 7 days). Larger randomized controlled trials are warranted to further validate these findings.
Mechanical Thrombectomy Versus Anticoagulation in Intermediate-Risk Pulmonary Embolism: A Risk-Stratified, Propensity Score-Matched Analysis.
Hanna F, Abdelmaksoud A, Dway A … +6 more , El-Helbawy A, Kaelber DC, Khan HR, Hammad N, Mohsen A, Basta M
Catheter Cardiovasc Interv · 2026 May · PMID 42219798 · Publisher ↗
OBJECTIVES: To compare 1-year all-cause mortality and long-term cardiopulmonary outcomes in intermediate-risk pulmonary embolism (PE) treated with mechanical thrombectomy (MT) versus anticoagulation (AC). BACKGROUND: Whe...
OBJECTIVES: To compare 1-year all-cause mortality and long-term cardiopulmonary outcomes in intermediate-risk pulmonary embolism (PE) treated with mechanical thrombectomy (MT) versus anticoagulation (AC). BACKGROUND: Whether MT confers a survival advantage-and whether this benefit differs across intermediate risk PE subgroups remains unknown. METHODS: Retrospective, 1:1 propensity score-matched cohort study using the TriNetX Analytics Network (2010-2026). Adults with acute PE were stratified into low-intermediate (corresponding to AHA/ACC PE Category C1-C2 in the 2026 AHA/ACC PE Guideline) and high-intermediate (corresponding to AHA/ACC PE Category C3) risk subgroups. The primary endpoint was all-cause mortality at 365 days. Secondary endpoints included new-onset pulmonary hypertension, right heart failure, acute respiratory failure, and bleeding. IRB waiver was applicable per HIPAA de-identification standards. RESULTS: After matching, 2717 patients per arm were included in the low-intermediate risk cohort and 1150 per arm in the high-intermediate risk cohort. MT was associated with lower 1-year all-cause mortality in both subgroups: low-intermediate risk (11.0% vs. 17.8%; HR 0.642 [95% CI 0.556-0.741]; p < 0.001) and high-intermediate risk (7.0% vs. 11.0%; HR 0.631 [95% CI 0.475-0.839]; p = 0.002). In low-intermediate risk PE, MT was associated with increased pulmonary hypertension (HR 1.578; p < 0.001) and right heart failure (HR 4.473; p < 0.001). In high-intermediate risk PE, MT reduced pulmonary hypertension (HR 0.764; p = 0.044) and bleeding (HR 0.744; p = 0.048). CONCLUSIONS: MT was associated with reduced 1-year mortality compared with AC alone in intermediate-risk PE. The net clinical benefit is risk-profile dependent: MT appears favorable in high-intermediate risk (AHA/ACC Category C3-equivalent) PE, whereas in low-intermediate risk (AHA/ACC Category C1-C2-equivalent) PE the apparent survival advantage is offset by elevated rates of pulmonary hypertension and right heart failure. These findings are hypothesis-generating and require validation in adequately powered randomized controlled trials with pre-specified long-term mortality endpoints.
Clinical and Echocardiographic Outcomes After Implantation of the ALLEGRA Transcatheter Valve Using the Fully Repositionable IMPERIA Delivery System: One-Year Results of the EMPIRE I Study.
Baz JA, Ren CB, Burgdorf C … +13 more , Frerker C, Cruz-González I, Gómez JA, Hernândez JM, Jimenez P, Spitzer E, Tonino P, Vriesendorp P, van Mieghem N, Copt S, Jönsson A, Oldroyd KG, Doll N
Catheter Cardiovasc Interv · 2026 May · PMID 42219796 · Publisher ↗
BACKGROUND: The EMPIRE I study assessed the early (30 days) safety and efficacy of a new fully repositionable delivery system (IMPERIA) for the commercially available ALLEGRA transcatheter aortic valve in patients with e...
BACKGROUND: The EMPIRE I study assessed the early (30 days) safety and efficacy of a new fully repositionable delivery system (IMPERIA) for the commercially available ALLEGRA transcatheter aortic valve in patients with either severe native aortic stenosis or a degenerated surgical bioprosthesis. AIM: To report the final 1-year results of the EMPIRE I study. METHODS: EMPIRE I is a pre-market, prospective, multi-center, single-arm study conducted at 11 centers in 3 European countries. There were independent data safety and clinical events committees and an independent echocardiographic core laboratory. In this analysis, VARC-3 definitions of all clinical endpoints and echocardiographic parameters were employed. RESULTS: The study recruited 121 patients with severe native aortic stenosis and 16 with degenerated surgical bioprosthesis. At 1 year, the incidence of bioprosthetic valve dysfunction in the native population was 5.9%. No patients developed structural valve deterioration or endocarditis, and there were no patients with haemodynamic valve deterioration or bioprosthetic valve failure. In the valve-in-valve sub-group, 2/14 (14.3%) patients had moderate patient prosthesis mismatch at 30 days with no evidence of new bioprosthetic valve dysfunction at 1 year. In the native population, new permanent pacemaker implantation was 14.3% at 30 days and remained unchanged at 1 year. Cardiovascular mortality was 6.8% in the native population and 0% in the valve-in-valve patients. At 1-year, all-cause mortality was 10.8% (95% CI 6.4%-17.8%) in the native aortic stenosis population and 0% in the valve-in-valve patients. CONCLUSION: After 1 year of follow-up, the results of the EMPIRE 1 study show excellent haemodynamic performance, a low rate of bioprosthetic valve dysfunction, and no bioprosthetic valve failure in patients treated with the ALLEGRATM trans-catheter aortic valve implanted using the new IMPERIATM fully repositionable delivery system.
Role of Neuroimaging Before Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest.
Wong E, Yu K, Tomassoni D … +6 more , Scully T, Yeung T, Cooke J, Tong D, Chandrasekhar J, Nogic J
Catheter Cardiovasc Interv · 2026 May · PMID 42219789 · Publisher ↗
BACKGROUND: Patients presenting following out-of-hospital cardiac arrest (OOHCA) often require emergency coronary angiography. Presentations can be associated with syncope or head-trauma. AIMS: We investigated the impact...
BACKGROUND: Patients presenting following out-of-hospital cardiac arrest (OOHCA) often require emergency coronary angiography. Presentations can be associated with syncope or head-trauma. AIMS: We investigated the impact and utility of pre-coronary angiography CT-Brain (CT-B) in patients following OOHCA on clinical outcomes. METHODS: Retrospective analysis was undertaken at a large metropolitan hospital to identify patients. Patients following OOHCA who were transferred directly to the cardiac catheterization lab were included with patients stratified according to whether they received a CT-B prior to coronary angiography or not. RESULTS: Following analysis, 235 patients met inclusion criteria. The CT-B (n = 39) and non-CT-B (n = 196) groups were similar in baseline demographics with respect to age (64.1 vs. 63.3 years, p = 0.739), male sex (79.2% vs. 82.7%, p = 0.637), hypertension (48.7% vs. 49.2%, p = 0.953), and hypercholesterolemia (33.3% vs. 32.8%, p = 0.950) respectively. There was no difference in ECGs suggestive of cardiac ischemia (53.8% vs. 61.7%, p = 0.338). The CT-B group were more likely to have fallen (89.7% vs. 50.5%, p < 0.001), and have documented head strike (61.5% vs. 8.2%, p < 0.001). Door-to-procedure time was significantly longer in the CT-B group (105 vs. 53 min, p < 0.001). There was no difference in length of ICU stay (median 3 (IQR 1-6) vs. 3-days (IQR 1-6), p = 0.44), or 30-day mortality (41.0% vs. 29.5%, p = 0.159). Of those undergoing CT-B, 17.9% had pathology identified, with only one patient (2.6%) having their angiogram deferred. CONCLUSION: In patients with OOHCA, pre-angiography CT-B has a low likelihood of identifying neuropathology and significantly increases DTP time.
Transcatheter Aortic Valve Implantation for Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa Causing Severe Aortic Regurgitation.
Martín PV, Garcia-Touchard A, Palomero VM … +1 more , Dominguez JFO
Catheter Cardiovasc Interv · 2026 May · PMID 42204444 · Publisher ↗
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare complication following infective endocarditis or valve surgery. We report the case of a 65-year-old male who developed a P-MAIVF following sur...
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare complication following infective endocarditis or valve surgery. We report the case of a 65-year-old male who developed a P-MAIVF following surgical mitral valve replacement for infective endocarditis. Shortly after the surgery, although the patient remained afebrile and blood cultures were negative, routine transthoracic echocardiography revealed new-onset severe aortic regurgitation. Multimodality imaging confirmed a P-MAIVF extending into the non-coronary sinus and the left ventricular outflow tract, causing valvular incompetence despite a structurally normal aortic valve. Given the prohibitive surgical risk, an off-label transcatheter aortic valve implantation (TAVI) using a 34 mm self-expanding Evolut FX prosthesis was performed, aiming to exclude the pseudoaneurysm. Despite technical challenges related to the absence of annular calcification and catheter misplacement into the pseudoaneurysm, the prosthesis was successfully implanted with full exclusion of the pseudoaneurysm. At 3-month follow-up, the patient remained asymptomatic, with no residual aortic regurgitation and complete exclusion of the P-MAIVF on CTA. To our knowledge, this is the first reported case of a native, non-calcified aortic root pseudoaneurysm causing severe aortic regurgitation successfully treated with off-label TAVI. Multimodal imaging and careful preprocedural planning were key to procedural success.
Coronary Perforation Caused by Burr Exit During Rotational Atherectomy Successfully Managed With the Ping-Pong Balloon Technique Without Covered Stent Implantation.
Ouerghi K, Lazizi T, Mateus V
Catheter Cardiovasc Interv · 2026 May · PMID 42204434 · Publisher ↗
Coronary artery perforation (CAP) is a rare but potentially life-threatening complication of percutaneous coronary intervention, particularly during complex procedures such as rotational atherectomy. Ellis type III perfo...
Coronary artery perforation (CAP) is a rare but potentially life-threatening complication of percutaneous coronary intervention, particularly during complex procedures such as rotational atherectomy. Ellis type III perforations are associated with high morbidity and mortality and usually require covered stent implantation or embolization techniques. We report the case of an 83-year-old man undergoing rotational atherectomy of a severely calcified left anterior descending artery. An Ellis type III coronary perforation occurred following abrupt burr exit at a curved mid-LAD segment. Immediate and prolonged balloon tamponade was performed, and the ping-pong technique was used to secure distal coronary access while maintaining continuous mechanical hemostasis. Partial heparin reversal with protamine was administered under sustained balloon inflation after exclusion of cardiac tamponade, using a half-dose strategy as a temporary bridging measure. During distal rewiring, no further contrast extravasation was observed, and the guidewire crossed easily into the distal true lumen. This structured bailout strategy resulted in successful sealing of the perforation without cardiac tamponade, pericardiocentesis, or covered stent implantation. Final angiographic and clinical outcomes were favorable. A systematic follow-up angiography performed at 3 weeks demonstrated an excellent result. At 8-month follow-up, the patient remained asymptomatic with normalization of left ventricular function and sustained clinical stability. This case illustrates a rare mechanism of coronary perforation related to burr exit during rotational atherectomy and highlights a structured bailout strategy combining prolonged balloon tamponade, the ping-pong technique, and controlled partial anticoagulation reversal. This approach may allow safe stabilization and facilitate definitive management in selected cases, without challenging the established role of covered stent implantation in major coronary perforations.
Nine-Year Follow-Up After M-TEER for Secondary Mitral Regurgitation in a Patient With Cardiogenic Shock.
Reithmayer T, Stocker TJ, Weckbach LT … +7 more , Novotny J, Doldi PM, Kempton H, Massberg S, Näbauer M, Hausleiter J, Stolz L
Catheter Cardiovasc Interv · 2026 May · PMID 42204414 · Publisher ↗
BACKGROUND: Transcatheter edge-to-edge repair (TEER) has become an established therapeutic option for patients with severe secondary mitral regurgitation (SMR). While randomized trials and registry data have reported out...
BACKGROUND: Transcatheter edge-to-edge repair (TEER) has become an established therapeutic option for patients with severe secondary mitral regurgitation (SMR). While randomized trials and registry data have reported outcomes up to 5 years, longer follow-up data remain scarce. CASE SUMMARY: We report the case of a 48-year-old male patient who was admitted to our hospital with cardiogenic shock, first diagnosis of dilated cardiomyopathy and severe ventricular SMR in August 2016. With the use of mechanical circulatory support, the patient underwent urgent M-TEER with implantation of one MitraClip device, reducing MR from severe to mild-to-moderate. At 9-year follow-up in 2025 and consequent optimization of guideline directed medical therapy, the patient remains clinically stable, with sustained MR reduction and good device function. DISCUSSION: This case highlights the durability of M-TEER even in a critically ill patient initially presenting with cardiogenic shock and multiorgan failure. To our knowledge, this represents one of the longest follow-up observations after M-TEER, supporting its role as a durable treatment strategy in high-risk patients. CONCLUSIONS: M-TEER can achieve durable long-term MR reduction and symptomatic benefit.
Is Imaging of a Single Vessel Sufficient to Assess Pan-Coronary Vulnerability?
Scalamera R, Andreaggi S, Kim S … +6 more , Lee H, McNulty I, Benenati S, Vergallo R, Porto I, Jang IK
Catheter Cardiovasc Interv · 2026 May · PMID 42204403 · Publisher ↗
BACKGROUND: Coronary atherosclerosis is a pan-coronary process. However, some studies investigated only one coronary artery and extrapolated the findings to the pan-vascular process. AIMS: We utilized a three-vessel opti...
BACKGROUND: Coronary atherosclerosis is a pan-coronary process. However, some studies investigated only one coronary artery and extrapolated the findings to the pan-vascular process. AIMS: We utilized a three-vessel optical coherence tomography (OCT) database to investigate whether plaque features in the left anterior descending coronary artery (LAD) mirror vulnerability in the remaining coronary vessels. METHODS: We analyzed 131 patients who underwent OCT imaging of the LAD, left circumflex (LCx), and right coronary artery (RCA). Vulnerable features, including thin-cap fibroatheroma (TCFA), lipid-rich plaque, macrophages, microvessels, and cholesterol crystals, were evaluated in each vessel. Vulnerable features in the LAD and non-LAD vessels were correlated at patient and plaque levels. RESULTS: At the patient level, vulnerable features in the LAD correlated with those in non-LAD vessels (TCFA p < 0.001; lipid-rich plaque p < 0.001; macrophages p = 0.010; microvessels p = 0.012; cholesterol crystals p = 0.045). However, an LAD-only strategy would have missed 30%-75% of patients with vulnerable features in non-LAD vessels; the adjusted miss rates were 58.7% for TCFA, 28.2% for lipid-rich plaque, 44.3% for macrophages, 36.9% for microvessels, and 75.7% for cholesterol crystals. At the plaque level, a similar number of high-risk plaques in non-LAD arteries would have been overlooked by the LAD-only approach, with the adjusted miss rates ranging from 74.3% for cholesterol crystals to 26.7% for lipid-rich plaque. CONCLUSIONS: Vulnerable plaque features in the LAD were associated with their presence in the other coronary arteries. However, a single-vessel LAD assessment would have missed a substantial proportion of patients with vulnerable features in the LCx or RCA.
Drug-Coated Balloons Versus Drug-Eluting Stents for Patients With Long De Novo Coronary Artery Lesions: Insights From the REC-CAGEFREE I Trial.
Lv Y, Yang F, Bai X … +26 more , Wang H, Wu Y, Fang Z, Zhou J, Gao H, Hu T, Sun D, Wang Q, Yin Z, Wen S, Jin Y, Hong L, Liu J, Fu G, Zhang R, He X, Zhu B, Jiang Z, Xia J, Capodanno D, Garg S, Onuma Y, Wang D, Serruys PW, Tao L, Gao C
Catheter Cardiovasc Interv · 2026 May · PMID 42204391 · Publisher ↗
BACKGROUND: For long coronary lesions, drug-coated balloons (DCBs) might be an attractive alternative compared with drug-eluting stents (DES); however, supporting evidence remains scarce. AIMS: To compare the efficacy of...
BACKGROUND: For long coronary lesions, drug-coated balloons (DCBs) might be an attractive alternative compared with drug-eluting stents (DES); however, supporting evidence remains scarce. AIMS: To compare the efficacy of DCBs versus DES for treating long de novo coronary lesions. METHODS: REC-CAGEFREE I was a non-inferiority trial conducted at 43 sites in China, which randomized 2272 patients to paclitaxel-coated balloon angioplasty with the option of rescue stenting or sirolimus-eluting stents for treating de novo lesions, regardless of vessel diameter. In this pre-specified subgroup analysis, patients were stratified by quantitative coronary angiography-assessed lesion length into short (< 20 mm) and long (≥ 20 mm) groups. The primary endpoint was a device-oriented composite endpoint (DoCE, including cardiovascular death, target vessel myocardial infarction, or clinically and physiologically-indicated target lesion revascularization) at 3 years. RESULTS: 2,223 (97.8%) participants with available angiograms were included, of which 302 (13.6%) had long lesions and 1921 (86.4%) had short lesions. At 3 years, DoCE occurred in 24/302 (8.0%) and 121/1921 (6.3%) patients in long and short groups, respectively. In the long lesions group, DoCE occurred in 14/121 (11.6%) and 10/181 (5.6%) in the DCBs and DES groups, respectively (HR: 2.46, 95% CI: 1.07-5.67, p = 0.034). In the short lesions group, DoCE occurred in 75/983 (7.7%) and 46/938 (4.9%) in the DCBs and DES groups, respectively (HR: 1.52, 95% CI: 1.03-2.22, p = 0.033). No significant interaction was observed between lesion length and DES/DCBs (P = 0.460). CONCLUSION: DCBs were associated with a higher risk of DoCE compared to DES for treating de novo lesions, regardless of lesion length.
Reverse Crush Versus Culotte in Bifurcation Lesions After Provisional Stenting: Insights From the PROGRESS-BIFURCATION Registry.
Kladou E, Strepkos D, Carvalho PEP … +18 more , Alexandrou M, Kultursay B, Karagoz A, Krestyaninov O, Khelimskii D, Uluganyan M, Soylu K, Yildirim U, Kilickesmez KO, Cetinkal G, Sural S, Mastrodemos O, Rangan BV, Voudris K, Williford NN, Burke MN, Sandoval Y, Brilakis ES
Catheter Cardiovasc Interv · 2026 May · PMID 42204386 · Publisher ↗
BACKGROUND: Reverse crush and culotte are commonly used strategies in case of side branch (SB) compromise after main vessel (MV) stenting during provisional bifurcation percutaneous coronary intervention (PCI). AIM: The...
BACKGROUND: Reverse crush and culotte are commonly used strategies in case of side branch (SB) compromise after main vessel (MV) stenting during provisional bifurcation percutaneous coronary intervention (PCI). AIM: The aim of this study is to compare the technical and procedural outcomes and safety of reverse crush versus (vs.) culotte technique in cases of SB compromise following MV stenting during provisional bifurcation PCI. METHODS: We analyzed 43 PCIs (43 patients) with SB compromise after MV stenting during provisional strategy from the PROGRESS-BIFURCATION registry that were treated with reverse crush or culotte. RESULTS: Of 43 PCIs (43 patients) with SB compromise after MV stenting during the provisional strategy, 29 (67%) were treated with reverse crush and 14 (33%) with culotte. Reverse crush and culotte patients had similar baseline characteristics. Reverse crush was more likely to be used in the left anterior descending artery (LAD) and in smaller bifurcation angles (45° [37.50, 60.00] vs. 70° [45.00, 80.00], p = 0.017). Culotte was more frequently used in the left main coronary artery (LMCA). Reverse crush cases had smaller proximal (3.25 [3.00, 3.50] vs. 4.00 [3.00, 5.00] mm, p = 0.028) and distal (3.00 [2.50, 3.00] vs. 3.50 [3.00, 4.00] mm, p = 0.013) MV diameter, smaller SB diameter (2.50 [2.25, 2.50] vs. 3.00 [2.50, 3.50] mm, p < 0.001) and longer proximal MV (10.00 [5.00, 20.00] vs. 5.00 [0.00, 10.00] mm, p = 0.003) and SB (10.00 [8.00, 12.00] vs. 4.00 [0.00, 10.00] mm, p = 0.002) lesions. SB total occlusion was a more frequent trigger for escalation to a two-stent strategy in the reverse crush group compared with the culotte group (42.3% vs. 0.0%, p = 0.016). Patients treated with the reverse crush technique were less likely to require escalation to a third stenting strategy compared with those treated with culotte (4.0% vs. 21.4%, p = 0.04), but had longer procedural time (102.00 [77.00, 144.00] vs. 60.00 [45.00, 110.00] min), p = 0.012). There was no difference in technical (100% vs. 100%, p = 1.00), procedural (96.6% vs 100%, p = 1.00) success, periprocedural major adverse cardiac events (MACE) (3.4% vs. 0.0%, p = 1.00) or long-term MACE (HR 0.59, 95% CI 0.12-2.92, p = 0.50) between reverse crush and culotte cases. CONCLUSION: Most cases of SB compromise during provisional MV stenting were treated with reverse crush, but periprocedural and long-term outcomes were similar between reverse crush and culotte.
Radial Versus Femoral Access for Diagnostic Coronary Angiography: Insights From a Tertiary Academic Center in Johannesburg.
Ntaka KL, Mpanya D, Adamu UG … +2 more , Kalk T, Tsabedze N
Catheter Cardiovasc Interv · 2026 May · PMID 42200420 · Publisher ↗
BACKGROUND: The radial artery is the preferred access for performing diagnostic coronary angiograms (DCA). However, data on the safety and efficacy of radial compared to femoral access in low- and middle-income countries...
BACKGROUND: The radial artery is the preferred access for performing diagnostic coronary angiograms (DCA). However, data on the safety and efficacy of radial compared to femoral access in low- and middle-income countries is limited. AIMS: This study aims to evaluate the safety and efficacy of radial versus femoral access in patients referred for a DCA. METHODS: We conducted a cross-sectional, retrospective study on patients referred for DCA to evaluate the safety and efficacy of radial versus femoral access routes. RESULTS: The study population comprised 653 patients with a mean age of 58.2 ± 12.7 years, of which 408 (62.5%) were males. Radial access was utilized in 318 (48.7%) patients. The median duration of the radial access was 50 min (Interquartile range [IQR]: 40-60) and was longer than that of the femoral artery access, which had a median duration of 45 min (IQR: 35-60) (p = 0.010). The median total radiation dose emitted during the DCA in the femoral access group was 3511 milligray per square meter (mGy/m²), (IQR: 2154-5821), and patients in the radial access group received a median radiation dose of 4011 mGy/m² (IQR: 2298-6411) (p = 0.0661). The mean contrast volume administered in the radial and femoral artery access group did not differ significantly, measuring 83.7 ± 36.1 milliliters (mL) and 88.9 ± 37.1 mL, respectively (p = 0.073). CONCLUSIONS: Radial access was used in nearly half of all DCA, reflecting its growing adoption in clinical practice. These findings support the use of radial access as a safe and viable alternative to femoral access, even in resource-limited settings.
PCI for Ostial Stenosis of Left Circumflex or Left Anterior Descending Artery.
Güner EG, Güner A, Tanık VO … +40 more , Serin E, Markirt S, Erdoğan M, Deniz MF, Çalık AN, Asil S, Arslan E, Karaüzüm K, Kalkan S, Başkurt AA, Kara F, Çizgici AY, Gök SB, Çebi Ö, Şafak A, Gökçe K, Çiloğlu K, Doğan A, Sönmez O, Bedir FF, Gürdal A, Özanalp C, Tunca Ç, Akbuğa K, Öztürk A, Kırmızıgül M, Mirzamidinov D, Akman C, Durak F, Uslu E, Agüloglu S, Karaer E, Göksoylu G, Uygun İH, Yüksel UÇ, Aktürk İF, Keskin K, Şahin İ, Tolunay H, Uzun F
Catheter Cardiovasc Interv · 2026 May · PMID 42192216 · Publisher ↗
BACKGROUND: To date, the clinical outcome of ostial stent implantation (OSI) in patients with ostial left circumflex artery (LCX) or left anterior descending artery (LAD) lesions has not been well established. This study...
BACKGROUND: To date, the clinical outcome of ostial stent implantation (OSI) in patients with ostial left circumflex artery (LCX) or left anterior descending artery (LAD) lesions has not been well established. This study sought to assess the cardiovascular outcomes of the ostial stent implantation (OSI) for the ostial LAD or LCX lesions under long-term follow-up. METHODS: This large-scale, multicenter (n = 13) observational, retrospective study included 839 patients (men: 619 [73.8%], mean age: 61.36 ± 11.93 years) who underwent PCI with OSI for ostial LAD or LCX lesions between 2014 and 2025. The primary outcome was major adverse cardiac events (MACE), including cardiac death, target lesion revascularisation, and target vessel myocardial infarction. RESULTS: The study cohort was divided into two groups: ostial LAD (n = 590) and ostial LCX (n = 249) revascularized with OSI. SYNTAX scores and the utilization of intravascular imaging rates were similar in both groups. Total stent length (22.79 ± 7.37 vs. 24.60 ± 7.57 mm, p = 0.001) was notably lower in the LCX group; however, the rate of bailout 2-stent technique (6.4 vs. 2.7%, p = 0.010) was significantly higher in the LCX group than in the LAD group. The risk-adjusted long-term MACE (HR: 1.591, p = 0.010) significantly differed in individuals with left-sided ostial lesions to revascularize with OSI. Additionally, diabetes mellitus, chronic kidney disease, intravascular imaging, reduced left ventricle ejection fraction, high SYNTAX score, statin usage, and total stent length were found to be independent predictors of MACE. CONCLUSIONS: This multicenter study demonstrates that the location of ostial stenosis in LCX was associated with a higher risk-adjusted MACE rate at long-term follow-up.
Intravascular Imaging-Guided Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Unprotected Left Main Stenosis.
Wańha W, Kuźma Ł, Święczkowski M … +15 more , Dąbrowski E, Iwańczyk S, Lesiak M, Kowalewski M, Dobrzycki S, Kralisz P, Kowalówka A, Makhoul M, Morshed K, Wita K, Gocoł R, Hudziak D, Wojakowski W, De la Torre Hernández JM, Cortese B
Catheter Cardiovasc Interv · 2026 May · PMID 42187185 · Publisher ↗
BACKGROUND: Randomized clinical trials comparing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) stenosis have indicated lower repeat revasculariza...
BACKGROUND: Randomized clinical trials comparing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) stenosis have indicated lower repeat revascularization after CABG. AIM: This multi-center study aimed to investigate outcomes of intravascular imaging (IVI)-guided PCI compared with CABG for treating LMCA stenosis. METHODS: Analysis included 855 patients (396 PCI) from 18 centers. The primary composite endpoint was major adverse cardiac and cerebrovascular events (MACCE: cardiovascular death, myocardial infarction, stroke, and target vessel revascularization at 2 years). Propensity score matching (PSM) analysis was used to limit differences among the groups. Cox regression event rates were calculated for matched groups. RESULTS: In the overall cohort, no difference in MACCE was observed (HR 0.97, 95% CI 0.72-1.32, p = 0.84). PSM resulted in 230 pairs, with no significant differences in baseline, procedural characteristics, and SYNTAX score between the two groups. The matched cohorts had no significant differences for the primary endpoint (HR 0.85, 95% CI 0.65-1.43, p = 0.85). No differences for all-cause mortality rates between the two groups were found at 2 years (10% in the PCI and 11% in the CABG arm, p = 0.65). During follow-up, patients undergoing CABG had lower rates of myocardial infarction (8.7% vs. 14.8%, p = 0.04). More frequent stroke incidence was noticed (8.7% vs. 0%, p < 0.001). There was no significant difference in the incidence of target vessel revascularization between PCI and CABG (3.91% vs. 2.61%, p = 0.43). CONCLUSIONS: IVI-guided PCI for LMCA stenosis provides similar 2-year outcomes to CABG. Lower MACCE rates with PCI were observed in patients with lower anatomic complexity.
Novel Precise Ostial and Bifurcation Stenting Using a Guide Extension Catheter: The Ostial Stenting With Guide Extension Catheter Tip Technique.
Kurimoto S, Kishi K
Catheter Cardiovasc Interv · 2026 May · PMID 42179329 · Publisher ↗
Precise stenting of coronary ostial and bifurcation lesions remains technically challenging. A geographical miss can cause incomplete lesion coverage or excessive stent protrusion, compromising procedural outcomes. We de...
Precise stenting of coronary ostial and bifurcation lesions remains technically challenging. A geographical miss can cause incomplete lesion coverage or excessive stent protrusion, compromising procedural outcomes. We developed a novel, streamlined approach utilizing a guide extension catheter, termed the Ostial Stenting with Guide Extension catheter Tip (OS-GET) technique, to enhance precision in stent placement. The OS-GET technique employs the distal tip of a guide extension catheter as a stable fluoroscopic landmark to achieve precise alignment of the proximal stent marker with the true coronary ostium. Stabilization by the guide extension catherter mitigates stent migration during balloon expansion, facilitating optimal positioning. This technique is feasible with a 6-Fr guiding system and is compatible with all contemporary stent platforms and guide extension catheters, offering high procedural versatility. This technique was applied in three representative cases: (1) left anterior descending artery (LAD) ostial stenting, (2) left circumflex artery ostial stenting with heavy calcification following intravascular lithotripsy, and (3) mid-LAD stenting distal to a large diagonal branch. In all interventions, OS-GET enabled precise stent deployment with full lesion coverage and without protrusion into the left main trunk or adjacent branches. Final angiography confirmed Thrombolysis In Myocardial Infarction (TIMI) 3 flow, while intravascular ultrasound demonstrated optimal expansion and apposition. The OS-GET technique represents a practical, reproducible, and versatile strategy for precise stent placement in complex ostial and bifurcated lesions.
Intravascular Ultrasound in Chronic Limb-Threatening Ischemia Endovascular Revascularization: A Multidisciplinary Survey of Clinical Practices and Operator Perceptions.
d'Entremont MA, Secemsky EA, McClure GR … +13 more , Kowalik K, Drudi LM, Lemaire-Paquette S, Brown AD, Greco E, Benko A, Mirakhur A, Girsowicz E, Newman J, Misskey J, Bérubé S, Harlock J, Jolly SS
Catheter Cardiovasc Interv · 2026 May · PMID 42179149 · Publisher ↗
BACKGROUND: Intravascular ultrasound (IVUS) may be beneficial for guiding endovascular revascularization in patients with chronic limb-threatening ischemia (CLTI); however, its use remains limited. METHODS: We surveyed i...
BACKGROUND: Intravascular ultrasound (IVUS) may be beneficial for guiding endovascular revascularization in patients with chronic limb-threatening ischemia (CLTI); however, its use remains limited. METHODS: We surveyed interventional radiologists, vascular surgeons, and interventional cardiologists in the United States, Canada, and the United Kingdom using a 13-question, anonymous online questionnaire to evaluate clinical equipoise, willingness to randomize, and opinions and perceptions regarding IVUS use in patients with CLTI undergoing endovascular revascularization. RESULTS: A total of 105 operators (5.7% response rate) participated in the survey: 42 interventional radiologists, 40 vascular surgeons and 23 interventional cardiologists. Operators indicated the main obstacles to adopting or expanding IVUS for endovascular revascularization were cost or lack of reimbursement (69.5%), concerns about longer procedural time (47.6%), and the absence of randomized data supporting its benefit (39.0%). Overall, 80.0% of operators agreed that a large, multicenter, randomized trial was required, and 77.1% were willing to randomize patients in such a trial. CONCLUSION: In this multidisciplinary survey, the identified barriers for IVUS use in CLTI revascularization were cost/non-reimbursement, increased procedural time, and lack of randomized evidence. Given respondents' clinical equipoise and willingness to randomize, large randomized controlled trials are needed to inform clinical practice.
Low-Dose Colchicine for Secondary Prevention in Patients With Chronic Coronary Syndrome: A Multicenter Real-World Study.
Gürses E, Doğduş M, Uyan U … +7 more , Öz A, Javadova S, İlhan GND, Çabuk G, Sivri F, Zoghi M, Gül İ
Catheter Cardiovasc Interv · 2026 May · PMID 42171107 · Publisher ↗
AIMS: Chronic coronary syndrome (CCS) remains associated with recurrent ischemic symptoms and impaired quality of life despite contemporary guideline-directed medical therapy. Low-dose colchicine has demonstrated prognos...
AIMS: Chronic coronary syndrome (CCS) remains associated with recurrent ischemic symptoms and impaired quality of life despite contemporary guideline-directed medical therapy. Low-dose colchicine has demonstrated prognostic benefits in randomized trials; however, real-world data regarding its effects on functional capacity and angina-related outcomes are limited. METHODS: This multicenter, real-world observational study included 614 patients with CCS receiving low-dose colchicine therapy for secondary prevention. Functional capacity and angina-related quality of life were assessed before and after colchicine treatment using the Seattle Angina Questionnaire. Changes in daily physical activities, angina frequency, nitroglycerin use, treatment satisfaction, and Canadian Cardiovascular Society (CCS) angina class were evaluated. Clinical outcomes and tolerability, including hospitalization, revascularization, and gastrointestinal adverse effects, were also analyzed. A clinically meaningful improvement was defined as a ≥ 10-point increase in the composite Seattle Angina Questionnaire score. RESULTS: The mean age of the study population was 68.8 ± 11.5 years, and 70.5% of patients were male. Following colchicine therapy, significant improvements were observed in functional capacity, including walking on level ground, household activities, and carrying heavy objects (all p < 0.001). Angina frequency scores improved, accompanied by reduced nitroglycerin use (p < 0.001). Treatment satisfaction increased and limitations in enjoyment of life decreased significantly (p < 0.001). CCS angina class decreased from 2.61 ± 0.7 to 1.4 ± 0.62 (p < 0.001). A clinically meaningful improvement in SAQ score was observed in 78.7% of patients. During follow-up, hospitalization occurred in 9.0% of patients, revascularization in 4.4%, and gastrointestinal adverse effects were reported in 9.4%. CONCLUSIONS: In a multicenter real-world cohort of patients with chronic coronary syndrome, low-dose colchicine therapy was associated with significant improvements in functional capacity, angina severity, and quality of life, with an acceptable safety profile. The high rate of clinically meaningful patient-reported improvement further supports colchicine as an effective adjunctive therapy for secondary prevention and symptom control in routine clinical practice.
RETRACTION: 8 F Catheter Percutaneous Mechanical Thrombectomy Plus Anticoagulation Versus Anticoagulation Alone in Intermediate-High Risk Acute Pulmonary Embolism: A Multicenter Real-World Study on Long-Term Complications, Right Heart Function, and Quality of Life.
Catheter Cardiovasc Interv · 2026 Jul · PMID 42165667 · Publisher ↗
P. Yuan, S. Shen, F. Chen, R. Shi, F. Wang, X. Huang, T. Xue, J. Fu, F. Wang, C. Du, J. Zhu, J. Huang, and X. He, "8 F Catheter Percutaneous Mechanical Thrombectomy Plus Anticoagulation Versus Anticoagulation Alone in In...
P. Yuan, S. Shen, F. Chen, R. Shi, F. Wang, X. Huang, T. Xue, J. Fu, F. Wang, C. Du, J. Zhu, J. Huang, and X. He, "8 F Catheter Percutaneous Mechanical Thrombectomy Plus Anticoagulation Versus Anticoagulation Alone in Intermediate-High Risk Acute Pulmonary Embolism: A Multicenter Real-World Study on Long-Term Complications, Right Heart Function, and Quality of Life," Catheterization and Cardiovascular Interventions (2025): e70403, https://doi.org/10.1002/ccd.70403. The above article, published online on 07 December 2025 in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Robert J. Chilton; and Wiley Periodicals LLC. The retraction has been agreed, as the vast majority of references cited in the article were found to be untraceable or non‑existent, resulting in the article being inadequately supported by the literature. The authors submitted a request for a Correction to replace the reference list; however, as the required changes were deemed too extensive, the article has been retracted. The corresponding author Peng Yuan agreed with the retraction decision. No confirmation was obtained by the remaining co-authors.
The Impact of COVID-19 Infection and Vaccination on Myocarditis Incidence: A Comparative Analysis of Pre-, Peri-, and Post-Pandemic Eras.
Waksman O, Abusnina W, Case BC … +6 more , Cellamare M, Zhang C, Rappaport H, Sawant V, Thakkar Y, Waksman R
Catheter Cardiovasc Interv · 2026 May · PMID 42144794 · Publisher ↗
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic introduced a surge in cardiovascular complications, with myocarditis emerging as a concern due to both direct viral effects and rare vaccine-associated events....
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic introduced a surge in cardiovascular complications, with myocarditis emerging as a concern due to both direct viral effects and rare vaccine-associated events. AIMS: This analysis examines the incidence and outcomes of myocarditis in patients across a large healthcare system in the Washington, DC Metropolitan Area, focusing on periods before, during, and after the COVID-19 pandemic. METHODS: A retrospective cohort study was conducted using electronic health records from the MedStar Health System (2017-2024). Myocarditis cases were identified using ICD-10 codes, with cases stratified by pre- (2017-2019), peri- (2020-2022), and post-COVID-19 (2023-2024) pandemic periods, as well as by association with COVID-19 infection and/or vaccination. The overall incidence and inpatient mortality of myocarditis were compared over these eras. RESULTS: This study included 778 myocarditis patients admitted between January 2017 and December 2024, categorized into pre-COVID-19 (n = 207), peri-COVID-19 (n = 370), and post-COVID-19 (n = 201) periods. Total myocarditis incidence surged during the peri-pandemic period, peaking in 2022, and declined in 2023-2024. In the post-pandemic period, total myocarditis remained elevated and higher than in the pre-pandemic era. During the pandemic and post-pandemic periods, myocarditis patients were older, included a higher proportion of African American individuals, and had a greater burden of cardiometabolic comorbidities, compared to pre-pandemic myocarditis hospitalizations. CONCLUSION: This study demonstrates a marked increase in myocarditis cases during the COVID-19 pandemic, driven initially by a surge in COVID-19-related myocarditis. Notably, total myocarditis cases remained elevated in the post-pandemic period compared to pre-pandemic levels. These findings, particularly the increased post-pandemic myocarditis patients, warrant further investigation into underlying risk factors and long-term outcomes.
Prognostic Value of Computational Pressure-Flow Dynamics Derived FFR Measured Immediately After Successful Paclitaxel‑Coated Balloon Angioplasty for In-Stent Restenosis Lesion.
Yang W, He X, Liu J … +12 more , Mou F, Liu Y, Yin Z, Li F, Zhou J, Gao H, Hu T, van Geuns RJ, Onuma Y, Serruys PW, Gao C, Tao L
Catheter Cardiovasc Interv · 2026 May · PMID 42144725 · Publisher ↗
BACKGROUND: The clinical impact of angiography-based, computational pressure-flow dynamics derived FFR (caFFR) after paclitaxel‑coated balloon (DCB) angioplasty remains unclear. AIMS: To investigate the prognostic value...
BACKGROUND: The clinical impact of angiography-based, computational pressure-flow dynamics derived FFR (caFFR) after paclitaxel‑coated balloon (DCB) angioplasty remains unclear. AIMS: To investigate the prognostic value of post-procedural caFFR in the treatment of in-stent restenosis (ISR) with DCB. METHODS: Consecutive patients undergoing DCB angioplasty for ISR at Xijing Hospital, China, between December 2015 and December 2019 were prospectively enrolled. The primary endpoint was vessel-oriented composite endpoint (VoCE), defined as a composite of vessel-related cardiovascular death, target-vessel myocardial infarction (TV-MI), and ischemia-driven target vessel revascularization (ID-TVR) at 3-year, assessed at the vessel level. RESULTS: A total of 1055 vessels treated with DCB were screened, and the post-procedural caFFR was analyzable in 999 (94.7%). At 3-year, 149 VoCE (14.9%) and 98 ID-TVR (9.8%) events occurred. Maximally-selected log-rank statistics respectively identified post-procedural caFFR value of 0.87 and post-procedural %DS of 28 as the optimal cutoff points to predict VoCE. Post-procedural caFFR demonstrates the superior predictive ability for VoCE compared to post-procedural %DS (NRI: 7.4%, p < 0.001). A negative correlation was discerned between post-procedural caFFR value and VoCE (HR: 0.72, 95% CI: 0.53-0.98, p = 0.039). Post-procedural caFFR ≤ 0.87 group was associated with a 1.5-fold increase in the risk of VoCE (HR: 1.53, 95% CI: 1.02-2.29) and a 1.8-fold increase in ID-TVR (HR: 1.82, 95% CI: 1.15-2.89). CONCLUSIONS: A higher post-procedural caFFR value is associated with improved vessel-related clinical outcomes in patients of ISR treated by DCB. Achieving a post-procedural caFFR value of 0.87 in the treated vessels may represent a reasonable procedural goal. TRIAL REGISTRATION: Clinicaltrial.gov identifier: NCT05133921.
Renal Denervation in Cardiovascular Diseases: Mechanisms, Evidence, and Expanding Applications.
Awashra A, Neiroukh H, Alnatour L … +9 more , Jibril NS, AbuBaha M, Emara A, Shehadeh W, Zahran A, Elgendy MS, Shubietah A, Al-Shammari AS, Sattar Y
Catheter Cardiovasc Interv · 2026 May · PMID 42144689 · Publisher ↗
Renal denervation (RDN) is a minimally invasive technique that disrupts renal sympathetic nerve activity, reducing sympathetic overdrive implicated in hypertension and other cardiovascular disorders. After early enthusia...
Renal denervation (RDN) is a minimally invasive technique that disrupts renal sympathetic nerve activity, reducing sympathetic overdrive implicated in hypertension and other cardiovascular disorders. After early enthusiasm waned following SYMPLICITY HTN-3, subsequent rigorously designed trials re-established its efficacy. This review summarizes mechanistic insights, clinical evidence, and emerging applications of RDN. Data from randomized trials, meta-analyses, registries, and translational studies were evaluated to assess their safety, efficacy, and broader therapeutic potential. Recent trials (SPYRAL HTN-OFF MED, RADIANCE HTN-TRIO, RADIANCE II) show consistent and durable systolic blood pressure reductions of approximately 5-10 mmHg with excellent safety. Beyond resistant hypertension, preliminary studies suggest benefits in heart failure (HFrEF and HFpEF), atrial fibrillation when combined with pulmonary vein isolation, chronic kidney disease, and metabolic syndrome. Mechanistic data reveal improved autonomic balance, regression of left ventricular hypertrophy, and possible renal protection. Limitations include procedural variability, incomplete nerve ablation, and the lack of large outcome-based cardiovascular trials. Nevertheless, cost-effectiveness analyses and recent ESC (2024) and AHA/ACC (2025) guidelines endorse RDN as a reasonable adjunct for resistant or uncontrolled hypertension. RDN offers sustained blood pressure control with a strong safety profile. Its expanding role across cardiovascular conditions positions it as a promising adjunctive therapy. Future outcome-driven studies and standardized procedural approaches are needed to refine its place in clinical practice.
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