A preclinical study of combined hepatic and renal artery denervation.

Background: Overactivity of the hepatic and renal sympathetic nerves is associated with chronic cardiovascular and metabolic conditions, including hypertension.

Aims: We studied the effect of combined renal and hepatic denervation through treatment of the common hepatic artery and the renal arteries.

Methods: Denervation was performed in the common hepatic artery and both renal arteries and their major branch vessels in normotensive swine using the same multielectrode radiofrequency (RF) ablation catheter (Symplicity Spyral).

Impact of Socioeconomic Wealth on CLTI Revascularization Outcomes Among Medicare Patients from 2016 to 2023.

Background: Prompt revascularization is crucial for managing for chronic limb-threatening ischemia (CLTI), but disparities in socioeconomic status (SES) and healthcare access affect outcomes. The COVID-19 pandemic exacerbated these inequities, yet their impact on CLTI outcomes remains underexplored.

Objective: This study evaluated the association between regional SES, measured by the Distressed Communities Index (DCI), and outcomes-including mortality, major amputation, and repeat interventions-before, during, and after the COVID-19 pandemic in Medicare beneficiaries undergoing CLTI revascularization.

Adjunctive Imaging and Physiology During PCI Among Black and White Medicare Beneficiaries: Disparities in Utilization Patterns and Outcomes.

Background: Racial differences in the use and outcomes of intravascular imaging (IVI) and invasive physiology (IP) during percutaneous coronary intervention (PCI) are underreported in the United States.

Methods: Medicare fee-for-service claims data were used to examine the use and outcomes of IVI- and IP-guided PCI by Black versus White race (2016-2023). Multivariable logistic regression was used to assess the association between race and IVI/IP use.

Ticagrelor Paradox: Systematic Review and Network Meta-Analysis.

Background: Based on the landmark PLATO (Platelet Inhibition and Patient Outcomes) and TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction) trials, current guidelines recommend ticagrelor and prasugrel over clopidogrel for acute coronary syndrome. However, subsequent studies have failed to replicate the reported benefits of ticagrelor, raising concerns about the validity of the PLATO trial's findings.

Methods: Randomized trials published until January 2025 were searched on PubMed and Embase and included if they compared 2 of the 3 standard dual antiplatelet therapies: 12 months aspirin plus clopidogrel, prasugrel, or ticagrelor.

Renal Denervation in Hypertension and Chronic Heart Failure.

Renal denervation (RDN) is an interventional approach that targets the sympathetic nervous system with the goal of modulating its activity, an important contributor to the pathogenesis of many cardiovascular and metabolic diseases. Unlike pharmacologic therapies, RDN efficacy is independent of patient adherence to medications, which remains a major limiting factor in long-term blood pressure control. Initially developed to treat severe, treatment-resistant hypertension, RDN has demonstrated consistent results in recent sham-controlled trials across the spectrum of hypertension.

Intravascular Ultrasound Guided Puncture of Stumpless Tibial Occlusions.

This report describes a novel technique using intravascular ultrasound (IVUS) to guide revascularization of a stumpless posterior tibial artery occlusion in a patient with chronic limb-threatening ischemia. After failed attempts at both antegrade and retrograde access, IVUS was employed to identify and mark the exact location of the posterior tibial artery ostium. Using this guidance, successful wire cannulation was achieved, confirmed intraluminally with IVUS, followed by balloon angioplasty and restoration of brisk in-line flow through the posterior tibial and lateral plantar arteries.

Interplay of Race and Community Characteristics on Health Disparities Among Medicare Beneficiaries With Peripheral Artery Disease.

Research on disparities in peripheral artery disease (PAD) often examines factors individually. However, complex interactions between sex, race, and geography likely influence outcomes and treatment use. This study investigates the combined effects of race and community characteristics on outcomes and treatment utilization among Medicare beneficiaries with PAD.

Geographic variation in endovascular revascularization for chronic limb-threatening ischemia care among Medicare beneficiaries (2016-2023).

Objective: Chronic limb-threatening ischemia (CLTI), the most severe manifestation of peripheral artery disease, is associated with high risk of major amputation and mortality. Although timely revascularization is a cornerstone of CLTI management, disparities in access to care and outcomes persist across U.S.

Measuring Success in Renal Denervation: Response Parameters and Predictors of Response.

Renal denervation has recently emerged as a novel approach to improving blood pressure control, particularly in patients with uncontrolled or resistant hypertension. Although a substantial body of evidence has accumulated regarding the procedure's efficacy and safety, considerable variation exists across studies in the primary measures used to assess treatment response. The degree of response also differs widely among individuals, highlighting the importance of identifying factors associated with enhanced or limited responses to the procedure.

Renal denervation for managing hypertension: Key elements in selecting and referring patients.

Renal denervation (RDN) is an innovative procedure with regulatory approval for treating patients whose blood pressure remains uncontrolled despite lifestyle changes and the prescription of antihypertensive medications. It is important to consider how to create accessible patient referral pathways for this complementary therapy in the context of differing healthcare systems and the availability of appropriate resources. Today, most hypertensive patients are managed by primary care practitioners in the community.

Clinical and Angiographic Outcomes of a Novel Thin Strut Poly(L-lactide) Based Bioresorbable Vascular Scaffold in Below the Knee Arterial Disease: The RESOLV I First in Human Study.

Objective: This first in human study evaluated the six month angiographic and one year clinical outcomes of a novel thin strut, sirolimus eluting, resorbable scaffold for symptomatic below the knee peripheral arterial disease (PAD). RESOLV I is an international, prospective, multicentre, single arm study assessing the performance of the MAGNITUDE drug eluting resorbable scaffold (DRS) for the treatment of below the knee lesions in patients with symptomatic PAD.

Methods: Angiographic and duplex ultrasound evaluations were performed by independent core labs at baseline, post-DRS implantation, and at six months follow up.

Radial vs femoral access for percutaneous coronary intervention: temporal trends and outcomes in the USA.

Background And Aims: Radial access site for percutaneous coronary intervention (PCI) is recommended by clinical practice guidelines because of superior outcomes compared with femoral access site. Historically, the adoption of radial access site in the USA has lagged behind much of the rest of the world, but contemporary data on access site selection across the spectrum of clinical presentations and its association with outcomes are lacking.

Methods: A retrospective cohort study from the National Cardiovascular Data Registry's CathPCI Registry was conducted including PCIs performed between 1 January 2013 and 30 June 2022.

Inpatient Outcomes for Patients With Peripheral Artery Disease Hospitalized for Acute Myocardial Infarction.

Background: Patients with both peripheral artery disease (PAD) and coronary artery disease are at heightened risk for adverse cardiovascular outcomes. Although long-term risk has been well documented, contemporary in-hospital outcomes for patients with PAD presenting with acute myocardial infarction (AMI) are less well characterized.

Methods: We analyzed 493 740 AMI hospitalizations from 670 US sites in the NCDR (National Cardiovascular Data Registry) Chest Pain-MI Registry between January 2019 and March 2023.

Longitudinal outcomes of forearm versus upper arm arteriovenous fistulas.

Background: National guidelines recommend forearm arteriovenous fistulas (AVFs) over upper arm AVFs as the initial permanent vascular access for hemodialysis if consistent with the end-stage kidney disease (ESKD) Life-Plan, but comparative outcomes are underexplored. Our objective was to assess longitudinal outcomes of forearm vs upper arm AVFs in patients with advanced kidney disease.

Methods: Using multicenter data from three prospective studies (Hemodialysis Fistula Maturation [HFM] Study, PATENCY-1 [A Study of PRT-201 Administered Immediately After Radiocephalic Arteriovenous Fistula (AVF) Creation in Patients With Chronic Kidney Disease], and PATENCY-2), we conducted a cohort study of 1516 patients who underwent upper extremity AVF creation (2014-2019).

Exploring socioeconomic disparities in outcomes and follow-up after endovascular treatment of abdominal aortic aneurysms among Medicare beneficiaries.

Objective: Socioeconomic disparities are known to contribute to adverse outcomes after surgery; however, the role of individual wealth and neighborhood environment on both follow-up and outcomes following endovascular aneurysm repair (EVAR) are not well-understood.

Methods: We included all fee-for-service Medicare beneficiaries aged ≥66 years who underwent infrarenal EVAR with a bifurcated endograft for intact abdominal aortic aneurysm (AAA) from 2011 to 2019. Patients were divided into cohorts using dual enrollment in Medicare/Medicaid (vs Medicare only) as a measure of individual wealth and residence in a distressed community (vs non-distressed community) as a measure of regional wealth (as defined by the Distressed Community Index [DCI]).