Interaction Between Guiding-Extension Catheter and Drug-Eluting Stents: Always Safe or Sometimes Harmful?

Background: Guiding-extension catheters (GECs) provide enhanced support to guiding catheter (GC) during complex percutaneous coronary intervention (PCI). However, by reducing the inner cross-sectional diameter, they can create high friction between the GEC and the drug-eluting stents (DES), potentially causing abrasion and damage to the abluminal struts.

Aim: This study aims to compare the performances of the Amphilimus Cre8 EVO polymer-free DES with all the other surface-coated DES.

Sex-specific disparities in clinical characteristics and outcomes of catheter-directed treatments for acute pulmonary embolism.

Background: Acute pulmonary embolism (PE) represents a cardiovascular emergency with increasing incidence. Catheter-directed treatments (CDTs) are increasingly used for high-risk or intermediate-high-risk PE patients when surgical embolectomy or systemic thrombolysis (ST) is contraindicated or ineffective. Although prior research suggests poorer outcomes in women with PE, sex-specific differences in CDTs outcomes remain unclear.

Mechanical external compression devices to manage bleeding during mechanical circulatory support with Impella CP.

Background: In recent years, there has been a significant increase in the use of mechanical circulatory support devices, including the Impella device (Abiomed, Danvers, MA, USA), as hemodynamic support during high-risk percutaneous coronary intervention (PCI) and in acute management of cardiogenic shock.

Results: In this case series, we present two patients with non-ST-elevation myocardial infarction complicated by cardiogenic shock treated with Impella CP-protected PCI. After the revascularization, for both patients, a clinically relevant, access-site bleeding occurred, challenging the Impella CP maintenance.

SGLT2 inhibitors across the acute cardiac care spectrum: insights and perspectives.

This review examines the evolving role of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in acute cardiac care. Originally developed as antidiabetic agents, SGLT2i have demonstrated significant and early benefits in chronic heart failure by reducing hospitalizations and cardiovascular mortality across all the ejection fraction spectrum. Recent evidence now suggests that these agents may also offer advantages in acute settings, including acute decompensated heart failure (ADHF) and post - acute myocardial infarction (AMI).

Cerebral Protection Devices in Case of Left Sided Intracardiac Thrombus: A Multicentre Experience From the Cath Lab and EP Lab.

Background: Performing a left atrial appendage occlusion (LAAO) or catheter ablation with left-sided intracardiac thrombus is considered very-high risk for periinterventional stroke. Cerebral embolic protection (CEP) devices are designed to prevent cardioembolic stroke and have been widely studied in TAVR procedures. However, their role in LAAO and catheter ablation of ventricular tachycardia (VT) or in pulmonary vein isolation (PVI) with cardiac thrombus present remains unknown.

[Italian Society of Interventional Cardiology (SICI-GISE) Position paper: Integrated management and transcatheter interventions for acute pulmonary embolism].

Pulmonary embolism (PE) is commonly treated primarily with pharmacological therapy, while advanced reperfusion therapies (transcatheter or surgical) are considered only in cases of contraindications or failure of standard therapies. Treatment algorithms vary depending on the patient's risk, with patients at intermediate or high risk potentially requiring evaluation for such advanced reperfusion therapies. Critical scenarios, such as contraindications to systemic thrombolysis or failure of pharmacological protocols, necessitate the activation of a multidisciplinary pulmonary embolism response team (PERT) and prompt therapeutic escalation.

[Percutaneous treatment of intermediate- and high-risk pulmonary embolism: two case reports].

Pulmonary embolism is the third most common cause of cardiovascular emergency. Risk stratification is crucial in the clinical and therapeutic management of these patients. The latest European guidelines introduced a new classification based on short-term mortality risk stratification, dividing patients into four categories (high, intermediate-high, intermediate-low and low risk).

Everolimus-eluting bioresorbable vascular scaffolds for treatment of complex chronic total occlusions.

Aims: Bioresorbable vascular scaffolds (BVS) represent a novel therapeutic option for the treatment of coronary artery diseases. The objective of this study was to evaluate the feasibility of BVS implantation in complex chronic total occlusions (CTO).

Methods And Results: The present report is a multicentre registry evaluating results after BVS deployment in challenging CTO lesions, defined as J-CTO score ≥2 (difficult or very difficult).