Rotational Atherectomy With or Without Intravascular Lithotripsy for Patients With Heavy Coronary Artery Calcification.

Recent advances in calcium debulking technologies may contribute to development of new percutaneous coronary intervention (PCI) paradigms for patients with heavy coronary artery calcification (CAC). Comparative data on safety and clinical efficacy of a combination strategy including rotational atherectomy (RA) and intravascular lithotripsy (IVL) is lacking. The aim of the study was to determine the addional effect of IVL when performed after RA in patients with heavy CAC.

Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage: The Global Burden of Disease Study 2021.

Importance: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure.

Objective: To estimate the worldwide burden of SAH.

Leaflet modification techniques to mitigate coronary obstruction risk during transcatheter aortic valve implantation.

Coronary obstruction is a rare but serious complication during transcatheter aortic valve implantation (TAVI), particularly in valve-in-valve procedures, which is associated with high mortality. This review explores various leaflet modification techniques designed to mitigate this risk. Among the most studied methods is Bioprosthetic or native Aortic Scallop Intentional Laceration to prevent Iatrogenic Coronary Artery obstruction (BASILICA), which uses transcatheter electrosurgery to lacerate the aortic valve leaflet and maintain coronary perfusion.

Percutaneous Coronary Intervention Outcomes by 5 Major Race and Ethnic Subgroups.

Background: Racial and ethnic disparities in cardiovascular disease outcomes, including percutaneous coronary intervention (PCI), are well-documented. However, studies do not stratify certain subgroups, such as separating South Asian and East Asian patients, who exhibit varying burdens of cardiovascular disease and PCI outcomes. Additionally, socioeconomic status (SES) further complicates outcomes, with low SES serving as an independent predictor of adverse outcomes post-PCI.

Long-term clinical outcomes of intravascular brachytherapy for multilayer drug-eluting in-stent restenosis.

Background: Multilayer in-stent restenosis (ISR) remains a clinical challenge. Intravascular brachytherapy (IVBT) offers a "metal-free" treatment modality for multilayer drug-eluting stent (DES)-ISR; however, long-term outcome data on IVBT safety and efficacy are lacking.

Aims: We sought to compare 3-year clinical outcomes between patients treated with IVBT and those treated with a non-IVBT strategy.

Development of a Novel BifurcAID Risk Score to Predict MACE Following Coronary True Bifurcation Intervention.

Background: Percutaneous coronary intervention (PCI) for true bifurcation lesions is associated with a higher risk of adverse clinical events.

Objectives: This study sought to establish a point-based score using clinical and angiographic characteristics in true bifurcation lesions before PCI to predict the risk of major adverse cardiovascular events (MACE).

Methods: A total of 1,896 consecutive patients undergoing PCI for true bifurcation lesions between 2012 and 2019 in our institution were included.

Treatment of Additional Vessels During Percutaneous Coronary Intervention for Unprotected Left Main Disease: Insights From a Large Prospective Registry.

Percutaneous coronary intervention (PCI) is an established alternative to coronary artery bypass grafting for the treatment of select patients with unprotected left main (LM) coronary artery disease (CAD). This study evaluates the safety and clinical impact of treating additional coronary arteries during LM-PCI. Consecutive patients undergoing PCI with drug-eluting stents for unprotected LM-CAD between 2010 and 2021 at The Mount Sinai Hospital, New York, USA were eligible for inclusion.

Drug-Coated Balloons for the Treatment of Coronary Artery Disease: A Review.

Importance: Drug-coated balloon (DCB) angioplasty has emerged as an alternative to drug-eluting stent (DES) implantation for percutaneous coronary intervention (PCI) in patients with coronary in-stent restenosis (ISR) as well as de novo coronary artery disease.

Observations: DCBs are balloons coated with antiproliferative agents and excipients, whose aim is to foster favorable vessel healing after appropriate lesion preparation. By providing homogeneous antiproliferative drug delivery in the absence of permanent foreign body implantation, DCBs offer multiple advantages over DES, including preservation of vessel anatomy and function and positive vessel remodeling.

Comprehensive Optical Coherence Tomography-Guided RotaTripsy for Massive Coronary Calcified Nodule: A Decision-Making Approach.

Objectives: We aim to describe the step-by-step optical coherence tomography-guided rotational atherectomy and intravascular lithotripsy for treating substantial coronary calcified nodules.

Key Steps: These include initial rotational atherectomy with a 1.5-mm burr, multiple optical coherence tomography imaging studies to assess lesion morphology, upsizing the rotational burr to 2.

Contrast-Induced Encephalopathy Following Transcatheter Aortic Valve Replacement: A Case Series.

Contrast-induced encephalopathy (CIE) is an idiopathic reaction following iodine-contrast dye administration in patients undergoing angiographic procedures. While it has been well-documented following coronary and carotid interventions, literature on CIE following transcatheter aortic valve replacement is limited. We report the multidisciplinary management of 3 patients with CIE following transcatheter aortic valve replacement.

Chunky Mitral Annular Calcification: Caseoma or a Tumor?

Mitral annular calcification (MAC) is relatively common in clinical practice. Females are more often affected than males. Patients with end-stage renal disease have MAC relatively more commonly than the general population.

Redo-TAVR Feasibility After SAPIEN 3 Stratified by Implant Depth and Commissural Alignment: A CT Simulation Study.

Background: Redo-transcatheter aortic valve replacement (TAVR) can pin the index transcatheter heart valve leaflets open leading to sinus sequestration and restricting coronary access. The impact of initial implant depth and commissural alignment on redo-TAVR feasibility is unclear. We sought to determine the feasibility of redo-TAVR and coronary access after SAPIEN 3 (S3) TAVR stratified by implant depth and commissural alignment.

Commissural vs Coronary Alignment to Avoid Coronary Overlap With THV-Commissure in TAVR: A CT-Simulation Study.

Background: Coronary alignment is proposed as an alternative to commissural alignment for reducing coronary overlap during transcatheter aortic valve replacement (TAVR). However, largescale studies are lacking.

Objectives: This study aimed to determine the incidence of coronary overlap with commissural vs coronary alignment using computed tomography (CT) simulation in patients undergoing TAVR evaluation.

Impact of diabetes mellitus on clinical outcomes after first episode in-stent restenosis PCI: Results from a large registry.

Background: Diabetes mellitus (DM) is associated with a high rate of major adverse cardiac events (MACE) after de novo coronary artery percutaneous coronary intervention (PCI). Whether patients with DM undergoing PCI for in-stent restenosis (ISR) experience a similar heightened risk of MACE is not known. Hence, we sought to compare the clinical outcomes of patients with and without DM undergoing PCI for ISR.

Impact of Bleeding Risk and Inflammation on Cardiovascular Outcomes After Percutaneous Coronary Intervention.

Background: Markers of systemic inflammation, such as high-sensitivity C-reactive protein (hsCRP), have been associated with the occurrence of major adverse cardiovascular and cerebrovascular events (MACCE) in patients undergoing percutaneous coronary intervention (PCI). Whether this risk varies according to the presence of high bleeding risk (HBR) conditions is unclear.

Objectives: The aim of this study was to evaluate the impact of systemic inflammation, as measured by hsCRP levels and cardiovascular outcomes in patients stratified by HBR status following PCI.

Transcatheter Aortic Valve Replacement: Current Status and Future Indications.

In the past two decades, transcatheter aortic valve replacement (TAVR) has transformed the management of aortic stenosis and has become the standard of care regardless of surgical risk levels. Advances in transcatheter valve design across newer generations, improved imaging, greater operator expertise, and technical enhancements have collectively contributed to increased safety and a decline in procedural complications over this timeframe. The application of TAVR has progressively expanded to include younger patients with lower risks, who have longer life expectancies.

The Evaluation and Management of Coronary Artery Disease in the Lung Transplant Patient.

Lung transplantation can greatly improve quality of life and extend survival in those with end-stage lung disease. In order to derive the maximal benefit from such a procedure, patients must be carefully selected and be otherwise healthy enough to survive a high-risk surgery and sometimes prolonged immunosuppressive therapy following surgery. Patients therefore must be critically assessed prior to being listed for transplantation with close attention paid towards assessment of cardiovascular health and operative risk.