Prognostic significance of angiography-derived index of microcirculatory resistance assessment after rotational atherectomy in patients with severely calcified lesions.

Coronary microcirculatory dysfunction (CMD) is a known predictor of adverse outcomes after percutaneous coronary intervention (PCI). However, the prognostic significance of CMD in patients with severely calcified lesions treated with rotational atherectomy (RA) remains unclear. We retrospectively studied consecutive chronic coronary syndrome patients who underwent PCI with RA followed by second-generation drug-eluting stent (DES) implantation.

Prognostic Utility of Nodular Calcification Detected on Non-Contrast Computed Tomography in Severely Calcified Coronary Lesions.

Background: Nodular calcification (NC) detected via intracoronary imaging is associated with adverse cardiovascular events after percutaneous coronary intervention (PCI). However, the impact of NC detected on pre-PCI non-contrast computed tomography (CT) on clinical outcomes has not been fully investigated.

Methods And Results: We retrospectively included 267 consecutive patients with chronic coronary syndrome who underwent electrocardiography-gated non-contrast CT before PCI for severely calcified lesions.

Impact of pericoronary adipose tissue attenuation on clinical outcomes after percutaneous coronary intervention.

Background: Pericoronary adipose tissue (PCAT) attenuation, measured using coronary computed tomography angiography (cCTA), is a potential marker of coronary inflammation.

Aims: We aimed to examine the association between coronary inflammation, as assessed by measuring PCAT attenuation before percutaneous coronary intervention (PCI), and clinical outcomes of PCI using current-generation drug-eluting stents (DES).

Methods: We retrospectively studied consecutive patients who underwent cCTA before PCI with current-generation DES.

Enhanced Plaque Stabilization Effects of Alirocumab - Insights From Artificial Intelligence-Aided Optical Coherence Tomography Analysis of the Alirocumab for Thin-Cap Fibroatheroma in Patients With Coronary Artery Disease Estimated by Optical Coherence Tomography (ALTAIR) Study.

Background: Proprotein convertase subtilisin/kexin type 9 inhibitors stabilize vulnerable plaque, reducing cardiovascular events. However, manual optical coherence tomography (OCT) analysis of drug efficacy is challenging because of signal attenuation within lipid plaques.

Methods And Results: Twenty-four patients with thin-cap fibroatheroma were prospectively enrolled and randomized to receive alirocumab (75 mg every 2 weeks) plus rosuvastatin (10 mg/day) or rosuvastatin (10 mg/day) alone.

Effectiveness of directional coronary atherectomy in treating recurrent in-stent restenosis: a case report.

Background: In-stent restenosis (ISR) remains a significant clinical problem. It is estimated that 10-20% of patients who develop a first event of ISR will develop recurrent ISR (R-ISR). However, the pathology of R-ISR remains largely unknown, and recommendations for its optimal management are lacking.

Impact of morphofunctional assessment with quantitative flow ratio and optical coherence tomography in patients with acute coronary syndromes.

Background: Combining morphological and physiological evaluations might improve the risk stratification of patients who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) culprit lesions.

Aims: We aimed to investigate the clinical utility of morphofunctional evaluation after PCI for identifying ACS patients with increased risk of subsequent clinical events.

Methods: We retrospectively studied 298 consecutive ACS patients who had undergone optical coherence tomography (OCT)-guided PCI.

Impact of Pericoronary Adipose Tissue Attenuation on Periprocedural Myocardial Injury in Patients With Chronic Coronary Syndrome.

Background: Perivascular inflammation contributes to the development of atherosclerosis and microcirculatory dysfunction. Pericoronary adipose tissue (PCAT) attenuation, measured by coronary computed tomography angiography, is a potential indicator of coronary inflammation. However, the relationship between PCAT attenuation, microcirculatory dysfunction, and periprocedural myocardial injury (PMI) remains unclear.

Diagnostic Accuracy of Pre-Transcatheter Aortic Valve Replacement Nitroglycerin-Free Fractional Flow Reserve-Computed Tomography-Based Physiological Assessment in Patients With Severe Aortic Stenosis for Predicting Post-Transcatheter Aortic Valve Replacement Ischemia.

Background: Fractional flow reserve-computed tomography (FFR) has not been validated in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) for coronary artery disease due to theoretical difficulties in using nitroglycerin for such patients.

Methods and results: In this single-center study, we prospectively enrolled 21 patients (34 vessels) and performed pre-TAVR FFRwithout nitroglycerin, pre-TAVR invasive instantaneous wave-free ratio (iFR) measurements, and post-TAVR FFR measurements using a pressure wire. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of pre-TAVR FFR≤0.

Clinical impact of optical coherence tomography findings after drug-coated balloon treatment for patients with acute coronary syndromes.

Background: Drug-coated balloon (DCB) became a potential treatment option for patients with acute coronary syndrome (ACS); however, factors associated with target lesion failure (TLF) remain uncertain.

Methods: This retrospective, multicentre, observational study included consecutive ACS patients who underwent optical coherence tomography (OCT)-guided DCB treatment. Patients were divided into two groups according to the occurrence of TLF, a composite of cardiac death, target vessel-related myocardial infarction, and ischemia-driven target lesion revascularisation.

Prediction of the debulking effect of rotational atherectomy using optical frequency domain imaging: a prospective study.

This study determined the predictive accuracy of optical frequency domain imaging (OFDI) on debulking effects of rotational atherectomy (RA) and compared the predictive accuracy of OFDI catheter-based with Rota wire-based prediction methods. This prospective, single-center, observational study included 55 consecutive patients who underwent OFDI-guided RA. On pre-RA OFDI images, a circle, identical to the Rota burr was drawn at the center of the OFDI catheter (OFDI catheter-based prediction method) or wire (wire-based prediction method).

Efficacy of Complex Fractionated Atrial Electrogram-Guided Extensive Encircling Pulmonary Vein Isolation for Persistent Atrial Fibrillation.

In persistent AF, the effect of adjunctive ablation in addition to PV isolation (PVI) is controversial. We considered a new modified PVI including complex fractionated atrial electrogram (CFAE) area. In 57 patients with persistent AF undergoing first ablation, CFAE were mapped before ablation and CFAE-guided extensive encircling PVI (CFAE-guided EEPVI) was performed.