Clinical Outcomes of Ezetimibe Plus Statins in Patients With Lower Extremity Artery Disease.

Background: The beneficial outcomes of ezetimibe plus statin therapy are well-established in coronary artery disease, but these remain unknown in lower extremity artery disease (LEAD).

Objectives: This study evaluated the efficacy of an intensified lipid-lowering strategy involving ezetimibe plus statins vs statin monotherapy for reducing major adverse limb events and mortality in patients with LEAD.

Methods: This retrospective analysis included patients aged ≥18 years diagnosed with LEAD from the TriNetX global health care database from 2013 to 2022, excluding those with recent acute coronary syndrome or stroke.

High levels of pericoronary adipose tissue inflammation are associated with coronary atherosclerosis independent of epicardial adipose tissue volume in patients with chronic coronary syndrome.

Aims: This study aimed to assess clinical risks and coronary atherosclerotic burden in patients with chronic coronary syndrome (CCS) stratified by pericoronary artery adipose tissue (PCAT) composition and epicardial adipose tissue volume (EAV).

Methods And Results: We retrospectively included 410 CCS patients who underwent coronary computed tomography angiography. Patients were divided into four groups based on an EAV index ≥ 73.

Risk stratification of net adverse clinical events using CHADS-PARC and CHADS scores in chronic coronary syndrome patients without atrial fibrillation: Insights from the CLIDAS-PCI.

Background: There are few data verifying the utility of the CHADS-PARC score in comparison with the CHADS score for estimating net adverse clinical events (NACE) in chronic coronary syndrome (CCS) patients without atrial fibrillation (AF) in real-world settings.

Methods: We performed analysis for a total of 3985 CCS patients without AF who underwent percutaneous coronary intervention (PCI) between April 2013 and March 2019 for whom information was obtained from the CLIDAS (Clinical Deep Data Accumulation System)-PCI database. The primary endpoint was NACE defined as the composite of 3-point major adverse cardiovascular events (3P-MACE) (cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke) and GUSTO moderate/severe bleeding events.

Endovascular Skirt Reconstruction of Aortoiliac Bifurcation Using Bare-nitinol Stents: ESCORT Technique.

BackgroundEndovascular treatment for aortoiliac occlusive disease (AIOD) is still challenging. We propose a stent deployment technique for AIOD using only bare-nitinol stents (BNSs) in a form that is ultimately similar to the normal aortoiliac bifurcation structure.Methods and case seriesThe Endovascular Skirt reCOnstruction of aoRToiliac bifurcation using bare-nitinol stents (ESCORT) technique involves primary implantation of a large BNS, with its distal edge being placed just at the edge of the carina by mounting onto 2 pull-through guidewires from the side of an upper extremity followed by V-stenting using BNSs into the pre-implanted BNS at the terminal aorta.

Plaque morphological changes after drug-coated balloon angioplasty according to underlying plaque components.

A 52-year-old man with a short chronic total occlusion in the left superficial femoral artery underwent drug-coated balloon (DCB) angioplasty. Evaluation using integrated backscatter intravascular ultrasound revealed that the plaque volume of fibrosis was compressed just after treatment (from 494.67 mm to 398.

Intravascular ultrasound-derived virtual fractional flow reserve in the superficial femoral artery.

Background: Fractional flow reserve (FFR) can be estimated by analysis of intravascular imaging in a coronary artery; however, there are no data for estimated FFR in an extremity artery. The aim of this concept-generating study was to determine whether it is possible to estimate the value of peripheral FFR (PFFR) by intravascular ultrasound (IVUS) analysis also in femoropopliteal artery lesions.

Methods: Between April 2022 and February 2023, PFFR was measured before endovascular therapy in 31 stenotic femoropopliteal artery lesions.

Impact of acute coronary syndrome on early in-stent neoatherosclerosis as shown by optical coherence tomography.

Background: Patients with acute coronary syndrome (ACS) have a higher risk of requiring target vessel revascularisation after percutaneous coronary intervention (PCI) than patients with stable angina. Neoatherosclerosis is a significant risk factor for very late stent thrombosis, and the presence of neoatherosclerosis is independently associated with major adverse cardiac events.

Aims: In this study, we used optical coherence tomography (OCT) to investigate the impact of ACS on neoatherosclerosis within 1 year after PCI.

Neurological prognosis prediction upon arrival at the hospital after out-of-hospital cardiac arrest: R-EDByUS score.

Aim: To develop a new scoring model for patients with cardiogenic out-of-hospital cardiac arrest (OHCA) to facilitate neurological prognosis prediction upon hospital arrival by using prehospital resuscitation features alone.

Methods: Between 2005 and 2019, we enrolled 942,891 adult patients with OHCA of presumed cardiac aetiology from the All-Japan Utstein Registry. Scoring models applied prehospital resuscitation features a priori from the variables the American College of Cardiology algorithm including age, duration to return of spontaneous circulation (ROSC) or hospital arrival, no bystander cardiopulmonary resuscitation (CPR), unwitnessed arrest, and nonshockable rhythm (R-EDByUS score) to predict unfavorable neurological outcomes defined as Cerebral Performance Category 3, 4, or 5 at 1 month.

Impact of post-procedural peripheral fractional flow reserve after drug-coated balloon angioplasty in femoropopliteal lesions.

Purpose: The aim of this study was to determine if postprocedural peripheral fractional flow reserve (pFFR) is associated with patency one year after drug-coated balloon (DCB) angioplasty for femoropopliteal (FP) lesions.

Materials And Methods: Forty-five consecutive patients having 49 de novo FP lesions were enrolled in this prospective, observational study conducted from April 2022 to Aug 2023. The pFFR was measured under hyperemic conditions after the administration of 30 mg of papaverine.

Utility and optimal dose of nicorandil for physiological assessment of the femoropopliteal artery.

Background: Nicorandil is widely used as a vasodilator for the physiological assessment of coronary arteries because of its usefulness and safety; however, there are no data on its use in peripheral arteries.

Aims: To identify the utility of nicorandil and its appropriate dose for the physiological assessment on the femoropopliteal artery.

Methods: We retrospectively enrolled patients from three institutes in which physiological assessment was carried out with various doses of nicorandil before treatment.

Predicting residual pressure gradients after balloon angioplasty in patients with femoropopliteal artery lesions.

In endovascular therapy (EVT) for femoropopliteal artery (FPA) lesions, studies examining the relationship between lesion morphology and hemodynamic status are limited. The purpose of this study was to investigate FPA lesion characteristics, including imaging findings and their cutoff values that can predict hemodynamic significance after balloon angioplasty. This single-center retrospective study enrolled 50 de novo FPA lesions from 43 patients treated under intravascular ultrasound (IVUS) usage between June 2022 and March 2023.

Tissue responses to everolimus-eluting stents implanted in severely calcified lesions following atherectomy.

Histopathological examination has revealed that stents on severely calcified plaques were associated with delayed vascular healing. Although atherectomy devices can increase the number of malapposed struts, tissue responses to implanted drug eluting stents in atherectomy patients remain largely unknown. This retrospective observational study included 30 patients who underwent atherectomy and everolimus-eluting stent (EES) deployment for severely calcified coronary lesions (biodegradable polymer EES (BP-EES), n = 15; durable polymer EES (DP-EES), n  = 15).

Correlation between physiological assessment and imaging findings during drug-coated balloon treatment for femoropopliteal diseases.

Background: This prospective cross-sectional study evaluated the correlation between physiological assessment (PA) and minimum lumen area (MLA) by intravascular ultrasound (IVUS) during drug-coated balloon (DCB) treatment for femoropopliteal (FP) diseases.

Methods: A total of 51 limbs of 44 patients undergoing endovascular treatment with DCB for de novo FP disease were examined from April 2022 to February 2023. PA was conducted at baseline, after balloon dilatation, and after DCB treatment.

Gastrointestinal and Intracranial Bleeding Events After Second-Generation Drug-Eluting Stent Implantation - Their Association With High Bleeding Risk, Predictors, and Clinical Outcomes.

Background: Gastrointestinal bleeding (GIB) and intracranial bleeding (ICB) are frequently observed as major bleeding events after percutaneous coronary intervention (PCI); however, there are few reports on these predictors and their association with the Academic Research Consortium for High Bleeding Risk (ARC-HBR).

Methods and results: The study included 3,453 patients who underwent PCI with second-generation drug-eluting stents between 2010 and 2013. Mean follow up was 2,663±596 days.

Delayed stenosis regression after drug-coated balloon angioplasty for femoropopliteal artery lesions.

Paclitaxel has the potential for inducing lumen enlargement by vessel enlargement, healing of dissection, and plaque regression. This study was carried out to determine the possibility of and the relevant factors of delayed stenosis regression after drug-coated balloon (DCB) angioplasty for femoropopliteal (FP) artery lesions. A total 105 de novo FP lesions were finalized with DCB angioplasty in our institute between May 2018 and June 2020.

Incidence, predictors, and clinical outcomes of mechanical circulatory support-related complications in patients with cardiogenic shock.

Background: Mechanical circulatory support (MCS) is essential to maintain the hemodynamics in selected patients with cardiogenic shock (CS). However, little is known about predictors and clinical impact of device-related complications on clinical outcomes in patients with MCS.

Methods: We retrospectively reviewed consecutive 477 patients who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO), Impella (Abiomed, Danvers, MA, USA), and intra-aortic balloon pump (IABP) from January 2012 to May 2020.

Outcomes at 1 Year of Non-Left Main Trunk Bifurcation Lesions Treated With a 2-Stent Strategy Using Newer-Generation Everolimus-Eluting Stents.

Background: Percutaneous coronary intervention (PCI) for coronary bifurcation lesions using the 2-stent strategy remains a challenging procedure for interventionalists because of the higher incidence of in-stent restenosis (ISR) and adverse events. ISR predictors in patients treated with newer-generation everolimus-eluting stents (EES) and the 2-stent strategy remain unknown. Hence, we aimed to evaluate the 1-year clinical and angiographic outcomes of non-left main trunk (LMT) bifurcation lesions treated with the 2-stent strategy using newer-generation EES.