• Issue

    Catheterization and Cardiovascular Interventions: Volume 98, Issue 7

    i-vii, 1211-1415, E977-E1065
    December 1, 2021

ISSUE INFORMATION – COPYRIGHT

Free Access

Issue Information – Copyright

  • Page: i
  • First Published: 01 December 2021

ISSUE INFORMATION – EDITORIAL BOARD

Free Access

Issue Information – Editorial Board

  • Page: ii
  • First Published: 01 December 2021

ISSUE INFORMATION – TOC

Free Access

Issue Information – TOC

  • Pages: iv-vii
  • First Published: 01 December 2021

CORONARY ARTERY DISEASE

EDITORIAL COMMENT

Tobacco and Venus may reduce man to ashes, even when Bacchus is on vacation

  • Pages: 1221-1222
  • First Published: 01 December 2021
Key Points

  • Mortality after spontaneous coronary artery dissection (SCAD) is low, and it is related to baseline cardiovascular risk factors as smoking and sex rather than management strategies.
  • Helping post-SCAD patients to quit smoking and a greater awareness of the possible occurrence of SCAD in men may improve outcomes.
  • Wider studies systematically reporting in-hospital and long-term mortality after SCAD will enhance our knowledge on this heterogeneous clinical entity.

EDITORIAL COMMENT

Surgical turndowns are not no option patients

  • Pages: 1230-1231
  • First Published: December 1, 2021
Key Points

  • Patients with extensive, high-risk coronary artery disease (CAD) deemed surgically ineligible who undergo elective percutaneous coronary intervention (PCI) have better than predicted surgical 30-day outcomes.
  • Risk factors predicting 1-year PCI outcomes include frailty and STS score.
  • Future trials are needed to best assess acceptable risk profiles for PCI in surgical turndowns as well as the impact of procedural characteristics such as completeness of revascularization, hemodynamic support, and image-guided stenting on late outcomes.

EDITORIAL COMMENT

Everything is outpatient these days: The new economics of sophisticated cardiovascular care

  • Page: 1240
  • First Published: December 1, 2021
Key Points

  • Same-day discharge (SDD) after percutaneous coronary intervention (PCI) is associated with reduced cost and increased patient satisfaction.
  • This study demonstrates the safety of SDD after uncomplicated chronic total occlusion PCI via the forearm approach.

EDITORIAL COMMENT

Debulking uncrossable lesions with excimer laser: The interplay between device performance and limitations

  • Pages: 1250-1251
  • First Published: December 1, 2021
Key Points

  • Excimer laser successfully debulks atherosclerotic plaques, noteworthy lesions that fail to yield (uncrossable) to standard tools.
  • Severe calcifications serve as an independent predictor of laser failure to recanalize uncrossable lesions, whereby other debulking technologies may better succeed.
  • Q-T prolongation during lasing represents dynamic ischemia caused either by impaired flow or distal spasm, leading to development of severe arrhythmias, thus, proper lasing techniques remain essential.

EDITORIAL COMMENT

Left main coronary revascularization strategies in the COVID-19 era

  • Pages: 1262-1263
  • First Published: 01 December 2021
Key Points

  • In a UK national analysis of a contemporary procedural cohort, the authors demonstrated that left main (LM) revascularization has significantly declined during the initial wave period of COVID-19, with a clear shift towards PCI as the preferred revascularization strategy.
  • Adjusted in-hospital and 30-day mortality within each revascularization group was similar in the pre-COVID and COVID periods, reflecting a maintenance in quality of short-term outcomes following LM revascularization.
  • More data are required to explain this phenomenon and to explore the long-term outcomes and temporal trands data.

EDITORIAL COMMENT

Risk prediction in cardiogenic shock

  • Pages: 1285-1286
  • First Published: 01 December 2021
Key Points

  • A new ACS-MCS risk score incorporating age, lactate, acute kidney injury, and SCAI Shock class predicts 30-day mortality in patients receiving short-term mechanical circulatory support for cardiogenic shock complicating acute coronary syndromes.
  • This study illustrates that shock severity, as defined by SCAI Shock class, is one of multiple key factors influencing mortality in cardiogenic shock.
  • Age and end-organ injury are important mediators of cardiogenic shock outcomes.

EDITORIAL COMMENT

Predicting mortality after percutaneous coronary intervention: The need for improved risk models

  • Pages: 1298-1299
  • First Published: December 1, 2021
Key Points

  • In the contemporary era of personalized medicine, accurate risk assessment following percutaneous coronary intervention (PCI) is important for patient selection and to guide the shared decision-making process by patients and interventional cardiologists.
  • The updated clinical logistic SYNTAX score incorporates the following five additional independent predictors into the risk model: history of lung disease, prior stroke, current smoking, hemoglobin level, and white blood cell count.
  • Compared with the old model, the updated clinical logistic SYNTAX score has improved discriminative ability for predicting 2-year mortality after PCI.

EDITORIAL COMMENT

You are only as old as you feel? It may depend on your score

  • Page: 1308
  • First Published: December 1, 2021
Key Points

  • Getting old makes you think more.
  • Hopefully those caring for you when you are old, will think more, too.
  • The preceding report gives a background for what parameters should be weighed prior to possible intervention in an elderly patient.

EDITORIAL COMMENT

When and how to close vessels in the cardiac catheterization laboratory

  • Pages: 1332-1334
  • First Published: December 1, 2021
Key Points

  • Coil embolization can be used to occlude various vessels and structures in the cardiac catheterization laboratory, such as coronary artery fistulas, left internal mammary artery side branches, coronary artery perforations, and coronary artery aneurysms and pseudoaneurysms.
  • Coiling can be achieved with high success and low complication rates.
  • Since coiling is performed infrequently in the cardiac catheterization laboratory, stocking an appropriate, limited selection of 0.014 inch detachable coils and learning how to deliver and deploy them can literally be a “life saver”!

PERIPHERAL VASCULAR DISEASE

EDITORIAL COMMENT

Do we have an ideal bleeding prediction scoring system yet?

  • Pages: 1373-1374
  • First Published: 01 December 2021
Key Points

  • Major bleeding is a frequent periprocedural complication of peripheral vascular interventions.
  • An integer scoring system can be used to stratify patients according to their bleeding risk.
  • Use of risk prediction scores may improve outcomes in PVI procedures; however, further studies are needed.

CORONARY ARTERY DISEASE

EDITORIAL COMMENT

Outflow graft obstruction in patients with left ventricular assist devices: Stenting the kink

  • Pages: 1391-1392
  • First Published: 01 December 2021
Key Points

  • Outflow graft obstruction (OGO) is a feared complication in patients with left ventricular assist devices.
  • It can be caused by graft kinking or twisting, external compression, or internal material deposition.
  • The best endovascular approach for treating this complication is not well established.
  • The authors report their institutional experience treating OGO in patients with HeartMate 3 devices, describing a straightforward approach that appears safe and feasible for a large proportion of patients.

VALVULAR AND STRUCTURAL HEART DISEASES

EDITORIAL COMMENT

Prediction of left circumflex artery impingement after indirect mitral annuloplasty with the carillon device: “There is more to this than meets the eye!”

  • Pages: 1402-1403
  • First Published: 01 December 2021
Key Points

  • CT angiography prior to indirect mitral annuloplasty with the Carillon device may provide useful information for prediction of left circumflex artery (LCX) impingement.
  • Application of coronary sinus to LCX distance, as a predictor of LCX impingement, needs further validation.
  • Future studies should examine anatomic predictors of LCX impingement within well-defined pathophysiological subsets of patients with functional mitral regurgitation.

EDITORIAL COMMENT

Transcatheter edge-to-edge mitral valve repair: Should we stay tied to COAPT tiers?

  • Pages: 1413-1414
  • First Published: 01 December 2021
Key Points

  • What the article teaches. Patients with secondary mitral regurgitation (SMR) undergoing transcatheter edge-to-edge mitral valve repair (TEER) have different prognosis based on eligibility criteria in the COAPT trial and on different echocardiographic tiers for enrollment in the same trial.
  • How it will impact practice. Patient selection for TEER should be based on an integrative approach rather than on a single parameter, and largely guided by the COAPT trial enrollment criteria.
  • What new research/study would help answer the question posed. Further studies are needed to clearly identify patients subgroups that could benefit from TEER and, within them, to identify parameters that may help stratifying patients with different outcomes.

VALVULAR AND STRUCTURAL HEART DISEASES

ORIGINAL STUDIES