[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).

Short term outcomes of Impella in cardiogenic shock: A review and meta-analysis of observational studies.

Introduction: The clinical impact of invasive hemodynamic support with Impella in patients with cardiogenic shock (CS) remains to be defined.

Method: Only studies including patients treated with Impella in CS were selected. The primary endpoint was short term mortality, while secondary endpoints were major vascular complications and major bleeding.

Cerebral protection in left atrial appendage closure in the presence of appendage thrombosis.

Background: Presence of thrombus in the left atrial appendage (LAA) remains a severe contraindication to the percutaneous left atrial appendage closure procedure (LAAC), due to increased embolic risk. Recently, the experience developed in cerebral protection device in transcatheter aortic valve implantation (TAVI) procedure was translated in LAAC to address this issue.

Aim: To evaluate efficacy and safety of Sentinel cerebral protection system (CPS) in supporting LAAC in real-world patient with persistent LAA thrombus.

[Retrieval of devices lost or entrapped during percutaneous coronary interventions].

Device loss or entrapment during percutaneous coronary interventions (PCI) is a rare circumstance whose incidence has decreased over time mainly because of device improvements. Nevertheless, they still represent fearful complications also and above all because the operators may be unfamiliar with rescue and retrieval techniques. The devices that most frequently experience loss or entrapment are stents, followed by angioplasty balloons, burrs for rotational atherectomy, guidewires and microcatheters.

Clinical impact of optical coherence tomography findings on culprit plaque in acute coronary syndrome: The OCT-FORMIDABLE study registry.

Background: Aim of this study was to evaluate the clinical impact of the culprit plaque features assessed by optical coherence tomography (OCT) in patients with acute coronary syndrome (ACS).

Methods: The OCT-FORMIDABLE register enrolled retrospectively all consecutive patients who perform OCT on culprit plaque in patients with ACS in nine European centres. The primary endpoint was the prevalence of culprit plaque rupture (CPR) in patients experiencing major adverse cardiovascular events (MACEs).

In-Hospital and 1-Year Outcomes of Rotational Atherectomy and Stent Implantation in Patients With Severely Calcified Unprotected Left Main Narrowings (from the Multicenter ROTATE Registry).

Heavily calcified unprotected left main (ULM) disease continues to be a challenging situation and represent a high-risk subset for interventional cardiologist. To date, there are limited data investigating the results after rotational atherectomy (RA) in this setting. The aim of this study was to investigate the in-hospital and 1-year outcomes after RA of heavily calcified ULM lesions.

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).

ROTational AThErectomy in acute coronary syndrome: early and midterm outcomes from a multicentre registry.

Aims: The safety and efficacy of rotational atherectomy (RA) in patients presenting with non-ST-elevation myocardial infarction (NSTE-ACS) remain to be defined. The aim of our study was to assess the safety and efficacy of RA in NSTE-ACS patients with reference to both short- and long-term follow-up.

Methods And Results: This was an observational retrospective registry which enrolled all consecutive patients undergoing RA, comparing patients with stable angina (SA) and NSTE-ACS.

In-hospital and midterm clinical outcomes of rotational atherectomy followed by stent implantation: the ROTATE multicentre registry.

Aims: The aim of this multicentre study was to investigate the in-hospital and midterm outcomes of rotational atherectomy (RA) followed by metallic stent implantation.

Methods And Results: Between 2002 and 2013, 1,176 de novo lesions with calcified coronary lesions treated by RA and metallic stent implantation at nine institutions were assessed. Patients with ST-segment elevation myocardial infarction (STEMI) within 30 days, cardiogenic shock before the procedure, lesions with thrombus, and in-stent restenosis were excluded from the current analysis.

Rotational atherectomy in very long lesions: Results for the ROTATE registry.

Background: Rotational atherectomy (RA) is relatively contraindicated in patients with lesions ≥25 mm of length. Aim of this study was to evaluate RA safety and efficacy in this subset of patients with new technology and devices.

Methods And Results: From April 2002 to August 2013, the ROTATE registry included all consecutive patients undergoing RA in 8 centres.

Planned versus provisional rotational atherectomy for severe calcified coronary lesions: Insights From the ROTATE multi-center registry.

Objectives: We aimed to investigate procedural feasibility and outcomes associated with planned rotational atherectomy (RA) for severely calcified coronary lesions.

Background: Limited data are available addressing the benefits of planned RA compared to provisional RA.

Methods: Between 2002 and 2013, all patients with calcified lesions treated by RA were enrolled.