Publications by authors named "Poletti E"

Article Synopsis
  • Heavily calcified coronary artery disease complicates percutaneous coronary intervention (PCI), requiring advanced techniques like cutting balloons (CB), which need standardization for better effectiveness.
  • The study presents the RODIN-CUT technique, which involves sequential CB inflations guided by intravascular ultrasound (IVUS) to improve plaque modification and stent expansion in difficult cases.
  • Results indicate that RODIN-CUT achieved high procedural success rates and minimal complications, suggesting it could be a simple and cost-effective method for treating calcified lesions, though larger studies are needed to confirm its validity.
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Veterans Health Administration (VHA) hospital libraries provide research to support and improve patient care and health outcomes. This report reviews and compares the results of a series of 6 studies conducted between 2010 and 2023 by Veterans Health Administration (VHA) hospital libraries to evaluate the information patrons received from their libraries in response to reference requests. The results found that the libraries' reference responses were relevant and timely and had a positive effect on patient care while saving staff time.

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Background: Distal trans-radial access (dTRA) for percutaneous coronary interventions (PCI) is increasingly gaining attention due to its potential to mitigate radial artery occlusion (RAO). However, a comprehensive understanding of the mechanical impact of the devices on the radial artery (RA) wall remains limited. Using a complete intravascular ultrasound (IVUS) evaluation of the RA, including also the vascular access site, we aimed to evaluate all the consequences related to the catheterization on the RA wall, starting from the vascular access, comparing conventional sheath and sheathless approaches.

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Background: Coronary chronic total occlusions (CTO) are associated with an increased chance of untreatable symptoms and worse prognosis. However, limited data are available about the interaction between treatment strategy, potential ischemia burden reduction and quality of life (QoL) improvement.

Methods: Our prospective registry aims to assess the potentially different impacts of treatment strategies (coronary artery bypass grafting vs.

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Article Synopsis
  • - The study compares the outcomes of different balloon-expandable (BE) transcatheter heart valve (THV) devices used to treat high-risk patients with severe pure native aortic valve regurgitation (NAVR), revealing suboptimal results with both device types.
  • - Out of 144 patients treated, those with the MyVal device had more frequent extra-large annuli, yet technical success rates were similar between MyVal (90%) and Sapien (81%).
  • - Overall, while BE devices might offer a treatment option for high-risk patients with NAVR, their effectiveness is limited and highlights the need for dedicated devices, as larger sizes might improve outcomes for traditionally unsuitable patients.
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Background: Severe pure aortic regurgitation (AR) carries a high mortality and morbidity risk, and it is often undertreated because of the inherent surgical risk. Transcatheter heart valves (THVs) have been used off-label in this setting with overall suboptimal results. The dedicated "purpose-built" Jena Valve Trilogy (JVT, JenaValve Technology) showed an encouraging performance, although it has never been compared to other THVs.

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Chronic total occlusions (CTOs) are frequent in patients with previous coronary artery bypass graft (CABG) surgery. Percutaneous coronary intervention (PCI) is the usual revascularization strategy. Whether or not the presence of a graft on a CTO vessel and post-PCI graft patency impacts outcomes after CTO-PCI is unknown.

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Article Synopsis
  • This study explores how the curvature and angulation of the aortic landing zone (LZ) can influence the depth of transcatheter aortic valve implantation (TAVI) using different types of devices: balloon-expanding (BE) and self-expanding (SE) valves.* -
  • Researchers found that SE devices exhibited greater LZ curvature and angulation characteristics compared to BE devices, affecting how deep the valves were implanted in patients.* -
  • The study concluded that greater LZ curvature (specifically at angles above 17.8°) was a reliable predictor of deeper implantation for SE devices, suggesting that device selection and anatomical factors need to be carefully considered during TAVI procedures.*
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Transcatheter aortic valve implantation (TAVI) is an established treatment strategy in aortic valve disease. Infolding, as a nonuniform expansion of the prosthesis leading to introflection of part of the device circumference, is a complication specific to self-expandable prostheses. The aim of the study is to determine incidence, predictors, treatment strategy, and outcomes of infolding during Medtronic Evolut TAVI (Minneapolis, MN, US).

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Article Synopsis
  • Coronary obstruction (CO) is a serious risk during transcatheter aortic valve replacement (TAVR), prompting the development of two techniques: chimney stenting and BASILICA, aimed at preventing CO.* -
  • This study compared the outcomes of these two methods in high-risk TAVR patients, finding that both techniques had similar rates of clinical success and periprocedural complications.* -
  • After one year, the rates of major adverse cardiovascular events were nearly identical between the chimney and BASILICA groups, although chimney stenting showed higher cardiovascular mortality, suggesting both methods are effective but may have different long-term risks.*
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Scant data exploring potential suboptimal physiological results after angiographic successful percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) are available. Sixty cases of successful CTO-PCI were selected for this retrospective analysis. Post-CTO-PCI angiography-based fractional flow reserve was computed using the Murray-based fractional flow reserve (μFR) software.

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Article Synopsis
  • The study assesses the effectiveness of self-expanding (SE) Evolut PRO/PRO+ versus balloon-expandable (BE) SAPIEN ULTRA valves in patients with small aortic annuli, using data from the OPERA-TAVI registry.
  • It finds that the 1-year primary effectiveness outcomes are similar for both valve types, but the SE group shows better results for 30-day device-related outcomes.
  • The SE valves have higher rates of disabling strokes and paravalvular leaks, while the BE valves exhibit more issues with prosthesis-patient mismatch and elevated residual mean gradients.
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Evidence regarding gender-related differences in response to transcatheter aortic valve implantation according to the valve type is lacking. This study aimed to evaluate the impact of gender on the treatment effect of Evolut PRO/PRO+ (PRO) or SAPIEN 3 Ultra (ULTRA) devices on clinical outcomes. The Comparative Analysis of Evolut PRO vs SAPIEN 3 Ultra Valves for Transfemoral Transcatheter Aortic Valve Implantation (OPERA-TAVI) is a multicenter, multinational registry including patients who underwent the latest-iteration PRO or ULTRA implantation.

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Background: The "Minimalistic Hybrid Approach" (MHA) has been proposed to reduce the invasiveness of chronic total occlusion (CTO) percutaneous coronary intervention (PCI).

Aims: This study aims to assess whether MHA may also reduce the utilization of PCI resources (devices, radiations, and contrast) by comparing it with other conventional algorithms.

Methods: We aimed to assess the impact of MHA on device, radiation, and contrast usage during CTO-PCI analyzing data from the Belgian Working Group on CTO (BWG-CTO) registry.

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The minimalistic hybrid approach (MHA) is a recently proposed algorithm to perform chronic total occlusion (CTO) percutaneous coronary intervention (PCI), reducing the overall invasiveness of the procedure without impacting the acute results. However, data on midterm results are lacking. This study aimed to evaluate the midterm clinical outcomes of a multicenter international cohort of CTO PCI treated according to the MHA.

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Article Synopsis
  • - The study compares 1-year clinical outcomes of TAVI patients using Evolut PRO/PRO+ and SAPIEN 3 Ultra devices, addressing a lack of midterm comparative analyses in current real-world practice.
  • - Using data from the OPERA-TAVI registry, 587 matched pairs of patients were analyzed, showing no significant difference in the primary endpoint (composite of death, disabling stroke, and rehospitalization), but higher rates of disabling stroke in the PRO group.
  • - Overall, while the clinical outcomes were similar between the two devices, patients receiving PRO experienced notably higher rates of disabling stroke, particularly within the first 30 days following the procedure.
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The presence of collateral channels providing distal blood supply is a distinctive characteristic of chronic total occlusion (CTO) lesions. However, data about the distinct baseline and procedural characteristics of each collateral subset are scarce. Accordingly, we sought to explore the procedural aspects specific for each collateral typology (ipsilateral collaterals [ICs], contralateral collaterals [CCs] or mixed) in CTO-percutaneous coronary intervention (PCI).

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Background: The trans-radial approach for cardiac catheterization led to an increasing adoption of 5 French (F) catheters. We aim to evaluate reliability and reproducibility of coronary physiology assessment performed with 5F guiding catheter (GC).

Methods: Physiological measurements were performed in a coronary flow simulator, which provides two pulsatile flows, the baseline and hyperaemic flows.

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Sewage sludge usage as agricultural soil amendment is a well-known practice employed worldwide. However, certain components may pose risks to the soil ecosystem. For a better verification of the potential adverse effects on the soil biota, biological assays have become an indispensable tool for an accurate understanding of the residue's behavior on soil, as well as its potential toxicity.

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Article Synopsis
  • Transcatheter aortic valve replacement (TAVR) for severe native aortic valve regurgitation has shown suboptimal outcomes, particularly with older valve technologies; this study evaluates newer devices.
  • The PANTHEON study analyzed 201 patients who received TAVR with both self-expanding and balloon-expandable valves, focusing on success rates and health outcomes after one year.
  • Results revealed that while technical success was high, issues like transcatheter valve embolization occurred in a significant number of cases, indicating that TAVR still poses challenges despite advancements in valve technology.
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The transradial approach (TRA) has become the primary choice for percutaneous coronary intervention (PCI); however, it may not be always feasible because of clinical and/or technical challenges. Alternative forearm accesses, such as transulnar approach (TUA) and distal radial approach (dTRA) may allow maintaining a wrist approach for the procedure, avoiding the femoral artery. This issue is particularly relevant in patients who underwent multiple revascularizations, such as those with chronic total occlusion (CTO) lesions.

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Left circumflex coronary artery (LCx) injury related to mitral valve surgery is a rare complication. The best treatment option is not defined, and percutaneous coronary intervention (PCI) may represent an effective treatment to avoid prolonged myocardial ischemia. To evaluate feasibility and efficacy of PCI treatment, all records of LCx injury related to mitral valve surgery and treated with PCI were included after a systematic PubMed searching.

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