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FFR-Negative Nonculprit High-Risk Plaques and Clinical Outcomes in High-Risk Populations: An Individual Patient-Data Pooled Analysis From COMBINE (OCT-FFR) and PECTUS-obs.
Circ Cardiovasc Interv
January 2025
Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands (R.H.J.A.V., J.-Q.M., N.v.R.).
Background: Despite fractional flow reserve (FFR)-guided deferral of revascularization, recurrent events in patients with diabetes or after myocardial infarction remain common. This study aimed to assess the association between FFR-negative but high-risk nonculprit lesions and clinical outcomes.
Methods: This is a patient-level pooled analysis of the prospective natural-history COMBINE (OCT-FFR) study (Optical Coherence Tomography Morphologic and Fractional Flow Reserve Assessment in Diabetes Mellitus Patients) and PECTUS-obs study (Identification of Risk Factors for Acute Coronary Events by OCT After STEMI and NSTEMI Patients With Residual Non- Flow Limiting Lesions).
Thirty-day stroke/mortality of carotid revascularization in asymptomatic patients with newly diagnosed and/or decompensated heart failure exceeds the Society for Vascular Society guideline risks.
J Vasc Surg
January 2025
The George Washington University Hospital, Department of Surgery, Washington, D.C., USA.
Background: According to the latest Society for Vascular Surgery (SVS) guidelines, carotid revascularization for asymptomatic individuals should be offered if the perioperative stroke/death rate does not exceed 3%. Heart failure (HF) has been associated with reduced survival rates following carotid revascularization, which may significantly impact the risk-benefit decision of treating asymptomatic patients with HF. This study aimed to evaluate the 30-day postoperative risks in asymptomatic patients with newly diagnosed and/or decompensated HF undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS).
View Article and Find Full Text PDFIn the era of transition from fiction to reality: Robotic-assisted neurointervention-a systematic review and meta-analysis.
Neurosurg Rev
December 2024
Neurological Surgery, Thomas Jefferson University, Philadelphia, PA, US.
Objective: In recent years, the application of robotic assistance in diagnostic and therapeutic endovascular neurointerventional procedures has gained notable attention. In this systematic review and meta-analysis, we aim to evaluate the feasibility, safety, and current indications of robotic-assisted neurointerventions and to assess the degree of robotic assistance and reasons for unplanned manual conversion from robotic assistance.
Methods: We searched Medline, Scopus, Web of Science, and Cochrane Library databases following PRISMA guidelines and included studies with ≥ 4 patients reporting on robotic-assisted neurointerventions.
Comparing FFR-Guided Complete Revascularization and Conservative Management for Non-Culprit Lesions in STEMI Patients With Multivessel Disease: A Systematic Review and Meta-Analysis.
Catheter Cardiovasc Interv
December 2024
Department of Interventional Cardiology, Lancashire Cardiac Centre, Blackpool, UK.
Background: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease, the optimal management strategy for non-culprit lesions is a subject of ongoing debate. There has been an increasing use of physiology-guidance to assess the extent of occlusion in non-culprit lesions, and hence the need for stenting. Fractional flow reserve (FFR) is commonly used as a technique.
View Article and Find Full Text PDFStent Omission after Ureteroscopy and Lithotripsy (SOUL) in the Michigan Urological Surgery Improvement Collaborative (MUSIC): study protocol for a pragmatic prospective combined randomized and observational clinical trial.
Trials
December 2024
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Article Synopsis
- - Ureteral stents are commonly used after ureteroscopy to prevent complications from kidney stones, yet they can cause significant pain and urinary issues, which has led to calls for their omission in many cases.
- - Guidelines support not using stents in uncomplicated surgeries, but over 80% of procedures still involve them, partly due to insufficient evidence about their impact on pain and patient outcomes.
- - A new study is being conducted where patients randomly choose whether to have a stent or not, while those who refuse randomization will be observed based on the doctor's decision, aiming to gather real-world data on the effectiveness of stent omission.
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