Registro Español de Hemodinámica y Cardiología Intervencionista. XXIX Informe Oficial de la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (1990-2019)

Ojeda, Soledad; Romaguera, Rafael; Cruz-González, Ignacio; Moreno, Raúl

doi:10.1016/j.recesp.2020.07.024

Cited by 41 publications

(8 citation statements)

References 58 publications

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“…Finally, the study did not assess the incidence of other clinical endpoints, such as urgent revascularization or stent thrombosis. Nonetheless, since clinical features and complications incidence were similar to previous reports 4,[6][7][8][9]13,[17][18][19][20][21][22][23][24][25][26] we believe that these limitations might have not major influence on results validity.…”

Section: Ddta Score and Mt Outcomessupporting

confidence: 77%

“…21 Routine MT is no longer recommended by clinical guidelines 1,2 although it is still used in many procedures under physicians' criteria. 4,[6][7][8] MT was used less frequently in the validation cohort, in concordance with all clinical registries, 4,5,7,28 but the TIMI 3 after MT was similar in both cohorts what might reflect that it was accurately performed. We believe that our results might help decision making for the selection of patients that obtain the highest benefit from this technique.…”

Section: Ddta Score and Mt Outcomessupporting

confidence: 55%

“…based to operators criteria. [6][7][8][9][10] Under the premises of the unmet need of uniform and standardized tools for decision-making on MT, we designed a simple scale to estimate the probability of successful MT in P-PCI: the DDTA score. 11 The DDTA score is based on four accessible variables (dual antiplatelet treatment [DAPT] before the P-PCI, delay to P-PCI, TIMI flow improvement after wiring the lesion, and age > 55) and had a high-predictive capacity in the retrospective analysis of a single-center cohort.…”

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confidence: 99%

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Multicenter and all‐comers validation of a score to select patients for manual thrombectomy, the DDTA score

Cordero

Cid-Álvarez

Alegría

et al. 2021

Cathet Cardio Intervent

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Background: Routine manual thrombectomy (MT) is not recommended in primary percutaneous coronary intervention (P-PCI) but it is performed in many procedures.The objective of our study was validating the DDTA score, designed for selecting patients who benefit most from MT.Methods: Observational and multicenter study of all consecutive patients undergoing P-PCI in five institutions. Results were compared with the design cohort and the performance of the DDTA was analyzed in all patients. Primary end-point of the analyses was TIMI 3 after MT; secondary endpoints were final TIMI 3, no-reflow incidence, in-hospital mortality and in-hospital major cardiovascular events (MACE).In-hospital prognosis was assessed by the Zwolle risk score.Results: Three hundred forty patients were included in the validation cohort and no differences were observed as compared to the design cohort (618 patients) except for lower use of MT and higher IIb/IIIa inhibitors or drug-eluting stents. The probability of TIMI 3 after MT decreased as delay to P-PCI was higher. If DDTA score, MT was associated to TIMI 3 after MT (OR: 4.11) and final TIMI 3 (OR: 2.44). There was a linear and continuous relationship between DDTA score and all endpoints. DDTA score ≥ 4 was independently associated to lower no-reflow, in-hospital MACE or mortality. The lowest incidence of in-hospital mortality or MACE was in patients who had DDTA score ≥ 4 and Zwolle risk score 0-3.Conclusions: MT is associated to higher rate of final TIMI3 in patients with the DDTA score ≥ 4. Patients with DDTA score ≥ 4 had lower no-reflow and in-hospital complications.

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Section: Ddta Score and Mt Outcomessupporting

confidence: 77%

Section: Ddta Score and Mt Outcomessupporting

confidence: 55%

mentioning

confidence: 99%

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Multicenter and all‐comers validation of a score to select patients for manual thrombectomy, the DDTA score

Cordero

Cid-Álvarez

Alegría

et al. 2021

Cathet Cardio Intervent

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“…Physiology-based decision-making about the need for revascularization in patients with stable coronary heart disease has consistently proven better clinical outcomes than a merely anatomical approach [ 1 – 5 ]. Notwithstanding this compelling evidence, the penetration of physiology in real-world surveys is still scarce [ 6 – 10 ], although modestly increasing over time [ 11 ]. Against current guideline recommendations [ 12 ], the indication for revascularization in most patients with chronic coronary syndromes still relies on coronary angiography alone, without a proper functional assessment [ 6 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Agreement between Murray law-based quantitative flow ratio (μQFR) and three-dimensional quantitative flow ratio (3D-QFR) in non-selected angiographic stenosis: A multicenter study

et al. 2022

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Background The agreement between single-projection Murray-based quantitative flow ratio ( μ QFR) and conventional three-dimensional quantitative flow ratio (3D-QFR) has not been reported hitherto. Methods Patients from a multinational database were randomly selected for the study of agreement, according to sample size calculation. Both conventional 3D-QFR and μ QFR were analyzed for all available arteries at a central corelab by independent analysts, blinded to each other’s results. Results Ninety-eight coronary arteries from 35 patients were finally analyzed. Median 3D-QFR was 0.82 (interquartile range 0.78–0.87). The intraclass correlation coefficient for the absolute agreement between 3D-QFR and μ QFR was 0.996 (95% confidence interval [CI]: 0.993–0.997); Lin’s coefficient 0.996 (95% CI: 0.993–0.997), without constant or proportional bias (intercept = 0 and slope = 1 in orthogonal regression). As dichotomous variable, there was absolute agreement between μ QFR and 3D-QFR, resulting in no single false positive or negative. Kappa index was 1 and the diagnostic accuracy 100%. Conclusions μ QFR using a single angiographic projection showed almost perfect agreement with standard 3D-QFR. These results encourage the interchangeable use of μ QFR and 3D-QFR, which can be interesting to improve QFR feasibility in retrospective studies, wherein appropriate double angiographic projections might be challenging to obtain.

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“…Left atrial appendage closure (LAAC) is the second most commonly performed structural procedure in Spain [1], 921 interventions in 2019. Nonetheless, LAAC indication is far from reaching its true potential, and less than 5% of possible candidates in Europe or United States actually benefit from this therapy [2].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Different Procedural Approaches for Left Atrial Appendage Closure: Searching for Simplicity

Ruíz-Salmerón

Robles-Pérez

Ronquillo-Japón

et al. 2021

Journal of Interventional Cardiology

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Aim. To assess procedural and long-term efficacy and safety of two alternative methods for appendage closure, conscious sedation with standard transoesophageal echo and procedure guided by rotational angiography. Background. Demand for appendage closure is increasing, and a reasonable time-response should be given to nonvalvular atrial fibrillation patients not suitable to receive anticoagulation. General anesthesia and the need for an anesthesiologist are limiting factors to improve procedure availability; it is time to introduce simpler approaches. Methods. Single center experience in appendage closure during 9 years, using three different procedural approaches: general anesthesia with echo guidance, conscious sedation with echo guidance, and rotational angiography guidance. Conscious sedation and rotational angiography-guided procedures were performed in the absence of an anesthesiologist. Procedural characteristics and follow-up events were recorded. Results. 260 consecutive appendage closure procedures were reviewed: 155 were performed under general anesthesia (59.6%), 71 were performed with conscious sedation (27.3%), and 34 were rotational angiography guided (13.1%). Device success rate for procedures guided by rotational angiography was significantly lower than that for general anesthesia and conscious sedation (91.2% versus 100% versus 98.6%, p = 0.001 ) because there was a greater need to recapture and change device size. However, final procedural success was high and without difference between approaches (98.8% versus 97.2% versus 100%, for general anesthesia, conscious sedation, and rotational angiography, respectively); with a median follow-up of 17 months (CI 95% 13–23 month) (637.9 patients-year), there was no difference among approaches for thromboembolic (1.3 versus 1.8 versus 1.8) and major bleeding events (3.2 versus 2.8 versus 1.8), respectively. Conclusions. Appendage closure performed, either with conscious sedation with echo guidance or rotational angiography guided, is feasible, with no difference in procedural success and follow-up events compared with general anesthesia and without the limitation of the need for an anesthesiologist on-site.

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Registro Español de Hemodinámica y Cardiología Intervencionista. XXIX Informe Oficial de la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (1990-2019)

Cited by 41 publications

References 58 publications

Multicenter and all‐comers validation of a score to select patients for manual thrombectomy, the DDTA score

Multicenter and all‐comers validation of a score to select patients for manual thrombectomy, the DDTA score

Agreement between Murray law-based quantitative flow ratio (μQFR) and three-dimensional quantitative flow ratio (3D-QFR) in non-selected angiographic stenosis: A multicenter study

Comparison of Different Procedural Approaches for Left Atrial Appendage Closure: Searching for Simplicity

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