Debating the REVIVED-BCIS2 trial; physiological assessments to predict haemodynamic outcomes; vessel location and iFR; laser intravascular lithotripsy; drug-coated balloon angioplasty in de novo lesions; phenotypes of extra-mitral valve cardiac involvement; THV deformation in mitral valve-in-valve procedures; the CAPTIS device for TAVI; and more

Davide Capodanno
This issue marks the conclusion of the third year since the current Editorial Board took charge of running EuroIntervention. While December is typically a month for reflections, an opportunity to look back at our past actions to improve the content and structure of the Journal, it’s more exciting to focus on the future and to share with you the numerous new developments in store for 2024.

The first, and perhaps most important, change is the publication frequency of EuroIntervention, which will now be released every two weeks. This represents a significant production effort, driven by the positive response from our readers. More frequent releases will allow us to publish accepted work faster, turning the Journal into both an information source and a scientific journal.

This transition coincides with another innovation: after several years, we’re discontinuing the publication of ahead-of-print articles as we know them today. While this may seem like a step back to some, it’s actually a strategy aimed at progress. Each new EuroIntervention issue will contain entirely new, unpublished content. In this way, we hope that the new electronic table of contents will engage and interest our readers more than ever before. We promise authors accepted by the Journal that this will not result in a significant delay in their publication time, because we have reached the point where our backlog optimisation strategy allows us to put in place this more efficient and more timely publication strategy. High-priority articles for the community and simultaneous publications will continue to be published ahead of print as their timeliness requires. By the way, I’m not even sure that “print” is still the correct term, as most of our content will be digital from now on. Big events like EuroPCR and the ESC Congress will remain the exception ofcourse, and for these events, we will continue to distribute our printed editions.

As my available space for this introduction is running out, and to make room for the customary description of this issue’s contents, I will leave you with some mysterious information to pique your interest, while not ruining the surprise: when you read the Journal in January, pay attention to both its content and its presentation. Also, don’t forget to explore the website in the near future, because the eye appreciates well-crafted articles along side their rigorous content, and graphics and layouts are definitely part of this game.

We are ready to take on this challenge and have you share in our evolution, but for now, let’s take a look at what lies ahead in the issue in hand.

After a viewpoint by Philippe E. Gaspard on the paradigm shift in catheter-based cardiovasculartherapies, we turn to a debate on whether or not patients with chronic heart failure with reduced ejection fraction, also known as ischaemic cardiomyopathy, should be revascularised. The authors on both sides of this issue’s debate turn to the results of the REVIVED-BCIS2 trial to probe the question. Divaka Perera reflects on the lack of durable improvement in quality of life after percutaneous coronary intervention (PCI) demonstrated in the study, and Cindy L. Grines and John Jeffrey Marshall find the limitations of the study sufficient to remain on the side of continuing to offer PCI in heart failure for patients with reduced ejection fraction.

In coronary interventions, Nozomi Kotoku, Patrick W. Serruys and colleagues examine the association between pathophysiology and plaque morphology, as derived by the hyperaemic pullback pressure gradient. Coronary artery disease with a physiologically diffuse pattern preprocedure was identified as an independent factor in predicting unfavourable haemodynamicoutcomes post-PCI. The authors discuss how comprehensive assessments, integrating intracoronary imaging and physiological patterns, can help to predict patient selectionand risk. Christos V. Bourantas and Nathan A.L. Yap contribute an accompanying editorial. In an effort to understand how vessel location impacts instantaneous wave-free ratio(iFR) measurement post-PCI, Mitsuaki Matsumura, Allen Jeremias and colleagues comparethe iFR in left anterior descending (LAD) compared to non-LAD arteries, pre- and post-PCI. LAD vessels had lower absolute post-PCI iFR values and larger residual in-stent pressuregradients, compared to the non-LAD vessels. Javier Escaned and Asad Shabbir provide a thoughtful take-home message from the study in an accompanying editorial.

In a translational research paper on coronary interventions, Aleksandra B. Gruslova, MarcD. Feldman and colleagues demonstrate the ability of laser intravascular lithotripsy (L-IVL)2 to fracture calcified plaques. The authors examine the limitations of electrical IVL and the possible ameliorations that laser IVL can offer. After validating L-IVL on phantoms simulating coronary artery calcification, they performed the same procedures on ex vivo calcified coronary arteries and present the results herein.

In a research correspondence, Pier Pasquale Leone, Antonio Colombo and colleagues examine the postprocedural and 6-month outcomes of drug-coated balloon angioplasty inpatients with de novo long lesions on large vessels. The advantages of DCB angioplasty –notably the direct delivery of the antiproliferative drug to the vessel wall, thus avoiding the implantation of metallic struts – have remained relatively unexplored in this patient population, and the authors find the safety and efficacy in these patients to be comparable topatients receiving shorter stents, paving the way for future studies. In an accompanying editorial, Nieves Gonzalo and Asad Shabbir examine the strengths and weaknesses of the study.

Turning towards interventions for valvular disease and heart failure, Antonio Popolo Rubbio, Francesco Bedogni and colleagues investigate the epidemiology and prognostic significance of different phenotypes of extra-mitral valve cardiac involvement in patients with primary mitral regurgitation referred for transcatheter edge-to-edge repair. The authors present a classification system, based on left- or right-heart criteria, that can help in risk stratification, procedural timing and patient management.

Miho Fukui, Vinayak N. Bapat and colleagues assess the extent and predictors of transcatheterheart valve (THV) deformation in mitral valve-in-valve procedures. Using computed tomography, patients were evaluated for THV deformation and hypoattenuating leaflet thickening after SAPIEN implantation. The authors found THV deformation to be common and that shallow implantation depths and oversizing may contribute to this phenomenon.

Haim D. Danenberg, Ran Kornowski and colleagues present their first-in-human safety and feasibility study on the CAPTIS cerebral embolic protection device, used during transcatheteraortic valve intervention (TAVI). CAPTIS is compatible with all commercial TAVI systems and is introduced via the same access routes used for the intervention, avoiding additional arterial access. Both deployment and retrieval were successful in all patients with a high number of debris particles retrieved of varying sources and sizes.

In peripheral interventions, Mazen S. Albaghdadi, Eric Secemsky and colleagues evaluate the in-hospital and post-discharge outcomes of patients undergoing peripheral vascular interventions with or without adjunctive atherectomy. Using a large, real-world population of patients with peripheral artery disease, their findings support the short- and long-termsafety of the procedure, and they found no association with an increase in procedure related in-hospital events. The use of atherectomy during peripheral vascular interventions was associated with a reduced risk of amputation and surgical revascularisation as well as an increased rate of endovascular reintervention at one year.

And now, we’ll let the articles speak for themselves.
Volume 19 Number 11
Dec 18, 2023
Volume 19 Number 11
View full issue

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