Original Research

DOI: 10.4244/EIJ-D-24-00933

Outcomes of complex, high-risk percutaneous coronary intervention in patients with severe aortic stenosis: the ASCoP registry

Claudio Montalto1,2, MD; Andrea R. Munafò1, MD; Francesco Soriano1, MD; Ketina Arslani3,4, MD; Stephanie Brunner5, MD; Sarah Verhemel6, MD; Ottavia Cozzi7, MD; Antonio Mangieri7, MD; Andrea Buono8, MD; Mattia Squillace9, MD; Stefano Nava1, MD; José Luis Díez Gil10, MD; Andrea Scotti11, MD; Marco Foroni12, MD; Giuseppe Esposito1, MD, PhD; Alessandro Mandurino-Mirizzi13, MD; David Bauer14, MD; Benjamin De Ornelas8, MD; Pablo Codner15, MD; Kerstin Piayda16, MD; Italo Porto17, MD, PhD; Federico De Marco18, MD, PhD; Horst Sievert16, MD; Ran Kornowski15, MD; Petr Tousek14, MD; Dionigi Fischetti13, MD; Azeem Latib11, MD; Jorge Sanz Sanchez10, MD; Diego Maffeo8, MD; Francesco Bedogni9, MD; Bernhard Reimers7, MD; Damiano Regazzoli7, MD; Nicolas Van Mieghem6, MD, PhD; Lars Sondergaard19, MD; Francesco Saia12, MD; Stefan Toggweiler5, MD; Ole De Backer3,20, MD, PhD; Jacopo A. Oreglia1, MD

Abstract

Background: There is a lack of evidence to guide treatment of patients with a concomitant indication for transcatheter aortic valve implantation (TAVI) and complex, high-risk percutaneous coronary intervention (PCI).

Aims: We aimed to assess different strategies of PCI timing in this high-risk TAVI cohort.

Methods: The ASCoP registry retrospectively included patients with a clinical indication for both TAVI and PCI with at least 1 criterion of complex or high-risk PCI. The primary endpoint was a composite of all-cause death and unplanned rehospitalisation for cardiovascular causes. The secondary endpoint was a composite of all-cause death, stroke, acute myocardial infarction, major bleeding, major vascular complication and unplanned revascularisation. Multivariable analysis was used to adjust for possible confounders.

Results: A total of 519 patients were included: 363 (69.9%) underwent staged procedures and 156 (30.1%) concomitant TAVI and PCI. After 441 (interquartile range 182-824) days, the primary endpoint occurred in 151 (36.5%) cases, without any significant difference between the 2 groups (p=0.98), while the secondary endpoint occurred more frequently in the concomitant group (n=36 [25.8%] vs n=57 [17.4%]; p=0.014).

Conclusions: In patients undergoing TAVI and complex/high-risk PCI, a concomitant strategy is associated with a higher rate of adverse events and increased procedural risk. (ClinicalTrials.gov: NCT05750927)

Sign in to read
the full article

Forgot your password?
No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Volume 21 Number 8
Apr 21, 2025
Volume 21 Number 8
View full issue


Key metrics

Suggested by Cory

Editorial

10.4244/EIJ-E-25-00011 Apr 21, 2025
Transcatheter aortic valve implantation with complex, high-risk indicated PCI
Patterson T and McDonaugh B
free

10.4244/EIJV10SUA10 Sep 27, 2014
Coronary artery disease in patients undergoing TAVI: why, what, when and how to treat
Stefanini G et al
free

Debate

10.4244/EIJ-E-24-00054 Nov 18, 2024
TAVI patients with bystander coronary artery disease should receive PCI: pros and cons
Rodés-Cabau J et al
free

10.4244/EIJV14I11A209 Dec 7, 2018
PCI in TAVI patients: who, why and when?
Patterson T et al
free

Debate

10.4244/EIJ-E-22-00038 Nov 18, 2022
PCI of bystander coronary artery lesions should be performed before TAVI: pros and cons
Amat-Santos I et al
free
Trending articles
166.7

Expert review

10.4244/EIJ-D-21-00690 May 15, 2022
Crush techniques for percutaneous coronary intervention of bifurcation lesions
Moroni F et al
free
92.45

State-of-the-Art Review

10.4244/EIJ-D-20-01296 Aug 27, 2021
Management of cardiogenic shock
Thiele H et al
free
72.95

State-of-the-Art

10.4244/EIJ-D-24-00386 Feb 3, 2025
Mechanical circulatory support for complex, high-risk percutaneous coronary intervention
Ferro E et al
free
60.55

State-of-the-Art

10.4244/EIJ-D-24-00066 Apr 21, 2025
Management of complications after valvular interventions
Bansal A et al
free
58.3

Clinical research

10.4244/EIJ-D-23-00344 Sep 18, 2023
Clinical outcomes of TAVI with the Myval balloon-expandable valve for non-calcified aortic regurgitation
Sanchez-Luna JP et al
free
33.9

CLINICAL RESEARCH

10.4244/EIJ-D-17-00381 Oct 11, 2017
Stent malapposition and the risk of stent thrombosis: mechanistic insights from an in vitro model
Foin N et al
free
33.65

State-of-the-Art

10.4244/EIJ-D-23-00606 Jan 1, 2024
Targeting inflammation in atherosclerosis: overview, strategy and directions
Waksman R et al
free
26

Expert Review

10.4244/EIJ-D-24-00535 May 5, 2025
Catheter-based techniques for pulmonary embolism treatment
Costa F et al
X

The Official Journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

EuroPCR EAPCI
PCR ESC
Impact factor: 7.6
2023 Journal Citation Reports®
Science Edition (Clarivate Analytics, 2024)
Online ISSN 1969-6213 - Print ISSN 1774-024X
© 2005-2025 Europa Group - All rights reserved