雷珠单抗玻璃体内注射治疗视网膜分支静脉阻塞相关黄斑水肿的临床疗效分析

目的 分析雷珠单抗玻璃体内注射(intravitreal ranibizumab,IVR)治疗视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)相关黄斑水肿(macular edema,ME)的疗效及安全性。方法 回顾性分析2017-05～2019-05该院因BRVO继发ME并接受IVR治疗的66例患者资料。根据荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查结果将研究对象分为缺血性BRVO组(无灌注面积≥5个视盘面积,20例)和非缺血性BRVO组(无灌注面积5个视盘面积,46例)。两组均采用3+prore nata(PRN) IVR方案进行治疗。比较两组治疗后1、3、6个月的最佳矫正视力(best-corrected visual acuity,BCVA)、黄斑中心凹视网膜厚度(central macular thickness,CMT),以及两组IVR注射次数和并发症发生情况。结果 治疗后两组BCVA均得到改善,与同组治疗前比较差异均有统计学意义(P 0. 05)。但两组治疗后1、3、6个月的BCVA水平比较差异均无统计学意义(P 0. 05)。治疗后两组CMT均呈下降趋势,与同组治疗前比较差异均有统计学意义(P 0. 05)。但两组治疗后1、3、6个月的CMT水平比较差异均无统计学意义(P 0. 05)。非缺血性BRVO组和缺血性BRVO组分别行IVR注射(4. 17±0. 93)次和(4. 45±0. 69)次,差异无统计学意义(P0. 05)。两组均未发生IVR相关的眼部或非眼部并发症。结论 采用3+PRN IVR方案治疗BRVO相关ME安全有效。     

玻璃体切割术治疗视网膜静脉阻塞的临床研究

目的 分析行玻璃体切割术的视网膜静脉阻塞(RVO)患者的发病因素、术后并发症和影响预后的因素.方法 观察143例(146眼)RVO患者,分别记录患者一般情况及术前、术后眼部及全身表现.结果 根据静脉阻塞部位的不同,颞上支67眼,占45.9%.既往单纯高血压病史患者90例,占62.9%.就诊前发病时间0～3个月58眼,术中需剥膜14眼,比例最低.3～6个月21眼,摘除白内障者5眼,视网膜裂孔7眼,比例最高.14眼术前存在视网膜脱离,均可见增殖条索,其中10眼可见裂孔或裂隙.术后发生高眼压31眼,术后72小时内21眼,其中14眼填充C3F8混合气体.硅油填充的6眼2周内均未见眼压增高.23例术后玻璃体积血复发,相应治疗后随访均未再次复发.4例视网膜脱离复发,3例经二次手术后,术后恢复尚可.另1例患者放弃治疗.中央静脉阻塞患者术前视力与术后视力差异没有统计学意义(P＞0.05),半侧分支静脉阻塞及BRVO患者术前视力与术后视力差异有统计学意义(P＜0.05).结论 预防和控制高血压可以有效预防RVO,发生玻璃体积血后手术时机和方法的选择十分重要.     

视网膜分支和中央静脉阻塞的激光治疗

视网膜分支和中央静脉阻塞是老年人常见的眼底血管病变。这两种病变的并发症黄斑水肿和眼的新生血管均可严重影响患者视力减退,而此种并发症可用激光凝固治疗。本文介绍此种光凝的一般原则和方法。     

Nd:YAG倍频激光治疗视网膜静脉阻塞新生血管27例报告

视网膜新生血管 (NV)是视网膜静脉阻塞的晚期并发症 ,其反复的玻璃体积血可严重影响视力 ,甚至导致失明。1999～2 0 0 2年 ,我院采用 Nd:YAG倍频激光对本病患者进行光凝治疗 ,取得较好疗效 ,现报告如下 :临床资料 :本组 2 7例 (2 7眼 )患者 ,男 17例 ,女 10例 ,年龄 36～ 74岁 ,平均 5 8岁。右眼 16例 ,左眼 11例 ;有高血压病史 8例 ,糖尿病病史 5例 ,视网膜 A硬化 期 11例。视网膜静脉阻塞病程 4个月至 10年。荧光眼底血管造影 (FFA)检查均为缺血型视网膜静脉阻塞 ,其中中央静脉阻塞、半侧性视网膜静脉阻塞各 1眼 ,分支静脉阻塞 2 5眼…     

激光治疗视网膜分支静脉阻塞的时机选择

视网膜分支静脉阻塞（ＢＲＶＯ）是常见的视网膜血管性疾病,其影响视力的主要原因是黄斑水肿、黄斑部视网膜萎缩、新生血管形成,导致反复玻璃体出血。我们对发病１　～２个月累及黄斑部的ＢＲＶＯ患者行氩激光视网膜光凝治疗,与用药物治疗者比较疗效满意,现报告如下。１　资料与方法　　　　将６０例（６０眼）ＢＲＶＯ发病１～２个月、经眼底荧光血管造影（ＦＦＡ）检查有黄斑部荧光素渗漏者随机分为两组。治疗组男１７例、女１３例,年龄４０～７８岁、平均５８．２岁;病变位于右眼１８例,左眼１２例;阻塞部位在颞上分支１８例,颞…     

玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞的疗效

目的探讨玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞的疗效。方法将2012年1月至2013年9月该院收治的老年黄斑变性合并视网膜中央静脉阻塞患者62例62眼随机分为观察组和对照组,每组31例31眼。对照组接受视网膜光凝治疗。观察组每月玻璃体内注射雷珠单抗0.5 mg,1次/月,连续治疗3个月。统计分析两组治疗期间和治疗后半年内的最佳矫正视力、眼压、黄斑中心凹厚度(CMT)、眼底荧光血管造影(FFA)黄斑区荧光渗漏和并发症发生情况。结果观察组治疗前最佳矫正视力为3.32±0.58,低于治疗1、2 w、1、2、3个月及治疗后1、3、6个月的3.58±0.67,3.65±0.62,3.68±0.66,3.71±0.95,3.76±0.73,3.79±0.75,3.80±0.77和3.81±0.65;对照组治疗1、2、3个月及治疗后1、3、6个月的最佳矫正视力亦高于治疗前,且治疗2个月和3个月及治疗后1、3、6个月观察组最佳矫正视力均高于对照组;治疗2 w内两组患者的眼压出现升高后逐渐下降和CMT变薄,且治疗2个月和3个月及治疗后1、3、6个月观察组眼压均低于对照组,CMT亦较对照组薄(P<0.05)。两组治疗后FFA黄斑区荧光渗漏情况均得以改善,且观察组无明显渗漏的患者比例较对照组升高(P<0.05)。两组结膜下出血、视网膜脱离、细菌性眼炎等并发症的总发生率均为9.38%,两者无差异(P>0.05)。结论玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞可有效提高患者视力、控制眼压、促进黄斑消退和视网膜出血的吸收且不会明显增加并发症的发生,具有良好的可行性和安全性,值得推广用。     

不同剂量的曲安奈德玻璃体腔注射联合光凝治疗视网膜分支静脉阻塞合并黄斑水肿的疗效观察

目的比较不同剂量的曲安奈德(TA)行玻璃体腔注射联合光凝治疗视网膜分支静脉阻塞(BRVO)合并黄斑水肿的疗效。方法本研究纳入缺血型BRVO患者78例78眼,病程均3月,将所有患者随机分为2组,A组40例(40眼),行玻璃体腔注射TA 2 mg,B组38例(38眼)行玻璃体腔注射TA 4 mg,2组患者均于2周后行视网膜局部光凝及黄斑区格栅样光凝治疗。分析比较2组治疗前后眼前节、最佳矫正视力(BCVA)、光学相干断层扫描(OCT)的改变。结果 A组、B组治疗前后BCVA及黄斑中心凹厚度(CMT)均较治疗前明显改善(P均0.05)。A组与B组间治疗后BCVA及CMT差异无统计学意义(P0.05)。A组、B组治疗前眼压比较无统计学差异(P0.05)。治疗后2周A组眼压与治疗前比较差异无统计学意义(P0.05),B组眼压与治疗前比较明显升高(P0.05);治疗后2周,B组眼压较A组显著升高(P0.05)。治疗后1,3,6月B组眼压与A组比较差异无统计学意义(P0.05)。结论不同剂量的TA玻璃体腔注射联合光凝治疗BRVO合并黄斑水肿均可起到持久的疗效,小剂量的TA玻璃体腔注射明显减少TA所引起的并发症,效果更佳。     

视网膜静脉阻塞及其并发症治疗的新进展

视网膜静脉阻塞的发病机理较复杂,其临床治疗更困难,一般的药物疗法效果并不显著。本文着重介绍最近行之有效的几种治疗视网膜静脉阻塞及其并发症的方法。     

视网膜静脉阻塞继发黄斑水肿治疗进展

<正>视网膜静脉阻塞(RVO)的发病机制尚不完全明确,多数学者认为是由于动脉供血不足,静脉管壁受损以及异常的血流动力学所致。RVO是仅次于糖尿病性视网膜病变的第二常见的视网膜血管性疾病〔1〕,BRVO,最常见的类型视网膜分支静脉阻塞(BRVO)其患病率0.6~1.1%,其次是视网膜中央静脉阻塞(CRVO),其患病率0.1%~0.4%〔2〕。黄斑水肿(ME)可出现     

手术治疗老年性黄斑变性致大量视网膜下及玻璃体积血56例

老年性黄斑变性(AMD)是一种严重影响老年人正常生活的致盲性眼病之一,且其确切原因至今尚未明确.脉络膜新生血管(CNV)是湿性AMD视力下降的主要原因,如何在不损害视网膜的前提下有效地封闭CNV是目前治疗热点之一.目前有较多方法治疗AMD,包括向玻璃体腔注射抗新生血管药物[1]、光动力学疗法[2]及应用中医药[3]等,并取得了较好疗效.而对于已经导致大量视网膜下及玻璃体积血的AMD患者而言,以上方法显然并不合适,本研究观察对该类患者行玻璃体视网膜联合手术的效果.     

两种不同方式治疗视网膜分支静脉阻塞继发黄斑水肿的meta分析

目的系统评价激光联合玻璃体腔注射雷珠单抗与单独玻璃体腔注射雷珠单抗治疗视网膜分支静脉阻塞(BRVO)继发黄斑水肿的疗效及安全性。方法通过检索PubMed、CNKI、万方等数据库收集有关治疗BRVO继发黄斑水肿的随机对照试验研究(RCT)。检索时间为建库至2019年5月。采用RevMan 5.3软件对纳入文献进行meta分析。结果共纳入12篇文献,包括1081例患者。meta分析结果显示:与单纯注药组相比,联合治疗组黄斑中心凹厚度(CMT)在随访1、3、6个月时均降低,差异有统计学意义[95%CI(-135.44^-15.54),P<0.001];但对于最佳矫正视力(BCVA)的提高,2组间无统计学差异[95%CI(-1.75~0.80),P>0.05];2组不良反应的发生率无统计学差异[OR=1.50,95%CI(0.97~2.30),P=0.07]。结论激光联合玻璃体腔注射雷珠单抗能够显著降低BRVO继发黄斑水肿患者的CMT,早期疗效优于单纯注药组。但两种方式对于治疗后BCVA的影响及不良反应的发生尚需要大样本的随机对照双盲研究加以验证。     

雷珠单抗治疗老年患者视网膜静脉阻塞继发黄斑水肿的临床观察

目的分析玻璃体腔注射雷珠单抗对老年视网膜静脉阻塞(RVO)继发黄斑水肿(ME)患者的疗效。方法回顾性研究2018年1月—2019年12月,复旦大学附属华东医院眼科收治的37例(37眼)老年RVO继发ME确诊患者。所有患者均接受3+PRN治疗方案,玻璃体腔注射雷珠单抗。分别于治疗前和治疗后1、3、6个月时,检测患者最佳矫正视力(BCVA);通过光学相干断层扫描分析患眼黄斑中心凹视网膜厚度(CMT)、黄斑区平均视网膜厚度(MMT)及黄斑中心体积(CMV)的变化情况。结果与治疗前比较,治疗后1、3和6个月患者的平均BCVA改善(χ²=37.70,P<0.05),CMT(F=22.06,P<0.01)及MMT变薄(F=30.75,P<0.01),CMV减小(F=27.57,P<0.01)。研究期间2例患者出现球结膜下出血,未见其他严重不良反应。结论玻璃体腔注射雷珠单抗治疗能一定程度上提高老年RVO继发ME患者的视力,减轻ME,有助于恢复患者的视网膜正常结构。     

The laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion: A protocol for systematic review and meta-analysis

Background:At present, laser is regarded as an effective treatment for macular edema secondary to branch retinal vein occlusion. With the breakthrough of anti-vascular endothelial growth factor drugs in ophthalmology clinical research, the intravitreal injection of ranibizumab is widely applied, but both methods have their limitations, so some clinical studies have combined and applied them together. However, the clinical results are inconsistent and controversial, and there is no relevant system evaluation for the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion now.Objective:Meta analysis is used to analyze and evaluate the effectiveness and safety of the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion.Method:CNKI, VIP, WANFANG, China Biology Medicine disc, Web of Science, PubMed, Embase, Cochrane Library have used random controlled clinical trial of laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion from the establishment of the database to October 2020. Two researchers conducted independent screening, quality assessment and data extraction for the literatures, and used RevMan5.3 to conduct Meta analysis for the included literatures.Result:The research has evaluated the effectiveness and safety of the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion through the aspects of the best corrected visual acuity 6 months after operation, macular center thickness and the incidence of adverse reactions such as elevated intraocular pressure, endophthalmitis, vitreous hemorrhage and cataract.Conclusion:Laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion has good effect, and the research has provided reliable evidence for the use of clinical treatment of the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion.     

Exacerbation of branch retinal vein occlusion post SARS-CoV2 vaccination: Case reports

Rationale:In this paper, we report on 2 patients who developed branch retinal vein occlusion (BRVO) exacerbation 1 day after administration of the BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine.Patient concerns:Case 1: A 71 year-old female developed vision loss in her left eye 1 day after receiving a second dose of the SARS-CoV-2 mRNA vaccine. This patient was diagnosed with temporal inferior BRVO and secondary macular edema (ME) in her left eye. ME resolved after 3 doses of intravitreal aflibercept (IVA). After treatment, no recurrence of ME was observed.Case 2: A 72 year-old man developed vision loss in his right eye 1 day after receiving the first dose of the SARS-CoV-2 mRNA vaccine. This patient was diagnosed with temporal superior BRVO in the right eye without ME. The patient was followed up and did not undergo any additional treatment.Diagnoses:Case1: Temporal superior BRVO and secondary ME were observed in the left eye. Her best-corrected visual acuity (BCVA) was 20/30.Case2: Temporal superior BRVO recurrence and secondary ME were observed in the right eye. BCVA was 20/25.Interventions:Case1: Additional dose of IVA was administered. Case2: Two times of Intravitreal ranibizumab was administered twice.Outcomes:Case1: Subsequently, ME resolved BCVA was 20/20. Case2: Subsequently, ME resolved BCVA was 20/25.Lessons:Both cases showed a possible association between SARS-CoV-2 vaccination and the exacerbation of BRVO.     

Comparative efficacy and safety of antivascular endothelial growth factors for central retinal vein occlusion: A protocol for systematic review and network meta-analysis

Background:Central retinal vein occlusion (CRVO) is one of the most common retinal vascular diseases, which is closely related to systemic diseases like hypertension, diabetes and arteriosclerosis. Due of its blinding, it will seriously reduce the quality of life. Macular edema (ME) caused by CRVO is one of the serious complications of visual impairment. We found that the severity of ME in CRVO was positively associated with vascular endothelial growth factor (VEGF) in the anterior chamber. With the accelerated pace of modern life and the changed dietary structure, the incidence of this disease will continue to rise. Therefore, it is of great practical significance to seek effective treatment methods. Intraocular injection of anti-VEGF can effectively alleviate ME and improve visual acuity, showing excellent clinical application prospects. In recent years, there have been some new understandings and advances on the etiology and treatment methods of the present disease, such as the deepening into the molecular biology and gene level. Clinical studies on the efficacy of the disease have emerging. Therefore, a network meta-analysis (NMA) of anti-VEGF treatment for CRVO is particularly necessary to systematically compare its efficacy.Methods:The two reviewers will comprehensively retrieved electronic databases such as PubMed, The Cochrane Library, Wanfang database, Web of Science, Chinese Scientifific Journals Database, EMBASE, China National Knowledge Infrastructure, and China BioMedical Literature. A randomized controlled trial for CRVO against VEGF between January 2010 and June 2021 was included according to the relevant content of the study. In addition, 2 researchers will screen the literature to assess the risk bias for the included articles. We will evaluate the collected evidence and data using a Bayesian NMA method, and analyzed it with STATA and WinBUGS software.Results:Anti-VEGF is one of the effective methods for ME in CRVO patients, accordingly, this study will evaluate its efficacy and safety using a Bayesian NMA system.Conclusion:This study can provide an effective rationale for the clinical application of anti-VEGF for CRVO, contribute to the treatment of CRVO and patient condition rehabilitation in clinical work.Ethics and dissemination:Do not require.INPLASY registration number:INPLASY2021110073.     

Clinical and endoscopic features of gastric varices secondary to splenic vein occlusion

Aim: This study provides a retrospective evaluation of cases with gastric varices secondary to splenic vein occlusion. Methods: Our study group consisted of 14 patients. The clinical manifestations, diagnostic methods and therapeutic modalities were analyzed retrospectively. Results: Eleven patients had co‐existing pancreatic diseases: seven with chronic pancreatitis, three with cancer of the pancreatic body or tail and one with severe acute pancreatitis. Among the three remaining patients, one had advanced left renal cancer, one had myeloproliferative disease and the third had splenic vein occlusion due to an obscure cause. A diagnosis of gastric varices was made following endoscope gastroduodenoscopy or endoscopic color Doppler ultrasonography (ECDUS), and splenic vein occlusions were diagnosed from enhanced computed tomography in all cases. Specific findings of gastric varices secondary to splenic vein occlusion were based on ECDUS color flow images of gastric variceal flow that clearly depicted round cardiac and fundal regions at the center, with varices expanding to the curvatura ventriculi major of the gastric body. For three cases with gastric variceal bleeding, endoscopic injection sclerotherapy using a mixture of histoacryl and lipiodol (70% histoacryl solution) was performed, after which no further bleeding from gastric varices was detected. Due to a high risk of gastric variceal rupture, splenectomy was performed in two cases and splenic arterial embolization in another two cases. Conclusion: ECDUS color flow images of gastric variceal flow depicted specific findings of gastric varices secondary to splenic vein occlusion. Treatment should take into account the diseases underlying these conditions.     

Antithrombotic treatment of retinal vein occlusion: a position statement from the Italian Society on Thrombosis and Haemostasis (SISET)

Retinal vein occlusion (RVO) represents a common cause of visual impairment and blindness. RVO may be associated with both local (e.g., hyperopia, glaucoma) and systemic (e.g., hypertension, diabetes, smoking, obesity, and dyslipidaemia) risk factors. The association with thrombophilia remains controversial. Data on the use of antithrombotic therapy for RVO are poor and inconsistent with most of the information being derived from observational studies. Here we provide a position statement from the Italian Society on Thrombosis and Haemostasis (SISET) to guide the clinical and therapeutic management of patients with RVO based on the available evidence and expert opinion.     

Low molecular weight heparin for the treatment of retinal vein occlusion: a systematic review and meta-analysis of randomized trials

Retinal vein occlusion is a frequent cause of visual loss for which few effective therapies are available. Anticoagulation with low molecular weight heparin might be of value in its treatment. We conducted a systematic review and meta analysis of randomized trials evaluating the effect of low molecular weight heparin in patients with retinal vein occlusion. Data sources included MEDLINE, EMBASE, HealthSTAR, the Cochrane Library, Lilacs, the Investigative Ophthalmology and Visual Science database and gray literature. Main outcome was the mean difference between the visual acuity measured at baseline and at six months expressed in the logMAR scale. Secondary outcome was a composite of any adverse ocular outcome including: worsening of visual acuity, visual fields or fluorescein angiography, or development of iris neovascularization, any neovascularization or neovascular glaucoma. Subgroup analyses for branch versus central retinal vein occlusion were conducted. We identified 1,084 references of which 3 studies comparing low molecular weight heparin with aspirin (229 evaluable patients) were included. Overall, the pooled mean visual acuity difference was −0.23 logMAR (95% CI −0.38, −0.09; P=0.002) in favor of low molecular weight heparin. Low molecular weight heparin was associated with a 78% risk reduction for developing any adverse ocular outcome (pooled RR 0.22; 95% CI 0.10, 0.46; P<0.001). In subgroup analyses benefits seemed lower in branch retinal vein occlusion. No increased vitreous hemorrhages were observed. In patients with retinal vein occlusion treatment with low molecular weight heparin seems to be associated with improvement in the visual acuity and less adverse ocular outcomes. These benefits might differ in patients with central as opposed to branch retinal vein occlusion. Further studies are required to confirm these findings and clarify its benefits in specific subgroups of patients before definitive recommendations can be made.     

Clinical safety and outcome of recombinant tissue plasminogen activator in patients with stroke attributable to small artery occlusion: A protocol for systematic review and meta-analysis

Background:Recent observations raised concern that the intravenous recombinant tissue plasminogen activator (rt-PA) may result in damage to stroke patients caused by small artery occlusion (SAO). Thus, we perform a protocol for meta-analysis to investigate the efficacy and safety of intravenous thrombolysis with rt-PA in SAO-patients.Methods:The search-style electronic libraries, including Pubmed, Embase, the Cochrane Library, Web of Science, Wanfang Data, VIP Chinese Journals, and China Biomedical Literature Service System are used for document retrieval in June 2021 with no restrictions on language. The risk of bias in include articles will be assessed using the Cochrane Risk of Bias Tool. We perform the meta-analysis by Stata version 10.0 software and calculated the statistics using the inverse variance statistical method. Binary outcomes are presented as Mantel-Haenszel-style risk ratios with 95% confidence interval. Continuous outcomes are reported as mean differences.Results:The results of the article will be shown in a peer-reviewed journal.Conclusion:Intravenous rt-PA may be effective and safe in SAO-patients.     

Acute procedural efficacy and safety of a novel cryoballoon for the treatment of paroxysmal atrial fibrillation: Results from the POLAR ICE study

Introduction

Pulmonary vein isolation (PVI) is well established as a primary treatment for atrial fibrillation (AF). The POLAR ICE study was designed to collect prospective real world data on the safety and effectiveness of the POLARx^TM cryoballoon for PVI to treat paroxysmal AF.

Methods

POLAR ICE, a prospective, non-randomized, multicenter (international) registry (NCT04250714), enrolled 399 patients across 19 European centers. Procedural characteristics, such as time to isolation, cryoablations per pulmonary vein (PV), balloon nadir temperature, and occlusion grade were recorded. PVI was confirmed with entrance block testing.

Results

Data on 372 de novo PVI procedures (n = 2190 ablations) were collected. Complete PVI was achieved in 96.8% of PVs. Procedure and fluoroscopy times were 68.2 ± 24.6 and 15.6 ± 9.6 min, respectively. Left atrial dwell time was 46.6 ± 18.3 min. Grade 3 or 4 occlusion was achieved in 98.2% of PVs reported and 71.2% of PVs isolation required only a single cryoablation. Of 2190 cryoapplications, 83% had a duration of at least 120 s; nadir temperature of these ablations averaged −56.3 ± 6.5°C. There were 6 phrenic nerve palsy events, 2 of which resolved within 3 months of the procedure.

Conclusion

This real-world usage data on a novel cryoballoon suggests this device is effective, safe, and relatively fast in centers with cryoballoon experience. These data are comparable to prior POLARx reports and in keeping with reported data on other cryoballoons. Future studies should examine the long-term outcomes and the relationship between biophysical parameters and outcomes for this novel cryoballoon.