Silent stroke is common after transcatheter aortic valve replacement (TAVR). Co-morbidities such as diabetes or chronic renal failure, as well as procedural factors such as pre-dilation, increase the risk of silent stroke. While many events of silent stroke have an early effect on cognition, it is necessary to learn whether the impairment is sustained over...
Might Alcohol Consumption Reduce Stroke?
A J shaped curve illustrating the link between alcohol consumption and ischemic stroke has been reported, suggesting that a certain amount of alcohol would be beneficial compared against absolute abstinence and excessive consumption. In order to shed some light on this matter, this study looked at alcohol consumption patterns and their effect on stroke in...
Aspiration Thrombectomy vs. Stent Retriever Thrombectomy: Is the Site of Stroke the Key to Make a Choice?
Thrombectomy with stent retriever and direct aspiration have been considered equally effective in the treatment of anterior circulation acute ischemic stroke. But are they really? This study recently published in Stroke compares the safety and efficacy of both techniques per occlusion segment. This study analyzed data from the MR CLEAN registry at every endovascular therapy...
Number of Hours of Sleep and Risk of Stroke
Sleep duration (either short or long) affect the risk of stroke according to this recent analysis. We had visited a study published in JACC on the link between acute MI and sleep duration. This study appears to show similar results as regards sleep duration and stroke. The work prospectively included 79,881 men and women between...
TCT 2020 | Surprising Differences in Stroke between SAPIEN 3 and Evolut R
One-year outcomes of the head to head trial between CoreValve Evolut R vs Sapien 3 showed a significantly higher difference in stroke vs. patients receiving the self-expanding valve (Sapien 3 6.9% vs Evolut R 1%; p=0.002). The SOLVE-TAVI randomized 2×2 patients with severe aortic stenosis and high surgical risk to Sapien 3 or Evolut R and...
Death, Stroke, and Hospitalization while Waiting for TAVR
The consequences of deferring transcatheter aortic valve replacement (TAVR) procedures because of the COVID 19 pandemic are piling up. Untreated severe aortic stenosis patients who had been scheduled for TAVR are seeing increased risk of all events, even mortality. According to recent studies published in JAMA, deferring TAVR in patients with symptomatic aortic stenosis is...
Infarction, Stroke and Aortic Emergency Syndromes in the Shadow of the Pandemic
The coronavirus pandemic has had a negative impact on the most pressing cardio and neurological emergencies, such as strokes or aortic dissection. These emergencies are normally treated in high complexity centers, which is why it is relatively simple to analyze the number of transfers before and after the pandemic. For some time, care centers have...
SPARCL: Highly Effective Prevention of New Events with Atorvastatin after a Stroke
In patients with recent stroke or transient ischemic attack, the total number of vascular events prevented by atorvastatin was twice as high as the number of prevented index events. In other words, the power of atorvastatin in secondary prevention is far superior to primary prevention. This gigantic reduction, both in index and recurrent events, gives...
Crest-2 Registry: Carotid PCI Presents Low Rates of Death and Stroke
Courtesy of Dr. Carlos Fava. In modern studies, carotid artery stenting (CAS) has been shown equal to surgery in terms of the composite end point of periprocedural stroke, death, acute myocardial infarction and late ipsilateral stroke. This was tested in different groups and by trained operators. In the CREST-2 Registry (C2R) 2141 patients were included,...
AHA 2019 | Treat Stroke to Target: Post-Stroke Aggressive Therapy with Statins
Indicating statins to reach more aggressive LDL goals in patients that have suffered transient ischemic attack or ischemic stroke driven by atherosclerosis significantly reduces major cardiovascular events according to this study presented in the AHA 2019 scientific sessions simultaneously published in NEJM. The study was prematurely ended because of lack of funding, but its outcomes...