stroke.

Clinical factors to help decide between angioplasty and carotid endarterectomy

Original title: A clinical rule (sex, contralateral occlusion, age, and restenosis) to select patients for stenting versus carotid endarterectomy: Systematic review of observational studies with validation in randomized trials. Reference: Touzé E et al. Stroke. 2013;Epub ahead of print Compared with carotid endarterectomy, angioplasty with stent is associated with an increased risk of pre- procedural stroke especially for...

Transradial access plus bivalirudin, the best combination to reduce bleeding

Original title: Comparison of bivalirudin and radial access across a spectrum of preprocedural risk of bleeding in percutaneous coronary intervention: Analysis from the National Cardiovascular Data Registry. Reference: Baklanov DV et al. Circ Cardiovasc Interv. 2013, article in press. Bleeding complications are clearly associated to mortality increase and two of the current best strategies to reduce bleeding are...

Endovascular Therapy in Acute Stroke Still Being Discussed

Original title: Mechanical Recanalization with Flow Restoration in Acute Ischemic Stroke. The Mechanical Recanalization with Flow Restoration in Acute Ischemic Stroke (ReFlow) Study. Reference: Christian Roth et al. J Am Coll Cardiol Intv 2013. Article in press. The intravenous tissue-type plasminogen activator (tPA) has proved to reduce morbidity and mortality in patients with acute ischemic stroke. In the...

Foramen ovale closure for cryptogenic stroke

Original title: Closure of Patent Foramen Ovale versus Medical Therapy after Cryptogenic Stroke. Randomized Evaluation of Recurrent Stroke Comparing PFO Closure to Established Current Standard of Care Treatment (RESPECT). Reference: John D. Carroll et al. N Engl J Med 2013;368:1092-100. It is still unclear if the closure of patent foramen ovale (PFO) is effective in preventing recurrent stroke<a href="https://solaci.org/en/2013/04/03/foramen-ovale-closure-for-cryptogenic-stroke/" title="Read more" >...

Endovascular therapy after t-PA: no additional benefit for patients with acute stroke

Original title: Endovascular Therapy after Intravenous t-PA versus t-PA Alone for Stroke. Interventional Management of Stroke (IMS) III. Reference: Joseph P. Broderick et al. N Engl J Med 2013.DOI: 10.1056/NEJMoa1214300 Tissue plasminogen activator (t-PA; alteplase [Activase, Genentech, or Actilyse, Boehringer Ingelheim]) is the only reperfusion therapy proved useful for patients with acute ischemic stroke and its clinical efficacy...

MRI different injuries post carotid angioplasty versus endarterectomy.

Original title: Characteristics of Ischemic Brain Lesions After Stenting or Endarterectomy for Symptomatic Carotid Artery Stenosis : Results From the International Carotid Stenting Study-Magnetic Resonance Imaging Substudy (ICSS-MRI). Reference: Henrik Gensicke et al. Stroke 2013;44:80-86. This work is a sub-study using magnetic resonance imaging (MRI) of the International Carotid Stenting Study (ICSS) that randomized carotid angioplasty (CAS) or...

Are reversal flow cerebral protection devices useful in carotid angioplasty?

Original title: Prospective, Multicenter European Study of the GORE Flor Reversal System for Providing Neuroprotection During Carotid Artery Stenting Reference: Dimitrios Nikas, et, al.Catheterization and Cardiovascular Intervention 80:1060-1068  Cerebral protection systems (CPS) have proved useful in carotid angioplasty stenting (CAS), although it is not clear what the advantages are in respect to carotid endarterectomy, except in high risk...

Risk Score for carotid angioplasty

Original title: Risk Prediction for Adverse Events After Carotid Artery Stenting in Higher Surgical Risk Patients Reference: Neil J. Wimmer et al. 2012;43: 3218-3224 Stroke. There are many patients with high surgical risk for carotid endarterectomy, either because of unfavorable anatomy, comorbidities or both. In this situation carotid angioplasty is a therapeutic option. However, no score has been...

Diabetics with multivessel, must keep waiting.

Original title: Strategies for Multivessel Revascularization in Patients with Diabetes. The FREEDOM Trial. Reference: Michael E. Farkouh et al. N Engl J Med 2012. DOI: 10.1056/NEJMoa1211585 This study was designed to determine the best revascularization strategy in diabetic patients with multivessel using current techniques of angioplasty (PCI) and surgery (CABG). Randomized 1:1 diabetic patients with injuries > 70%...

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