Original Title: Predictors of Restenosis Following Carotid Angioplasty and Stenting. Reference: Elena Zapata-Arriaza et al. Stroke. 2016 Jun 21. Epub ahead of print. Restenosis after carotid PCI is associated to an increase of stroke and death risk. The purpose of this study was to determine the risk and predicting factors associated to carotid restenosis...
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...
Original title: A Direct Comparison of Early and Late Outcomes with Three Approaches to Carotid Revascularization and Open Heart Surgery. Reference: Mehdi H. Shishehbor et al. J Am Coll Cardiol, article in press. The prevalence of severe carotid stenosis (> 80%) in patients planning to have a Central Venous Catheter (CVC) is estimated at between 6 and...
Original title: Hemorrhagic and ischemic outcomes after bivalirudin versus unfractionated heparin during carotid artery stenting: A propensity score analysis from the NCDR. Reference: Wayangankar SA et al. Circ Cardiovasc Interv. 2013;Epub ahead of print. Bivalirudin is a direct thrombin inhibitor that has shown similar efficacy with a better safety profile in the context of coronary angioplasty. However, its...
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...
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...
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...
As regards the use of antithrombotic agents, the risk of bleeding will always be an issue, and in the case of aspirin this risk is twice as big: it does have the desired antiaggregation effect, but on top of the increased bleeding risk, it has a damaging effect on stomach lining that increases the risk...
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is very frequent and many of these medications are sold over-the-counter, but they can expose patients with atrial fibrillation using warfarin or dabigatran to potentially dangerous bleeding. Such a combination is a “perfect storm” of sorts, since atrial fibrillation is the most frequent type of arrhythmia and its...
The prevalence of peripheral arterial disease is between 15% and 20% of patients older than 65 years and its severity is greatly underestimated. In fact, annual mortality is higher in patients with peripheral arterial disease (8.2%) than in those after acute myocardial infarction (6.3%). Despite the above, medical advice and efforts to modify risk factors...