Courtesy of Dr. Carlos Fava. The real incidence of peripheral artery (PAD) disease in TAVR remains unclear. Different reports still estimate it is between 10 and 46%, but they have shown it has a negative impact in evolution. 51,685 TAVR patients were analyzed. 12,740 of these patients presented PAD (24.6%). PAD patients tended to be...
This new “Paladin” system for post-dilation during carotid artery stenting was safe and may effectively reduce the number of particles that reach the brain, with a subsequent decreased risk for peri-procedural stroke. This study evaluated the safety and efficacy of the Paladin System, a novel post-dilation balloon with an integrated distal protection filter designed to...
Chronic kidney disease, even in moderate or severe stages before dialysis, is associated with an increased risk of aortic stenosis according to this work recently published in J Am Coll Cardiol. Both share several risk factors, something that complicates the identification of the association between these diseases due to multiple confounding variables. The study...
Courtesy of Dr. Carlos Fava. One of the limitations to percutaneous interventions is poor or impossible femoral access. This happens especially in TAVR, with endoprosthesis or ventricular assistance devices, when the transcaval approach with cardiac occluder rises as a viable alternative. We have started to use it in TAVR, but at present there is little...
The title of this article leads us to think that we will find a list of things that we can do to reduce kidney injury. However, (unfortunately) sodium bicarbonate showed no benefit over saline and n-acetylcysteine showed no benefit over a placebo for the reduction of kidney damage after coronary angioplasty. Among the protective measures...
Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial in high and moderate risk patients, but there is a group of patients that require dialysis on account of kidney deterioration. This comorbidity is due to bad cardiovascular evolution associated to diabetes, bleeding and thromboembolic events. For some time, we have been using an...
EXCEL patients with chronic kidney disease and left main coronary artery disease have higher rates of acute renal failure and other events compared with the general population. However, acute renal failure was less frequent with angioplasty than with surgery, while other events such as death, stroke, or infarction at 3 years were similar for both revascularization...
This work shows the safety of carotid artery stenting within 14 days of a stroke and, so far, this is the largest series of symptomatic patients published by an institution. The exact moment to conduct this procedure after an acute stroke is still controversial, although most publications so far have favored early endarterectomy over early angioplasty....
Current models are not reliable when it comes to predicting events after carotid revascularization in acute patients. Peri-procedural events seem to be particularly hard to predict. The development of models that can be externally validated is essential for the decision-making process in patients with high event rates, both during the procedure or while the case...
This syndrome, which can be reverted, is also one of the causes of preventable stroke, at least in the context of carotid endarterectomy. At present, there is little information on the incidence of this condition in the context of carotid stenting, which is the purpose of this study, in addition to providing tips to prevent it....