Closing off the left appendage as an add-on procedure while performing other cardiac surgery in patients with atrial fibrillation resulted in a reduction in risk of embolic stroke of nearly 40% over 12 months, according to an analysis carried out on the Society of Thoracic Surgeons (STS) database. Patients who had surgical appendage occlusion had...
How Important Is Controlling Risk Factors for the Prevention of a Stroke?
There has been a recent decline of about 20% to 40% in the incidence of cerebrovascular accidents (stroke). Although this is attributed to the improvement of risk factor control, the reason behind it is not utterly clear. This study estimated the impact of modifiable cardiovascular risk factors on the incidence of stroke between 1995 and...
Carotid Revascularization After Stroke: When Should It Be Performed?
In 2006, the American Heart Association guidelines recommended that carotid revascularization be performed within 2 weeks of stroke based on data from 2 randomized trials on carotid endarterectomy. This study aimed to determine whether the time between the event and revascularization has decreased after these guidelines were issued, and the proportion of patients receiving some sort of revascularization (endarterectomy...
Carotid PCI at Long Term: Effective in Stroke Prevention?
There are no data outside controlled studies, neither are there long term outcomes, on carotid artery stenting. This study was designed to assess the long term effectiveness of carotid stenting to prevent strokes in a large number of real life patients. This registry included prospective data with a strict follow up protocol on 901...
Stroke Predictors in TAVR: CoreValve vs. Sapien
A comprehensive analyzis of cerebrovascular events in major randomized controlled studies on transcatheter aortic valve replacement (TAVR) has shown some interesting data on both risks and timing of stroke in this setting. The study carried out by Dr. Neal Kleiman, reviewed data on stroke and stroke predictors among 3,687 patients included in the CoreValve...
Ticagrelor: Similar to Aspirin in Patients with Stroke or TIA
Ticagrelor might be a more effective antiplatelet therapy than aspirin for the prevention of recurrent stroke and cardiovascular events in patients admitted for acute cerebral ischemia. This double-blind, controlled trial randomized 13,199 patients from 33 countries. Subjects presented a non-severe stroke or a high-risk transient ischemic attack (TIA) (not considered as cardioembolic) and had not received...
Prevention of Stroke: Carotid Artery Stenting or Endarterectomy?
Original Title: Long-Term Outcome after Carotid Artery Stenting. A Population-Based Matched Cohort Study. Reference: Stroke. 2016 Jul 12. [Epub ahead of print]. In the prevention of stroke, carotid artery stenting (CAS) is far less invasive than endarterectomy, but its long term outcomes remain unclear. This large cohort study compared the long term outcomes of...
Left Atrial Appendage Closure: Effective to Reduce Risk of Stroke?
Original Title: Effectiveness of Left Atrial Appendage Exclusion Procedures to Reduce the Risk of Stroke: A Systematic Review of the Evidence. Reference: North Noelck et al. Circ Cardiovasc Qual Outcomes. July 2016. Published ahead of print. Atrial fibrillation is an important cause of stroke. Oral anticoagulation reduces the risk of stroke but, on the...
Predictors of Restenosis and Stroke Following Carotid PCI
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...
LAA Closure: Preventing Stroke in Patients with Atrial Fibrillation and Prior Intracerebral Hemorrhage
Original Title: LAA occlusion vs. standard care in patients with atrial fibrillation and intracerebral hemorrhage – A propensity score matched follow-up study. Presenter: Jens Erik Nielsen-Kudsk Patients with atrial fibrillation and a history of intracerebral hemorrhage, have an elevated risk of both ischemic and hemorrhagic stroke. There is no consensus on how to treat...