With endovascular therapy as the standard of care in ischemic stroke and with a community of interventional cardiologists increasingly committed to assisting neurologists in providing 24/7 thrombectomy, staying informed is paramount. The number of thrombectomy attempts with retractable stent (>3) is associated with hemorrhagic transformation beyond age, baseline NIHSS (National Institutes of Health Stroke Scale)...
01- Post MI Betablockers for Good? Patients receiving optimal medical treatment after MI do not seem to benefit from betablockers in the long term, provided they do not present cardiac failure or systolic function deterioration. Read more HERE 02- Thrombocytopenia and Thrombosis May Be Linked to AstraZeneca Vaccine, Analysis Reports This is one of the...
The ambitious SOLVE-TAVI (soon to be published in JACC) is aimed at answering to of the most important questions we make when facing a TAVR procedure: What valve do we choose, a self-expanding or a balloon expandable? And once we have chosen our device, do we proceed with general anesthesia or conscious sedation? The...
Yet another observational study has come to question the antiaggregation power of ticagrelor when it comes to death or MI reduction, pointing at its higher risk of bleeding vs. clopidogrel. This new analysis recently published in JAHA includes a large number of patients undergoing acute coronary syndrome (ACS) in the clinical practice. Ticagrelor has been...
Computed tomographic (CT) angiography showed a high degree of agreement with conventional angiography to detect significant coronary artery disease and rule out left main disease. This imaging study was done on a group of patients before their randomization in the ISCHEMIA trial. Data are soon to be published in JACC Cardiovascular Imaging and add plenty...
Controlling stent expansion with optical coherence tomography (OCT) based on an external elastic membrane–based protocol for stent sizing resulted non-inferior to the control group which used intravascular ultrasound (IVUS) and superior the angiography only group. Based on these study outcomes and the prior outcomes, we should use IVUS imaging if available. There are no specific algorithms...
For many patients, the first symptom of heart disease is acute MI, or even sudden death. Changes in lifestyle and optimal medical treatment (OMT) are vital to the prevention of serious events, but we cannot help wondering whether preventive stenting might do it. Intravascular ultrasound (IVUS), optical coherence tomography (OCT), NIRS near-infrared spectroscopy (NIRS) and computed...
01- Surgeons’ Claim on Low-Risk Patients with Aortic Stenosis Recent randomized trials including low-risk patients showed positive results for transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement. Read more HERE 02- Major Cause of Myocardial Injury by COVID-19 The most common cause of myocardial necrosis in patient undergoing COVID-19 infection is microthrombi. These...
Recent randomized trials including low-risk patients showed positive results for transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement. However, surgeons argue that these cases fail to consider patients from daily clinical practice, but rather include a population that has been carefully selected for randomized trials. Patients with non-tricuspid aortic stenosis, with severe...
The most common cause of myocardial necrosis in patient undergoing COVID-19 infection is microthrombi. These microthrombi resulted quite different in composition vs. thrombi obtained from COVID-19 negative patients and thrombi obtained from infected patients with ACS. Myocardial injury is common in patients hospitalized for COVID-19 and has worse prognosis. Regardless its frequency, the mechanism and...