This study provides the steps to follow in order to prevent or at least reduce radial artery occlusion after using it as an access for a diagnosis or treatment study. The use of transradial access is exponentially increasing worldwide due to its lower chance of bleeding events and vascular complications than transfemoral access. Radial artery<a href="https://solaci.org/en/2019/12/03/international-consensus-to-prevent-radial-artery-occlusion-after-interventions/" title="Read more" >...</a>
Net Benefit of Left Atrial Appendage Closure vs. Anticoagulation in Atrial Fibrillation
This analysis shows that the long-term clinical benefit of left atrial appendage closure with Watchman is superior to warfarin in patients with atrial fibrillation (AF). The initial peri-procedural risks of device implantation are counterbalanced over time, with reduced risk of bleeding and death. The PROTECT-AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in<a href="https://solaci.org/en/2019/12/02/net-benefit-of-left-atrial-appendage-closure-vs-anticoagulation-in-atrial-fibrillation/" title="Read more" >...</a>
The Most Read Articles of November at Solaci.org
1- AHA 2019 | ISCHEMIA: The Invasive Approach (PCI or Surgery) Results Similar to Optimal Medical Treatment After a several year follow up, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) has shown that an invasive approach in addition to optimal medical treatment (OMT) does not offer benefits when it<a href="https://solaci.org/en/2019/12/02/the-most-read-articles-of-november-at-solaci-org/" title="Read more" >...</a>
AHA 2019 | Sapien vs Evolut: A Head-to-Head Study Seems Mandatory
Two French registries have carried out a propensity matched comparison which suggest differences between balloon-expandable valves (BEV) and self-expandable valves (SEV) in hard end points such as mortality. The only FDA approved commercially available transcatheter heart valves in the US are the BE Sapien 3 (Edwards Lifesciences) and the SE CoreValve Evolut PRO (Medtronic). Both<a href="https://solaci.org/en/2019/11/27/aha-2019-sapien-vs-evolut-a-head-to-head-study-seems-mandatory/" title="Read more" >...</a>
Lower Mismatch Rate with the New Self-Expandable Valves
Prosthesis mismatch (PPM) was introduced by Rahimtoola in 1978 and happens when the effective orifice area of a heart valve prosthesis is too small in relation to patient body size. Surgical valves have been well documented, but there is little information on percutaneous valves. The study looked at 757 patients undergoing TAVR with pre and post procedural eco-Doppler<a href="https://solaci.org/en/2019/11/25/lower-mismatch-rate-with-the-new-self-expandable-valves/" title="Read more" >...</a>
AHA 2019 | ISCHEMIA-CKD: Chronic Kidney Disease and Stable Coronary Disease
Among patients in the main ISCHEMIA trial, those with chronic kidney disease are a particularly high-risk subgroup. However, an invasive strategy with coronary angiography and revascularization did not improve the rate of events, similarly to what happened in the general population for the aforementioned trial. The rate of death or acute myocardial infarction was 36.4%<a href="https://solaci.org/en/2019/11/22/aha-2019-ischemia-ckd-chronic-kidney-disease-and-stable-coronary-disease/" title="Read more" >...</a>
AHA 2019 | TWILIGHT: Discontinue Aspirin after Acute Coronary Syndrome
This study findings confirm less bleeding at no extra cost of thrombotic events when aspirin is discontinued after an acute coronary syndrome (ACS). In the same line as the original TWILIGHT, this study focused on ACS patients alone (excluding STEMI) and confirmed that aspirin discontinuation after 3-month DAPT to continue with ticagrelor alone, reduced the<a href="https://solaci.org/en/2019/11/20/aha-2019-twilight-discontinue-aspirin-after-acute-coronary-syndrome/" title="Read more" >...</a>
AHA 2019 | RECOVERY: Early Surgery in Asymptomatic Severe Aortic Stenosis
This small randomized study heated the debate about when to intervene aortic stenosis (AS). Putting off surgical valve replacement (SAVR) in patients with asymptomatic AS and waiting for symptom onset with conservative care increased periprocedural risk and all cause cardiovascular death. This study presented by Dr Duk-Hyun Kang during AHA 2019 scientific sessions (simultaneously published<a href="https://solaci.org/en/2019/11/20/aha-2019-recovery-early-surgery-in-asymptomatic-severe-aortic-stenosis/" title="Read more" >...</a>
AHA 2019 | ISCHEMIA: The Invasive Approach (PCI or Surgery) Results Similar to Optimal Medical Treatment
After a several year follow up, the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) has shown that an invasive approach in addition to optimal medical treatment (OMT) does not offer benefits when it comes to preventing major cardiovascular events compared against optimal medical treatment alone in stable patients with moderate<a href="https://solaci.org/en/2019/11/19/aha-2019-ischemia-the-invasive-approach-pci-or-surgery-results-similar-to-optimal-medical-treatment/" title="Read more" >...</a>
Europe Grants Approval to Balloon-Expandable Valve in Low-Risk Patients; Self-Expanding Valve Still Waiting for It
The balloon-expandable valve has been granted approval in Europe for treatment of the complete risk spectrum of symptomatic severe aortic stenosis. Europe has recently approved an expanded indication for the Sapien 3 system for use in low-risk patients, as reported by Edward Lifesciences. Sapien 3, which includes the next-generation Sapien 3 Ultra, is the first transcatheter heart valve<a href="https://solaci.org/en/2019/11/15/europe-grants-approval-to-balloon-expandable-valve-in-low-risk-patients-self-expanding-valve-still-waiting-for-it/" title="Read more" >...</a>