Most certainly, as we read this title, we imagine the conclusion (as does the editor): patients with prior cerebrovascular disease (CEVD) benefit from a less invasive revascularization strategy, such as PCI. However, the EXCEL outcomes tell us that patients with left main coronary artery disease (LMCAD) and a history of CEVD will not benefit from…
Cerebral Protection in TAVR: Does It Improve Cognitive Function?
Neurological complications during transcatheter aortic valve replacement (TAVR) may be reduced with cerebral protection devices; this study was designed to explore that hypothesis. The study enrolled 363 patients undergoing TAVR in 19 sites and divided them in three arms: a safety arm (n = 123), a device imaging arm (n = 121), and a non-device imaging arm (n = 119). The…
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…
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…