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…
Bivalirudin or Heparin to Decrease Cerebral Embolization Post TAVI?
Cerebral embolization is a relatively frequent complication during transcatheter aortic valve replacement (TAVR). The hypothesis behind this study is that the incidence of cerebral embolization might be decreased by anticoagulation with bivalirudin, instead of heparin. The first study objective was to determine the proportion of patients with new cerebral embolus after TAVI and…
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…
TriGuard: NeuroProtection Device during TAVI
Original Title: A Patient Level Pooled Analysis of NeuroProtection with the TriGuard Embolic DEFLECTion Device Compared to Unprotected Transcatheter Aortic Valve Replacement. Presenter: Alexandra Lansky This work was designed to assess the safety and efficacy of the TriGuard device as a complement during transcatheter aortic valve implantation (TAVI) compared to no protection in a…
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…
Beta Blockers Could Improve Outcomes in Carotid Artery Stenting
Original Title: Beta-blocker use is associated with lower stroke and death after carotid artery stenting. Reference: Tammman Obeid, et al. J Vasc. Surg. 2016;63:363-9. Courtesy of Dr. Carlos Fava. The latest trials on Carotid Artery Stenting (CAS) have shown significantly improved effectiveness. The use of drugs such as beta blockers (BB) have proved beneficial in some…
Carotid stenting similar to surgery in asymptomatic patients
Original Title: Randomized Trial of stent versus Surgery for Asymptomatic Carotid Stenosis. Kenneth Rosenfield. N Engl J Med. 2016 Feb 17. [Epub ahead of print] Courtesy of Dr. Carlos Fava. Stokes are one of the main causes of death and disability in the world and up to 20% of strokes can be explained by carotid stenosis.…