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https://www.readbyqxmd.com/read/29045310/risk-of-stroke-after-transcatheter-prosthetic-aortic-valve-implant-with-aortic-bioprosthesis-subclinical-thrombosis-and-possible-therapeutic-implications
#1
Giuseppe Di Pasquale, Gloria V Coutsoumbas, Silvia Zagnoni
: Many factors could increase the risk of stroke after transcatheter prosthetic aortic valve implant, mainly related to the procedure itself, or to the type of valvular prosthesis, or to the presence of atrial fibrillation. There is a wide variability in the antithrombotic treatment utilized in clinical practice, as far as the choice of drugs (anticoagulant, single or dual antiplatelet treatment), and its optimal duration. The most popular therapeutic strategy, also recommended by the Scientific Societies, is dual antiplatelet (aspirin and clopidogrel) for the first 3-6 months then switching to single antiplatelet (usually aspirin), limiting oral anticoagulant therapy only to those patients with other primary indication to the treatment...
October 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29044795/ahns-series-do-you-know-your-guidelines-perioperative-antithrombotic-management-in-head-and-neck-surgery
#2
Annika Meyer, Neil Gross, Marita Teng
Head and neck surgeons are commonly faced with surgical patients who have underlying medical problems requiring antithrombotic therapy. It is difficult to achieve a balance between minimizing the risk of thromboembolism and hemorrhage in the perioperative period. Data from randomized, controlled trials are limited, and procedure-specific bleed rates are also difficult to pinpoint. The decision is made more difficult when patients with moderate-to-high risk for thromboembolic events undergo procedures that are high risk for bleeding...
October 16, 2017: Head & Neck
https://www.readbyqxmd.com/read/29043079/acute-coronary-syndromes-in-the-elderly
#3
REVIEW
Niels Engberding, Nanette K Wenger
The clinical evidence for treatment of acute coronary syndrome (ACS) in the elderly is less robust than in patients younger than 75 years. The elderly have the highest incidence of cardiovascular disease and frequently present with ACS. This number can be expected to increase over time because society is aging. Older adults often sustain unfavorable outcomes from ACS because of atypical presentation and delay in recognition. In addition, elderly patients commonly do not receive optimal guideline-directed ACS treatment...
2017: F1000Research
https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#4
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29042008/risky-business-investigating-outcomes-of-patients-undergoing-urgent-laparoscopic-appendectomy-on-antithrombotic-therapy
#5
Christopher Pearcy, Khalid Almahmoud, Theresa Jackson, Cassie Hartline, Anthony Cahill, Lara Spence, Dennis Kim, Oluwabukola Olatubosun, S Rob Todd, Eric M Campion, Clay Cothren Burlew, Justin Regner, Richard Frazee, David Michaels, Sharmila Dissanaike, Collin Stewart, Neal Foley, Paul Nelson, Vaidehi Agrawal, Michael S Truitt
No abstract text is available yet for this article.
October 5, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29037012/medical-treatment-of-intracranial-atherosclerosis-an-update
#6
REVIEW
Jong S Kim, Oh Young Bang
For patients with symptomatic intracranial atherosclerosis (ICAS), antithrombotic agents are the mainstay of therapy. Anticoagulation (warfarin) is not widely used since it is not more effective than aspirin and carries a high risk of bleeding. New oral anticoagulants are showing promise, but their use has not been investigated in appropriate clinical trials. Since the recurrent stroke risk is high with aspirin monotherapy, dual antiplatelets are considered in the early stage of symptomatic ICAS. Based on the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) and Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) results, aspirin plus clopidogrel has been recommended...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29035553/construction-of-antithrombotic-tissue-engineered-blood-vessel-via-reduced-graphene-oxide-based-dual-enzyme-biomimetic-cascade
#7
Da Huo, Ge Liu, Yanzhao Li, Yuxin Wang, Ge Guan, Mingcan Yang, Keyu Wei, Jingyuan Yang, Lingqin Zeng, Gang Li, Wen Zeng, Chuhong Zhu
Thrombosis is one of the biggest obstacles in the clinical application of small-diameter tissue-engineered blood vessels (TEBVs). The implantation of an unmodified TEBV will lead to platelet aggregation and further activation of the coagulation cascade, in which the high concentration of adenosine diphosphate (ADP) that is released by platelets plays an important role. Inspired by the phenomenon that endothelial cells continuously generate endogenous antiplatelet substances via enzymatic reactions, we designed a reduced graphene oxide (RGO) based dual-enzyme biomimetic cascade to successively convert ADP into adenosine monophosphate (AMP) and AMP into adenosine...
October 16, 2017: ACS Nano
https://www.readbyqxmd.com/read/29034832/new-advances-in-atrial-fibrillation-management-the-role-of-apixaban
#8
Giuseppe Mc Rosano, Ilaria Spoletini, Walter Gianni, Cristiana Vitale
Prevention of stroke is a pivotal intervention in the management of patients with atrial fibrillation (AF) at increased risk of systemic embolism. Because of the difficulties of safely implementing Vitamin K Antagonists in all patients, there has been a growing interest in improving the pharmacological management of AF, with newer antithrombotic agents. The new oral anticoagulants (NOACs) have been developed to overcome the limitations and improve the efficacy of the conventional oral anticoagulant drugs. Among the NOACs, apixaban - a very specific antagonist of activated factor Xa - has pharmacokinetic and pharmacodynamic properties that allow significant efficacy in AF management...
October 12, 2017: Current Drug Targets
https://www.readbyqxmd.com/read/29033031/the-next-challenges-for-optimal-reperfusion-in-the-era-of-mechanical-thrombectomy
#9
REVIEW
M Mazighi
The therapeutic management of acute ischemic stroke has changed tremendously over the past few years. Mechanical thrombectomy in addition to intravenous tissue plasminogen activator (t-PA) is currently the standard of care for patients experiencing acute ischemic stroke as a consequence of large vessel occlusion of the anterior circulation. Yet, despite strong evidence supporting such a therapeutic approach, several issues remain a source of debate, such as the need for intravenous t-PA, the optimal target for blood pressure levels and the opportunity for additional antithrombotic therapies to improve reperfusion...
October 12, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/29031015/the-venous-thromboembolic-risk-and-the-clot-wave-analysis-a-useful-relationship
#10
Maria Filomena Ruberto, Francesco Marongiu, Antonella Mandas, Antonella Mameli, Mariagrazia Porru, Elisabetta Cianchetti, Doris Barcellona
BACKGROUND: Hospitalized patients with acute medical conditions have higher venous thromboembolism (VTE) risk. A patient with a final Padua Prediction Score (PPS) of ≥4 is considered to be at high risk for VTE. The aim of this study was to investigate on a possible relationship between PPS, the dynamics of the clot formation, i.e. the clot waveform analysis (CWA) of aPTT, fibrinogen and D-Dimer in a large group of medical patients. METHODS: CWA in terms of velocity (first derivative), acceleration (second derivative), density (Delta) of aPTT, fibrinogen, D-Dimer and PPS for VTE were determined in 801 medical patients divided in three groups (without antithrombotic prophylaxis and high PPS, without antithrombotic prophylaxis and low PPS, with antithrombotic prophylaxis and high PPS) and a group of healthy subjects...
October 14, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29029944/-antithrombotic-treatment-consensus-protocol-anticoagulation-and-antiplatelet-therapy-during-the-perioperative-and-periprocedural-period-in-neurosurgery
#11
Fuat Arikan Abelló, Luis Ley Urzaiz, José Fernández Alén, Rubén Martín Láez
The use of antithrombotic medication (antiplatelet and/or anticoagulant therapy) is widespread. Currently, the management of neurosurgical patients receiving this type of therapy continues to be a problem of special importance. Patients receiving antithrombotic treatment may need neurosurgical care because of bleeding secondary to such treatment, non-haemorrhagic neurosurgical lesions requiring urgent attention, or simply elective neurosurgical procedures. In addition, the consequences of reintroducing early (bleeding or rebleeding) or late (thrombotic or thromboembolic) anticoagulation can be devastating...
October 10, 2017: Neurocirugía
https://www.readbyqxmd.com/read/29025156/risk-factors-associated-with-mortality-from-vascular-thromboembolic-events-in-patients-diagnosed-with-non-small-cell-lung-cancer-a-population-based-analysis
#12
Xian-Jun He, Ying-Ying Wu, Ming-Rong Xia, Zhi-Qiang Li, Ming Zhao, Quan-De Dai, Jian-Ping Zhang, Jian-Hua Xia, Jie-Wen Zhang
Background: Lung cancer patients are at increased risk for vascular events possibly due to cancer induced hypercoagulation. Aim: The purpose of this study was to evaluate risk factors associated with the mortality from vascular thromboembolic events in patients diagnosed with non-small cell lung cancer (NSCLC). Design: Retrospective population-based analysis. Methods: We used Surveillance, Epidemiology, and End Results Program for 2004 - 2013 and evaluated 199,337 patients with NSCLC...
August 24, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29023526/antithrombotic-therapy-strategies-for-atrial-fibrillation-patients-undergoing-percutaneous-coronary-intervention-a-systematic-review-and-network-meta-analysis
#13
Xiaoxuan Gong, Shaowen Tang, Jiangjin Li, Xiwen Zhang, Xiaoyi Tian, Shuren Ma
OBJECTIVE: The aim of this systematic review and network meta-analysis was to evaluate the comparative efficacy and safety of antiplatelet agents, vitamin K antagonist (VKA) and non-VKA oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). METHODS: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify clinical trials comparing antiplatelet drugs with VKA and NOACs or their combination in AF patients undergoing PCI with a mean/median follow-up of at least 12 months...
2017: PloS One
https://www.readbyqxmd.com/read/29021578/strong-binding-of-platelet-integrin-%C3%AE-iib%C3%AE-3-to-fibrin-clots-potential-target-to-destabilize-thrombi
#14
Peter Höök, Rustem I Litvinov, Oleg V Kim, Shixin Xu, Zhiliang Xu, Joel S Bennett, Mark S Alber, John W Weisel
The formation of platelet thrombi is determined by the integrin αIIbβ3-mediated interactions of platelets with fibrinogen and fibrin. Blood clotting in vivo is catalyzed by thrombin, which simultaneously induces fibrinogen binding to αIIbβ3 and converts fibrinogen to fibrin. Thus, after a short time, thrombus formation is governed by αIIbβ3 binding to fibrin fibers. Surprisingly, there is little understanding of αIIbβ3 interaction with fibrin polymers. Here we used an optical trap-based system to measure the binding of single αIIbβ3 molecules to polymeric fibrin and compare it to αIIbβ3 binding to monomeric fibrin and fibrinogen...
October 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#15
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29020333/thrombo-embolic-prevention-after-transcatheter-aortic-valve-implantation
#16
Pascal Vranckx, Stephan Windecker, Robert C Welsh, Marco Valgimigli, Roxana Mehran, George Dangas
Transcatheter aortic valve implantation (TAVI) has emerged as a valuable treatment alternative to surgical aortic valve replacement among patients with symptomatic aortic stenosis at increased surgical risk. The rapid technological evolution from early to current-generation TAVI systems with low-profile delivery catheters, bioprosthetic valves with proven midterm durability, and improved positioning and retrieval features have made important contributions to the widespread clinical use of this minimal invasive therapy...
July 25, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29018133/carotid-web-intimal-fibromuscular-dysplasia-has-high-stroke-recurrence-risk-and-is-amenable-to-stenting
#17
Diogo C Haussen, Jonathan A Grossberg, Mehdi Bouslama, Gustavo Pradilla, Samir Belagaje, Nicolas Bianchi, Jason W Allen, Michael Frankel, Raul G Nogueira
BACKGROUND AND PURPOSE: Carotid webs have been increasingly recognized as a cause of recurrent stroke, but evidence remains scarce. We aim to report the clinical outcomes and first series of carotid stenting in a cohort of patients with strokes from symptomatic carotid webs. METHODS: Prospective and consecutive data of patients <65 years old with cryptogenic stroke admitted within September 2014 to May 2017. Carotid web was defined by a shelf-like/linear filling defect in the posterior internal carotid artery bulb by computed tomographic angiography...
October 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29016832/contemporary-stroke-prevention-strategies-in-11%C3%A2-096-european-patients-with-atrial-fibrillation-a-report-from-the-eurobservational-research-programme-on-atrial-fibrillation-eorp-af-long-term-general-registry
#18
Giuseppe Boriani, Marco Proietti, Cécile Laroche, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Igor Diemberger, Luigi Tavazzi, Aldo P Maggioni, Gregory Y H Lip
Aims: Contemporary data regarding atrial fibrillation (AF) management and current use of oral anticoagulants (OACs) for stroke prevention are needed. Methods and results: The EURObservational Research Programme on AF (EORP-AF) Long-Term General Registry analysed consecutive AF patients presenting to cardiologists in 250 centres from 27 European countries. From 2013 to 2016, 11 096 patients were enrolled (40.7% female; mean age 69 ± 11 years). At discharge, OACs were used in 9379 patients (84...
September 14, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016758/non-vitamin-k-antagonist-oral-anticoagulants-in-atrial-fibrillation-patients-undergoing-elective-cardioversion
#19
Saga Itäinen, Mika Lehto, Tuija Vasankari, Pirjo Mustonen, Mervi Kotamäki, Anna Numminen, Heli Lahtela, Aissa Bah, Juha Hartikainen, Anna-Mari Hekkala, Juhani K E Airaksinen
Aims: Non-vitamin K antagonist oral anticoagulants (NOAC) have been shown to be safe and effective alternatives to warfarin for the prevention of thromboembolic complications in patients with non-valvular atrial fibrillation (AF). The aim of this study was to investigate the complications and the use of NOACs in AF patients undergoing elective cardioversion. Methods and results: This nationwide multicentre study included consecutive elective cardioversions in AF patients treated with NOACs between October 2011 and May 2016...
July 10, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#20
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
September 2017: Stroke and Vascular Neurology
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