Novel Embolic Protection Device: a Feasibility Study

AbstractStroke is ranked as the second leading cause of death worldwide. Ischemic stroke commonly results from emboli that originate in the heart among high-risk patients, such as those who develop atrial fibrillation. Yet, treatment is currently limited to anticoagulants, which may be associated with life-threatening bleeding. Our aim was to develop an alternative, device-based approach for continuous stroke prevention in high-risk patients. To this end, a novel endovascular tubular mesh was designed to be implanted in the aortic arch and to reroute emboli away from critical cerebral arteries. The feasibility of this approach as a means of ischemic stroke prevention was tested in vitro. The simulated cerebral perfusion pressures were not affected by the device. Also, the device efficiently diverted clinically meaningful embolic particles away from the cerebral circulation. It is proposed that this device could be used to reroute cardio-emboli away from intracranial vessels as a means of stroke prevention among patients for which anticoagulants are contraindicated.
Source: Journal of Cardiovascular Translational Research - Category: Cardiology Source Type: research

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CONCLUSIONS: In highly selected patients at very HBR, discontinuation of any antithrombotic therapy after LAAC appears safe and feasible. PMID: 32999093 [PubMed - in process]
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
ConclusionsIn the treatment of AF, CA appeared to be superior to AADs, decreasing the risk of all-cause death and cardiovascular hospitalization and improving the long-term QoL of patients with AF. CA was better tolerated and more effective than pharmacological therapy and allowed for improved QoL.
Source: American Journal of Cardiovascular Drugs - Category: Cardiology Source Type: research
AbstractPurposeOptimal stroke prevention strategies for patients with atrial fibrillation (AF) who experience a major bleed are poorly defined. We sought to estimate the effectiveness and safety of oral anticoagulation (OAC) represcription after an OAC contraindication.MethodsTREAT-AF is a retrospective cohort study of patients with newly diagnosed AF (2004 –2012), treated in the Veterans Health Administration. From this cohort, we identified patients with a contraindication to OAC after AF diagnoses, defined as incident intracranial bleeding, non-intracranial bleeding requiring hospitalization, or unrepaired cerebra...
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
ConclusionIn NVAF patients of all ages initiating either apixaban or warfarin for stroke prevention in the Sentinel System, apixaban was associated with a decreased risk of GI bleeding, ICH, and ischemic stroke compared with warfarin. Among patients less than 65  years of age, apixaban use was associated with a decreased risk of GI bleeding and ischemic stroke.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
AbstractBackgroundWomen undergoing atrial fibrillation catheter ablation (AFCA) have higher rates of vascular complications and major bleeding. However, most studies have been underpowered to detect differences in rarer complications such as stroke/transient ischemic attack (TIA) and procedural mortality.MethodsWe performed a systematic review of databases (PubMed, World of Science, Embase) to identify studies published since 2010 reporting AFCA complications by sex. Six complications of interest were: 1) vascular/groin complications; 2) pericardial effusion/tamponade; 3) stroke/TIA; 4) permanent phrenic nerve injury; 5) m...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ‐ ELECTROPHYSIOLOGY Source Type: research
AbstractPurposeThe purpose of the present study was to compare the long-term effectiveness and safety of newly initiated anticoagulation with edoxaban (EDO) versus uninterrupted vitamin K antagonist (VKA) therapy in patients with atrial fibrillation (AF) scheduled for transesophageal echocardiogram (TEE)-guided direct electrical current cardioversion (DCC).MethodsA propensity score-matched cohort observational study was performed comparing the safety and effectiveness of edoxaban versus well-controlled VKA therapy among a cohort of consecutive non-valvular AF patients scheduled for DCC. The primary safety outcome was major...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
ConclusionsConcurrent LAA exclusion during MVR is a safe and effective way to reduce postoperative ischemic stroke, particularly in patients with AF.
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation therapy in patients with non-valvular atrial fibrillation for the prevention of embolic stroke and systemic embolism. Although elderly patients (>75 years) have both higher ischemic and bleeding risk as compared to younger patients, they benefit from optimal anticoagulation. The sub-analysis aimed to assess the indications, the safety, efficacy, and 1-year outcomes of interventional LAAC in elderly patients ( ≥ 75 years) compared to younger (
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Left atrial appendage closure (LAAC) is an alternative to oral anticoagulation therapy in patients with non-valvular atrial fibrillation for the prevention of embolic stroke and systemic embolism. Although elderly patients (>75 years) have both higher ischemic and bleeding risk as compared with younger patients, they benefit from optimal anticoagulation. The subanalysis aimed to assess the indications, the safety, efficacy, and 1-year outcomes of interventional LAAC in elderly patients ( ≥ 75 years) compared with younger (
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractAimsMajor bleeding events in heart failure (HF) patients are poorly described. We sought to investigate the importance of major bleeding and its impact on outcomes in HF patients.Methods and resultsWe analysed incident bleeding and ischaemic events during a 3  year follow‐up in 2910 HF outpatients included in a prospective multicentre registry. Major bleeding was defined as a Type ≥3 bleed using the Bleeding Academic Research Consortium definition. Ischaemic event was a composite of ischaemic stroke and myocardial infarction. Events were adjudicated by a blinded committee. At inclusion, most patients (89%...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
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