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Initial report of percutaneous left atrial appendage closure in hemodialysis patients with atrial fibrillation and high risk of bleeding in Japan
AbstractIn the countries like Japan where anticoagulation is not recommended in hemodialysis patients, the feasibility of percutaneous left atrial appendage closure (LAAC) in hemodialysis patients with non-valvular atrial fibrillation (NVAF) accompanying high risks of thromboembolic stroke and bleeding remains unknown. Peri-procedural and 45-day clinical outcomes following LAAC using WATCHMAN system, which were performed in our institute between Jun 2020 and April 2022 according to the Japanese Circulation Society guidelines, were retrospectively compared between those with and without hemodialysis. 118 patients (median 79...
Source: Cardiovascular Intervention and Therapeutics - December 23, 2022 Category: Cardiology Source Type: research

Duration and clinical outcome of dual antiplatelet therapy after percutaneous coronary intervention: a retrospective cohort study using a medical information database from Japanese hospitals
In conclusion, early DAPT discontinuation is more likely in patients at high bleeding risk, but may influence the occurrence of ischemic events in these patients. Determination of DAPT duration should take into account potential ischemic risk, even in patients at high bleeding risk.
Source: Cardiovascular Intervention and Therapeutics - February 9, 2022 Category: Cardiology Source Type: research

Latest outcomes of transcatheter left atrial appendage closure devices and direct oral anticoagulant therapy in patients with atrial fibrillation over the past 5  years: a systematic review and meta-analysis
AbstractLeft atrial appendage closure (LAAC) are emerging treatment for patients with atrial fibrillation (AF). However, data on the safety, efficacy, and medications for LAAC devices in patients with AF are lacking. We aimed to investigate the incidence of all-cause mortality, stroke, and major bleeding in AF patients with LAAC devices and DOACs. Moreover, we aimed to investigate the incidence rate of device-related thrombus (DRT) and the medications used in the management of AF patients with LAAC devices to gain insights into achieving better outcome. Based on a literature search using PubMed, EMBASE, Cochrane Library, a...
Source: Cardiovascular Intervention and Therapeutics - January 30, 2022 Category: Cardiology Source Type: research

Feasibility and safety of transradial balloon aortic valvuloplasty in patients with severe aortic stenosis
AbstractBalloon aortic valvuloplasty (BAV) was developed as a technique to treat aortic stenosis (AS) and is associated with significant improvements in aortic valve area and trans-aortic valve gradient in the early and immediate periods after the procedure. BAV is commonly performed using a trans-femoral retrograde approach; however, trans-femoral access is associated with frequent access-site bleeding. Among 146 patients with symptomatic severe AS who were treated with BAV in our institution, 123 patients received BAV treatment via a trans-radial approach using a 7-Fr Glidesheath. The balloon size was 16 –20 mm for al...
Source: Cardiovascular Intervention and Therapeutics - January 4, 2022 Category: Cardiology Source Type: research

Safety and efficacy of cerebral embolic protection devices in patients undergoing transcatheter aortic valve replacement: a meta-analysis of in-hospital outcomes
The objective of this study was to evaluate in-hospital outcomes with the use of cerebral EPDs in TAVR. We performed a comprehensive EMBASE and PUBMED search to investigate randomized control studies or propensity score-matched retrospective studies which assessed patients undergoing TAVR with or without EPD up to April 2021. Endpoints of interest were in-hospital mortality, stroke, acute kidney injury, pacemaker implantation, major bleeding, vascular complication, length of stay. Ten studies involving 173,002 patients with EPD (n = 16,898, 9.8%) and those without (n = 156,104, 90.2%) fulfilled the inclusion criter...
Source: Cardiovascular Intervention and Therapeutics - November 13, 2021 Category: Cardiology Source Type: research

Relationship between in-hospital event rates and high bleeding risk score in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction
In conclusion, the HBR criteria were associated with in-hospital events in AMI patients who underwent primary PCI.
Source: Cardiovascular Intervention and Therapeutics - August 18, 2021 Category: Cardiology Source Type: research

Clinical outcomes in nonagenarians undergoing transcatheter aortic valve implantation: a systematic review and meta-analysis
AbstractTo compare the risk of procedural complications and mortality after transcatheter aortic valve implantation (TAVI) in nonagenarians (age  ≥ 90 years) compared to younger patients (<  90 years). Although TAVI could be considered as a treatment option in nonagenarians, several previous studies have shown conflicting outcomes between nonagenarians and younger patients who underwent TAVI. We conducted a comprehensive literature search through PubMed and EMBASE to investigate the clinical outcomes of nonagenarians after TAVI. The outcomes of interest were short- and long-term mortality and procedural compli...
Source: Cardiovascular Intervention and Therapeutics - January 11, 2021 Category: Cardiology Source Type: research

Clinical outcomes of transcatheter aortic valve implantation in failed bioprosthetic surgical valves vs. native aortic stenosis: insights from a meta-analysis
AbstractThere is no meta-analysis comparing clinical outcomes between valve-in-valve transcatheter aortic valve implantation for failed surgical bioprosthetic valves (ViV-TAVI) and native valve TAVI for aortic stenosis (NV-TAVI). We aimed to investigate clinical outcomes between ViV-TAVI and NV-TAVI using a meta-analysis. EMBASE and MEDLINE were searched through April 2020 to investigate the comparative outcomes between ViV-TAVI and NV-TAVI. The main outcomes were short-term (30-day/in-hospital) mortality, pacemaker implantation (PMI), life threatening and/or major bleeding, stroke, and coronary obstruction, and long-term ...
Source: Cardiovascular Intervention and Therapeutics - November 18, 2020 Category: Cardiology Source Type: research

Clinical outcomes of patients treated using very short duration dual antiplatelet therapy after implantation of biodegradable-polymer drug-eluting stents: rationale and design of a prospective multicenter REIWA registry
This study is an observational, prospective, multicenter registry encompassing the entire local medical region of Iwate Prefecture (northern area of mainland Japan). A total of 1200 patients who underwent successful PCI with a novel thin strut BP-DES (Synergy, Ultimaster or Orsiro) and are considered to be appropriate patients for very short DAPT, are registered and subsequently administered 1-month DAPT followed by P2Y12 inhibitor monotherapy (clopidogr el 75 mg/day or prasugrel 3.75 mg/day). The primary endpoint was a composite of cardiovascular and bleeding events, which included cardiovascular death, spontaneous myoc...
Source: Cardiovascular Intervention and Therapeutics - August 9, 2020 Category: Cardiology Source Type: research

Details on the effect of very short dual antiplatelet therapy after drug-eluting stent implantation in patients with high bleeding risk: insight from the STOPDAPT-2 trial
In conclusion, the effects of 1-month DAPT for the primary and major secondary endpoints were consistent in HBR and non-HBR patients without any significant interactions. The benefit of 1-month DAPT in reducing major bleeding was numerically greater in HBR patients.Clinical trial registration Short and optimal duration of dual antiplatelet therapy after everolimus-eluting cobalt –chromium stent-2 [STOPDAPT-2]; NCT02619760.
Source: Cardiovascular Intervention and Therapeutics - February 20, 2020 Category: Cardiology Source Type: research

Slender transradial iliac artery stenting using a 4.5  French guiding sheath
AbstractWe previously reported safety and usefulness of transradial iliac artery stenting using 6  Fr guiding sheath. However, radial artery occlusion was a major limitation of this procedure. We analyzed the safety and utility of slender transradial iliac artery stenting using a 4.5 Fr guiding sheath to prevent radial artery occlusion. We performed transradial iliac artery stenting in left ra dial artery, using a 4.5 Fr sheath incorporating a shaft length of 110 cm, for 34 lesions in 29 patients. Transradial intervention was attempted at the discretion of the operator. Clinical data were analyzed retrospectively. Case...
Source: Cardiovascular Intervention and Therapeutics - January 5, 2018 Category: Cardiology Source Type: research

Short versus prolonged dual antiplatelet therapy duration after bare-metal stent implantation: 2-month landmark analysis from the CREDO-Kyoto registry cohort-2
In conclusion, short DAPT<2 month after BMS implantation was as safe as prolonged DAPT ≥2-month in both AMI and non-AMI patients.
Source: Cardiovascular Intervention and Therapeutics - September 18, 2016 Category: Cardiology Source Type: research

One-year outcome of a prospective trial stopping dual antiplatelet therapy at 3  months after everolimus-eluting cobalt-chromium stent implantation: ShortT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent (STOPDAPT) trial
In conclusion, stopping DAPT at 3 months in selected patients after CoCr-EES implantation was at least as safe as the prolonged DAPT regimen adopted in the historical control group.
Source: Cardiovascular Intervention and Therapeutics - June 30, 2016 Category: Cardiology Source Type: research

Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry
Abstract Little is known about the mid-term outcomes of patients with atrial fibrillation (AF) who undergo coronary stenting in the second-generation drug-eluting stent (DES) era. We evaluated the 1-year outcomes of AF patients undergoing percutaneous coronary intervention (PCI) with second-generation DES. This retrospective cohort analysis used integrated data from the SHINANO registry, a prospective observational multicenter cohort study, which enrolled 1923 consecutive patients undergoing PCI for any coronary artery disease. We retrospectively recruited 917 of these patients (mean age, 71.3 ± 10.0 years; ma...
Source: Cardiovascular Intervention and Therapeutics - June 15, 2016 Category: Cardiology Source Type: research

One-year outcome of a prospective trial stopping dual antiplatelet therapy at 3 months after everolimus-eluting cobalt-chromium stent implantation: ShortT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent (STOPDAPT) trial
In conclusion, stopping DAPT at 3 months in selected patients after CoCr-EES implantation was at least as safe as the prolonged DAPT regimen adopted in the historical control group.
Source: Cardiovascular Intervention and Therapeutics - October 30, 2015 Category: Cardiology Source Type: research