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Transcarotid versus transfemoral access for cerebrovascular intervention: protocol for a systematic review and meta-analysis
Introduction Cerebrovascular intervention is an excellent option to treat cerebrovascular diseases. Interventional access is a prerequisite and a foundation for cerebrovascular intervention, which is crucial to the success of an intervention. Although transfemoral arterial access (TFA) has become a popular and acceptable method of access for cerebrovascular angiography and intervention in clinical practice, it has some drawbacks that limit the usage in cerebrovascular interventions. Therefore, transcarotid arterial access (TCA) has been developed in cerebrovascular interventions. We aim to conduct a systematic review to co...
Source: BMJ Open - June 14, 2023 Category: General Medicine Authors: Luo, J., Liao, W., Lei, D., Xing, Z., Wang, T., Xu, W., Wang, X., Yang, R., Wang, J., Gong, H., Yang, B., Ma, Y., Jiao, L., Chen, Y. Tags: Open access, Neurology Source Type: research

Effects of intensive lipid lowering compared with moderate-intensity lipid lowering on coronary atherosclerotic plaque phenotype and major adverse cardiovascular events in adults with low to intermediate 10-year ASCVD risk (ILLUMINATION study): protocol for a multicentre, open-label, blinded-endpoint, randomised controlled trial
Introduction Current guidelines recommend moderate-intensity lipid lowering (low-density lipoprotein cholesterol, LDL-C of <2.6 mmol/L or 30%–49% reduction from the baseline) for patients with intermediate 10-year atherosclerotic cardiovascular disease (ASCVD) risk. The effects of intensive lipid lowering (LDL-C of <1.8 mmol/L) on coronary atherosclerotic plaque phenotype and major adverse cardiovascular events (MACE) in adults with both non-obstructive coronary artery disease (CAD) and low to intermediate 10-year ASCVD risk remain uncertain. Methods and analysis Intensive Lipid-lowering for Plaque and Major A...
Source: BMJ Open - June 5, 2023 Category: General Medicine Authors: Zheng, J., Hou, Z., Yuan, J., Zhao, X., Wang, Y., Li, J., Zhang, W., Dou, K., Lu, B. Tags: Open access, Cardiovascular medicine Source Type: research

Protocol for Guos aortIc Arch recoNstrucTion: a prospective, multicentre and single-arm study to evaluate the safety and efficacy of the WeFlow-Arch modular inner branch stent-graft system for aortic arch lesions (GIANT study)
This study aims to evaluate the safety and efficacy of the novel modular branch stent-graft system in patients with aortic arch lesions who are unsuitable for open aortic arch replacement. Methods and analysis This prospective, multicentre, single-arm, clinical trial will enrol 80 patients with aortic arch lesions requiring intervention, namely, true aortic arch aneurysms, pseudo-aortic arch aneurysms and penetrating ulcers involving the aortic arch. Clinical information and CT angiography (CTA) images will be collected and analysed to investigate the safety and efficacy of the novel modular branch stent-graft system. Pat...
Source: BMJ Open - October 10, 2022 Category: General Medicine Authors: Liu, F., Zhang, H., Rong, D., Ge, Y., Jia, X., Xiong, J., Ma, X., Wang, L., Fan, T., Guo, W. Tags: Open access, Surgery Source Type: research

Cost-effectiveness of follow-up invasive coronary angiography after percutaneous coronary stenting: a real-world observational cohort study in Japan
Conclusions FUICA increased the costs but did not improve clinical benefits. Thus, FUICA is not economically more attractive than CF alone. Trial registration number UMIN000039768.
Source: BMJ Open - August 30, 2022 Category: General Medicine Authors: Shiina, T., Goto-Hirano, K., Takura, T., Daida, H. Tags: Open access, Health economics Source Type: research

Impact of multimorbidity on long-term outcomes in older adults with non-ST elevation acute coronary syndrome in the North East of England: a multi-centre cohort study of patients undergoing invasive care
Conclusions In older adults with NSTE-ACS referred for coronary angiography, the presence of multimorbidity is associated with an increased risk of long-term adverse cardiovascular events, driven by a higher risk of all-cause mortality. Trial registration number NCT01933581; ClinicalTrials.gov.
Source: BMJ Open - July 26, 2022 Category: General Medicine Authors: Beska, B., Mills, G. B., Ratcovich, H., Wilkinson, C., Damluji, A. A., Kunadian, V. Tags: Open access, Cardiovascular medicine Source Type: research

Very early invasive angiography versus standard of care in higher-risk non-ST elevation myocardial infarction: study protocol for the prospective multicentre randomised controlled RAPID N-STEMI trial
Background There are a paucity of randomised data on the optimal timing of invasive coronary angiography (ICA) in higher-risk patients with non-ST elevation myocardial infarction (N-STEMI). International guideline recommendations for early ICA are primarily based on retrospective subgroup analyses of neutral trials. Aims The RAPID N-STEMI trial aims to determine whether very early percutaneous revascularisation improves clinical outcomes as compared with a standard of care strategy in higher-risk N-STEMI patients. Methods and analysis RAPID N-STEMI is a prospective, multicentre, open-label, randomised-controlled, pragmat...
Source: BMJ Open - May 3, 2022 Category: General Medicine Authors: Kite, T. A., Banning, A. S., Ladwiniec, A., Gale, C. P., Greenwood, J. P., Dalby, M., Hobson, R., Barber, S., Parker, E., Berry, C., Flather, M. D., Curzen, N., Banning, A. P., McCann, G. P., Gershlick, A. H. Tags: Open access, Cardiovascular medicine, COVID-19 Source Type: research

Expediting workflow in the acute stroke pathway for endovascular thrombectomy in the northern Netherlands: a simulation model
Conclusions In our region, the proposed workflow improvements might reduce time to treatment by about 1 hour and increase the number of patients regaining functional independence by 6%. Simulation modelling is useful for assessing the potential effects of interventions aimed at reducing time from onset to EVT.
Source: BMJ Open - April 6, 2022 Category: General Medicine Authors: Maas, W. J., Lahr, M. M. H., Uyttenboogaart, M., Buskens, E., van der Zee, D.-J., On behalf of CONTRAST investigators Tags: Open access, Neurology Source Type: research

Protocol for GUos renovisceral Artery reconstruction-1: a prospective, multicentre, single-arm clinical trial to evaluate the safety and efficacy of a multibRANched sTEnt graft systEm for thoracoabdominal aortic aneurysm (GUARANTEE study)
Introduction The multibranched off-the-shelf stent graft is a promising treatment option for thoracoabdominal aortic aneurysm (TAAA). A commercially available, multibranched, off-the-shelf endograft called the t-Branch stent graft has demonstrated favourable midterm outcomes. Another two investigational off-the-shelf endografts, the GORE EXCLUDER Thoracoabdominal Branch Endoprosthesis and E-nside multibranch stent graft system, are still being developed. However, these three endografts have an unsatisfactory anatomic feasibility rate in patients with TAAA. Based on the concept of Guo’s renovisceral artery reconstruct...
Source: BMJ Open - March 23, 2022 Category: General Medicine Authors: Ge, Y., Zhang, H., Rong, D., Liu, F., Jia, X., Xiong, J., Ma, X., Wang, L., Fan, T., Guo, W. Tags: Open access, Cardiovascular medicine Source Type: research

Impact of interankle blood pressure difference on major adverse cardiovascular events in cryptogenic stroke patients without peripheral artery disease: a retrospective cohort study
Conclusions Large IAND is independently associated with the long-term occurrence of MACEs in patients with CS without PAD. In particular, the association between IAND and MACEs is only valid in elderly patients.
Source: BMJ Open - February 23, 2022 Category: General Medicine Authors: Han, M., Baik, M., Kim, Y. D., Choi, J., Seo, K., Park, E., Heo, J. H., Nam, H. S. Tags: Open access, Neurology Source Type: research

Clinical characteristics, management and 1-year outcomes of patients with acute coronary syndrome in Iran: the Iranian Project for Assessment of Coronary Events 2 (IPACE2)
Conclusions Our study showed that the composition of Iranian patients with ACS regarding the type of ACS is similar to that in developed European countries and is unlike that in developing countries of the Middle East and Africa. We found that our patients with ACS are treated with high levels of adherence to guideline-recommended in-hospital medications.
Source: BMJ Open - December 15, 2015 Category: Journals (General) Authors: Kassaian, S. E., Masoudkabir, F., Sezavar, H., Mohammadi, M., Pourmoghaddas, A., Kojouri, J., Ghaffari, S., Sanaati, H., Alaeddini, F., Pourmirza, B., Mir, E., on-behalf of the IPACE2 registry investigators Tags: Open access, Cardiovascular medicine, Evidence based practice, Medical management Research Source Type: research

Prediction and prognostication of neurological deterioration in patients with acute ICH: a hospital-based cohort study
Conclusions These results suggest that stability during the first week entails an optimistic prognosis. A relatively easy and effective risk stratification of END and LND is possible on admission based on the spot sign, IVH and clinical parameters.
Source: BMJ Open - July 28, 2015 Category: Journals (General) Authors: Ovesen, C., Christensen, A. F., Havsteen, I., Krarup Hansen, C., Rosenbaum, S., Kurt, E., Christensen, H. Tags: Open access, Cardiovascular medicine, Medical management, Neurology, Radiology and imaging Research Source Type: research