Neuroprotection Devices in Cardiac Catheterization Laboratories: Does It Sufficiently Protect Our Patients?

Medicina, Journal Year: 2025, Volume and Issue: 61(2), P. 305 - 305

Published: Feb. 10, 2025

Stroke is a devastating complication of cardiovascular interventions. Intraprocedural stroke well-documented and feared risk cardiac percutaneous transcatheter procedures. If clinically significant strokes are absent, silent remain the next in line to pose large concerns related future cognitive decline, risk, overall increased morbidity mortality. Cerebral protection devices (CPD) developed overtime aim neutralize this through either capture-based filter or deflector mechanism. Many CPDs exist currently, each one unique, with varying degrees evidence. The adoption has allowed procedures be carried out patients high thromboembolic risks who may have historically been discommended. Though skewed towards certain procedures, body evidence still present across other This review will discuss clinical importance respective rates, updated surrounding CPDs, differing opinions types cost benefits, what lies ahead for within realm undertaken catheterization laboratories.

Language: Английский

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Cerebral Embolic Protection Devices in Transcatheter Aortic Valve Implantation: Meta‐Analysis With Trial Sequential Analysis

Journal of the American Heart Association, Journal Year: 2025, Volume and Issue: unknown

Published: March 21, 2025

Background We aimed to reevaluate randomized controlled trial data on outcomes of cerebral embolic protection device use during transcatheter aortic valve implantation. A conventional meta‐analysis followed by sequential analysis was conducted evaluate the strength current evidence. Methods and Results Databases were searched for trials. Primary included all stroke, disabling all‐cause mortality. Conventional study‐level performed using random‐effects modeling. Trial generate adjusted significance boundaries, futility required information size considering a type I error 5% power 90%. Seven trials with total 4031 patients, whom 2171 treated 1860 not. showed no significant difference in stroke (relative risk [RR], 0.85 [95% CI, 0.61–1.18]; P =0.339) (RR, 0.59 0.30–1.13]; =0.113) use. The determined an absence evidence (required 71 650 [5.6%]) 337 256 [1.2%]). mortality 1.03 0.49–2.17]; =0.928) that boundary reached 5772 [69.3%]). Conclusions There are insufficient provide conclusive meta‐analytic findings outcomes.

Language: Английский

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A Systematic Review of Transcarotid Approach for Endovascular Aortic Repair in Treating Aortic Disease

Vascular and Endovascular Surgery, Journal Year: 2025, Volume and Issue: unknown

Published: April 25, 2025

Purpose The purpose of this study is to evaluate the feasibility, efficacy, and safety transcarotid approach endovascular aortic repair (EVAR) in patients where conventional femoral access not possible. Materials Methods A systematic review all articles discussing EVAR published PubMed, Embase, Ovid, Web Science, Cochrane Library databases were conducted. This was conducted accordance with Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines. Results In inclusion criteria, 17 retrieved, encompassing 18 patients. Among these patients, 6 related ascending disease, including 4 cases pseudoaneurysms, 1 case penetrating ulcer, dissection. 9 had descending comprising aneurysms, 2 ulcers, pseudoaneurysm. There 3 abdominal aneurysms endoleak. 10 through left common carotid artery, 8 right artery. One patient experienced spinal cord ischemia subsequently died multi-organ failure caused by acute pancreatitis. Additionally, there one minor embolization nonsurgical supply area. No cerebral infarctions observed vascular territory ipsilateral artery at surgical site. Conclusions Research on limited predominantly consists reports, a notable absence randomized controlled trials. suggests that may be viable alternative selecting groups when feasible. These findings indicate method associated relatively manageable perioperative complications mortality rates.

Language: Английский

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Transcarotid Artery Approach for Endovascular Aortic Repair in Treating Complex Descending Thoracic Aortic Pseudoaneurysm With Aortoiliac Occlusion: A Case Report

Vascular and Endovascular Surgery, Journal Year: 2025, Volume and Issue: unknown

Published: May 10, 2025

Background Endovascular aortic repair has emerged as the preferred treatment modality over open surgery for diseases, primarily because of its association with lower perioperative morbidity and mortality rates. Current diagnostic guidelines generally advocate endovascular in most cases, femoral artery serving conventional access route. However, this approach may not be feasible all patients, particularly those aortoiliac occlusion, necessitating alternative strategies. Case Summary This paper presents a complex case study patient occlusion who underwent via left carotid pseudoaneurysm at anastomotic site descending prosthetic graft. underscores potential value utilizing an route anatomically challenging situations. Conclusion Research on transcarotid is limited predominantly consists reports, notable absence randomized controlled trials. report suggests that viable selecting groups when feasible. While our single demonstrated successful management minimal complications, larger studies are needed to fully establish safety profile determine if complications rates indeed manageable across diverse populations. Clinical Impact provides valuable insights into feasibility patients occlusion. It offers clinicians strategy cases where The findings presented herein aim demonstrate practicality relative procedures scenarios, contributing broader understanding alternatives interventions.

Language: Английский

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Meta-Analysis on Comparison of Fasting Versus No Fasting Before Cardiac Catheterization

Cardiology in Review, Journal Year: 2025, Volume and Issue: unknown

Published: April 22, 2025

Patients undergoing cardiac catheterization are advised not to take anything by mouth after midnight. However, limited scientific data exist on whether fasting before procedures improves clinical outcomes compared with nonfasting. A comprehensive literature search was performed investigators using major bibliographic databases identify studies that for versus nonfasting patient groups following procedures. The risk ratios (RR) and mean difference (MD) were pooled along 95% confidence intervals (CIs) dichotomous continuous R studios. total of 9 trials included in the review reporting 3432 patients (fasting: 1710 nonfasting: 1702). There no statistically significant between 2 incidence procedural complications (RR: 1.05, CI: 0.78–1.40; P = 0.757), 30-day mortality 0.83, 0.32–2.18; 0.71), readmissions 0.74–1.49; 0.77), aspiration 0.45, 0.06–3.50; 0.45), contrast-associated acute kidney injury 0.90, 0.52–1.58; p 0.72), hypoglycemia 1.27, 0.74–2.17; 0.39), nausea/vomiting 0.46–1.51; 0.55). group associated significantly better satisfaction scores (standardized MD: 0.70, 0.13–1.27; 0.02). Before catheterization, a approach is higher similar adverse events approach. practice routine should be reconsidered.

Language: Английский

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