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Vascular & Endovascular

 - Stroke, endovascular. neuroimaging, neuro

Blood pressure may not be the key to improving stroke outcomes after all. In an international study published online Oct. 22 in The Lancet, stroke patients randomized to have blood pressure control within 48 hours of infarct did no better than patients whose high blood pressure remained untreated. They did no worse, either. 

 - Big Risk

Endovascular aneurysm repair (EVAR) has a lower 30-day mortality rate than open abdominal aortic aneurysm (AAA) surgery in trials, but rates may not be as low in a real-world setting. Researchers who compared findings from a national clinical database against a recent trial believe the difference may be in the patient cohort’s pre-existing health status.

 - heart, cardiology, cardiac

Drug-eluting balloons (DEBs) gave patients with early, recurrent and significant in-stent carotid artery restenosis longer freedom from restenosis in a trial published in the October issue of the Journal of Endovascular Therapy. More than half of patients in this small cohort were symptom-free at a mean follow-up of 36.6 months.

 - choice, path, equal

In the battle between endarterectomy and carotid artery stenting, the patient emerged as the ultimate victor in a study published online Oct. 14 in The Lancet. Both approaches proved to be equally effective at preventing severe stroke at 10 years, giving physicians a green light to choose the treatment that best fits the individual patient.

 - Brain, neuro, carotid stenting

Atherosclerotic patients in a real-world setting did better when carotid endarterectomy (CEA) was used as opposed to carotid angioplasty and stenting (CAS). Contradictory to some earlier prospective studies, at no point did researchers find equipoise between the two procedures. 


More Stories

More than a pain: NSAIDs may raise VTE risk

Non-steroidal anti-inflammatory drugs (NSAIDs) may be good for what hurts, but they also could be setting patients up for pulmonary embolism. Venous thromboembolism (VTE) risk was increased in patients on NSAIDs, according to a study published Sept. 29 in Rheumatology.

Pharmacies to offer rivaroxaban starter packs

Janssen Pharmaceuticals plans to make a starter pack of the anticoagulant rivaroxaban available in pharmacies in October. The starter pack is designed to simplify dosing for patients at risk of deep vein thrombosis or pulmonary embolism during the first 30 days of treatment.

Review of thromboembolism treatments finds one laggard, two contenders

Unfractionated heparin-vitamin K antagonist combination was found to be the least effective of venous thromboembolism treatments in a meta-analysis published online Sept. 17 in JAMA while some novel oral anticoagulants carried lower bleeding risks.

SCAI releases recommendations for renal artery stenting

Experts from the Society for Cardiovascular Angiography and Interventions (SCAI) recommended the use of renal artery stenting to benefit patients who historically were excluded from clinical trials in a document published Aug. 19 in Catheterization and Cardiovascular Intervention.

An aspirin a day can keep VTE at bay

Venous thromboembolism (VTE) risks in patients taking aspirin were significantly reduced over nontreatment in a study published online Aug. 25  in Circulation.

Do-it-yourself BP control: Hypertension treatment puts patients in charge

The best way to reduce a patient’s blood pressure may be by getting the patient more involved. Hypertension patients not only effectively self-managed, but saw a greater reduction in mean blood pressure compared to those who did not, according to a study published in the Aug. 27 issue of JAMA.

PAD’s promise: Same-day discharge after angioplasty

Hospitals that want to add efficiencies to their peripheral artery disease (PAD) programs might take a page from PCI’s playbook. Just as same-day PCI can be feasible and safe for selected patients, same-day discharge after angioplasty may be possible for PAD patients.

FDA adds DVT, PE to apixaban’s approval list

The FDA gave the green light to apixaban as a treatment for deep vein thrombosis (DVT) and pulmonary embolism (PE) and to reduce the risk of DVT and PE recurrence.

Stroke in sickle cell children reduced through blood transfusions

Children receiving blood transfusions for sickle cell anemia saw a 56 percent reduction in the risk for stroke in a study published Aug. 21 in the New England Journal of Medicine.

Atherectomy system recalled due to sheath flaw

The FDA placed a Class I recall on the Diamondback 360 Peripheral Orbital Atherectomy System because the sheath may fracture during use.

Alteplase for stroke: Time, but not age or severity, affects outcomes

Counter to current guidelines in some countries where it is used, intravenous alteplase has been shown to be effective in stroke patients irrespective of age up to 4.5 hours after stroke onset, according to a study published online Aug. 6 in The Lancet. However, for best outcomes, speed was important.

Centralized stroke care reduces mortality, hospital stays

British stroke patients are seeing improvements in areas where full centralization of stroke care has occurred, according to an article published online Aug. 5 in BMJ.

Warfarin still offers benefits after traumatic brain injury

In spite of increased bleeding risks, resumption of anticoagulant therapy was beneficial to patients following a traumatic brain injury, according to an article published in the August issue of JAMA: Internal Medicine.

Thrombolysis may benefit patients with no visible occlusions on scans

Stroke patients without occlusions treated via thrombolysis fared better than patients who weren’t in a study published online July 29 in Stroke.

Atherectomy-filter combo safe, effective for PAD

A combination of directional atherectomy and embolitic protection filter to treat calcification in peripheral artery disease (PAD) patients showed a 97.2 percent success rate, according to a study published Aug. 1 in Catheterization and Cardiovascular Interventions.

Anticoagulants hold edge over catheter approach for DVT

Researchers are asking if physicians still are on a learning curve when it comes to catheter-directed thrombolysis for proximal deep vein thrombosis (DVT) patients after noting no improvements over anticoagulant therapy in a study published July 21 in JAMA: Internal Medicine.

Stroke trends

Two recently published studies on stroke attest to the gains made in controlling hypertension and reducing stroke risk factors—at least in older Americans.

Surgical patients at increased risk up to 9 months post-stroke

Stroke patients may be at a greater risk for post-surgical complications, particularly when they had a stroke less than three months prior to surgery, according to a study published July 16 in JAMA

Stroke differences dissolve by race, sex but not age

The incidence and mortality rates of stroke decreased for elderly men, women, blacks and whites over time for participants in the Atherosclerosis Risk in Communities group, a study published July 16 in JAMA showed. But for younger adults, the incidence trend didn’t carry through.

Stroke rates decline in U.S. among elderly patients

Incidence of ischemic stroke in patients aged 65 and older decreased by 41 percent between 1988 and 2008, according to data published in the July issue of the American Journal of Medicine. Hemorrhagic stroke decreased 16 percent in the same time period.