Scripps Clinic interventional cardiologist Paul Teirstein, M.D., became the first in Southern California to use a newly approved drug-coated balloon to clear a clogged stent that previously had been placed in a blocked heart vessel.

In patients with acute ischemic stroke and elevated high-sensitivity cardiac troponin (hs-cTn), dynamic changes in hs-cTn are not helpful in identifying myocardial infarction (MI) or distinguishing MI from other causes of acute myocardial injury, results of the PRAISE study showed. In contrast, the absolute hs-cTn value on admission provides better diagnostic clarity and was independently associated with atherosclerotic (type 1) MI, which was relatively common in this cohort of patients with acute ischemic stroke and elevated hs-cTn levels.

Given the limitations of existing risk stratification models, which often fail to account for the complex interplay of genetic, environmental, and clinical factors influencing thrombus formation and stability, the ability to accurately measure clot permeability and thereby assess individual thrombotic risk is crucial for developing personalized prophylactic and therapeutic strategies. The precision and repeatability of our proposed device’s measurements are enhanced by its design, which minimizes the influence of external variables.

Cardiovascular diseases have been primarily characterized by the dysfunction of the myocardium as the primary and major cause of morbidity and mortality and have shown an increased rate across the globe. Both experimental and clinical studies show that the activation of inflammatory responses, myocardial necrotic, apoptotic, and autophagic processes substantially aggravate cardiac dysfunction, leading to the development of heart failure, ventricular arrhythmias, and sudden cardiac death.

Poly-L-lactic acid (PLLA) stents have broad application prospects in the treatment of cardiovascular diseases due to their excellent mechanical properties and biodegradability. However, foreign body reactions caused by stent implantation remain a bottleneck that limits the clinical application of PLLA stents. To solve this problem, the biocompatibility of PLLA stents must be urgently improved. Albumin, the most abundant inert protein in the blood, possesses the ability to modify the surface of biomaterials, mitigating foreign body reactions—a phenomenon described as the “stealth effect”.

Despite improvements in modern DESs, concerns remain about negative effects related to stents, especially for patients with CTO CAD. Using the DCB-based treatment approach, either with DCB alone or combined with DESs, has shown great potential in reducing the stent-related adverse events, particularly by reducing the use of smaller DESs. Additionally, this approach led to a lower risk of MACEs one year after treatment compared to that when only DESs were used. Our study adds to the growing evidence that supports the DCB-based approach as a promising strategy for effectively managing this difficult condition. To further confirm the safety and effectiveness of the DCB-based treatment in CTO PCI, future research, including larger randomized controlled trials, will be crucial.

Mitigating the foreign body response (FBR) to implantable medical devices (IMDs) is critical for successful long-term clinical deployment. The FBR is an inevitable immunological reaction to IMDs, resulting in inflammation and subsequent fibrotic encapsulation. Excessive fibrosis may impair IMDs function, eventually necessitating retrieval or replacement for continued therapy. Therefore, understanding the implant design parameters and their degree of influence on FBR is pivotal to effective and long lasting IMDs. This review gives an overview of FBR as well as anti-FBR strategies. Furthermore, we highlight recent advances in biomimetic approaches to resist FBR, focusing on their characteristics and potential biomedical applications.

GLP-1 receptor agonists (GLP-1s) and SGLT-2 inhibitors lower the risk of major cardiovascular events like heart attacks and severe liver complications compared to other diabetes treatments, according to data being presented Sunday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass.

Anchorperson: Patrick Serruys. Spokesperson: Faisal SharifDiscussants: Ignacio J Amat-Santos, Gianluca Campo, Helge Möllmann, Valeria Paradies, Ashok Seth

In conclusion, our findings affirm the procedural success and safety of LAA closure across a spectrum of occluder devices and patient anatomies. The ongoing evolution of device technology and procedural techniques promises to further enhance the outcomes of this important therapeutic option by decreasing the bleeding rate, incidence of pericardial effusion, radiation exposure, peridevice leak, and device-related thrombi.

At the 24-month follow-up, the incidence of target lesion failure (TLF) was 3.5% alongside a corresponding 3.5% incidence of target lesion revascularisation (TLR) compares favourably with various second-generation DES. No cases of myocardial infarction (MI), cardiac death, or definite/probable scaffold thrombosis were reported.

Acid-related upper gastrointestinal bleeding is largely controlled by PPIs in post-PCI patients. Furthermore, the risk factors for non-acid-related bleeding include older age, lower weight, and concomitant warfarin use.

Based on the abundant published literature, here we expand the understanding of cardiovascular diseases in a framework already presented in previous articles. In this context, some unique distinguishing features of vascular lesions are explained. A rationale for the role of apolipoprotein apoB100 is presented. It is hypothesized that KATP channels and their control by blood pH are behind the development of coronary artery spasm and cardiomyocyte death. Finally, the main cardiovascular risks are explained within the proposed framework.

Use of radial access for percutaneous coronary intervention (PCI) increased 2.8-fold in the United States between 2013 and 2022, according to a study presented at the annual meeting of the Society for Cardiovascular Angiography and Interventions, held from May 2 to 4 in Long Beach, California.

Data on side-branch (SB) ostial effect after drug-coated balloon (DCB) treatment in the context of de novo coronary bifurcation lesions are limited. We aimed to investigate the angiographic outcomes of SB ostium after DCB treatment compared with drug-eluting stents (DESs) implantation in the main vessel (MV) or optimal medical therapy (OMT) for the treatment of de novo coronary bifurcation lesions.

In REC-CAGEFREE II, the strategy of stepwise dual antiplatelet (DAPT) de-escalation − aspirin plus ticagrelor (Brilinta) for 1 month, then 5 months of ticagrelor monotherapy, and finally 6 months of aspirin monotherapy -- showed noninferiority against standard 12-month DAPT in the nearly 2,000-person study, reported Ling Tao, MD, PhD, of Xijing Hospital in Xi'an, China.

In the present study, the performances of the crimping mechanical and degradation behaviors of four structured PLA BVS were comprehensively assessed by utilizing a custom finite element method. The results show that the stent’s design strongly affects its mechanical properties and degradation behaviors. Under the current framework, the DESolve stent performed better with respect to radial stiffness, diameter maintenance, and degradation controllability, even though the degradation and reduction of residual volume were faster compared to the Igaki-Tamai and Fantom stents. The findings provide a theoretical method for studying the mechanical and degradation behaviors of PLA BVS, and could be potentially useful in advancing BVS design and clinical protocols.

DESyne BDS Plus (Elixir Medical) is a thin-strut stent system that uses sirolimus and two anticoagulants (argatroban and rivaroxaban) at the site of implant to deliver site-specific antithrombotic therapy, Alexandre Abizaid (Instituto do Coração, Sao Paulo, Brazil) detailed during a late-breaking trial session at EuroPCR 2024 (14–17 May, Paris, France) where he delivered results from the DESyne BDS Plus trial.

LAAO is a procedure that reduces the risk of stroke in people with atrial fibrillation (AFib). It is an alternative to blood thinner medication. Those with AFib are five times more likely to suffer a stroke. For them, blood does not pump out of the top of the heart normally, and blood clots can form in the left atrial appendage (LAA). The blood clots can then break loose and flow into the bloodstream, where they may travel to the brain causing a stroke.

SAPT following Amplatzer LAAO displayed rates of DRT and stroke comparable to those reported with more intensive antithrombotic regimens. Meanwhile, we observed low rates of major bleeding.

The design of blood-compatible materials requires understanding the physiological mechanisms that give rise to undesirable blood-material interactions. In particular, the materials used in the design of CMDs are determined by the disease for which the CMDs are intended. For example, we review the utility of polymers in developing CMDs when the necessary materials need to be flexible and durable. On the other hand, when there is a need of materials with high mechanical resistance or more remarkable conductors, metals, and metals alloys are the best option. Also, the combination of these two types of materials is used to develop and enhance the ability to perform high workflow rates in CMDs. Even though metals and polymers have tremendous advantages in developing CMDs, there is a predominant recurring challenge, which is biocompatibility.

Stroke is a major driver of increased morbidity and mortality in patients with non-valvular atrial fibrillation (NVAF). While systemic oral anticoagulation (OAC) continues to be the mainstay for stroke reduction therapy in patients with NVAF, several barriers prevent the sustained long-term use of OAC, including increased risk of bleeding, non-compliance, cost, drug-drug interactions, and the need for ongoing laboratory testing. Given the need for continued stroke reduction therapies in patients who are intolerant of or non-compliant with OAC, percutaneous left atrial appendage (LAA) occlusion (LAAO) has emerged as a nonpharmacologic alternative to OAC.

Left atrial appendage occlusion (LAAO) is a reasonable alternative approach that is used in patients with atrial fibrillation who are not candidates for anticoagulation. A number of key trials have shown that Watchman device is non-inferior to warfarin therapy in preventing ischemic stroke/systemic thromboembolism. However, it is associated with lower rates of hemorrhagic stroke, bleeding and death. Multiple retrospective and prospective studies of Amplatzer device (ACP and Amulet) reported high success rates in device implantation and stroke prevention. Our objective is to consolidate the current literature to better delineate the safety, efficacy and indication of LAAO for stroke prevention.

LAAO is suggested to be of major clinical benefit in AF patients having sustained an ICH. These results have to be confirmed in a randomised clinical trial.

This large real-world prospective registry of catheter-based LAAO using the AMPLATZER Amulet device reports a high implant success rate and a low periprocedural complication rate in a population with a high risk of stroke and bleeding. Transoesophageal echo data confirm good closure rates during follow-up and low rates of device-associated thrombus.