From surgical clamping to endovascular flow arrest/reversal: the concept behind the system.

Carotid artery lesions are frequently composed of friable, thrombotic, ulcerated and/or hemorrhagic materials which can embolize during surgical or endovascular interventions. The use of embolic protection devices (EPD) during carotid angioplasty and stenting (CAS) has been proven to be associated with a reduction of the embolic load. Many studies indicate that the clinical results of CAS are comparable with the best surgical series, when EPD are routinely applied.

Incidence, Predictor, and Clinical Outcomes of Multiple Resheathing With Self-Expanding Valves During Transcatheter Aortic Valve Replacement.

Background No study has evaluated the impact of the additional manipulation demanded by multiple resheathing (MR) in patients undergoing transcatheter aortic valve replacement with repositionable self-expanding valves. Methods and Results This study included a real-world, multicenter registry involving 16 centers from Canada, Germany, Latin America, and Spain. All consecutive patients who underwent transcatheter aortic valve replacement with the Evolut R, Evolut PRO, and Portico valves were included.

Similarities and Differences Between Primary Percutaneous Coronary Intervention and Mechanical Thrombectomy.

Acute ischemic stroke is among the leading causes of mortality and disability worldwide. Since 2015, as was the case for primary percutaneous coronary intervention for acute myocardial infarction, catheter-based reperfusion via mechanical thrombectomy (MT) has become the gold-standard treatment for acute ischemic stroke caused by large-vessel occlusion. Despite that, only a fraction of the world's population currently would be able to undergo MT in time, mostly because of the scarcity of 24/7 coverage by neurointerventionalists to deal with this enormous burden.

Percutaneous Transseptal Bioprosthetic Implantation in Failed Prosthetic Surgical Mitral Valve - Brazilian Multicenter Experience.

Background: Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment.

Objectives: To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV).

Methods: Patients with surgical bioprosthetic dysfunction submitted to transseptal-TMVIV in 12 Brazilian hospitals were included.

Proposed practical anatomical-procedural classification systems for evaluating carotid lesions and carotid artery stenting.

Aims: The aim of this study was to propose new anatomical-procedural classification systems for evaluating carotid lesions and carotid artery stenting (CAS).

Methods And Results: The methodology used to propose new concepts to be applied in the carotid district was based on three steps: 1) research in PubMed with the terms "carotid artery" (CA) plus "classification" was performed in August 2010 to verify the existence of any classification system for the CA that could be applied for evaluating CAS; 2) formulation of the "stenting segment" concept and elaboration of two classification systems - (a) the "ABC" system for classifying carotid lesions according to their location, and (b) the "five arterial zones" system for identifying specific arterial zones of the CA concerning the basics steps of CAS; and 3) retrospective testing of the applicability of these classification systems on two hundred and fifty consecutive CA angiograms, in which an obstructive lesion was identified. It was possible to delimit the "stenting segment", to classify the carotid lesions according to the "ABC" classification system and to identify the arterial zones according to the "five arterial zones" classification system in all (100%) CA angiograms studied.

Stent migration as a late complication following carotid angioplasty and stenting.

Background: A 69-year-old male patient with severe asymptomatic carotid artery stenosis was treated percutaneously with implant of two self-expandable stents in the right carotid overlapped to each other by 5 mm. The 15-month follow-up colour-Doppler ultrasound (CDU) revealed a severe stenosis in the target vessel and an image suggesting migration of the distal stent.

Investigations: Physical examination, laboratory test, CDU, carotid angiography, quantitative carotid angiography (QCA), brain computed tomography (CT).

Cutting balloon angioplasty in percutaneous carotid interventions.

Purpose: To report a prospective feasibility study of cutting balloon angioplasty (CBA) applied in the predilation phase of carotid artery stenting (CAS) in highly calcified lesions.

Methods: From January 2003 to February 2007, 178 consecutive patients (109 men; mean age 73.1+/-7.

Percutaneous retrieval of intracardiac foreign body with a novel technique.

We report on the case of a patient with a long term vascular catheter embolized into the right ventricle. This case had unique characteristics since both ends of the catheter were inaccessible for snare, which made it difficult to capture them using conventional techniques. We describe a new method to retrieve the foreign body through its mid-point portion, using a single catheter with two independent snare and hook systems.