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Massive pulmonary thromboembolism in a pediatric patient with eosinophilic granulomatosis with polyangiitis: a case-based review emphasizing management.
Pediatr Rheumatol Online J
January 2025
Department of Pediatric Rheumatology, Faculty of Medicine, Gazi University, Ankara, Besevler, 06500, Turkey.
Background: Pediatric patients with Eosinophilic Granulomatosis with Polyangiitis (EGPA) are at an increased risk of arterial and venous thromboembolism (AVTE). Although the exact mechanisms underlying AVTE remain unclear, eosinophils play a pivotal role in AVTE.
Main Body: Current guidelines lack evidence-based recommendations, particularly concerning anticoagulant and antiplatelet treatments for this condition.
Inhibition of nitric oxide synthase transforms carotid occlusion-mediated benign oligemia into large cerebral infarction.
Theranostics
January 2025
Department of neurology, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea.
It remains unclear why unilateral proximal carotid artery occlusion (UCAO) causes benign oligemia in mice, yet leads to various outcomes (asymptomatic-to-death) in humans. We hypothesized that inhibition of nitric oxide synthase (NOS) both transforms UCAO-mediated oligemia into full infarction and expands pre-existing infarction. Using 900 mice, we i) investigated stroke-related effects of UCAO with/without intraperitoneal administration of the NOS inhibitor (NOSi) N-nitro-L-arginine methyl ester (L-NAME, 400 mg/kg); ii) examined the rescue effect of the NO-donor, molsidomine (200 mg/kg at 30 minutes); and iii) tested the impact of antiplatelet medications.
View Article and Find Full Text PDFPrevention of Stroke in Intracerebral Haemorrhage Survivors with Atrial Fibrillation: Rationale and Design for PRESTIGE-AF Trial.
Thromb Haemost
December 2024
Department of Brain Sciences, Imperial College London, London, United Kingdom.
Adequate secondary prevention in survivors of intracerebral hemorrhage (ICH) who also have atrial fibrillation (AF) is a long-standing clinical dilemma because these patients are at increased risk of recurrent ICH as well as of ischemic stroke. The efficacy and safety of oral anticoagulation, the standard preventive medication for ischemic stroke patients with AF, in ICH patients with AF are uncertain. PRESTIGE-AF is an international, phase 3b, multi-center, randomized, open, blinded end-point assessment (PROBE) clinical trial that compared the efficacy and safety of direct oral anticoagulants (DOACs) with no DOAC (either no antithrombotic treatment or any antiplatelet drug).
View Article and Find Full Text PDFAnticoagulation therapy for the prevention of subclinical leaflet thrombosis after transcatheter aortic valve replacement: A comprehensive literature review and future directions.
Int J Cardiol
December 2024
Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA. Electronic address:
Leaflet thrombosis after transcatheter aortic valve replacement (TAVR) presents a significant challenge, leading to adverse clinical outcomes. Subclinical leaflet thrombosis (SLT) is increasingly recognized, and there is a growing concern about its role in clinical events and hemodynamic valve deterioration. Current recommendations for prophylactic anticoagulation or antiplatelet therapy following TAVR are primarily based on expert consensus rather than definitive evidence from randomized trials, resulting in a variety of antithrombotic strategies in clinical practice.
View Article and Find Full Text PDFA review of clopidogrel resistance in lower extremity arterial disease.
JVS Vasc Insights
January 2024
Manchester Vascular Centre, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Objective: Lower extremity arterial disease (LEAD) is a prevalent condition that produces a significant burden on health care systems. Patients with LEAD have an increased risk of major adverse cardiovascular events as well as major adverse limb events. Despite significant variation in guidance on antiplatelet therapy for LEAD worldwide, many governing bodies recommend clopidogrel as the preferred single anti-platelet agent.
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