Aims: Vascular and bleeding complications increase morbidity and mortality in transcatheter aortic valve replacement (TAVR). However, data regarding the efficacy and safety of the MANTA percutaneous vascular closure device (VCD) are scarce. The present study sought to compare VARC-2 complications between collagen plug-based closure using "MANTA" and suture-based closure using "ProGlide" to evaluate the efficacy of the novel MANTA VCD.
Methods And Results: We performed a retrospective, propensity score-matched study to compare vascular and bleeding complications in 325 consecutive patients who underwent TAVR using MANTA and ProGlide. The 1:1 propensity score matching resulted in 111 matched pairs. For MANTA- versus ProGlide-treated patients, all-cause mortality (0% vs. 4%, p=0.02), vascular complications (14% vs. 21%, p=0.21), and bleeding complications (18% vs. 33%, p=0.01) were observed. Access-site vascular injury was significantly less frequent in patients who received MANTA versus ProGlide (8% vs. 17%, p=0.04). MANTA resulted in a significantly lower haemoglobin decrease (16.4 vs. 20.0 g/l, p=0.04) and shorter hospital stay after TAVR (3.3 vs. 5.8 days, p=0.02). It was also associated with fewer bleeding complications (OR 0.44, 95% CI: 0.23-0.83; p=0.01). Moreover, significant decreases of all endpoints were not seen across the procedure date tertiles in the MANTA group.
Conclusions: MANTA resulted in a significantly lower complication rate, especially for bleeding, than did ProGlide, despite the operators' inexperience in the use of MANTA.
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http://dx.doi.org/10.4244/EIJ-D-18-00769 | DOI Listing |
Cardiovasc Hematol Disord Drug Targets
January 2025
Division of Pulmonary and Critical Care Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.
Background: Pulmonary embolism (PE) is a frequent cause of death. Acute PE may be treated either with full anticoagulation (AC) alone or thrombolytic therapy with systemic tissue-- type-plasminogen-activator (tPA) based on risk assessment. Currently, AC is the standard of care for most patients with intermediate-high-risk PE, with low-dose tPA emerging as an effective alternative.
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Department of Neurosurgery, Kohka Public Hospital, Kohka, JPN.
Central venous catheters (CVCs) are commonly used for multiple clinical purposes. The internal jugular vein (IJV) is preferred among the most frequently used insertion sites due to its higher success rates and lower complication risks. Although CVC placement is generally considered a safe procedure, several complications have been reported.
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December 2024
Department of Obstetrics and Gynecology, Osaka Metropolitan University Graduate School of Medicine, Osaka, JPN.
Immune checkpoint inhibitors (ICIs), such as pembrolizumab, have revolutionized cancer therapy but can lead to severe immune-related adverse events (irAEs). We present a case of fulminant type 1 diabetes mellitus (T1DM) with diabetic ketoacidosis (DKA) and mesenteric ischemia in a 78-year-old woman with recurrent stage IIIC1 cervical cancer treated with pembrolizumab. Thirty-four days after initiating a pembrolizumab-containing regimen, she presented with vomiting, severe hyperglycemia, metabolic acidosis, and strongly positive urine ketones.
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January 2025
School of Interdisciplinary Engineering and Sciences (SINES), Department of Sciences, National University of Sciences and Technology (NUST), Islamabad, Pakistan.
The hemostatic system prevents and stops bleeding, maintaining circulatory integrity after injury. It directly interacts with the complement system, which is key to innate immunity. In coronavirus disease 2019 (COVID-19), dysregulation of the hemostatic and complement systems has been associated with several complications.
View Article and Find Full Text PDFVasa
January 2025
Department of Vascular Surgery, Aristotle University of Thessaloniki, AHEPA University General Hospital, Thessaloniki, Greece.
We investigated the safety and efficacy of rivaroxaban as routine thromboprophylaxis after endovenous thermal ablation (EVTA). Adhering to the PRISMA 2020 guidelines, we conducted a systematic review for studies published up to April 2024. Primary endpoints included endovenous heat-induced thrombosis (EHIT) class ≥ II, deep vein thrombosis (DVT), major and minor bleeding and the composite endpoint of major thromboembolic complications including any incidents of EHIT ≥ III, DVT or pulmonary embolism (PE).
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