Managing antithrombotic therapy in patients undergoing complex and high-risk in indicated patients, including those treated with complex percutaneous coronary intervention (PCI) or presenting with cardiogenic shock (CS), is challenging. This review highlights the critical role of antithrombotic therapy, during and after PCI, to optimize the efficacy while minimizing risks. Unfractionated heparin remains the mainstay anticoagulant for complex PCI and CS, with bivalirudin as a potential safer alternative. Cangrelor offers consistent antiplatelet effects, especially when timely absorption of oral agents is uncertain.
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http://dx.doi.org/10.1016/j.iccl.2024.06.006 | DOI Listing |
Trends Cardiovasc Med
January 2025
Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Medical University of Bialystok, Bialystok, Poland.
Atrial fibrillation (AF) and atrial myopathy are recognized contributors to cardiovascular morbidity, particularly ischemic stroke. AF poses an elevated risk of thrombogenesis due to irregular heart rhythm leading to blood stasis and clot formation. Atrial myopathy, marked by structural and functional alterations in the atria, is emerging as a crucial factor influencing thromboembolic events, independently of AF.
View Article and Find Full Text PDFInt J Stroke
January 2025
Medical University of South Carolina, Charleston, SC, USA.
Background: The usual antithrombotic treatment for symptomatic intracranial atherosclerotic stenosis (ICAS) consists of dual treatment with clopidogrel and aspirin for 90 days followed by aspirin alone but the risk of recurrent stroke remains high up to 12 months. The Comparison of Anticoagulation and anti-Platelet Therapies for Intracranial Vascular Atherostenosis (CAPTIVA) trial was designed to determine whether other combinations of dual antithrombotic therapy are superior to clopidogrel and aspirin.
Methods: CAPTIVA is an ongoing, prospective, double-blinded, three-arm clinical trial at over 100 sites in the United States and Canada that will randomize 1683 high-risk subjects with a symptomatic infarct attributed to 70-99% stenosis of a major intracranial artery to 12 months of treatment with (1) ticagrelor (180 mg loading dose, then 90 mg twice daily), (2) low-dose rivaroxaban (2.
ACS Appl Mater Interfaces
January 2025
Key Laboratory of High Efficiency and Clean Mechanical Manufacture of Ministry of Education, School of Mechanical Engineering, Shandong University, Jinan 250061, P. R. China.
Interventional catheters have been widely applied in diagnostics, therapeutics, and other biomedical areas. The complications caused by catheter-related bacterial infection, venous thrombosis, and vascular abrasion have become the main reasons for the failure of interventional therapy. In this study, polyacrylamide/poly(acrylic acid) lubricating copolymer brushes were constructed on the surface of catheters and efficiently resisted the adhesion of blood components and bacteria through hydration and electrostatic repulsion effects.
View Article and Find Full Text PDFCells
January 2025
Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20125 Milan, Italy.
Venous thromboembolism (VTE) and arterial thrombosis (AT) are distinct yet closely related pathological processes. While traditionally considered separate entities, accumulating evidence suggests that they share common risk factors, such as inflammation and endothelial dysfunction (ED). This review explores the parallels and differences between venous and arterial thrombosis, with particular attention to the role of unprovoked VTE and its potential links to atherosclerosis and systemic inflammation.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China.
Necrotising soft tissue infections (NSTIs) are one of the most challenging and severe forms of infections. The prognosis requires accurate and aggressive diagnosis and management. In this case, we present an unexplained case of concurrence of TE events following BKA for the surgical management of NSTI.
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