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Cerebral Air Embolism Risks in TAVR Procedures: Insights from a 75-Year-Old Patient Case.
Am J Case Rep
January 2025
Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
BACKGROUND Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure increasingly used to treat severe aortic stenosis, especially in elderly patients and those with significant comorbidities who are at high risk for surgical intervention. While TAVR is generally safe and effective, rare complications can occur, including cerebral air embolism, which can result in acute neurological deficits. This report presents the case of a 75-year-old man who developed a cerebral air embolism following TAVR.
View Article and Find Full Text PDFNet Benefit of Early Anticoagulation for Stroke With Atrial Fibrillation: Post Hoc Analysis of the ELAN Randomized Clinical Trial.
JAMA Netw Open
January 2025
Department of Neurology, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Importance: The net clinical effect of early vs later direct oral anticoagulant (DOAC) initiation after atrial fibrillation-associated ischemic stroke is unclear.
Objective: To investigate whether early DOAC treatment is associated with a net clinical benefit (NCB).
Design, Setting, And Participants: This was a post hoc analysis of the Early Versus Late Initiation of Direct Oral Anticoagulants in Post-Ischaemic Stroke Patients With Atrial Fibrillation (ELAN) open-label randomized clinical trial conducted across 103 sites in 15 countries in Europe, the Middle East, and Asia between November 6, 2017, and September 12, 2022, with a 90-day follow-up.
Cancer History, Antiphospholipid Syndrome, and Lupus Anticoagulant: A Perfect Storm for Thrombosis.
Cureus
December 2024
Pulmonary and Critical Care, Jackson Memorial Hospital, Miami, USA.
Cancer and antiphospholipid syndrome (APS) independently increase thrombotic risk, and their coexistence can create a particularly hazardous prothrombotic state. This case report aims to highlight the complex challenges in managing concurrent thrombotic and hemorrhagic events in patients with a history of cancer and APS. The combination of these conditions presents a rare and difficult clinical scenario, requiring careful consideration in anticoagulation management.
View Article and Find Full Text PDFThe Association Between Pulmonary Embolism and Deep Vein Thrombosis in the Upper or Lower Extremities in Neurocritical Care Patients.
World Neurosurg
January 2025
Department of Neurological Surgery, Brooke Army Medical Center, United States of America.
Introduction: Patients in the neurological intensive care unit (ICU) are at an increased risk of venous thromboembolism (VTE). Anticoagulation is often indicated because deep venous thrombosis (DVT) can develop into pulmonary embolism (PE). However, anticoagulation also increases the risk of intracranial bleeding.
View Article and Find Full Text PDFFor Atrial Fibrillation, DOACs Outperform Warfarin in Patients with Reduced Kidney Function.
J Am Board Fam Med
January 2025
From the Madigan Army Medical Center Family Medicine Residency, Tacoma, WA (RP, JC, AH).
At standard doses, direct oral anticoagulants (DOACs) were associated with a reduced risk of systemic embolism and intracranial hemorrhage (ICH) when compared with warfarin, with a greater derived benefit at lower creatinine clearance (CrCl-down to 25 mL/min). Lower doses of DOACs were associated with increased overall mortality without a significant decrease in ICH and incident bleeding when compared with standard dose DOACs and warfarin, across all CrCl down to 25 mL/min..
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