Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures
Advancements in clinical management, pharmacological therapy and interventional procedures have strongly improved the survival rate for cardiovascular diseases (CVDs). Nevertheless, the patients affected by CVDs are more often elderly and present several comorbidities such as atrial fibrillation, va...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/1/45 |
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| author | Giovanni Ciccarelli Francesca Renon Renato Bianchi Donato Tartaglione Maurizio Cappelli Bigazzi Francesco Loffredo Paolo Golino Giovanni Cimmino |
| author_facet | Giovanni Ciccarelli Francesca Renon Renato Bianchi Donato Tartaglione Maurizio Cappelli Bigazzi Francesco Loffredo Paolo Golino Giovanni Cimmino |
| author_sort | Giovanni Ciccarelli |
| collection | DOAJ |
| description | Advancements in clinical management, pharmacological therapy and interventional procedures have strongly improved the survival rate for cardiovascular diseases (CVDs). Nevertheless, the patients affected by CVDs are more often elderly and present several comorbidities such as atrial fibrillation, valvular heart disease, heart failure, and chronic coronary syndrome. Standard treatments are frequently not available for “frail patients”, in particular due to high surgical risk or drug interaction. In the past decades, novel less-invasive procedures such as transcatheter aortic valve implantation (TAVI), MitraClip or left atrial appendage occlusion have been proposed to treat CVD patients who are not candidates for standard procedures. These procedures have been confirmed to be effective and safe compared to conventional surgery, and symptomatic thromboembolic stroke represents a rare complication. However, while the peri-procedural risk of symptomatic stroke is low, several studies highlight the presence of a high number of silent ischemic brain lesions occurring mainly in areas with a low clinical impact. The silent brain damage could cause neuropsychological deficits or worse, a preexisting dementia, suggesting the need to systematically evaluate the impact of these procedures on neurological function. |
| first_indexed | 2024-03-10T01:00:54Z |
| format | Article |
| id | doaj.art-b4026e668c374230b4857d99e017b91f |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T01:00:54Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-b4026e668c374230b4857d99e017b91f2023-11-23T14:36:02ZengMDPI AGMedicina1010-660X1648-91442021-12-015814510.3390/medicina58010045Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention ProceduresGiovanni Ciccarelli0Francesca Renon1Renato Bianchi2Donato Tartaglione3Maurizio Cappelli Bigazzi4Francesco Loffredo5Paolo Golino6Giovanni Cimmino7Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyVanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, ItalyAdvancements in clinical management, pharmacological therapy and interventional procedures have strongly improved the survival rate for cardiovascular diseases (CVDs). Nevertheless, the patients affected by CVDs are more often elderly and present several comorbidities such as atrial fibrillation, valvular heart disease, heart failure, and chronic coronary syndrome. Standard treatments are frequently not available for “frail patients”, in particular due to high surgical risk or drug interaction. In the past decades, novel less-invasive procedures such as transcatheter aortic valve implantation (TAVI), MitraClip or left atrial appendage occlusion have been proposed to treat CVD patients who are not candidates for standard procedures. These procedures have been confirmed to be effective and safe compared to conventional surgery, and symptomatic thromboembolic stroke represents a rare complication. However, while the peri-procedural risk of symptomatic stroke is low, several studies highlight the presence of a high number of silent ischemic brain lesions occurring mainly in areas with a low clinical impact. The silent brain damage could cause neuropsychological deficits or worse, a preexisting dementia, suggesting the need to systematically evaluate the impact of these procedures on neurological function.https://www.mdpi.com/1648-9144/58/1/45silent cerebral ischemiaasymptomatic strokenon-coronary cardiac procedures |
| spellingShingle | Giovanni Ciccarelli Francesca Renon Renato Bianchi Donato Tartaglione Maurizio Cappelli Bigazzi Francesco Loffredo Paolo Golino Giovanni Cimmino Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures Medicina silent cerebral ischemia asymptomatic stroke non-coronary cardiac procedures |
| title | Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures |
| title_full | Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures |
| title_fullStr | Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures |
| title_full_unstemmed | Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures |
| title_short | Asymptomatic Stroke in the Setting of Percutaneous Non-Coronary Intervention Procedures |
| title_sort | asymptomatic stroke in the setting of percutaneous non coronary intervention procedures |
| topic | silent cerebral ischemia asymptomatic stroke non-coronary cardiac procedures |
| url | https://www.mdpi.com/1648-9144/58/1/45 |
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