The pandemic forced medical professionals, including Nebraska-based researchers and physicians, to innovate. Some innovations likely will be around for good.
May 17, 2021
Use of apixaban (Eliquis; Bristol-Myers Squibb) following transcatheter aortic valve implantation does not significantly reduce the risk of subclinical valve thrombosis when compared with standard of care, according to a CT substudy from the ATLANTIS trial presented today.
However, the results are nuanced, with investigators reporting an intriguing interaction between thrombus risk and prior oral anticoagulation indication. For patients without an indication for oral anticoagulation, use of apixaban as opposed to antiplatelet therapy was associated with a lower risk of subclinical valve thrombosis as measured by reduced leaflet motion (RLM) and hypoattenuated leaflet thickening (HALT).
By contrast, for those with an indication for oral anticoagulation, apixaban failed to prevent subclinical valve thrombosis when compared with a vitamin K antagonist.
Photo Credit: Ron Waksman/Medstar Washington Hospital Center
The BASILICA procedure, which involves the intentional laceration of a preexisting aortic leaflet prior to TAVI in order to prevent coronary obstruction, can be safely performed in the vast majority of patients, according to new data from an international registry.
Among 214 patients undergoing BASILICA at 25 centers, the rate of death at 30 days was 2.8%, as was the rate of stroke, and just one patient (0.5%) had a disabling stroke.
Senior investigator Ron Waksman, MD (MedStar Washington Hospital Center, Washington, DC), said BASILICA offers a “unique solution” to patients at high risk for coronary obstruction with TAVI, one that isn’t associated with increased cost. “We wanted to prove that BASILICA was safe, number one, and feasible, number two, and effective,” Waksman told TCTMD.