Abstract
While transcatheter aortic valve implantation (TAVI) has rapidly evolved as an acceptable alternative to conventional surgical aortic valve replacement in elderly, high-risk surgical candidates with critical aortic stenosis, thrombotic and bleeding complications remain relatively frequent and potentially life-threatening. Thrombotic events during and following TAVI relate to the dynamic interplay between the systemic burden of atherosclerotic disease, atrial arrhythmias, device and native aortic valve interactions, as well as platelet and coagulation cascade activation. Bleeding in the acute setting relates primarily to access site vascular complications, but also appears related to pre-existing renal impairment and anemia. Current pre-, peri- and post-procedural anti-thrombotic regimens are empirical, based on expert consensus following extrapolation from the wealth of experience gleaned following percutaneous coronary intervention. However the complexities of the TAVI procedure, the high-risk clinical substrate and competing effects of anti-thrombotic regimens and bleeding risk are yet to be prospectively assessed in randomized clinical trials for defining evidence-based anti-thrombotic strategies.
Keywords: TAVI, bleeding, thromobosis, DAPT, warfarin.
Current Pharmaceutical Design
Title:Balancing the Risks of Thrombosis and Bleeding Following Transcatheter Aortic Valve Implantation: Current State-of-Evidence
Volume: 22 Issue: 13
Author(s): Rishi Puri, Omar Abdul-Jawad Altisent, Francisco Campelo-Parada, Maria del Trigo, Ander Regueiro and Josep Rodés-Cabau
Affiliation:
Keywords: TAVI, bleeding, thromobosis, DAPT, warfarin.
Abstract: While transcatheter aortic valve implantation (TAVI) has rapidly evolved as an acceptable alternative to conventional surgical aortic valve replacement in elderly, high-risk surgical candidates with critical aortic stenosis, thrombotic and bleeding complications remain relatively frequent and potentially life-threatening. Thrombotic events during and following TAVI relate to the dynamic interplay between the systemic burden of atherosclerotic disease, atrial arrhythmias, device and native aortic valve interactions, as well as platelet and coagulation cascade activation. Bleeding in the acute setting relates primarily to access site vascular complications, but also appears related to pre-existing renal impairment and anemia. Current pre-, peri- and post-procedural anti-thrombotic regimens are empirical, based on expert consensus following extrapolation from the wealth of experience gleaned following percutaneous coronary intervention. However the complexities of the TAVI procedure, the high-risk clinical substrate and competing effects of anti-thrombotic regimens and bleeding risk are yet to be prospectively assessed in randomized clinical trials for defining evidence-based anti-thrombotic strategies.
Export Options
About this article
Cite this article as:
Puri Rishi, Altisent Abdul-Jawad Omar, Campelo-Parada Francisco, del Trigo Maria, Regueiro Ander and Rodés-Cabau Josep, Balancing the Risks of Thrombosis and Bleeding Following Transcatheter Aortic Valve Implantation: Current State-of-Evidence, Current Pharmaceutical Design 2016; 22 (13) . https://dx.doi.org/10.2174/1381612822666151208122628
DOI https://dx.doi.org/10.2174/1381612822666151208122628 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Innovative Stride to Zero Hunger Beyond 2015 in Nigeria
Recent Patents on Food, Nutrition & Agriculture Antioxidants Suppress Th1-Type Immune Response In Vitro
Drug Metabolism Letters Cholesterol Homeostasis Failure in the Brain: Implications for Synaptic Dysfunction and Cognitive Decline
Current Medicinal Chemistry Treatment of Hypertension in Heart Failure with Preserved Ejection Fraction
Current Hypertension Reviews Cell Sheet-Based Myocardial Tissue Engineering: New Hope for Damaged Heart Rescue
Current Pharmaceutical Design Minocycline Repurposing in Critical Illness: Focus on Stroke
Current Topics in Medicinal Chemistry Discharge Interventions and Modifiable Risk Factors for Preventing Hospital Readmissions in Children with Medical Complexity
Reviews on Recent Clinical Trials Antiplatelet Treatment in Ischemic Stroke Treatment
Current Topics in Medicinal Chemistry Unusual Clinical Manifestations of the Antiphospholipid Syndrome
Current Rheumatology Reviews “Endothelial Progenitor Cells” as a Therapeutic Strategy in Cardiovascular Disease
Current Vascular Pharmacology The Long Pentraxin PTX3, a Soluble Pattern Recognition Receptor Involved in Innate Immunity,Inflammation and Female Fertility
Current Immunology Reviews (Discontinued) New Horizons in Diabetes Therapy
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) The Gut and Intestinal Bacteria in Chronic Heart Failure
Current Drug Metabolism Canine Nutritional Model: Influence of Age, Diet, and Genetics on Health and Well-Being
Current Nutrition & Food Science Modulating Mesenchymal Stromal Cell Function with Cholesterol Synthesis Inhibitors
Current Medicinal Chemistry Sepsis: Links between Pathogen Sensing and Organ Damage
Current Pharmaceutical Design Editorial: [Statins and Cardiovascular Events in Patients with End-Stage Renal Disease on Hemodialysis. The AURORA Results Suggest the Need for Earlier Intervention]
Current Vascular Pharmacology Polyphenols Beyond Barriers: A Glimpse into the Brain
Current Neuropharmacology Bioactivities of Iridoids
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Functional Food: Product Development and Health Benefits
Recent Patents on Engineering