Bad Eyeballing of Stroke Scans; Pre-Stenting Lithotripsy; CTO PCI Bleeds

Eighteen physicians experienced with MRI for acute stroke imaging often estimated infarct volumes incorrectly when simply examining scans visually. Their estimates would have led to wrong decisions on thrombectomy (based on DAWN criteria) in 19% of cases, according to a study in the Journal of NeuroInterventional Surgery.

Medtronic said its Pipeline Flex embolization device is now approved for a new indication: treating small or medium wide-necked intracranial aneurysms located between the petrous and terminus of the internal carotid artery.

Having good leptomeningeal collaterals on baseline CT angiography did not make patients more likely to achieve functional independence after late stroke thrombectomy. Good collaterals were associated with slower ischemic core growth, however, a prespecified analysis of DEFUSE 3 showed. (Stroke)

Operators showed the feasibility of using an intravascular lithotripsy catheter before stenting to reduce calcified coronary plaques. Among 60 patients, stenosis was reduced from 72.5% to 12.2%, according to Disrupt CAD I study results published in Circulation.

In ST-segment elevation MI patients, the Absorb bioresorbable scaffold performed similarly to everolimus-eluting stents. At 1 year, scaffold and stent thrombosis rates were 1.8% with Absorb and 1.2% with metallic stents (P=0.69), respectively, investigators found from pooling individual-level data from the ISAR-Absorb MI and ABSORB STEMI TROFI II trials. (EuroIntervention)

Time spent in therapeutic range for warfarin did not change the benefit of rivaroxaban over warfarin and dual antiplatelet therapy for atrial fibrillation patients undergoing percutaneous coronary intervention (PCI) in the PIONEER AF-PCI trial, according to a report in Circulation: Cardiovascular Interventions.

PCI for chronic total occlusion left elderly patients with the same adverse event rates at 6 months whether they had been randomized to bivalirudin or unfractionated heparin. All trial participants had been at high bleeding risk at baseline. (Catheterization & Cardiovascular Interventions)