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Authors = Adel Aminian

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14 pages, 1349 KiB  
Review
Percutaneous Left Atrial Appendage Closure: Supporting Evidence, Limitations and Future Directions
by Giuseppe Imperatore, Stijn Lochy, Mohamed Ben Yedder, Roberto Galea and Adel Aminian
J. Clin. Med. 2025, 14(7), 2300; https://doi.org/10.3390/jcm14072300 - 27 Mar 2025
Viewed by 835
Abstract
Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a promising intervention for stroke prevention in patients with atrial fibrillation who are contraindicated for long-term anticoagulation therapy. Despite its growing adoption, a comprehensive review of the LAAO procedure is essential to consolidate the [...] Read more.
Percutaneous Left Atrial Appendage Occlusion (LAAO) has emerged as a promising intervention for stroke prevention in patients with atrial fibrillation who are contraindicated for long-term anticoagulation therapy. Despite its growing adoption, a comprehensive review of the LAAO procedure is essential to consolidate the supporting evidence, identify limitations, and outline future directions. This review aims to evaluate the efficacy and safety of LAAO, drawing on clinical trials and real-world studies to provide a balanced perspective. Additionally, we address the limitations of current research, including variability in patient selection, procedural techniques, and follow-up protocols. By highlighting gaps in the knowledge and areas for improvement, this review aims to guide future research efforts to optimize and expand the therapeutic potential of LAAO. Full article
(This article belongs to the Special Issue Atrial Fibrillation and Its Complications: Preventive Strategies and Relative Evidence)
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12 pages, 983 KiB  
Review
Preventing and Managing Radial Artery Occlusion following Transradial Procedures: Strategies and Considerations
by Grigorios Tsigkas, Amalia Papanikolaou, Anastasios Apostolos, Angelos Kramvis, Filippos Timpilis, Anastasia Latta, Michail I. Papafaklis, Adel Aminian and Periklis Davlouros
J. Cardiovasc. Dev. Dis. 2023, 10(7), 283; https://doi.org/10.3390/jcdd10070283 - 30 Jun 2023
Cited by 25 | Viewed by 5301
Abstract
Τransradial artery access has recently gained widespread acceptance as the preferred approach for coronary angiography and interventions, due to its lower incidence of bleeding and vascular complications compared to transfemoral access. However, thrombotic occlusion of the radial artery has emerged as the most [...] Read more.
Τransradial artery access has recently gained widespread acceptance as the preferred approach for coronary angiography and interventions, due to its lower incidence of bleeding and vascular complications compared to transfemoral access. However, thrombotic occlusion of the radial artery has emerged as the most common complication of this method, impeding its use in future interventions, and in the creation of arteriovenous fistulae for hemodialysis patients, or as a graft for coronary artery bypasses grafting. In this comprehensive review, we delve into the anatomy of the radial artery, the pathophysiology and diagnosis of radial artery occlusion, the identification of potential risk factors and, finally, prevention and treatment strategies. We acknowledge that distal transradial access provides an effective alternative for coronary angiography and catheterizations, with a reduced incidence of radial artery occlusion. Full article
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16 pages, 967 KiB  
Review
Dual Antiplatelet Therapy and Cancer; Balancing between Ischemic and Bleeding Risk: A Narrative Review
by Grigorios Tsigkas, Angeliki Vakka, Anastasios Apostolos, Eleni Bousoula, Nikolaos Vythoulkas-Biotis, Eleni-Evangelia Koufou, Georgios Vasilagkos, Ioannis Tsiafoutis, Michalis Hamilos, Adel Aminian and Periklis Davlouros
J. Cardiovasc. Dev. Dis. 2023, 10(4), 135; https://doi.org/10.3390/jcdd10040135 - 23 Mar 2023
Cited by 7 | Viewed by 3720
Abstract
Cardiovascular (CV) events in patients with cancer can be caused by concomitant CV risk factors, cancer itself, and anticancer therapy. Since malignancy can dysregulate the hemostatic system, predisposing cancer patients to both thrombosis and hemorrhage, the administration of dual antiplatelet therapy (DAPT) to [...] Read more.
Cardiovascular (CV) events in patients with cancer can be caused by concomitant CV risk factors, cancer itself, and anticancer therapy. Since malignancy can dysregulate the hemostatic system, predisposing cancer patients to both thrombosis and hemorrhage, the administration of dual antiplatelet therapy (DAPT) to patients with cancer who suffer from acute coronary syndrome (ACS) or undergo percutaneous coronary intervention (PCI) is a clinical challenge to cardiologists. Apart from PCI and ACS, other structural interventions, such as TAVR, PFO-ASD closure, and LAA occlusion, and non-cardiac diseases, such as PAD and CVAs, may require DAPT. The aim of the present review is to review the current literature on the optimal antiplatelet therapy and duration of DAPT for oncologic patients, in order to reduce both the ischemic and bleeding risk in this high-risk population. Full article
(This article belongs to the Special Issue New Insights into Antithrombotic Therapy for Cardio- and Cerebrovascular Disease: From Molecular Mechanisms to Clinical Application)
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14 pages, 1646 KiB  
Systematic Review
Thirty-Days versus Longer Duration of Dual Antiplatelet Treatment after Percutaneous Coronary Interventions with Newer Drug-Eluting Stents: A Systematic Review and Meta-Analysis
by Grigorios Tsigkas, Anastasios Apostolos, David-Dimitrios Chlorogiannis, Elena Bousoula, Georgios Vasilagkos, Sotirios Tsalamandris, Ioannis Tsiafoutis, Konstantinos Katsanos, Konstantinos Toutouzas, Adel Aminian, Dimitrios Alexopoulos and Periklis Davlouros
Life 2023, 13(3), 666; https://doi.org/10.3390/life13030666 - 28 Feb 2023
Cited by 5 | Viewed by 2486
Abstract
Abbreviation of the duration of dual antiplatelet therapy (DAPT) (one or three months) has been recently proposed, especially for high bleeding risk patients, after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). Three databases were screened for eligible randomized control trials. The primary [...] Read more.
Abbreviation of the duration of dual antiplatelet therapy (DAPT) (one or three months) has been recently proposed, especially for high bleeding risk patients, after percutaneous coronary intervention (PCI) with drug-eluting stent (DES). Three databases were screened for eligible randomized control trials. The primary endpoint was the incidence of net adverse clinical events (NACE). Secondary endpoints consisted of major adverse cardiovascular events (MACE), all-cause and cardiovascular mortality, myocardial infarction, stroke, stent-thrombosis, repeat revascularization and major bleeding. We included four RCTs with a total of 26,576 patients; 13,282 patients were grouped in 30-days DAPT, while the remaining 13,294 were allocated in a longer period of DAPT. One month of DAPT did not significantly reduce NACE (odds ratio [OR]: 0.87, 95% confidence intervals [Cl]: 0.74–1.03); however, major bleedings were significantly reduced by 22% (OR: 0.78, 95% Cl: 0.65–0.94). Mortality or ischemic events (stroke, myocardial infarction, revascularization and stent thrombosis) were not affected. Thus, 30-days DAPT could be considered as safe and feasible after PCI with DES in selected patients, especially those with high bleeding risk. Forthcoming RCTs could shed light on the optimal duration of DAPT. Full article
(This article belongs to the Collection Advances in Coronary Heart Disease)
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