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Lenarczyk R, Proietti M, Scheitz JF, Shah D, Siebert E, Gorog DA, Kowalczyk J, Bonaros N, Ntaios G, Doehner W, Van Mieghem NM, Nardai S, Kovac J, Fiszer R, Lorusso R, Navarese E, Castrejón S, Rubboli A, Rivera-Caravaca JM, Chieffo A, Lip GYH. Clinical and subclinical acute brain injury caused by invasive cardiovascular procedures. Nat Rev Cardiol 2024:10.1038/s41569-024-01076-0. [PMID: 39394524 DOI: 10.1038/s41569-024-01076-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/23/2024] [Indexed: 10/13/2024]
Abstract
Over the past 50 years, the number and invasiveness of percutaneous cardiovascular procedures globally have increased substantially. However, cardiovascular interventions are inherently associated with a risk of acute brain injury, both periprocedurally and postprocedurally, which impairs medical outcomes and increases health-care costs. Current international clinical guidelines generally do not cover the area of acute brain injury related to cardiovascular invasive procedures. In this international Consensus Statement, we compile the available knowledge (including data on prevalence, pathophysiology, risk factors, clinical presentation and management) to formulate consensus recommendations on the prevention, diagnosis and treatment of acute brain injury caused by cardiovascular interventions. We also identify knowledge gaps and possible future directions in clinical research into acute brain injury related to cardiovascular interventions.
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Affiliation(s)
- Radosław Lenarczyk
- Department of Cardiology and Electrotherapy, Silesian Centre for Heart Diseases, Zabrze, Poland.
- The Medical University of Silesia in Katowice, Faculty of Medical Sciences in Zabrze, Zabrze, Poland.
| | - Marco Proietti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Division of Subacute Care, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Jan F Scheitz
- Department of Neurology and Experimental Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Center for Stroke Research Berlin, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany
| | - Dipen Shah
- Cardiology Service, University Hospital Geneva, Geneva, Switzerland
| | - Eberhard Siebert
- Institute for Neuroradiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Diana A Gorog
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, UK
- Centre for Health Services Research, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Jacek Kowalczyk
- Department of Cardiology and Electrotherapy, Silesian Centre for Heart Diseases, Zabrze, Poland
- The Medical University of Silesia in Katowice, Faculty of Medical Sciences in Zabrze, Zabrze, Poland
| | - Nikolaos Bonaros
- Department of Cardiac Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - George Ntaios
- Department of Internal Medicine, University of Thessaly, Larissa, Greece
| | - Wolfram Doehner
- Center for Stroke Research Berlin, Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site, Berlin, Germany
- Berlin Institute of Health-Center for Regenerative Therapies, Berlin, Germany
- Deutsches Herzzentrum der Charité, Campus Virchow Klinikum, Berlin, Germany
| | - Nicolas M Van Mieghem
- Department of Interventional Cardiology, Cardiovascular Institute, Thoraxcenter, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Sandor Nardai
- Semmelweis University, Department of Neurosurgery and Neurointervention, Budapest, Hungary
| | - Jan Kovac
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Roland Fiszer
- The Medical University of Silesia in Katowice, Faculty of Medical Sciences in Zabrze, Zabrze, Poland
- Department of Paediatric Cardiology and Congenital Heart Defects, Silesian Centre for Heart Diseases, Zabrze, Poland
| | - Roberto Lorusso
- Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Cardiovascular Research Institute Maastricht (CARIM), Maastricht, Netherlands
| | - Eliano Navarese
- Clinical Experimental Cardiology, Department of Cardiology, Azienda Ospedaliero Universitaria di Sassari, Sassari, Italy
- SIRIO MEDICINE Research Network, Sassari, Italy
| | - Sergio Castrejón
- Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain
| | - Andrea Rubboli
- Department of Emergency, Internal Medicine and Cardiology, Division of Cardiology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - José Miguel Rivera-Caravaca
- Faculty of Nursing, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Alaide Chieffo
- San Raffaele Vita Salute, University Milan, Milan, Italy
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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