ARC-HBR criteria and TAVR: not all high bleeding risk patients look alike

EuroIntervention 2022;18:448-449. DOI: 10.4244/EIJ-E-22-00024

Mitchell Krucoff
Mitchell W. Krucoff1, MD; Davide Cao2,3, MD; Roxana Mehran2, MD
1. Duke University Medical Center-Duke Clinical Research Institute, Durham, NC, USA; 2. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA; 3. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
Bleeding is a challenging conundrum in cardiovascular medicine, especially in interventional cardiology, as it can arise from 2 different mechanisms: the local disruption of vascular or adjacent tissues at the access site during any invasive intravascular procedure, and the administration of antithrombotic drugs. The prognostic impact of major bleeding events is detrimental1, and the cardiology community has long strived to find strategies to minimise this risk, e.g., by recommending transradial over transfemoral access for percutaneous coronary interventions (PCI), avoiding routine pretreatment before invasive procedures, and tailoring long-term antithrombotic therapies based on individual risk profiles2. The latter aspect is critical because ...

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