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• Minimalist TAVR outperforms standard TAVR in terms of fluoroscopy time, contrast agent usage, and total procedure duration. • Minimalist TAVR shows comparable short-term efficacy to standard TAVR, with reduced risks of major vascular complications and bleeding events. • Further extensive research is still needed to confirm the long-term efficacy and safety of minimalist TAVR, and to promote its standardization. Transcatheter aortic valve replacement (TAVR) is a preferred treatment for patients with highly critical aortic stenosis (AS), which is a difficult and complicated procedure, leaving a heavy economical burden on patients and national health insurance. Minimalist TAVR can simplify a part of the operation procedures, but the surgical efficacy and safety are still under debated. Explore the effectiveness and safety of minimalist TAVR in the treatment of patients with aortic stenosis. A systematic search of PubMed, Web of Science, and Embase databases was conducted for studies involving application of minimalist TAVR in patients with severe aortic stenosis, two researchers independently screened the literature, extracted data and Meta-analysis was performed using STATA 16.0 software. Nine studies, involving a total of 3,148 AS patients, were included. Minimalist TAVR has similar surgical success rates compared to standardized TAVR, intraoperative fluoroscopy time, dosage of contrast agent, and total operative time were superior to standard TAVR. Regarding surgical complications, the incidence of permanent pacemaker placement and moderate to severe paravalvular leakage were similar for both TAVR, the risk of major vascular complications and major bleeding events in the minimalist TAVR was significantly lower than the standard TAVR. The risk of overall death, stroke, and cardiovascular-related readmission within 30 days was similar in both procedures. Patients with severe aortic stenosis treated with minimalist TAVR have similar short-term efficacy as well as 30-day clinical outcomes to standard TAVR, while minimalist TAVR could reduce the risk of major vascular complications and bleeding complications. [ABSTRACT FROM AUTHOR]

Patients with large artery occlusion-acute ischemic stroke (LAO-AIS) can experience adverse outcomes, such as brain herniation due to complications. This study aimed to construct a nomogram prediction model for prognosis in patients with LAO-AIS in order to maximize the benefits for clinical patients. Retrospective analysis of 243 patients with LAO-AIS from January 2019 to January 2022 with medical history data and blood examination at admission. Univariate and multivariate analyses were conducted through binary logistic regression equation analysis, and a nomogram prediction model was constructed. Results of this study showed that hyperlipidemia (odds ratio [OR] = 2.849, 95% confidence interval [CI] = 1.100–7.375, P = 0.031), right cerebral infarction (OR = 2.144, 95% CI = 1.106–4.156, P = 0.024), D-Dimer>500 ng/mL (OR = 2.891, 95% CI = 1.398–5.980, P = 0.004), and neutrophil-lymphocyte ratio >7.8 (OR = 2.149, 95% CI = 1.093–4.225, P = 0.027) were independent risk factors for poor early prognosis in patients with LAO-AIS. In addition, hypertension (OR = 1.947, 95% CI = 1.114–3.405, P = 0.019), hyperlipidemia (OR = 2.594, 95% CI = 1.281–5.252, P = 0.008), smoking (OR = 2.414, 95% CI = 1.368–4.261, P = 0.002), D-dimer>500 ng/mL (OR = 3.170, 95% CI = 1.533–6.553, P = 0.002), and neutrophil-lymphocyte ratio >7.8 (OR = 2.144, 95% CI = 1.231–3.735, P = 0.007) were independent risk factors for poor long-term prognosis. The early prognosis nomogram receiver operating characteristic curve area under the curve value was 0.688 for the training set and 0.805 for the validation set, which was highly differentiated. The mean error was 0.025 for the training set calibration curve and 0.016 for the validation set calibration curve. Both the training and validation set decision curve analyses indicated that the clinical benefit of the nomogram was significant. The long-term prognosis nomogram receiver operating characteristic curve area under the curve values was 0.697 for the training set and 0.735 for the validation set, showing high differentiation. The mean error was 0.041 for the training set calibration curve and 0.021 for the validation set calibration curve. Both of the training and validation set decision curve analyses demonstrated a substantial clinical benefit of the nomogram. The nomogram prediction model based on admission history data and blood examination are easy-to-use tools that provide an accurate individualized prediction for patients with LAO-AIS and can assist in early clinical decisions and in obtaining an early prognosis. [ABSTRACT FROM AUTHOR]