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International Briefs: NICE On Sutureless Aortic Valves, Mechanical Clot Retrieval, Microsphere Cancer Therapy

In recent guidance documents, the U.K.’s National Institute for Health and Care Excellence offers tempered support for sutureless aortic valve replacement, and calls mechanical clot retrieval in stroke patients unproven and risky. Also, its support for radioactive microspheres for liver cancer depends on malignancy type.

Sutureless aortic valve replacement to treat aortic stenosis should be performed in surgically high-risk patients only with special arrangements for patient consent and data collection, and should be performed in non-high-risk patients only as part of a research study, the U.K.’s National Institute for Health and Care Excellence said in an interventional procedure guidance issued July 24. The procedure is a new alternative to both conventional surgical aortic valve replacement and transcatheter aortic valve implantation, and potentially will allow physicians to perform valve replacement and coronary artery bypass grafting in one procedure while reducing the overall procedure time.

But NICE noted that the efficacy evidence is of “limited quality.” Regarding safety, NICE said the only major short-term concern is paravalvular leak, but that “there is concern about the...

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