Cardiovascular Video Recap—December 18, 2025

Welcome to the latest edition of Cardiovascular & Neuro Updates, covering breakthroughs in the past two weeks. Brought to you by LucidQuest.

First, stroke rehabilitation. The UK TRICEPS study passed a key milestone, with two hundred and five of a planned two hundred and seventy participants enrolled. This double-blind trial tests non-invasive transcutaneous vagus nerve stimulation, delivered via a wearable earpiece, paired with home-based therapy for hand and arm weakness six months to ten years after stroke. The two-million-pound program spans nineteen NHS centres and includes one-hour sessions five times weekly for twelve weeks for many participants. Results could shape at-home neurorehabilitation if efficacy is confirmed.

Next, thrombolysis for obstructive mechanical valve thrombosis. In an open-label randomized trial at AIIMS New Delhi with eighty-three patients, tenecteplase was non-inferior to low-dose slow-infusion alteplase for thrombolytic success. Complete success occurred in ninety-seven point five percent of tenecteplase patients versus eighty-one point four percent with alteplase, and hospital stay was shorter with tenecteplase. Adverse events were similar, though the study excluded patients in cardiogenic shock, included few with NYHA class four symptoms, and lacked long-term follow-up.

Emergency intubation sedatives were tested head-to-head. In the NEJM RSI trial across fourteen US emergency departments and intensive care units, two thousand three hundred and sixty-five adults were randomized to ketamine or etomidate. Mortality was similar, at twenty-eight point one percent with ketamine and twenty-nine point one percent with etomidate, but ketamine caused more cardiovascular collapse, particularly severe hypotension. The findings support careful drug selection based on hemodynamic risk.

In surgical robotics, SS Innovations submitted a five-ten-k for the SSi Mantra system to the US FDA. The company cites one hundred and thirty-eight installed systems across eight countries and more than seven thousand three hundred procedures to date, including eighty-eight telesurgeries and three hundred and ninety cardiac cases. The firm pursued five-ten-k after FDA feedback and continues toward EU CE marking, which it believes could arrive in the first half of two thousand and twenty-six.

Digital screening for atrial fibrillation is expanding, but who joins matters. In a JACC: Advances substudy from eBRAVE-AF, sixty-seven thousand four hundred and eighty-eight German insurance policyholders were invited and five thousand five hundred and fifty-one consented and were randomized to smartphone-based screening or usual care, with claims data available for fifty-one thousand seven hundred and seventy-five. Participants were younger and healthier than nonparticipants. Screening more than doubled detection of atrial fibrillation requiring oral anticoagulation in the trial, and model-based extrapolation suggested higher yields in the broader invited population. Most anticoagulation was with factor Xa inhibitors. Limitations include reliance on claims data and modeling.

Gene editing in cardiometabolic disease reached a first-in-human milestone. In the open-label Phase one CRISP-ANGPTL3 trial of CTX310, a single lipid nanoparticle infusion designed to disrupt hepatic ANGPTL3 lowered ANGPTL3 protein by seventy-three to eighty percent at higher doses. This was accompanied by reductions in LDL cholesterol of forty-eight point nine percent, triglycerides by fifty-five point two percent, and apolipoprotein B by thirty-three point four percent at around sixty days. No dose-limiting toxicities occurred, with mostly mild transient events reported. One death occurred one hundred and seventy-nine days after the lowest dose, and longer-term follow-up is planned.

Cholesterol therapeutics also advanced via traditional pathways. The FDA approved lerodalcibep, branded Lerochol, a monthly self-administered PCSK9 inhibitor for adults with hypercholesterolemia, including heterozygous familial hypercholesterolemia. It can be stored at room temperature for up to three months. Approval was supported by the Phase three LIBerate-HR trial, which showed an absolute fifty-six percent LDL cholesterol reduction versus placebo over one year, with consistent findings across the broader LIBerate program.

Finally, acute arrhythmia care moves into the home. The FDA approved Cardamyst, etripamil nasal spray, for the conversion of acute symptomatic episodes of paroxysmal supraventricular tachycardia in adults. In the Phase three RAPID trial, sixty-four percent of patients who self-administered etripamil converted to sinus rhythm within thirty minutes versus thirty-one percent with placebo, corresponding to a hazard ratio of two point six two. Median time to conversion was seventeen minutes versus fifty-four minutes. The most common adverse events were transient local nasal effects, and fewer than two percent discontinued due to adverse events.

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