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BACKGROUND: Findings from the Look AHEAD trial showed no significant reductions in the primary outcome of cardiovascular disease incidence in adults with type 2 diabetes randomly assigned to an intensive lifestyle intervention for weight loss compared with those randomly assigned to diabetes support and education (control). We examined whether the incidence of cardiovascular disease in Look AHEAD varied by changes in weight or fitness. METHODS: Look AHEAD was a randomised clinical trial done at 16 clinical sites in the USA, recruiting patients from Aug 22, 2001, to April 30, 2004...
August 30, 2016: Lancet Diabetes & Endocrinology
M Taurino, F Filippi, F Persiani, C Tirotti, R Dito, D Brancadoro, L Rizzo
OBJECTIVES: The eversion carotid endartectomy (E-CEA), mainly performed by means of Vanmaele technique, has been associated with loss of the baroreceptor reflex and postoperative hypertension. The purpose of this paper is to determine whether the eversion endarterectomy performed by means of Chevalier technique (C-CEA) modifies the function and the efficiency of baroreceptors, leading to lower postoperative hemodynamic change. METHODS: A retrospective review of 380 patients who underwent carotid endarterectomy (120 Chevalier-CEA; 260 Standard-CEA) from December 2002 to November 2012 has been performed...
November 2014: European Journal of Vascular and Endovascular Surgery
A N Sumin, R A Gaĭfulin, M G Mos'kin, E V Korok, A V Shcheglova, O I Raĭkh, S V Ivanov, O L Barbarash
The study was aimed at examining the factors having an impact on changes in the quality of life (QL) parameters a year after coronary artery bypass surgery (CABG) in different age groups. 408 patients aged 31-79 years had their QL assessed by means of the SF-36 questionnaire before and one year after elective CABG. Additionally, the patients were tested for the presence of type D personality before and one year after CABG by means of the DS-14 questionnaire. The groups were comparable in terms of previous carotid endarterectomy, peripheral arterial and aortic reconstruction number (p > 0...
2013: Advances in Gerontology, Uspekhi Gerontologii
Matthew L Flaherty, Brett Kissela, Heidi Sucharew, Kathleen Alwell, Charles J Moomaw, Daniel Woo, Pooja Khatri, Simona Ferioli, Opeolu Adeoye, Jason Mackey, Joseph P Broderick, Dawn Kleindorfer
Carotid endartectomy (CEA) and carotid artery stenting (CAS) reduce the risk of stroke when performed with acceptable perioperative morbidity and mortality. Studies from the 1980s in the greater Cincinnati/northern Kentucky population showed that perioperative risk after CEA exceeded the recommended boundaries of 3.0% for asymptomatic stenosis and 6.0% for symptomatic stenosis. We investigated the indications and outcomes for CEA and CAS in the same population during 2005. We identified all residents of the greater Cincinnati/northern Kentucky region who underwent CEA or CAS at any local hospital during 2005...
February 2013: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
William R Auger, Nick H Kim, Terence K Trow
Chronic thromboembolic pulmonary hypertension is one of the few forms of pulmonary hypertension that is surgically curable. It is likely underdiagnosed and must be considered in every patient presenting with pulmonary hypertension to avoid missing the opportunity to cure these patients. This article discusses the epidemiology, risk factors, natural history, diagnosis, and preoperative evaluation of patients with this disorder. Also covered are putative mechanisms for the conversion of acute emboli into fibrosed thrombembolic residua...
December 2010: Clinics in Chest Medicine
M I Neĭmark, V V Shmelev, V Iu Simagin
Total intravenous anesthesia with diprivan and inhaled sevoflurane was assessed in 130 patients undergoing carotid endartectomy. The parameters of hemodynamics and cerebral circulation and the markers of brain lesion were studied. Sevoflurane anesthesia was shown to induce less depression of hemodynamic parameters and to maintain the more optimal level of cerebral circulation, limiting brain ischemic and reperfusion lesions and causing a fewer number of postoperative complications.
March 2010: Anesteziologiia i Reanimatologiia
L Rodríguez-Bel, J Mora Salvadó, M Bajén Lázaro, R Puchal Añé, I Sancho Kolster, S Guirao Marín, A Doménech Vilardell, C Sánchez Catasus, M Font Padrós, Y Krupinspy, J Martín Comín
UNLABELLED: The efficacy of carotid endartectomy (CE) in cerebrovascular accidents produced by carotid stenosis can be evaluated with the cerebral perfusion with single photon emission tomography, using statistical parametric mapping (SPM). MATERIAL AND METHODS: Twelve patients with significant carotid stenosis who underwent endartectomy were included in the study. All underwent a cerebral perfusion study with 99mTc-etilen cisteinato dietilester (ECD) at baseline and after the endartectomy...
January 2010: Revista Española de Medicina Nuclear
Gábor Széplaki, Lilian Varga, George Füst, Zoltán Prohászka
In the first part of the review article authors summarize our knowledge on the role of complement in atherogenesis and the development of I/R injury as well as the complement activation products which contribute to these pathological processes. In the second part of the review authors highlight the complement dependent processes which participate at the pathomechanism of cerebrovascular diseases, the development of cerebral infarct in ischemic stroke and the restenosis which may occur a part of the patients who underwent eversion endartectomy operation...
September 2009: Molecular Immunology
Jens Fiehler, Olav Jansen, Jürgen Berger, Hans-Henning Eckstein, Peter A Ringleb, Robert Stingele
INTRODUCTION: Despite the high grade of standardisation of study protocols, there is still room for variability among the centres in specific treatment aspects. We evaluated the treatment risk in stent-protected angioplasty of the carotid versus endarterectomy (SPACE) associated with the specific patient enrollment rates of the centres. MATERIALS AND METHODS: The analysed endpoints were ipsilateral stroke or death [primary outcome event (pOE)] and any stroke or death [secondary outcome event (sOE)] until 30 days after treatment...
December 2008: Neuroradiology
P J E Holt, J D Poloniecki, I M Loftus, M M Thompson
OBJECTIVES: To assess the outcome of carotid endarterectomy in England with respect to the hospital case-volume. METHODS: Data were from English Hospital Episode Statistics (2000-2005). Admissions were classified as elective or emergency. Risk-adjusted data were analysed through modelling of death rate, complication rate and length of admission with regard to the year of procedure and annual hospital volume of surgery. Hospitals with elevated death rates were identified and the evidence quantified that they had outlying mortality rates...
December 2007: European Journal of Vascular and Endovascular Surgery
J Lindner, P Jansa, J Kunstyr, E Mayer, J Blaha, T Palecek, M Aschermann, T Grus, D Ambroz, J Tosovský, I Vitkova
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) in indicated cases can be successfully cured by endartectomy of pulmonary arteries (PEA). Symptomatic nontreated CTEPH has a very poor prognosis; the five-year survival rate in patients with a medium pressure of over 50 mmHg in the main pulmonary artery is as low as 10 %. This kind of operation was previously not available in the Czech Republic. In 2004, a PEA programme was launched at the Cardiocentre of the General Teaching Hospital in Prague in co-operation with the institution of a well known specialist in this field (Prof...
December 2006: Thoracic and Cardiovascular Surgeon
T Stafinski, D Menon
(1) Cerebral protection devices offer a new approach to reducing the risk of stroke and death in patients undergoing carotid angioplasty with stenting (CAS). (2) Nine studies have examined the efficacy of cerebral protection devices, by comparing the incidence of procedure related stroke and death to that of CAS without protection, and to surgical endarterectomy. Few of the studies were of high quality. (3) Overall, the differences in the incidence of procedure-related stroke and death were not statistically significant among patients who underwent CAS without protection, compared to those who received CAS with protection, or to those who underwent endarterectomy...
December 2005: Issues in Emerging Health Technologies
P Rossi, A Riutta, P Kuukasjärvi, T Vehmas, I Mucha, J P Salenius
8-Isoprostaglandin F2alpha is one of a series of isoprostanes formed by free radical catalysed peroxidation of arachidonic acid. Urinary 8-isoprostaglandin F2alpha is a new marker which reflects oxidative stress in vivo and can be utilized as a diagnostic tool to assess the extent of oxidative stress in various disease states associated with lipid peroxidation. Increased levels of 8-isoprostaglandin F2alpha in cardiac ischemia/reperfusion provide evidence for oxidative stress during coronary perfusion. In animal studies, the restoration of blood flow after lower limb ischemia is followed by reperfusion syndrome...
August 2004: Prostaglandins, Leukotrienes, and Essential Fatty Acids
P Ringleb, A Kunze, J R Allenberg, M Hennerici, O Jansen, P C Maurer, H Zeumer, W Hacke
During recent years, stent-protected angioplasty of the carotid artery (SPAC) has become an alternative to endartectomy (CEA) in many centers. Despite many case reports, case series, and open records, it has not been proven that these therapeutical regimens are comparable regarding complication rates and long-term outcome. Until now, only three randomized trials were published on this theme, two of them only as abstracts. This is not sufficient for answering the question of whether SPAC is a good alternative to CEA...
June 2003: Der Nervenarzt
Melanie Cochrane, Andreas Pospischil, Philip Walker, Harry Gibbs, Peter Timms
Despite extensive efforts to confirm a direct association between Chlamydia pneumoniae and atherosclerosis, different laboratories continue to report a large variability in detection rates. In this study, we analyzed multiple sections from atherosclerotic carotid arteries from 10 endartectomy patients to determine the location of C. pneumoniae DNA and the number of sections of the plaque required for analysis to obtain a 95% confidence of detecting the bacterium. A sensitive nested PCR assay detected C. pneumoniae DNA in all patients at one or more locations within the plaque...
April 2003: Journal of Clinical Microbiology
A Hingorani, E Ascher, B Tsemekhim, N Markevich, S Kallakuri, R Schutzer, Th Jacob
OBJECTIVE: Early stroke occurs in 0.9% to 7% of patients undergoing carotid endarterectomy (CEA). These have been thought to be mostly due to embolization. However, in our recent clinical experience, we noted hyperperfusion syndrome to be a significant cause of postoperative strokes. Therefore, we reviewed our experience and investigated the distribution of causes of early postoperative strokes. MATERIALS AND METHODS: A retrospective chart review of 444 consecutive patients who underwent CEA at our institution between June 1997 and October 1999 (500 operations) was performed to evaluate the incidence and etiology of early postoperative strokes...
December 2002: Acta Chirurgica Belgica
Anil Hingorani, Enrico Ascher
PURPOSE: The morbidity associated with contrast-based diagnostics performed for preoperative evaluation prior to vascular intervention ranges from 1 to 21%. These complications range from minor hematomas to death. However, these exams are commonly felt to be a necessary step to completely evaluate the arterial tree before intervention is undertaken. Since this has varied from our experience, we reviewed our experience with repair of abdominal aortic aneurysms (AAAs), carotid endartectomy (CEA), and lower extremity revascularization performed without preoperative contrast studies...
February 2003: Cardiovascular Surgery: Official Journal of the International Society for Cardiovascular Surgery
J F Bechtel, C Bartels, S Hopstein, S Horsch
BACKGROUND: Major aortic surgery carries a high risk of stroke. Carotid artery occlusive disease (CAOD) has been identified as one of the contributing risk factors. Regarding the long-term prevention of stroke, carotid endartectomy (CEA) seems to be superior to the best medical treatment in patients with high-grade CAOD. However, the role of CEA prior to major aortic surgery has not been studied. METHODS: HASH(0x4d87d88) DESIGN: Prospective study, observational design...
April 2000: Journal of Cardiovascular Surgery
J D Knighton, M D Stoneham
We conducted a postal questionnaire survey of the members of the Vascular Anasthesia Society of Great Britain and Ireland, asking questions about the provision of anasthesia for carotid endartectomy. Of 215 respondents, 187 were currently providing anasthesia for carotid endarterectomy. The majority of respondents (69%) always use general anasthesia for this operation but 99/215 (46%) had some experience of regional anasthesia for carotid endartectomy. Amongst those currently using regional anasthesia, combined deep and superficial cervical plexus block was the technique used by 71%...
May 2000: Anaesthesia
S Zannetti, P Cao, P De Rango, G Giordano, G Parlani, M Lenti, A Nora
OBJECTIVE: to define the incidence of technical defects and the impact of technical errors on ipsilateral carotid occlusion, ipsilateral stroke, and early restenosis rates, we analysed 1305 patients undergoing carotid completion procedures. DESIGN: prospective multicentre study. PATIENTS AND METHODS: adequacy of CEA was assessed intraoperatively by angiography in 1004 (77%), by angioscopy in 299 (22%), and by duplex scan in two patients (1%)...
July 1999: European Journal of Vascular and Endovascular Surgery
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