keyword
MENU ▼
Read by QxMD icon Read
search

Carotid endarterectomy in asymptomatic patients

keyword
https://www.readbyqxmd.com/read/28323231/carotid-endarterectomy-in-the-southern-california-vascular-outcomes-improvement-collaborative
#1
Kaelan Chan, Ahmed Abouzamzam, Karen Woo
OBJECTIVE: The objective of this study is to examine the variation in practice patterns and associated outcomes for carotid endarterectomy (CEA) within the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe), a regional quality group of the Vascular Quality Initiative (VQI). METHODS: All cases entered in the CEA registry by the So Cal VOICe were included in the study. RESULTS: From September 2010 through September 2015, 1110 CEA cases were entered by nine centers in the So Cal VOICe...
March 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28319050/extracellular-matrix-proteomics-identifies-molecular-signature-of-symptomatic-carotid-plaques
#2
Sarah R Langley, Karin Willeit, Athanasios Didangelos, Ljubica Perisic Matic, Philipp Skroblin, Javier Barallobre-Barreiro, Mariette Lengquist, Gregor Rungger, Alexander Kapustin, Ludmilla Kedenko, Chris Molenaar, Ruifang Lu, Temo Barwari, Gonca Suna, Xiaoke Yin, Bernhard Iglseder, Bernhard Paulweber, Peter Willeit, Joseph Shalhoub, Gerard Pasterkamp, Alun H Davies, Claudia Monaco, Ulf Hedin, Catherine M Shanahan, Johann Willeit, Stefan Kiechl, Manuel Mayr
BACKGROUND: The identification of patients with high-risk atherosclerotic plaques prior to the manifestation of clinical events remains challenging. Recent findings question histology- and imaging-based definitions of the "vulnerable plaque," necessitating an improved approach for predicting onset of symptoms. METHODS: We performed a proteomics comparison of the vascular extracellular matrix and associated molecules in human carotid endarterectomy specimens from 6 symptomatic versus 6 asymptomatic patients to identify a protein signature for high-risk atherosclerotic plaques...
March 20, 2017: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28318997/diastolic-blood-pressure-is-a-risk-factor-for-peri-procedural-stroke-following-carotid-endarterectomy-in-asymptomatic-patients
#3
D D de Waard, G J de Borst, R Bulbulia, A Huibers, A Halliday
OBJECTIVE/BACKGROUND: Carotid endarterectomy (CEA) prevents future stroke, but this benefit depends on detection and control of high peri-operative risk factors. In symptomatic patients, diastolic hypertension has been causally related to procedural stroke following CEA. The aim was to identify risk factors causing peri-procedural stroke in asymptomatic patients and to relate these to timing of surgery and mechanism of stroke. METHODS: In the first Asymptomatic Carotid Surgery Trial (ACST-1), 3,120 patients with severe asymptomatic carotid stenosis were randomly assigned to CEA plus medical therapy or to medical therapy alone...
March 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28300680/evaluation-by-mri-of-silent-brain-infarcts-in-pre-and-post-operative-asymptomatic-carotid-surgery
#4
Remy Pascot, Anne Daoudal, Alain Cardon, Gilles Godet, Antoine Lucas, Elodie Clochard, Jean-Yves Gauvrit, Yann Le Teurnier, Adrien Kaladji
OBJECTIVE: To report the prevalence of Silent Brain Infarcts (SBI) at MRI before and after surgery for asymptomatic high grade carotid stenosis. DESIGN: Single-center retrospective observational study METHODS: Asymptomatic patients who underwent carotid endarterectomy between October 2012 and October 2014 were included. The preoperative assessment included a Doppler and a CT scan dating less than 3 months. A neurological examination was performed during the anesthesia consultation and in the 15 days before surgery...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28292859/-18-f-fluoride-and-18-f-fluorodeoxyglucose-positron-emission-tomography-after-transient-ischemic-attack-or-minor-ischemic-stroke-case-control-study
#5
Alex T Vesey, William S A Jenkins, Agnese Irkle, Alastair Moss, Greg Sng, Rachael O Forsythe, Tim Clark, Gemma Roberts, Alison Fletcher, Christophe Lucatelli, James H F Rudd, Anthony P Davenport, Nicholas L Mills, Rustam Al-Shahi Salman, Martin Dennis, William N Whiteley, Edwin J R van Beek, Marc R Dweck, David E Newby
BACKGROUND: Combined positron emission tomography (PET) and computed tomography (CT) can assess both anatomy and biology of carotid atherosclerosis. We sought to assess whether (18)F-fluoride or (18)F-fluorodeoxyglucose can identify culprit and high-risk carotid plaque. METHODS AND RESULTS: We performed (18)F-fluoride and (18)F-fluorodeoxyglucose PET/CT in 26 patients after recent transient ischemic attack or minor ischemic stroke: 18 patients with culprit carotid stenosis awaiting carotid endarterectomy and 8 controls without culprit carotid atheroma...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28288976/risk-of-inhospital-stroke-or-death-is-associated-with-age-but-not-sex-in-patients-treated-with-carotid-endarterectomy-for-asymptomatic-or-symptomatic-stenosis-in-routine-practice-secondary-data-analysis-of-the-nationwide-german-statutory-quality-assurance-database
#6
Sofie Schmid, Pavlos Tsantilas, Christoph Knappich, Michael Kallmayer, Thomas König, Thorben Breitkreuz, Alexander Zimmermann, Andreas Kuehnl, Hans-Henning Eckstein
BACKGROUND: Guideline recommendations on carotid endarterectomy are based predominantly on randomized, controlled trials, in which women or elderly patients are often under-represented. This study analyzed the association of age and sex with the risk of in-hospital stroke or death following carotid endarterectomy under routine conditions in Germany. METHODS AND RESULTS: Secondary data analysis using the Statutory German Quality Assurance Database on all carotid endarterectomy procedures (n=142 074) performed between 2009 and 2014...
March 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28283609/intraoperative-completion-studies-local-anesthesia-and-antiplatelet-medication-are-associated-with-lower-risk-in-carotid-endarterectomy
#7
Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein
BACKGROUND AND PURPOSE: In Germany, all surgical and endovascular procedures on the carotid bifurcation must be documented in a statutory nationwide quality assurance database. We aimed to analyze the association between procedural and perioperative variables and in-hospital stroke or death rates after carotid endarterectomy. METHODS: Between 2009 and 2014, overall 142 074 elective carotid endarterectomy procedures for asymptomatic or symptomatic carotid artery stenosis were documented in the database...
March 10, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28260723/evidence-based-carotid-interventions-for-stroke-prevention-state-of-the-art-review
#8
Dylan R Morris, Kengo Ayabe, Takashi Inoue, Nobuyuki Sakai, Richard Bulbulia, Alison Halliday, Shinya Goto
Carotid artery stenosis is responsible for between 10-20% of all ischaemic strokes. Interventions, such as carotid endarterectomy and carotid stenting, effectively reduce the risk of stroke in selected individuals. This review describes the history of carotid interventions, and summarises reliable evidence on the safety and efficacy of these interventions gained from large randomised clinical trials.Early trials comparing carotid endarterectomy to medical therapy alone in symptomatic patients, and asymptomatic patients, demonstrated that endarterectomy halved the risk of stroke and perioperative death in these two unique populations...
March 4, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28249083/provider-induced-demand-in-the-treatment-of-carotid-artery-stenosis-variation-in-treatment-decisions-between-private-sector-fee-for-service-vs-salary-based-military-physicians
#9
Louis L Nguyen, Ann D Smith, Rebecca E Scully, Wei Jiang, Peter A Learn, Stuart R Lipsitz, Joel S Weissman, Lorens A Helmchen, Tracey Koehlmoos, Andrew Hoburg, Linda G Kimsey
Importance: Although many factors influence the management of carotid artery stenosis, it is not well understood whether a preference toward procedural management exists when procedural volume and physician compensation are linked in the fee-for-service environment. Objective: To explore evidence for provider-induced demand in the management of carotid artery stenosis. Design, Setting, and Participants: The Department of Defense Military Health System Data Repository was queried for individuals diagnosed with carotid artery stenosis between October 1, 2006, and September 30, 2010...
March 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28216356/fixed-and-variable-cost-of-carotid-endarterectomy-and-stenting-in-the-united-states-a-comparative-study
#10
Tammam Obeid, Husain Alshaikh, Besma Nejim, Isibor Arhuidese, Satinderjit Locham, Mahmoud Malas
OBJECTIVE: Despite multiple landmark clinical trials, little data exists on real-world cost of carotid artery stenting (CAS) and carotid endarterectomy (CEA) to the United States healthcare system. We aim to study differences in actual hospitalization cost between patients who underwent CAS vs CEA in a nationally representative database. METHODS: We studied hospital discharge and billing records of all patients, in the Premier Perspective Database, who underwent CEA or CAS between the third quarter of 2009 and the first quarter of 2015...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28202829/-treatment-strategy-and-results-of-carotid-endarterectomy-in-chronic-renal-failure-patients
#11
Takeo Murahashi, Kenji Kamiyama, Toshiaki Osato, Toshiichi Watanabe, Tatsuya Ogino, Hironori Sugio, Hideki Endo, Kazuki Takahira, Koichiro Shindo, Shuhei Takahashi, Hirohiko Nakamura
INTRODUCTION: The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. METHODS: The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#12
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190714/carotid-endarterectomy-should-not-be-based-on-consensus-statement-duplex-velocity-criteria
#13
Jesse A Columbo, Bjoern D Suckow, Claire L Griffin, Jack L Cronenwett, Philip P Goodney, Timothy G Lukovits, Robert M Zwolak, Mark F Fillinger
OBJECTIVE: Randomized trials support carotid endarterectomy (CEA) in asymptomatic patients with ≥60% internal carotid artery (ICA) stenosis. The widely referenced Society for Radiologists in Ultrasound Consensus Statement on carotid duplex ultrasound (CDUS) imaging indicates that an ICA peak systolic velocity (PSV) ≥230 cm/s corresponds to a ≥70% ICA stenosis, leading to the potential conclusion that asymptomatic patients with an ICA PSV ≥230 cm/s would benefit from CEA. Our goal was to determine the natural history stroke risk of asymptomatic patients who might have undergone CEA based on consensus statement PSV of ≥230 cm/s but instead were treated medically based on more conservative CDUS imaging criteria...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28183175/carotid-endarterectomy-has-significantly-lower-risk-in-the-last-two-decades-should-the-guidelines-now-be-updated
#14
Djordje Radak, Djurre de Waard, Alison Halliday, Mihailo Neskovic, Slobodan Tanaskovic
Carotid endarterectomy (CEA) carries a significant risk of procedural stroke and death Guidelines recommend keeping this risk below 6% and below 3% for symptomatic and asymptomatic patients respectively. After analysing our Institute's CEA results during the past 25 years, we found the rate of postoperative complications was now well below Guideline thresholds. Accordingly, we studied temporal changes in procedural risks in randomized controlled trials (RCTs) and in large observational studies in order to compare these against Guidelines...
February 9, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28161565/dual-antiplatelet-therapy-does-not-increase-the-risk-of-bleeding-after-carotid-endarterectomy-results-of-a-prospective-study
#15
Giulio Illuminati, Fabrice Schneider, Giulia Pizzardi, Federica Masci, Francesco G Calio', Jean-Baptiste Ricco
BACKGROUND: The purpose of this study was to evaluate the risk of bleeding and other postoperative complications of carotid endarterectomy (CEA) in patients receiving dual antiplatelet therapy (DAPT). METHODS: From January 2005 to December 2015, 188 consecutive patients undergoing CEA and receiving DAPT (aspirin 100 mg + clopidogrel 75 mg) were enrolled in a prospective study. All of them underwent coronary artery stenting with drug-eluting stents during the 6 months preceding CEA...
February 2, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28157748/large-artery-atherosclerotic-occlusive-disease
#16
John W Cole
PURPOSE OF REVIEW: Extracranial or intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack. Given the high prevalence of large artery atherosclerosis in the general population, determining whether an identified atherosclerotic lesion is truly the cause of a patient's symptomatology can be difficult. In all cases, optimally treating each patient to minimize future stroke risk is paramount. Extracranial or intracranial large artery atherosclerosis can be broadly compartmentalized into four distinct clinical scenarios based upon the individual patient's history, examination, and anatomic imaging findings: asymptomatic and symptomatic extracranial carotid stenosis, intracranial atherosclerosis, and extracranial vertebral artery atherosclerotic disease...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28154099/stroke-caused-by-extracranial-disease
#17
Kevin M Barrett, Thomas G Brott
Extracranial internal carotid artery atherosclerotic occlusive disease is a common ischemic stroke mechanism. Vascular risk factor control remains the cornerstone of stroke prevention in patients with both asymptomatic and symptomatic carotid occlusive diseases. Intensive medical therapy refers to the contemporary approach of antiplatelet therapy, blood pressure control, low-density lipoprotein reduction, and lifestyle modification to reduce stroke risk. Carotid revascularization with endarterectomy or angioplasty and stenting are established treatments for patients with symptomatic carotid stenosis ≥70%...
February 3, 2017: Circulation Research
https://www.readbyqxmd.com/read/28127515/effects-of-preoperative-statin-use-on-perioperative-outcomes-of-carotid-endarterectomy
#18
Enzo Ballotta, Antonio Toniato, Filippo Farina, Claudio Baracchini
OBJECTIVES: Several studies have shown the beneficial role of statins in reducing the risk of major perioperative complications and death associated with noncardiac vascular surgery, but few have focused on their effects in the event of carotid endarterectomy (CEA). This study analyzes the effects of preoperative statin use on perioperative outcomes in patients undergoing CEA. MATERIALS AND METHODS: Data from all consecutive patients who underwent primary CEA for symptomatic and asymptomatic carotid disease between 2002 and 2014 at a single institution were prospectively stored in a vascular surgery registry, recording risk factors, medication, and indication for surgery...
January 2017: Brain and Behavior
https://www.readbyqxmd.com/read/28124515/anatomic-criteria-determining-high-risk-carotid-surgery-patients
#19
REVIEW
Pavlos Tsantilas, Andreas Kuehnl, Erich Brenner, Hans-Henning Eckstein
INTRODUCTION: Based on randomized trials, carotid endarterectomy (CEA) is the standard procedure for patients with a 50-99% symptomatic carotid stenosis and carefully selected patients with an asymptomatic high-grade carotid stenosis. Carotid artery stenting (CAS) is a technical alternative for patients with a high surgical risk or difficult anatomic conditions (e.g., recurrent stenosis). This study aims to provide an overview of anatomic factors associated with a higher risk of CEA complications...
April 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28095924/sonolysis-in-prevention-of-brain-infarctions-during-internal-carotid-endarterectomy-sonobirdie-trial-study-protocol-for-a-randomized-controlled-trial
#20
Tomáš Hrbáč, David Netuka, Vladimír Beneš, Vladimír Nosáľ, Petra Kešnerová, Aleš Tomek, Táňa Fadrná, Vladimír Beneš, Jiří Fiedler, Vladimír Přibáň, Miroslav Brozman, Kateřina Langová, Roman Herzig, David Školoudík
BACKGROUND: Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe with maximal diagnostic energy on the reduction of the incidence of stroke, transient ischemic attack (TIA) and brain infarction detected using magnetic resonance imaging (MRI) by the activation of the endogenous fibrinolytic system during CEA...
January 17, 2017: Trials
keyword
keyword
117878
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"