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Carotid endarterectomy

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https://www.readbyqxmd.com/read/29136204/thrombolysis-is-an-independent-risk-factor-for-poor-outcome-after-carotid-revascularization
#1
Ananth K Vellimana, Chad W Washington, Chester K Yarbrough, Thomas K Pilgram, Brian L Hoh, Colin P Derdeyn, Gregory J Zipfel
BACKGROUND: Thrombolysis is the standard of care for acute ischemic stroke patients presenting in the appropriate time window. Studies suggest that the risk of recurrent ischemia is lower if carotid revascularization is performed early after the index event. The safety of early carotid revascularization in this patient population is unclear. OBJECTIVE: To evaluate the safety of carotid revascularization in patients who received thrombolysis for acute ischemic stroke...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#2
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29129364/diabetes-control-decreases-morbidity-and-mortality-after-carotid-endarterectomy
#3
Matthew S Parr, Viktor Y Dombrovskiy, Khanjan H Nagarsheth, Randy Shafritz, Saum A Rahimi
BACKGROUND: Single-institution studies have demonstrated a negative effect of diabetes mellitus on outcomes after carotid endarterectomy (CEA). The aim of this study was to compare patients with explicitly controlled and uncontrolled diabetes at the population level. METHODS: Using the National Inpatient Sample 2006-2013, we selected patients undergoing CEA. Rates of stroke, myocardial infarction (MI), and hospital mortality, as well as duration of stay and cost were compared among patients with uncontrolled diabetes (UCDM), well-controlled diabetes (WCDM), and those without diabetes (NDM)...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29129081/identification-of-mature-atherosclerotic-plaque-proteome-signatures-using-data-independent-acquisition-mass-spectrometry
#4
Nicole Hansmeier, Josef Buttigieg, Pankaj Kumar, Shaneen Pelle, Kyoo Yoon Choi, David Kopriva, Tzu-Chiao Chao
Atherosclerosis is a chronic inflammatory disease with complex pathobiology and one of the most common causes of cardiovascular events. The process is characterized by complex vascular remodeling processes that require the actions of numerous proteins. The composition of atherosclerotic plaque is increasingly recognized as a major factor governing the occurrence of cardiovascular or neurological symptoms. In order to gain deeper insights in the composition of atherosclerotic plaques, we created quantitative proteome profiles of advanced plaque tissues of six male patients undergoing carotid endarterectomy for stroke prevention...
November 11, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/29117648/serum-neuron-specific-enolase-as-a-marker-of-brain-ischemia-reperfusion-injury-in-patients-undergoing-carotid-endarterectomy
#5
Marek Iłżecki, Joanna Iłżecka, Stanisław Przywara, Piotr Terlecki, Aneta Grabarska, Andrzej Stepulak, Tomasz Zubilewicz
In patients with atherosclerotic stenosis of the extracranial segment of internal carotid artery, surgical intervention is an effective method to prevent cerebral ischemic stroke. However, this surgical procedure may cause vascular brain damage. The aim of the study was to investigate consequential brain ischemia-reperfusion injury by measuring the cerebral specific marker, neuron-specific (NSE), in serum of patients having undergone internal carotid endarterectomy (CEA). The study involved 25 patients that underwent CEA due to internal carotid artery stenosis...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29117409/development-of-a-perfusion-based-cadaveric-simulation-model-integrated-into-neurosurgical-training-feasibility-based-on-reconstitution-of-vascular-and-cerebrospinal-fluid-systems
#6
Gabriel Zada, Joshua Bakhsheshian, Martin Pham, Mike Minneti, Eisha Christian, Jesse Winer, Aaron Robison, Bozena Wrobel, Jonathan Russin, William J Mack, Steven Giannotta
BACKGROUND: Novel methodologies providing realistic simulation of the neurosurgical operating room environment are currently needed, particularly for highly subspecialized operations with steep learning curves, high-risk profiles, and demands for advanced psychomotor skills. OBJECTIVE: To describe the development of a curriculum for using perfusion-based cadaveric simulation models in a "Mock Operating Room" for neurosurgical procedures. METHODS: At the USC Keck School of Medicine Fresh Tissue Dissection Laboratory between 2012 and 2016, 43 cadaveric specimens underwent cannulation of the femoral or carotid artery and artificial perfusion of the arterial system, and/or cannulation of the intradural cervical spine for intrathecal reconstitution of the cerebrospinal fluid (CSF) system...
May 13, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29117272/risks-associated-with-primary-and-redo-carotid-endarterectomy-in-the-endovascular-era
#7
Isibor J Arhuidese, Muhammad Faateh, Besma J Nejim, Satinderjit Locham, Christopher J Abularrage, Mahmoud B Malas
Importance: Clinical experience suggests worse outcomes for redo carotid endarterectomy (CEA) relative to primary CEA. Objective quantification of the excess risk attributable to redo CEA in this era of proliferating endovascular therapy remains to be determined. Objective: To evaluate the risks of redo CEA relative to primary CEA. Design, Setting, and Participants: This study was a retrospective analysis of a prospective cohort of patients maintained by the Society for Vascular Surgery in the Vascular Quality Initiative between January 1, 2003, and April 30, 2016...
November 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29114319/carotid-endarterectomy-a-video-demonstration
#8
Yoko Kato, Mohsen Nouri, Motoki Oheda
No abstract text is available yet for this article.
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29113863/long-term-outcomes-after-carotid-artery-stenting-of-patients-with-prior-neck-irradiation-or-surgery
#9
Ho-Hin K Choy, Damianos G Kokkinidis, Ryan Cotter, Gagan D Singh, R Kevin Rogers, Stephen W Waldo, John R Laird, Ehrin J Armstrong
BACKGROUND: Carotid artery stenting (CAS) is often performed in patients with carotid artery stenosis who have relative contraindications to carotid endarterectomy (CEA), including hostile neck anatomy (e.g., history of neck irradiation or prior surgery). We examined the impact of hostile neck anatomy on long-term outcomes after CAS. METHODS: All carotid artery stent procedures performed at two institutions from 2006 to 2016 were reviewed. Routine duplex carotid ultrasound was used to assess target lesion restenosis at regular intervals...
September 21, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29109328/semi-automated-carotid-lumen-segmentation-in-computed-tomography-angiography-images
#10
Hamid Reza Hemmati, Mahdi Alizadeh, Alireza Kamali-Asl, Shapour Shirani
Carotid artery stenosis causes narrowing of carotid lumens and may lead to brain infarction. The purpose of this study was to develop a semi-automated method of segmenting vessel walls, surrounding tissues, and more importantly, the carotid artery lumen by contrast computed tomography angiography (CTA) images and to define the severity of stenosis and present a three-dimensional model of the carotid for visual inspection. In vivo contrast CTA images of 14 patients (7 normal subjects and 7 patients undergoing endarterectomy) were analyzed using a multi-step segmentation algorithm...
November 5, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/29101840/ex%C3%A2-vivo-culture-of-human-atherosclerotic-plaques-a-model-to-study-immune-cells-in-atherogenesis
#11
Anna Lebedeva, Daria Vorobyeva, Murad Vagida, Oxana Ivanova, Eugeny Felker, Wendy Fitzgerald, Natalya Danilova, Vladimir Gontarenko, Alexander Shpektor, Elena Vasilieva, Leonid Margolis
BACKGROUND AND AIMS: The mechanisms that drive atherosclerotic plaque progression and destabilization in humans remain largely unknown. Laboratory models are needed to study these mechanisms under controlled conditions. The aim of this study was to establish a new ex vivo model of human atherosclerotic plaques that preserves the main cell types in plaques and the extracellular components in the context of native cytoarchitecture. METHODS: Atherosclerotic plaques from carotid arteries of 28 patients undergoing carotid endarterectomy were dissected and cultured...
October 7, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29101839/community-based-statins-and-advanced-carotid-plaque-role-of-cd163-positive-macrophages-in-lipoprotein-associated-phospholipase-a2-activity-in-atherosclerotic-plaque
#12
Fumiyuki Otsuka, XiaoQing Zhao, Hugh H Trout, Ye Qiao, Bruce A Wasserman, Masataka Nakano, Colin H Macphee, Martin Brandt, Sue Krug-Gourley, Liang Guo, Elena R Ladich, Qi Cheng, Harry R Davis, Aloke V Finn, Renu Virmani, Frank D Kolodgie
BACKGROUND AND AIMS: Lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzymatic inflammatory biomarker primarily bound to low-density lipoprotein cholesterol, is associated with an approximate twofold increased risk of cardiovascular disease and stroke. Despite indications that circulating Lp-PLA2 is sensitive to statins, it remains largely unknown whether statin usage exerts local effects on Lp-PLA2 expression at the site of atheromatous plaque. METHODS: Carotid plaques (n = 38) were prospectively collected from symptomatic (n = 18) and asymptomatic (n = 20) patients with (n = 20) or without (n = 18) documented statin history...
October 14, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29101838/a-molecular-intravascular-ultrasound-contrast-agent-allows-detection-of-activated-platelets-on-the-surface-of-symptomatic-human-plaques
#13
Alexander Maier, Patricia Plaza-Heck, Fabian Meixner, Felix Guenther, Beat A Kaufmann, Mara Kramer, Timo Heidt, Andreas Zirlik, Ingo Hilgendorf, Jochen Reinöhl, Peter Stachon, Peter Bronsert, Ralf Birkemeyer, Irene Neudorfer, Karlheinz Peter, Christoph Bode, Constantin von Zur Mühlen
BACKGROUND AND AIMS: Activated platelets are amongst the most attractive imaging targets in atherosclerosis due to their important role in early processes of atherogenesis and thrombus formation. We developed a molecular intravascular ultrasound (IVUS) approach to detect activated platelets ex vivo on the surface of human plaques, using an IVUS system applied in clinical routine. METHODS: Human carotid endarterectomy specimens were obtained directly from the operating room and exposed to artificial arterial flow conditions for incubation with the contrast agent...
October 24, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29100876/preoperative-antiplatelet-and-statin-use-does-not-affect-outcomes-after-carotid-endarterectomy
#14
Brianna M Krafcik, Alik Farber, Robert T Eberhardt, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Steven L Pike, Jeffrey J Siracuse
OBJECTIVE: The use of statin and antiplatelet medications has been advocated in patients with cerebrovascular disease as primary medical therapy and as an adjunct to carotid endarterectomy (CEA). Our goal was to assess the prevalence of preoperative statin and antiplatelet use and its effect on perioperative outcomes after CEA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program targeted CEA database was queried for patients undergoing CEA between 2011 and 2014...
October 31, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29100856/recanalization-after-extracranial-dissection-effect-of-antiplatelet-compared-with-anticoagulant-therapy
#15
Preethi Ramchand, Michael T Mullen, Aaron Bress, Robert Hurst, Scott E Kasner, Brett L Cucchiara, Steven R Messé
BACKGROUND: Cervical arterial dissection is a leading cause of stroke in young patients, yet optimal management remains controversial. Existing studies focusing on recurrent stroke were underpowered to demonstrate differences between antithrombotic strategies. Vessel recanalization is a more prevalent outcome and is potentially clinically important. We aimed to assess recanalization rates with anticoagulation compared with antiplatelet therapy. METHODS: We studied a single-center retrospective cohort of patients with extracranial carotid or vertebral artery dissection...
October 31, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29092087/three-dimensional-fusion-imaging-without-contrast-medium-for-carotid-endarterectomy
#16
Masaki Matsumoto, Tohru Mizutani, Kenji Sumi, Katsuyoshi Shimizu
No abstract text is available yet for this article.
November 1, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29090261/measurements-of-oxygen-saturation-of-brain-liver-and-heart-areas-in-the-supine-and-sitting-position-using-near-infrared-spectrophotometry
#17
Athanasia Tsaroucha, Anteia Paraskeva, Argyro Fassoulaki
BACKGROUND AND AIMS: Regional oxygen saturation (rSO2) monitoring of the brain by near-infrared spectroscopy (NIRS) has been mainly used during carotid endarterectomy. The present study was conducted in volunteers and investigates the rSO2 values of the brain, heart and liver tissue as assessed by NIRS in the supine and the sitting position. METHODS: After obtaining written informed consent from forty-nine healthy volunteers, rSO2 values were recorded in the heart and liver areas in the supine and the sitting position, while simultaneously the rSO2 values of the brain...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29082746/changes-in-ocular-subfoveal-choroidal-thickness-after-carotid-endarterectomy-using-enhanced-depth-imaging-optical-coherence-tomography-a-pilot-study
#18
Fabien Lareyre, Elisabeth Nguyen, Juliette Raffort, Joseph Carboni, Jérôme Doyen, Réda Hassen-Khodja, Pierre Gastaud, Jacques Chofflet, Elixène Jean-Baptiste
The influence of both severe chronic carotid stenosis and carotid endarterectomy (CEA) on ocular tissue has been poorly evaluated. The goal of this study was to measure subfoveal choroidal thickness (SFCT), before and after CEA, in patients with severe carotid stenosis. Consecutive patients (n = 36) with severe carotid stenosis were prospectively included. Patients (n = 19) were followed up at 1 and 3 months after CEA. The SFCT was measured bilaterally using enhanced depth imaging optical coherence tomography (EDI-OCT)...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#19
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29076745/cost-effectiveness-of-magnetic-resonance-carotid-plaque-imaging-for-primary-stroke-prevention-in-canada
#20
Lechtman E, Balki I, Thomas K, Chen K, Moody Ar, Tyrrell Pn
OBJECTIVES: Magnetic resonance (MR) imaging of the carotid arteries provides important insight into plaque composition and vulnerability in addition to the traditional measure of stenosis. The purpose of this study was to evaluate the cost-effectiveness of MR imaging as a first-line modality to assess carotid disease and guide management for high-risk patients with < 50% stenosis. METHODS: Using TreeAge Pro, a cost effectiveness simulation was conducted comparing two strategies: a) standard of care first-line carotid duplex ultrasound (DUS) with regular follow-up, versus b) first-line MR assessment of stenosis and intraplaque hemorrhage (MRIPH) in which patients with IPH received annual DUS surveillance and immediate carotid endarterectomy in case of plaque progression...
October 27, 2017: British Journal of Radiology
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