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Carotid endarterectomy

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https://www.readbyqxmd.com/read/28919313/periprocedural-outcomes-of-carotid-artery-stenting-in-elderly-patients
#1
Masataka Nanto, Yudai Goto, Hiroyuki Yamamoto, Seisuke Tanigawa, Michiko Takado, Takahiro Ogawa, Yoshikazu Nakahara
BACKGROUND: Carotid artery stenting has emerged as an alternative to carotid endarterectomy especially in patients with high risk of carotid endarterectomy. Older age (≥80 years old) was recognized as one of the high risk factors of carotid endarterectomy. However, the association between older age and increased risk of adverse events for carotid artery stenting has been reported. The purpose of this study was to evaluate the association between age and periprocedural outcomes after carotid artery stenting...
September 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28919267/post-carotid-endarterectomy-hypertension-part-2-association-with-peri-operative-clinical-anaesthetic-and-transcranial-doppler-derived-parameters
#2
Jeremy E Newman, Mathew J Bown, Robert D Sayers, Jonathan P Thompson, Thompson G Robinson, Bryan Williams, Ronney Panerai, Peter Lacy, A Ross Naylor
OBJECTIVE/BACKGROUND: The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH. METHODS: In total, 106 patients underwent carotid endarterectomy (CEA) under general anaesthesia...
September 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28916863/intracerebral-hemorrhage-as-a-manifestation-of-cerebral-hyperperfusion-syndrome-after-carotid-revascularization-systematic-review-and-meta-analysis
#3
REVIEW
Pedro Abreu, Jerina Nogueira, Filipe Brogueira Rodrigues, Ana Nascimento, Mariana Carvalho, Ana Marreiros, Hipólito Nzwalo
BACKGROUND: Intracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. METHODS: We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization...
September 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28916664/safety-of-simultaneous-coronary-artery-bypass-grafting-and-carotid-endarterectomy-versus-isolated-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#4
Christian Weimar, Konstantinos Bilbilis, Jan Rekowski, Torulv Holst, Friedhelm Beyersdorf, Martin Breuer, Manfred Dahm, Anno Diegeler, Arne Kowalski, Sven Martens, Friedrich W Mohr, Jiri Ondrášek, Beate Reiter, Peter Roth, Ralf Seipelt, Markus Siggelkow, Gustav Steinhoff, Anton Moritz, Mathias Wilhelmi, Gerhard Wimmer-Greinecker, Hans-Christoph Diener, Heinz Jakob, Claudia Ose, Andre Scherag, Stephan C Knipp
BACKGROUND AND PURPOSE: The optimal operative strategy in patients with severe carotid artery disease undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety and efficacy of synchronous combined carotid endarterectomy and CABG as compared with isolated CABG. METHODS: Patients with asymptomatic high-grade carotid artery stenosis ≥80% according to ECST (European Carotid Surgery Trial) ultrasound criteria (corresponding to ≥70% NASCET [North American Symptomatic Carotid Endarterectomy Trial]) who required CABG surgery were randomly assigned to synchronous carotid endarterectomy+CABG or isolated CABG...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28910807/cerebral-infarct-topography-and-early-outcome-after-surgery-for-symptomatic-carotid-stenosis-a-multicentre-study
#5
Caroline Kazandjian, Nicla Settembre, Fabien Lareyre, Benjamin Kretz, Agnès Soudry-Faure, Yannick Béjot, Sergueï Malikov, Reda Hassen-Khodja, Elixene Jean-Baptiste, Eric Steinmetz
INTRODUCTION: Although carotid stenosis can cause both territorial and border-zone (BZ) cerebral infarcts (CI), the influence of CI topography on postoperative complications after surgery remains unclear. We compared early outcomes after endarterectomy on the basis of CI location: territorial (T group) or BZ group. MATERIAL AND METHODS: During the period between 2009 and 2013, ischaemic stroke patients who had undergone surgery for symptomatic carotid stenosis were identified from prospective databases from 3 French centres...
September 15, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28903431/detection-of-specific-chlamydia-pneumoniae-and-cytomegalovirus-antigens-in-human-carotid-atherosclerotic-plaque-in-a-chinese-population
#6
Jiachao Cao, Yumin Mao, Bo Dong, Wei Guan, Jia Shi, Suinuan Wang
To explore the relationship between certain pathogens, such as chlamydia pneumonia (Cpn) and cytomegalovirus (CMV), and carotid atherosclerosis (AS) in a Chinese population.Twenty-five carotid atherosclerotic stenosis patients from the Beijing Tiantan Hospital (affiliated with Capital Medical University) participated in the study. After undergoing digital subtraction angiography (DSA) and/or computed tomography angiography (CTA), the degree of carotid artery stenosis was over 70% in all cases, and the patients underwent carotid endarterectomy...
August 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28902823/-comparing-the-risks-for-the-development-of-perioperative-complications-in-carotid-endarterectomy-and-carotid-angioplasty
#7
R A Vinogradov, K A Lashevich, V S Pykhteev
The article is a literature review presenting a comparative analysis of 30-day risks of mortality and complications after carotid endarterectomy and carotid angioplasty with stenting. The risks studied were as follows: myocardial infarction, stroke, transitory ischaemic attacks, bradycardia, hypotension, postoperative haematomas, and damages to the craniocerebral nerves. The authors analysed a series of recently published foreign studies and meta-analyses dedicated to the problem concerned. The obtained findings revealed that carotid endarterectomy turned out to be associated with a higher perioperative risk for the development of myocardial infarction, postoperative haematomas and damages to the craniocerebral nerves, whereas carotid angioplasty with stenting appeared to be associated with an increased risk for the development of stroke, bradycardia and hypotension within the first 30 postoperative days...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902821/-outcomes-of-open-endovascular-operations-on-the-internal-carotid-artery-in-acute-stage-of-ischaemic-stroke
#8
A I Khripun, A D Priamikov, A B Mironkov, I N Tiurin, S A Asratian, V S Suriakhin, O V Simonov, O A Sazhina, V P Mikhaĭlenko
INTRODUCTION: The authors share their experience in diagnosis and treatment of patients with acute ischaemic stroke. PATIENTS AND METHODS: The study included a total of 33 patients. Of these, 20 patients (Study Group) were operated on at terms ranging from 2 to 7 days after onset of acute cerebral circulatory impairment. The Control Group was composed of 13 patients with ischaemic stroke, having refused surgical prevention of recurrent stroke. Both groups were matched by age, gender, level of neurological deficiency and size of cerebral ischaemic foci...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902813/-surgical-decision-making-during-treatment-of-a-patient-with-multifocal-atherosclerosis-based-on-intraoperative-epiaortic-scanning
#9
A V Marchenko, P A Mialiuk, A S Vronskiĭ
The article deals with a clinical case report regarding surgical management of a patient presenting with multifocal atherosclerosis. Taking into consideration critical stenoses of the anterior interventricular artery (80%) and circumflex artery (80%), as well as subocclusion of the left internal carotid artery and stenosis of the right internal carotid artery (60%), there were high risks for intraoperative cerebral circulation impairment. It was decided to perform a two-stage operation on the coronary and carotid beds...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902810/biochemical-markers-in-blood-serum-of-patients-undergoing-various-methods-of-carotid-endarterectomy
#10
V S Kozyreva, A N Shilova, A A Karpenko, P V Ignatenko, V V Lomivorotov
The authors studied the concentration of CRP, sE-selectin, sP-selectin, sICAM-1, sICAM-3, sVCAM-1, sPECAM and endothelin-1 in blood serum of patients presenting with stenotic lesions of carotid arteries and undergoing various methods of carotid endarterectomy (CEAE): eversion CEAE (Group I) and CEAE using a xenopericardium patch (Group II). Within the time frame of the study, patients in both groups were found to have an elevated CRP level in the early postoperative period, having returned to the baseline values at 6 postoperative months, as well as an increase in the concentration of endothelin-1 at six months after surgery and a decrease of the sE-selectin concentration in the early postoperative period...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28894898/effective-collateral-circulation-may-indicate-improved-perfusion-territory-restoration-after-carotid-endarterectomy
#11
Tianye Lin, Zhichao Lai, Yuelei Lv, Jianxun Qu, Zhentao Zuo, Hui You, Bing Wu, Bo Hou, Changwei Liu, Feng Feng
OBJECTIVES: To investigate the relationship between the level of collateral circulation and perfusion territory normalisation after carotid endarterectomy (CEA). METHODS: This study enrolled 22 patients with severe carotid stenosis that underwent CEA and 54 volunteers without significant carotid stenosis. All patients were scanned with ASL and t-ASL within 1 month before and 1 week after CEA. Collateral circulation was assessed on preoperative ASL images based on the presence of ATA...
September 11, 2017: European Radiology
https://www.readbyqxmd.com/read/28893482/comparison-of-early-outcomes-and-restenosis-rate-between-carotid-endarterectomy-and-carotid-artery-stenting-using-propensity-score-matching-analysis
#12
Seon-Hee Heo, Kyoung-Won Yoon, Shin-Young Woo, Yang-Jin Park, Young-Wook Kim, Keon-Ha Kim, Chin-Sang Chung, Oh-Young Bang, Dong-Ik Kim
OBJECTIVE/BACKGROUND: Despite randomised evidence, the debate continues about the preferred treatment strategy for carotid stenosis in routine clinical practice. The aim of this study was to compare early outcomes and restenosis rates after carotid endarterectomy (CEA) and carotid stenting (CAS) in unselected patients using propensity score matching (PSM). METHODS: The 30 day incidence of major adverse clinical events (MACE; defined as stroke, transient ischaemic attack, myocardial infarction, or death) and procedure related complications, as well as restenosis rates during follow-up were compared between unselected patients undergoing CEA or CAS between January 2002 and December 2015 at a single institution...
September 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28890063/the-value-of-carotid-endarterectomy-as-a-learning-tool-for-trainees
#13
L M Cacioppa, R Pini, M Longhi, A Vacirca, E Gallitto, G L Faggioli, M Gargiulo, A Stella
INTRODUCTION: Carotid endarterectomy (CEA) intervention needs a specific training and a sufficient learning curve to obtain optimal results in terms of outcome. A formative program was settled up in a single academic center in order to optimize training of standard CEA procedures. This study aims to evaluate the 11-year results of the teaching CEA program. METHODS: The trainees CEA teaching program is carried on during the 5-year vascular surgery residency period and it is stratified as follows: learning theory and intervention assistance (minimum 50 procedures per-year) in the first and second residency-year; performing CEA as second operator in the third and fourth residency-year (minimum 50 procedures per-year); CEA execution as first operator with attending supervision in the last residency-year...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890012/ethnicity-race-and-post-operative-stroke-risk-among-53-593-patients-with-asymptomatic-carotid-stenosis-undergoing-revascularization
#14
Roxanna M Garcia, Seungwon Yoon, Tene Cage, Matthew B Potts, Michael T Lawton
BACKGROUND: The incidence of post-operative stroke following carotid endarterectomy is an uncommon event and differences by racial and ethnic subgroups are not fully described in the literature. OBJECTIVE: To investigate the impact of race and ethnicity on post-operative stroke risk among patients with asymptomatic carotid stenosis undergoing carotid endarterectomy. METHODS: The ACS-NSQIP database between 2008 and 2015 was used to identify patients undergoing carotid endarterectomy with no stroke history...
September 7, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28887238/emergent-carotid-stent-removal-after-carotid-stent-thrombosis-surgical-technique
#15
Konstantinos G Moulakakis, Andreas Lazaris
OBJECTIVE: To present the technique for emergent removal of the thrombosed stent in acute carotid stent thrombosis in patients undergoing carotid artery angioplasty-stenting (CAS) BACKGROUND: Acute carotid stent thrombosis in patients undergoing CAS is a relatively rare and potentially devastating complication influencing significantly the quality of life. With the increasing use of stenting in clinical practice, it is expected to represent a more often encountered complication for physicians performing CAS...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28882820/high-levels-of-un-switched-memory-b-cells-are-associated-with-better-outcome-in-patients-with-advanced-atherosclerotic-disease
#16
John A L Meeuwsen, Amerik van Duijvenvoorde, Aisha Gohar, Maria O Kozma, Sander M van de Weg, Crystel M Gijsberts, Saskia Haitjema, Harry Björkbacka, Gunilla N Fredrikson, Gert J de Borst, Hester M den Ruijter, Gerard Pasterkamp, Christoph J Binder, Imo E Hoefer, Saskia C A de Jager
BACKGROUND: Atherosclerosis is an inflammatory lipid disorder and the main underlying pathology of acute ischemic events. Despite a vast amount of data from murine atherosclerosis models, evidence of B-cell involvement in human atherosclerotic disease is limited. We therefore investigated the association of circulating B-cell subtypes with the occurrence of secondary cardiovascular events in advanced atherosclerotic disease. METHODS AND RESULTS: This cohort study consists of 168 patients who were included in the Athero-Express biobank between 2009 and 2011...
September 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28881532/-safety-analysis-of-carotid-endarterectomy-without-shunting-in-carotid-artery-stenosis-patients-with-contralateral-carotid-occlusion
#17
R T Luo, G Y Yu, D Zhang, R Wang, J Z Zhao, Y Zhang
Objective: To investigate the safety of carotid endarterectomy (CEA) without shunting in carotid artery stenosis (CAS) patients with contralateral carotid occlusion (CAO) under the protection of monitoring of cerebral blood oxygen saturation. Methods: A total of 71 patients with CAS was enrolled in our research during 2013 to 2016. They were divided into two groups which were group A: 20 CAS patients with contralateral CAO, and group B: 51 CAS patients without contralateral CAO. All patients were given CEA without shunting during operation...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28877387/recommendations-for-low-grade-carotid-stenosis-follow-up-based-on-a-single-institution-database
#18
Garrett M Bennett, Edward I Bluth, Michael L Larson, Qingyang Luo
OBJECTIVES: The purpose of this study was to determine the incidences and rates of progression of varying degrees of carotid stenosis that do not require intervention according to the Asymptomatic Carotid Atherosclerosis Study, the European Carotid Surgery Trial, and the North American Symptomatic Carotid Endarterectomy Trial, and from this information, to provide evidence-based recommendations for follow-up imaging. METHODS: A retrospective review was performed of all carotid ultrasound examinations performed at a single institution from January 1995 through April 2015...
September 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28877355/sonographic-evaluation-of-complications-of-extracranial-carotid-artery-interventions
#19
John D Millet, Joseph J Cavallo, Leslie M Scoutt, Gowthaman Gunabushanam
Carotid endarterectomy and carotid artery stenting are among the most common peripheral vascular procedures performed worldwide. Sonography is the initial and often only imaging modality used in the evaluation of iatrogenic carotid arterial injuries. This pictorial essay provides an overview of the clinical and sonographic findings of complications after interventions in the extracranial carotid arteries, including dissection, fluid collections, pseudoaneurysm, thrombosis, thromboembolism, restenosis, and stent deformation...
September 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28874626/anatomical-variations-of-cervical-vein-drainage-in-candidates-for-neck-surgery
#20
Raoul Borioni, Federico Maspes, Virgilio Baldassarre, Mariano Garofalo
The knowledge of both normal and abnormal anatomy of the veins of the neck may be important for surgeons performing neck surgery, to avoid inadvertent injury to vascular structures. In a 75-year-old man candidated to carotid endarterectomy preoperative CT-scan showed a rare anomaly of the venous drainage in the area of the anterior jugular vein (AJV), that usually begins in the suprahyoid region via the confluence of several superficial veins, to open into the ipsilateral external jugular vein. A large left sided venous trunk, originating from an anomalous proximal confluence with the internal jugular vein, descended in the AJV anatomical position, to cross over the sternum draining into the right subclavian vein...
2017: Annali Italiani di Chirurgia
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