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Carotid endarterectomy

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https://www.readbyqxmd.com/read/27924050/timing-of-carotid-revascularization-procedures-after-ischemic-stroke
#1
Michael Reznik, Hooman Kamel, Gino Gialdini, Ankur Pandya, Babak B Navi, Ajay Gupta
BACKGROUND AND PURPOSE: In 2006, the American Heart Association recommended that carotid revascularization generally occurs within 2 weeks of stroke based on data from 2 trials of carotid endarterectomy (CEA). We aimed to determine whether the time between stroke and CEA or carotid artery stenting (CAS) has decreased and whether the proportion of procedures occurring within 14 days has increased. METHODS: Using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes and administrative claims data from nonfederal hospitals in CA, FL, and NY, we identified patients with ischemic stroke who underwent CEA or CAS within 90 days of an ischemic stroke from 2005 to 2013...
December 6, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27922252/update-on-new-stents-and-protection-devices-for-carotid-artery-stenting-what-we-know-what-we-learnt-recently-and-what-we-need-to-know
#2
Dimitrios N Nikas, Xenofon Makos, Tomoyuki Umemoto, George Liappas, Andrea Pacchioni, Narek Zakarian, Bernhard Reimers
Carotid artery stenting (CAS) is considered an alternative option to carotid endarterectomy (CEA) for significant carotid stenosis, in both symptomatic and asymptomatic patients. Comparing to CEA, CAS offers significant advantages. The most important arise from the minimally invasive nature of the procedure, which reduces the surgical complications and adds significant comfort to the patient, without compromising the efficacy. Nowadays, CAS can achieve acute and long-term outcome results comparable to CEA, maintaining low rates of periprocedural embolic events...
December 6, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27916073/-perioperative-safety-analysis-of-carotid-endarterectomy-in-diabetic-patients
#3
X N Liu, L Ni, W D Wang, R Zeng, C W Liu
Objective: To compare perioperative outcome of carotid endarterectomy (CEA) between diabetic and non-diabetic patients and discuss the safety of CEA in diabetic patients. Methods: A total of 572 patients with carotid stenosis who underwent CEA from Juanuary 2006 to September 2014 in Peking Union Medical Colloge Hospital were collected and analyzed retrospectively. The patients were distributed into diabetes mellitus (DM) group and non-DM group according to the comorbidities. Their baseline characteristics, intraoperative index and major complications in perioperative period were analyzed and compared...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27913124/lower-expression-of-genes-involved-in-protection-against-oxidative-stress-in-symptomatic-carotid-atherosclerosis
#4
Nuria Zamora-González, Jesús Crespo-Sanjuán, M Dolores Calvo-Nieves, Diego Sánchez, M Dolores Ganfornina, Gerardo Martínez, Beatriz Aguirre-Gervás, J Antonio González-Fajardo
OBJECTIVE: Oxidative stress is increased in atherosclerosis, manifested both in blood and tissue (atherosclerotic plaque). We aim at describing the expression of a number of genes related to oxidative stress response in carotid atherosclerotic plaques and their relation to symtomatic state. MATERIALS AND METHODS: We have studied the mRNA expression levels for genes related to oxidative stress in a population of 44 patients undergoing carotid endarterectomy, according to the presence (24 patients) or absence (20 patients) of symptoms...
November 29, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908821/carotid-bypass-using-gore-hybrid-vascular-graft-for-in-stent-restenosis-after-carotid-stenting
#5
Andrea Agostinucci, Andrea Cumino, Roberta Suita, Andrea Bellan, Davide Lazzaro, Elisa Pagliasso, Ferruccio Ferrero
In-stent restenosis (ISR) is the most common long-term complication following Carotid Artery Stenting (CAS), affecting 3.5% to 21% of patients after a mean follow up of 18 months in published reports. Until now, the optimal management for ISR after CAS is still not clear and different endovascular treatments along with various surgical options have been proposed. Moreover, surgical treatment for ISR in a previously operated patient of ipsilateral endarterectomy is a technically demanding procedure. In this report, we describe a case of severe carotid recurrent ISR, which occurred after CAS for post-endarterectomy restenosis, that was successfully treated, in a straightforward way, with a carotid bypass using a Gore(®) Hybrid Vascular Graft...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#6
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27906089/esophageal-perforation-after-perioperative-transesophageal-echocardiography-a-case-report
#7
Hyun-Chang Kim, Jung-Hyou Oh, Yong-Cheol Lee
BACKGROUND: Transesophageal echocardiography is widely used in cardiac surgery. Transesophageal echocardiography probe insertion and manipulation can injure the esophagus. CASE PRESENTATION: A 76-year-old Asian man was admitted to our hospital for coronary artery bypass graft revascularization surgery. A right carotid endarterectomy was successfully performed 2 days before coronary artery bypass graft revascularization surgery. After the coronary artery bypass graft revascularization surgery was done successfully, postoperative computed tomography and esophagography revealed perforation of the middle esophagus...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27905692/remote-pre-procedural-ischemic-stroke-was-the-strongest-risk-for-stroke-and-death-associated-with-carotid-stenting-a-single-center-experience
#8
Mária Rašiová, Ľubomír Špak, Ľudmila Farkašová, Štefan Pataky, Martin Koščo, Marek Hudák, Matej Moščovič, Norbert Leško
BACKGROUND: The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. Patient selection for carotid procedure who benefit from procedure and who is the procedure hazardous for is important. Remote ischemic stroke is known risk factor for stroke reccurence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) between patients with remote pre- procedural ischemic stroke and without it; to analyse periprocedural risk in other specific patient subgroups treated with CAS and to determine the impact of observed variables on all- cause mortality during long-term follow-up...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27904004/delayed-diagnosis-of-blunt-carotid-trauma-in-a-seat-belt-syndrome-with-associated-abdominal-wall-injury-a-case-report
#9
Savino Occhionorelli, Dario Andreotti, Daniela Tartarini, Lorenzo Cappellari, Rocco Stano, Lucia Morganti, Giorgio Vasquez
: The aim of this case report is to be aware of occult carotid lesions in thoracic- abdominal trauma because, carotid artery injury consequent to blunt trauma is rare, affecting less than 1% of patients as reported in literature. A 45-years-old female, involved in a traffic accident, arrived to Emergency Room hemodynamically stable, with a Glasgow Coma Scale of 15, complaining abdominal pain, without any neurological signs. She underwent Computed Tomography (CT) scan that showed a complete disruption of left abdominal wall muscles, associated with massive bowel loops herniation...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27903469/determinants-of-follow-up-failure-in-patients-undergoing-vascular-surgery-procedures
#10
Dejah R Judelson, Jessica P Simons, Julie M Flahive, Virendra I Patel, Christopher T Healey, Brian W Nolan, Daniel J Bertges, Andres Schanzer
OBJECTIVE: The Vascular Study Group of New England (VSGNE) requires documentation of follow-up for >80% of patients at least 9 months post-procedure. However, many participating groups fall short of this goal. We sought to identify factors independently associated with loss to long-term follow-up (LTF). METHODS: The VSGNE was queried from 2008-2012, for all carotid endarterectomy (CEA), endovascular aneurysm repair (EVAR), open abdominal aortic aneurysm repair (OPEN), infrainguinal bypass (INFRA), and suprainguinal bypass (SUPRA) procedures in patients who survived greater than 9 months post-procedure...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27901323/safety-of-carotid-revascularization-within-48-hours-of-symptomatic-presentation
#11
Kosmas I Paraskevas, Ian M Loftus
In the last few years, there has been a gradual shift in the recommendations of carotid guidelines towards performance of carotid endarterectomy (CEA) earlier in patients with >70% carotid artery stenosis suffering an ipsilateral transient ischemic attack (TIA)/minor stroke episode. The "6-month" threshold in the early guidelines was subsequently replaced with a "14-day" target. More recently, an even earlier intervention (i.e. "within 48 hours") gains support as the optimal timing for the performance of CEA in patients with symptomatic carotid artery stenosis...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27898488/reply-to-regional-or-general-anaesthesia-for-carotid-endarterectomy
#12
Dragana Unic-Stojanovic
No abstract text is available yet for this article.
January 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27898487/regional-or-general-anaesthesia-for-carotid-endarterectomy
#13
Mark D Stoneham
No abstract text is available yet for this article.
January 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27898402/recent-update-on-carotid-endarterectomy-versus-carotid-artery-stenting
#14
Raywat Noiphithak, Anusak Liengudom
Carotid artery stenosis (CS) is a major cause of ischemic stroke. Treatment of CS consists of best medical treatment and carotid revascularization (CR), including carotid endarterectomy (CEA) and carotid artery stenting (CAS). Both CR techniques have their own procedural risks. Therefore, selection of the appropriate treatment for patients with CS is relatively complicated. Many studies and guidelines have reported the efficacy of each treatment for both symptomatic and asymptomatic patients. However, the results are still controversial, especially concerning the efficacy and safety of CEA and CAS...
November 30, 2016: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/27895459/amaurosis-fugax-delay-between-symptoms-and-surgery-by-specialty
#15
Pia Kvickström, Bertil Lindblom, Göran Bergström, Madeleine Zetterberg
PURPOSE: To describe the time course of management of patients with amaurosis fugax and analyze differences in management by different specialties. METHODS: Patients diagnosed with amaurosis fugax and subjected to carotid ultrasound in 2004-2010 at the Sahlgrenska University Hospital, Gothenburg, Sweden (n=302) were included in this retrospective cohort study, and data were collected from medical records. RESULTS: The prevalence of significant carotid stenosis was 18...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27895035/microrna-210-enhances-fibrous-cap-stability-in-advanced-atherosclerotic-lesions
#16
Suzanne M Eken, Hong Jin, Ekaterina Chernogubova, Yuhuang Li, Nancy Simon, Changyan Sun, Greg Korzunowicz, Albert Busch, Alexandra Bäcklund, Cecilia Österholm, Anton Razuvaev, Thomas Renné, Hans-Henning Eckstein, Jaroslav Pelisek, Per Eriksson, Maria Gonzalez Diez, Ljubica P Matic Perisic, Isabel N Schellinger, Uwe Raaz, Nicholas J Leeper, Göran K Hansson, Gabrielle Paulsson-Berne, Ulf Hedin, Lars Maegdefessel
RATIONALE: In the search for markers and modulators of vascular disease, miRNAs have emerged as potent therapeutic targets. OBJECTIVE: To investigate miRNAs of clinical interest in patients with unstable carotid stenosis at risk of stroke. METHODS AND RESULTS: Utilizing patient material from the Biobank of Karolinska Endarterectomies (BiKE), we profiled miRNA expression in patients with stable vs unstable carotid plaque. A PCR-based miRNA array of plasma, sampled at the carotid lesion site, identified eight deregulated miRNAs (miR-15b, -29c, -30c/d, -150, -191, -210 and -500)...
November 28, 2016: Circulation Research
https://www.readbyqxmd.com/read/27894896/systematic-review-and-meta-analysis-of-dual-versus-single-antiplatelet-therapy-in-carotid-interventions
#17
REVIEW
M Barkat, S Hajibandeh, S Hajibandeh, F Torella, G A Antoniou
BACKGROUND: The importance of antiplatelet therapy for the management and prevention of ischaemic stroke cannot be overstated. Despite the established guidelines, there is no clear consensus on how to manage antiplatelet therapy during and after carotid interventions. OBJECTIVE: The objective was to undertake a systematic literature review and perform a meta-analysis to assess the effects of dual antiplatelet therapy in carotid endarterectomy (CEA) and stenting (CAS)...
November 26, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27881699/multicenter-experience-of-surgical-explantation-of-carotid-stents-for-recurrent-stenosis
#18
Jesse A Columbo, John C McCallum, Philip P Goodney, Thomas C Bower, Marc L Schermerhorn, Richard J Powell, Randall R DeMartino
OBJECTIVE: A significant cohort of patients who have undergone carotid artery stenting (CAS) will have in-stent restenosis (ISR). The optimal management of symptomatic or severe ISR remains poorly defined. The purpose of this study was to describe the indications, treatment, and mid- to long-term outcomes of patients undergoing CAS explantation for ISR. METHODS: All patients undergoing internal carotid artery stent explantation with carotid artery reconstruction at Mayo Clinic Rochester, Dartmouth-Hitchcock Medical Center, and Beth-Israel Deaconess Medical Center from 2003 to 2013 were retrospectively reviewed...
November 22, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27881360/an-observational-registry-of-carotid-endarterectomy-and-carotid-artery-stenting-in-brazil-study-protocol
#19
Edwaldo Edner Joviliano, Winston Bonetti Yoshida, Marcone Lima Sobreira, Regina Moura, Ana Terezinha Guillaumon, Selma Regina De Oliveira Raymundo, Daniel Gustavo Miquelin, Ludvig Hafner, Marcelo Jose Almeida
BACKGROUND: Carotid artery stenting (CAS) and carotid endarterectomy (CEA) are alternative strategies for stroke prevention in patients with atherosclerotic carotid disease. CEA has been considered the first-line treatment for carotid stenosis worldwide, and the safety and efficacy of CAS compared to CEA remains in question. OBJECTIVE: The purpose of this study is to compare the practice and outcomes of CAS and CEA in a real-world setting within public university hospitals in Brazil...
November 23, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27875340/which-patients-with-asymptomatic-carotid-stenosis-benefit-from-revascularization
#20
A Ross Naylor
PURPOSE OF THE REVIEW: To summarize why there are polarized opinions regarding the management of patients with asymptomatic carotid disease and whether it is possible to identify patients who might benefit from carotid interventions. RECENT FINDINGS: Carotid Revascularization Endarterectomy Versus Stenting Trial and Asymptomatic Carotid Trial 1 (ACT-1) recently concluded that outcomes after carotid endarterectomy and carotid stenting were not significantly different in asymptomatic patients and that procedural risks were below the accepted 3% threshold...
November 21, 2016: Current Opinion in Neurology
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