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Carotid endarterectomy

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https://www.readbyqxmd.com/read/28214642/short-term-results-of-carotid-endarterectomy-and-stenting-after-the-introduction-of-carotid-magnetic-resonance-imaging-a-single-institutional-retrospective-study
#1
Ryu Fukumitsu, Kazumichi Yoshida, Yoshitaka Kurosaki, Koichi Torihashi, Nobutake Sadamasa, Masaomi Koyanagi, Osamu Narumi, Tsukasa Sato, Masaki Chin, Akira Handa, Sen Yamagata, Susumu Miyamoto
OBJECTIVE: While carotid artery stenting (CAS) has been gaining popularity as an alternative to carotid endarterectomy (CEA), the perioperative stroke rate following contemporary CAS remains significantly higher than that in CEA. The purpose of this study was to assess perioperative (within 30-day) therapeutic results in patients with carotid stenosis (CS) after the introduction of preoperative carotid magnetic resonance plaque evaluation in a single center offering both CEA and CAS. METHODS: Based on prospectively collected data for patients with CS who were scheduled for carotid revascularization, retrospective analysis was conducted of 295 consecutive CS patients...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28214453/reciprocal-regulation-of-enos-h2s-and-co-synthesizing-enzymes-in-human-atheroma-correlation-with-plaque-stability-and-effects-of-simvastatin
#2
Fragiska Sigala, Panagiotis Efentakis, Dimitra Karageorgiadi, Konstadinos Filis, Paraskevas Zampas, Efstathios K Iliodromitis, George Zografos, Andreas Papapetropoulos, Ioanna Andreadou
The molecular and cellular mechanisms underlying plaque destabilization remain obscure. We sought to elucidate the correlation between NO, H2S and CO-generating enzymes, nitro-oxidative stress and plaque stability in carotid arteries. Carotid atherosclerotic plaques were collected from 62 patients who had undergone endarterectomy due to internal artery stenosis. Following histological evaluation the plaques were divided into stable and unstable ones. To investigate the impact of simvastatin we divided patients with stable plaques, into those receiving and to those not receiving simvastatin...
February 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28203558/cerebral-monitoring-during-carotid-endarterectomy-by-transcranial-doppler-ultrasonography
#3
Woo-Sung Yun
PURPOSE: To evaluate the efficacy and safety of cerebral monitoring by transcranial Doppler ultrasonography (TCD) for the detection of cerebral ischemia during carotid endarterectomy (CEA). METHODS: From August 2004 to December 2013, 159 CEAs were performed in a tertiary hospital. All procedures were performed under general anesthesia. Intraoperative TCD was routinely used to detect cerebral ischemia. Of the 159 patients, 102 patients were included in this study, excluding 27 patients who had a poor transtemporal isonation window and 30 patients who used additional cerebral monitoring systems such as electroencephalography or somatosensory evoked potentials...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28202829/-treatment-strategy-and-results-of-carotid-endarterectomy-in-chronic-renal-failure-patients
#4
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/28196937/magnetic-resonance-imaging-plaque-hemorrhage-for-risk-stratification-in-carotid-artery-disease-with-moderate-risk-under-current-medical-therapy
#5
Akram A Hosseini, Richard J Simpson, Nishath Altaf, Philip M Bath, Shane T MacSweeney, Dorothee P Auer
BACKGROUND AND PURPOSE: Magnetic resonance imaging (MRI)-defined carotid plaque hemorrhage (MRIPH) can predict recurrent cerebrovascular ischemic events in severe symptomatic carotid stenosis. It is less clear whether MRIPH can improve risk stratification despite optimized medical secondary prevention in those with moderate risk. METHODS: One-hundred fifty-one symptomatic patients with 30% to 99% carotid artery stenosis (median age: 77, 60.5% men) clinically deemed to not benefit from endarterectomy were prospectively recruited to undergo MRI and clinical follow-up (mean, 22 months)...
February 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#6
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
#7
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...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190436/neurologic-complications-of-cardiac-and-vascular-surgery
#8
K N Sheth, E Nourollahzadeh
This chapter will provide an overview of the major neurologic complications of common cardiac and vascular surgeries, such as coronary artery bypass grafting and carotid endarterectomy. Neurologic complications after cardiac and vascular surgeries can cause significant morbidity and mortality, which can negate the beneficial effects of the intervention. Some of the complications to be discussed include ischemic and hemorrhagic stroke, seizures, delirium, cognitive dysfunction, cerebral hyperperfusion syndrome, cranial nerve injuries, and peripheral neuropathies...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#9
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28183469/comparison-of-trends-and-in-hospital-outcomes-of-concurrent-carotid-artery-revascularization-and%C3%A2-coronary-artery-bypass-graft-surgery-the-united-states-experience-2004-to-2012
#10
Dmitriy N Feldman, Rajesh V Swaminathan, Joshua D Geleris, Peter Okin, Robert M Minutello, Udhay Krishnan, Daniel J McCormick, Geoffrey Bergman, Harsimran Singh, S Chiu Wong, Luke K Kim
OBJECTIVES: The aim of this study was to compare trends and outcomes of 3 approaches to carotid revascularization in the coronary artery bypass graft (CABG) population when performed during the same hospitalization. BACKGROUND: The optimal approach to managing coexisting severe carotid and coronary disease remains controversial. Carotid endarterectomy (CEA) or carotid artery stenting (CAS) are used to decrease the risk of stroke in patients with carotid disease undergoing CABG surgery...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183175/carotid-endarterectomy-has-significantly-lower-risk-in-the-last-two-decades-should-the-guidelines-now-be-updated
#11
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/28181855/a-contemporary-evaluation-of-carotid-endarterectomy-outcomes-in-patients-with-chronic-kidney-disease-in-the-united-states
#12
Amit R Patel, Viktor Y Dombrovskiy, Todd R Vogel
Objectives Chronic kidney disease (CKD) has been identified as a significant risk factor for poor post-surgical outcomes. This study was designed to provide a contemporary analysis of carotid endarterectomy (CEA) outcomes in patients with CKD, end-stage renal disease (ESRD), and normal renal function (NF). Methods The Nationwide Inpatient Sample data 2006-2012 was queried to select patients aging 40 years old and above who underwent CEA during two days after admission and had a diagnosis of ESRD on long-term hemodialysis, patients with non-dialysis-dependent CKD, or NF...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28175918/impact-of-surgical-specialty-on-outcomes-following-carotid-endarterectomy
#13
Bryan A Lieber, Jensen K Henry, Nitin Agarwal, John D Day, Thomas W Morris, Marcus L Stephens, Adib A Abla
No abstract text is available yet for this article.
February 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28175469/108%C3%A2-adverse-events-after-carotid-endarterectomy-a-national-surgical-quality-improvement-program-analysis
#14
Hormuzdiyar H Dasenbrock, Timothy R Smith, William B Gormley, Kai U Frerichs, Mohammad Ali Aziz-Sultan, Rose Du
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
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 1, 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/28153553/commentary-on-cranial-nerve-injury-after-carotid-endarterectomy-incidence-risk-factors-and-time-trends
#18
G J de Borst
No abstract text is available yet for this article.
January 30, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28152528/post-operative-cluster-headache-following-carotid-endarterectomy
#19
Thijs H T Dirkx, Peter J Koehler
BACKGROUND: Secondary cluster headache following carotid endarterectomy (CEA) is a rare condition and may help us understand the pathophysiology of primary cluster headache. SUMMARY: We describe 2 patients diagnosed with cluster headache, fulfilling the ICHD-IIIB criteria, following CEA. Neither of the patients had headache prior to surgery. They both responded to treatment with oxygen and verapamil. Recent medical literature does not describe any definite cases of cluster headache following CEA...
February 3, 2017: European Neurology
https://www.readbyqxmd.com/read/28152245/vessel-wall-and-adventitial-dce-mri-parameters-demonstrate-similar-correlations-with-carotid-plaque-microvasculature-on-histology
#20
Raf H M van Hoof, Stefan A Vöö, Judith C Sluimer, Nicky J A Wijnen, Evelien Hermeling, Floris H B M Schreuder, Martine T B Truijman, Jack P M Cleutjens, Mat J A P Daemen, Jan-Willem H Daemen, Robert J van Oostenbrugge, Werner H Mess, Joachim E Wildberger, Sylvia Heeneman, M Eline Kooi
PURPOSE: To assess parameter agreement of volume transfer coefficient (K(trans) ) between two vascular regions and to study the correlation with microvessel density on histology. The dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameter K(trans) is frequently used to study atherosclerotic plaque microvasculature. K(trans) has been reported using different descriptive statistics (mean, median, 75(th) percentile) either for the whole vessel wall or the adventitia in previous studies...
February 2, 2017: Journal of Magnetic Resonance Imaging: JMRI
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