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Carotid endarterectomy

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https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#1
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29769180/factors-associated-with-delay-in-carotid-endarterectomy-for-patients-with-symptomatic-severe-internal-carotid-artery-stenosis-a-case-control-study
#2
Daniel Meyer, Erwin Karreman, David Kopriva
BACKGROUND: The Canadian Best Practice Recommendations for Stroke Care (2008 update) recommend that patients with neurologic symptoms secondary to severe internal carotid artery stenosis undergo carotid endarterectomy within 14 days of symptom onset to prevent stroke. The purpose of this study was to identify patient and system factors associated with meeting, or failing to meet, the guideline. METHODS: In this case-control study, potential study participants were identified through an electronic search of the Discharge Abstract Database...
May 15, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29760458/hyperglycemia-does-not-affect-tissue-repair-responses-in-shear-stress-induced-atherosclerotic-plaques-in-apoe-mice
#3
Sabrina Hsiung, Anki Knutsson, Jenifer Vallejo, Pontus Dunér, Suvi E Heinonen, Ann-Cathrine Jönsson-Rylander, Eva Bengtsson, Jan Nilsson, Anna Hultgårdh-Nilsson
The mechanisms responsible for macrovascular complications in diabetes remain to be fully understood. Recent studies have identified impaired vascular repair as a possible cause of plaque vulnerability in diabetes. This notion is supported by observations of a reduced content of fibrous proteins and smooth muscle cell mitogens in carotid endarterectomy from diabetic patients along with findings of decreased circulating levels of endothelial progenitor cells. In the present study we used a diabetic mouse model to characterize how hyperglycemia affects arterial repair responses...
May 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29757452/prevalence-of-anomalously-originating-occipital-artery-in-a-group-of-turkish-individuals-a-retrospective-study-using-angiography
#4
Nese Keser, Osman Kula, Merih Is, Ismail Yardimcioglu
AIM: Although it is well known that the occipital artery (OA) originates from the external carotid artery (ECA), the incidence of variations remains unknown. In our study, we investigated the prevalence of anomalously originating OA using angiography in a group of Turkish individuals. MATERIAL AND METHODS: The images recorded in the picture archiving and communication system for a total of 114 patients, in which the whole vertebral artery, as well as the ECA and its branches, were visualized, were retrospectively reviewed...
April 26, 2018: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29754909/serum-pcsk9-levels-predict-the-occurrence-of-acute-coronary-syndromes-in-patients-with-severe-carotid-artery-stenosis
#5
Luca Liberale, Federico Carbone, Maria Bertolotto, Aldo Bonaventura, Alessandra Vecchié, François Mach, Fabienne Burger, Aldo Pende, Giovanni Spinella, Bianca Pane, Giovanni G Camici, Domenico Palombo, Franco Dallegri, Fabrizio Montecucco
BACKGROUND: The pharmacological inhibition of Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) has shown to dramatically impact on low-density lipoprotein-cholesterol (LDL-C) levels and associated cardiovascular (CV) diseases. However, the potential use of PCSK9 serum levels as a CV risk biomarker remains to be clarified. METHODS: 189 patients with severe carotid artery atherosclerosis undergoing carotid endarterectomy (CEA) and whose clinical records and serum sample aliquots for PCSK9 level measurement were available both directly before CEA and at 24-month follow-up were included in the present pilot study...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29747016/carotid-endarterectomy-and-concurrent-clopidogrel-use-us-national-practice-patterns
#6
Eva A Mistry, Jane C Khoury, Dawn Kleindorfer
BACKGROUND: Patients diagnosed with high-grade carotid stenosis often receive a carotid endarterectomy (CEA) during their hospital stay and most receive antiplatelet medication. There is inter-surgeon variability in performing CEA in patients receiving clopidogrel given the potent antiplatelet effect. METHODS: Utilizing the PREMIER database, adults with principal discharge diagnosis of stroke, transient ischemic attack (TIA) or carotid artery stenosis or occlusion without stroke/TIA(CAS), who had a CEA during the same hospital stay, in 2014 were analyzed...
May 7, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29740506/carotid-artery-stenting-vs-carotid-endarterectomy-in-the-management-of-carotid-artery-stenosis-lessons-learned-from-randomized-controlled-trials
#7
REVIEW
Mohamed M Salem, Abdulrahman Y Alturki, Matthew R Fusco, Ajith J Thomas, Bob S Carter, Clark C Chen, Ekkehard M Kasper
Background: Carotid artery stenosis, both symptomatic and asymptomatic, has been well studied with several multicenter randomized trials. The superiority of carotid endarterectomy (CEA) to medical therapy alone in both symptomatic and asymptomatic carotid artery stenosis has been well established in previous trials in the 1990s. The consequent era of endovascular carotid artery stenting (CAS) has offered another option for treating carotid artery stenosis. A series of randomized trials have now been conducted to compare CEA and CAS in the treatment of carotid artery disease...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29735302/a-physician-led-initiative-to-improve-clinical-documentation-results-in-improved-health-care-documentation-case-mix-index-and-increased-contribution-margin
#8
Francesco A Aiello, Dejah R Judelson, Jonathan M Durgin, Danielle R Doucet, Jessica P Simons, Dawn M Durocher, Julie M Flahive, Andres Schanzer
INTRODUCTION: Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin...
May 4, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29731407/cardiovascular-disease-and-use-of-contemporary-protease-inhibitors-the-d-a-d-international-prospective-multicohort-study
#9
Lene Ryom, Jens D Lundgren, Wafaa El-Sadr, Peter Reiss, Ole Kirk, Matthew Law, Andrew Phillips, Rainer Weber, Eric Fontas, Antonella d' Arminio Monforte, Stéphane De Wit, Francois Dabis, Camilla I Hatleberg, Caroline Sabin, Amanda Mocroft
BACKGROUND: Although earlier protease inhibitors have been associated with increased risk of cardiovascular disease, whether this increased risk also applies to more contemporary protease inhibitors is unknown. We aimed to assess whether cumulative use of ritonavir-boosted atazanavir and ritonavir-boosted darunavir were associated with increased incidence of cardiovascular disease in people living with HIV. METHODS: The prospective Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study consists of people living with HIV-1 from 11 cohorts in Australia, Europe, and the USA...
May 3, 2018: Lancet HIV
https://www.readbyqxmd.com/read/29706113/neck-haematoma-after-carotid-endarterectomy-risks-rescue-and-prevention
#10
Tomonori Tamaki, Akio Morita
OBJECTIVE: This study was performed to identify risk factors for neck haematoma requiring re-exploration after carotid endarterectomy. Neck haematoma is a well-known complication after carotid endarterectomy, but there has been little discussion about intraoperative techniques for its prevention. We also investigated an intraoperative neck flexion technique for prevention of neck haematoma. METHODS: A retrospective study reviewed 384 carotid endarterectomies performed at our institution from 2003 to 2016...
April 28, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29701500/does-surgical-technique-influence-the-postoperative-hemodynamic-disturbances-and-neurological-outcomes-in-carotid-endarterectomy
#11
Serkan Burç Deşer, Mustafa Kemal Demirag, Fersat Kolbakir
INTRODUCTION: The carotid endarterectomy is already well established in patients with symptomatic or asymptomatic internal carotid artery (ICA) stenosis. The aim of this study was to determine whether there is a difference in postoperative blood pressure changes, stroke rate and postoperative complications following eversion carotid endarterectomy (E-CEA) and conventional carotid endarterectomy (C-CEA). METHODS: From 1 January 2010 to 31 March 2017 consecutive patients admitted to our department with symptomatic or asymptomatic ICA stenosis were included in this retrospective study...
April 27, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29701426/is-invasive-pressure-monitoring-more-reliable-than-non-invasive-in-patients-with-cardiovascular-pathology-a-case-report
#12
Andreia Fernandes, Luísa Coimbra, Inês Delgado, José Carvalho, Carla Bentes
INTRODUCTION: Patients undergoing carotid endarterectomy (CEA) require strict arterial blood pressure (BP) control to maintain adequate cerebral perfusion. Invasive blood pressure (IBP) is the gold standard, however artifacts may lead to erroneous readings. METHODS: We report a case of CEA using IBP monitoring. RESULTS: A 64-year-old man, American Society Anaesthesiology (ASA) physical status 3 (diffuse atheromathosis, dyslipidemia and non-medicated hypertension), was presented for an elective right CEA...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699618/cerebrovascular-events-after-cardiovascular-procedures-risk-factors-recognition-and-prevention-strategies
#13
REVIEW
Jasneet K Devgun, Sajjad Gul, Divyanshu Mohananey, Brandon M Jones, M Shazam Hussain, Yash Jobanputra, Arnav Kumar, Lars G Svensson, E Murat Tuzcu, Samir R Kapadia
Stroke has long been a devastating complication of any cardiovascular procedure that unfavorably affects survival and quality of life. Over time, strategies have been developed to substantially reduce the incidence of stroke after traditional cardiovascular procedures such as coronary artery bypass grafting, isolated valve surgery, and carotid endarterectomy. Subsequently, with the advent of minimally invasive technologies including percutaneous coronary intervention, carotid artery stenting, and transcatheter valve therapies, operators were faced with a new host of procedural risk factors, and efforts again turned toward identifying novel ways to reduce the risk of stroke...
May 1, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29697684/-carotid-endarterectomy-and-stenting-in-patients-with-internal-carotid-artery-stenosis-and-contralateral-occlusion
#14
A V Gavrilenko, S I Skrylev, A A Kravchenko, A V Novikov
AIM: To determine surgical risk factors and to compare early outcomes after carotid endarterectomy and carotid stenting in patients with internal carotid artery stenosis and contralateral occlusion. MATERIAL AND METHODS: 132 patients were enrolled. 62 and 70 patients underwent carotid endarterectomy and carotid stenting respectively. Early postoperative results were compared depending on type of surgical intervention and presence of risk factors. RESULTS: Significant difference between groups was only found for incidence of neuropathy of the cranial nerves...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29695254/atherosclerosis-t1-weighted-characterization-catch-evaluation-of-the-accuracy-for-identifying-intraplaque-hemorrhage-with-histological-validation-in-carotid-and-coronary-artery-specimens
#15
Wen Liu, Yibin Xie, Chuan Wang, Yanni Du, Christopher Nguyen, Zhenjia Wang, Zhaoyang Fan, Li Dong, Yi Liu, Xiaoming Bi, Jing An, Chengxiong Gu, Wei Yu, Debiao Li
BACKGROUND: Coronary high intensity plaques (CHIPs) detected using cardiovascular magnetic resonance (CMR) coronary atherosclerosis T1-weighted characterization with integrated anatomical reference (CATCH) have been shown to be positively associated with high-risk morphology observed on intracoronary optical coherence tomography (OCT). This study sought to validate whether CHIPs detected on CATCH indicate the presence of intraplaque hemorrhage (IPH) through ex vivo imaging of carotid and coronary plaque specimens, with histopathology as the standard reference...
April 26, 2018: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29688196/-ultrasonographic-control-of-cerebral-blood-flow-in-patients-with-stenosis-of-brachiocephalic-arteries-before-and-after-carotid-endarterectomy
#16
I L Bukhovets, A S Maksimova, M P Plotnikov, B N Kozlov, I N Vorozhtsova, V Iu Usov
The authors studied the parameters of arterial and venous blood flow in patients presenting with haemodynamically significant atherosclerosis of the carotid arteries before and after carotid endarterectomy, as well as while carrying out functional tests. Comparing the indices of arterial blood flow in the Study Group consisting of 52 patients and the Control Group comprising 15 apparently healthy volunteers at rest prior to the operation revealed statistically significant differences of volumetric parameters of blood flow in the internal carotid artery...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29685507/the-effect-of-statin-use-and-intensity-on-stroke-and-myocardial-infarction-after-carotid-endarterectomy
#17
Nkiruka Arinze, Alik Farber, Teviah Sachs, Gregory Patts, Jeffrey Kalish, Angela Kuhnen, George Kasotakis, Jeffrey J Siracuse
OBJECTIVE: Statin use in patients with cerebrovascular disease undergoing carotid endarterectomy (CEA) has been advocated for prevention of stroke and cardiovascular events. However, the effect of statin therapy on long-term outcomes after CEA still needs to be delineated. METHODS: OptumLabs Data Warehouse, a comprehensive, longitudinal, real-world dataset with deidentified lives across claims and clinical information, was used to analyze the rates of stroke, myocardial infarction (MI), and statin use after CEA...
April 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29682104/predictors-of-perioperative-stroke-death-after-carotid-artery-stenting-a-review-article
#18
REVIEW
Ali F AbuRahma
Carotid artery stenting (CAS) has been recommended as an alternative treatment to carotid endarterectomy for patients with significant carotid stenosis. Only a few studies have analyzed clinical/anatomical and technical variables that affect perioperative outcomes of CAS. Following a comprehensive Medline search, it was reported that clinical factors, including age of >80 years, chronic renal failure, diabetes mellitus, symptomatic indications, and procedures performed within 2 weeks of transient ischemic attack symptoms, are associated with high perioperative stroke and death rates...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29681577/carotid-artery-stenting-versus-carotid-endarterectomy-for-treatment-of-asymptomatic-carotid-artery-stenosis
#19
Guiyi Yuan, Shuxian Zhou, Wei Wu, Yuling Zhang, Juan Lei, Boshui Huang
Asymptomatic carotid stenosis is common and is associated with increased risk of stroke. The relative efficacy and safety of carotid endarterectomy (CEA) and carotid stenting (CAS) in patients with asymptomatic carotid stenosis remain unclear. Five studies that recruited patients with asymptomatic but significant carotid stenosis, who underwent CEA or CAS, were included in this systematic review and meta-analysis. The analyzed outcomes included risks of stroke, myocardial infarction (MI), and death. Risk ratio (RR) and 95% confidence interval (95% CI) were calculated and pooled for meta-analysis...
April 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29676604/is-diabetes-a-marker-of-higher-risk-after-carotid-revascularization-experience-from-a-single-centre
#20
Renato Casana, Chiara Malloggi, Andrea Odero, Valerio Tolva, Richard Bulbulia, Alison Halliday, Vincenzo Silani
PURPOSE: This single centre study investigates the influence of diabetes mellitus on outcomes following carotid artery endarterectomy or stenting. METHODS: In total, 752 carotid revascularizations (58.2% carotid artery stenting and 41.8% carotid endarterectomy) were performed in 221 (29.4%) patients with diabetes and 532 (70.6%) patients without diabetes. The study outcomes were death, disabling and non-disabling stroke, transient ischaemic attack and restenosis within 36 months after the procedure...
April 1, 2018: Diabetes & Vascular Disease Research
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