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Carotid endarterectomy

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https://www.readbyqxmd.com/read/28742705/carotid-endarterectomy-versus-carotid-stenting-to-treat-carotid-stenosis-there-is-more-to-than-meets-the-eye
#1
Demetrios Moris, Georgios Karaolanis, Eleftherios Spartalis, Sotirios Georgopoulos
No abstract text is available yet for this article.
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28742693/reply-to-letter-to-the-editor-carotid-endarterectomy-versus-stenting-to-treat-carotid-stenosis-there-is-more-to-than-meets-the-eye
#2
Mohamad A Hussain, Mohammed Al-Omran
No abstract text is available yet for this article.
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28739521/effective-intraluminal-shunt-in-carotid-endarterectomy-for-carotid-artery-near-occlusion-a-technical-report
#3
Yoichiro Kawamura, Daisuke Maruyama, Yojiro Akagi, Koji Iihara
BACKGROUND: Carotid artery near occlusion is a critical degree of stenosis whereby blood flow is decreased and the distal cervical and intracranial internal carotid arteries (ICAs) are prone to collapse. Considering the diminished perfusion and the risk of progression to total occlusion and periocclusive embolism, we performed carotid endarterectomy (CEA) for carotid artery near occlusion. METHODS: Accurate evaluation of tandem stenosis or patency of the post-stenotic ICA in carotid artery near occlusion is often difficult preoperatively...
July 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28738590/extracellular-matrix-characterization-in-plaques-from-carotid-endarterectomy-by-a-proteomics-approach
#4
N Ucciferri, S Rocchiccioli, L Comelli, M Marconi, M Ferrari, G Pelosi, A Cecchettini
Extracellular matrix (ECM) is a fundamental component of multicellular organisms. Alteration of its structure and/or molecular composition are associated with several pathologies, among the others with atherosclerosis. To determine how the overall ECM architecture of a tissue as complex as the atheroma may change under varying pathological conditions constitutes a great technical challenge. This entails removing cell components and solubilisation of fibrillar proteins in order to allow enzymatic digestion and mass spectrometry analyses...
November 1, 2017: Talanta
https://www.readbyqxmd.com/read/28735954/endarterectomy-achieves-lower-stroke-and-death-rates-compared-with-stenting-in-patients-with-asymptomatic-carotid-stenosis
#5
REVIEW
Stavros K Kakkos, Ioannis Kakisis, Ioannis A Tsolakis, George Geroulakos
BACKGROUND: It is currently unclear if carotid artery stenting (CAS) is as safe as carotid endarterectomy (CEA) for patients with significant asymptomatic stenosis. The aim of our study was to perform a systematic review and meta-analysis of trials comparing CAS with CEA. METHODS: On March 17, 2017, a search for randomized controlled trials was performed in MEDLINE and Scopus databases with no time limits. We performed meta-analyses with Peto odds ratios (ORs) and 95% confidence intervals (CIs)...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28734927/4-dimensionally-guided-3-dimensional-color-doppler-ultrasonography-quantifies-carotid-artery-stenosis-with-high-reproducibility-and-accuracy
#6
Roland Richard Macharzina, Sascha Kocher, Steven R Messé, Thomas Rutkowski, Fabian Hoffmann, Matthias Vogt, Werner Vach, Nian Fan, Aljoscha Rastan, Franz-Josef Neumann, Thomas Zeller
OBJECTIVES: The purpose was to analyze the agreement and binary accuracy of the degree of internal carotid artery stenosis (ICAS) as determined by 4-dimensionally (4D) real-time gray-scale guided 3-dimensional (3D) color-Doppler ultrasonography (3DC-US) (4D/3DC-US) compared with catheter angiography (CA) and duplex ultrasonography (DUS). This study hypothesized that 4D/3DC-US is noninferior to CA and DUS in grading ICAS in selected patients. BACKGROUND: Clinical stratification in patients with ICAS largely depends on a patient's symptomatic status and the degree of stenosis...
July 13, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28733710/a-matched-case-control-study-on-early-and-late-results-of-carotid-endarterectomy-performed-in-young-patients
#7
Walter Dorigo, Aaron Fargion, Elena Giacomelli, Giulia Bassoli, Raffaele Pulli, Giovanni Pratesi, Gabriele Piffaretti, Carlo Pratesi
OBJECTIVE: The aim of the study was to describe the perioperative and long-term results of carotid endarterectomy (CEA) in patients aged 60 or less and compare them to patients of more advanced age in a retrospective single-centre case-control study. METHODS: From January 1996 to December 2014, 5893 consecutive CEAs were performed in our institution. Data concerning these interventions were prospectively inserted in a dedicated database. A retrospective analysis of that database was performed and 457 interventions performed in patients aged 60 or less were found (group 1)...
July 21, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28732809/oleacein-may-inhibit-destabilization-of-carotid-plaques-from-hypertensive-patients-impact-on-high-mobility-group-protein-1
#8
Agnieszka Filipek, Monika E Czerwińska, Anna K Kiss, Jerzy A Polański, Marek Naruszewicz
BACKGROUND: In patients with hypertension the haemorrhage into carotid atherosclerotic plaque increases risk of plaque destabilization and rupture. Our previous study showed that oleacein, a secoiridoid present in extra virgin olive oil, enhanced uptake of haemoglobin-haptoglobin complex and change macrophage phenotype from pro-inflammatory M1 to anti-inflammatory M2. PURPOSE: The aim this study was to investigate a potential role of oleacein in attenuation of carotid plaque destabilisation ex vivo...
August 15, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/28727356/-management-of-carotid-artery-stenosis
#9
Francesco Puccinelli, Marco Roffi, Nicolas Murith, Roman Sztajzel
Carotid artery atherosclerosis remains one of the major causes of stroke. The efficacy of carotid artery recanalization has already been established and is considered significant for symptomatic stenosis >70% and moderate for stenosis between 50-69 %. Regarding asymptomatic stenosis, carotid artery recanalization should be reserved for carefully selected patients with a stenosis between 70-90 % and an estimated procedural risk at less than 3 %. Two therapeutic options are currently available : angioplasty with stent placement and endarterectomy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726649/lipoprotein-associated-phospholipase-a2-as-a-marker-of-vulnerable-atherosclerotic-plaque-in-patients-with-internal-carotid-artery-stenosis
#10
P Štefanič, I Kopolovets, Z Hertelyová, Š Tóth, M Frankovičová
The aim of this study was to compare the concentration of inflammatory vascular markers and morphological structure of atherosclerotic plaque in symptomatic and asymptomatic patients with the stenosis of internal carotid artery (ICA). The research was carried out in 70 patients with hemodynamically significant stenosis of ICA out of which 40 (57%) were asymptomatic patients and 30 (43%) were symptomatic patients, of which 20 patients (66%) have had a stroke, or transient ischemic attack (TIA), 10 patients (33%)...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28724881/effect-of-carotid-endarterectomy-on-retinal-function-in-asymptomatic-patients-with-hemodynamically-significant-carotid-artery-stenosis
#11
Anna Machalińska, Aleksandra Kowalska-Budek, Miłosz Piotr Kawa, Arkadiusz Kazimierczak, Krzysztof Safranow, Marta Kirkiewicz, Paweł Rynio, Grażyna Wilk, Wojciech Lubiński, Piotr Gutowski, Bogusław Machaliński
INTRODUCTION    The corrective effect of carotid endarterectomy (CEA) on disturbed ophthalmic artery flow in patients with a significant internal carotid artery stenosis (ICAS) presenting with ocular ischemic syndrome (i.e., symptomatic patients) is well established. However, no clear evidence exists regarding the efficacy of CEA for improvement of neuro-retinal function in patients without symptoms of ocular ischemic syndrome. OBJECTIVES    We determined the effects of CEA on retinal function in asymptomatic patients with hemodynamically significant internal carotid artery stenosis...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28716303/early-results-of-endovascular-treatment-of-patients-with-bilateral-stenoses-of-the-internal-carotid-arteries-using-proximal-protection-systems-at-30-day-follow-up
#12
Paweł Latacz, Marian Simka, Tadeusz Popiela, Marek Kazibudzki, Tomasz Mrowiecki
BACKGROUND: Although surgical endarterectomy remains the treatment of choice for carotid artery stenosis, carotid artery stenting (CAS) with use of proximal protection systems (PPS) plays an very important role as alternative treatment modality, especially in patients with critical, symptomatic lesions. This study was single-centre study to evaluate the technical and clinical success of proximal protection devices as the first choice for embolic protection in symptomatic and asymptomatic carotid stenosis in patients with bilateral, advanced lesions of carotid arteries (bilateral stenoses or stenosis and occlusion)...
July 8, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28712813/factors-affecting-operative-time-and-outcome-of-carotid-endarterectomy-in-the-vascular-quality-initiative
#13
Jennifer L Perri, Brian W Nolan, Philip P Goodney, Randall R DeMartino, Benjamin S Brooke, Shipra Arya, Mark F Conrad, Jack L Cronenwett
OBJECTIVE: Prior studies have suggested a relationship between operative (Op) time and outcome after major vascular procedures. This study analyzed factors associated with Op time and outcome after carotid endarterectomy (CEA) in the Vascular Quality Initiative (VQI) registry. METHODS: Elective, primary CEAs without high anatomic risk or concomitant procedures from 2012 to 2015 in the VQI were analyzed (N = 26,327, performed by 1188 surgeons from 249 centers). Multivariable analysis was used to identify patient, procedure, and surgeon factors associated with Op time and major adverse events (MAEs), categorized as either technical (ipsilateral stroke, cranial nerve injury, reoperation) or cardiac (myocardial infarction, congestive heart failure, dysrhythmia requiring treatment, surgical site infection, and death)...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711401/performance-of-acoustic-radiation-force-impulse-ultrasound-imaging-for-carotid-plaque-characterization-with-histologic-validation
#14
Tomasz J Czernuszewicz, Jonathon W Homeister, Melissa C Caughey, Yue Wang, Hongtu Zhu, Benjamin Y Huang, Ellie R Lee, Carlos A Zamora, Mark A Farber, Joseph J Fulton, Peter F Ford, William A Marston, Raghuveer Vallabhaneni, Timothy C Nichols, Caterina M Gallippi
OBJECTIVE: Stroke is commonly caused by thromboembolic events originating from ruptured carotid plaque with vulnerable composition. This study assessed the performance of acoustic radiation force impulse (ARFI) imaging, a noninvasive ultrasound elasticity imaging method, for delineating the composition of human carotid plaque in vivo with histologic validation. METHODS: Carotid ARFI images were captured before surgery in 25 patients undergoing clinically indicated carotid endarterectomy...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28708869/long-term-efficacy-and-safety-of-carotid-artery-stenting-versus-endarterectomy-a-meta-analysis-of-randomized-controlled-trials
#15
Yang Li, Jing-Jing Yang, Su-Hui Zhu, Biao Xu, Lian Wang
BACKGROUND: Many recent trials have investigated the long-term efficacy and safety of endarterectomy versus stenting in treating patients with carotid artery stenosis. We aimed to determine the long-term comparative efficacy and safety of both procedures by pooling this evidence in a meta-analysis. METHODS: We searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published until May 6, 2016. Randomized controlled trials, which reported outcomes of interest with a median follow-up of at least 4-year, were included...
2017: PloS One
https://www.readbyqxmd.com/read/28706202/near-infrared-autofluorescence-induced-by-intraplaque-hemorrhage-and-heme-degradation-as-marker-for-high-risk-atherosclerotic-plaques
#16
Nay Min Htun, Yung Chih Chen, Bock Lim, Tara Schiller, Ghassan J Maghzal, Alex L Huang, Kirstin D Elgass, Jennifer Rivera, Hans G Schneider, Bayden R Wood, Roland Stocker, Karlheinz Peter
Atherosclerosis is a major cause of mortality and morbidity, which is mainly driven by complications such as myocardial infarction and stroke. These complications are caused by thrombotic arterial occlusion localized at the site of high-risk atherosclerotic plaques, of which early detection and therapeutic stabilization are urgently needed. Here we show that near-infrared autofluorescence is associated with the presence of intraplaque hemorrhage and heme degradation products, particularly bilirubin by using our recently created mouse model, which uniquely reflects plaque instability as seen in humans, and human carotid endarterectomy samples...
July 13, 2017: Nature Communications
https://www.readbyqxmd.com/read/28706117/age-specific-sex-differences-in-magnetic-resonance-imaging-depicted-carotid-intraplaque-hemorrhage
#17
Navneet Singh, Alan R Moody, Bowen Zhang, Isabella Kaminski, Kush Kapur, Stephanie Chiu, Pascal N Tyrrell
BACKGROUND AND PURPOSE: Stroke rates are higher in men compared with women in the fourth through seventh decades of life, and higher rates may result from differences in carotid intraplaque hemorrhage (IPH), an unstable atherosclerotic plaque component. We report age-specific sex differences in the presence of magnetic resonance imaging-depicted carotid IPH. METHODS: Patients (n=1115) underwent magnetic resonance imaging for carotid IPH between 2005 and 2014. Low-grade carotid stenosis patients (n=906) without prior endarterectomy were eligible for this cross-sectional study...
August 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28701298/carotid-stenting-for-unilateral-stenosis-can-increase-contralateral-hemispheric-cerebral-blood-flow
#18
Akiyo Sadato, Shingo Maeda, Motoharu Hayakawa, Kazuhide Adachi, Hiroshi Toyama, Ichiro Nakahara, Yuichi Hirose
BACKGROUND: The revascularization of carotid stenosis can increase ipsilateral cerebral blood flow (CBF). Occasionally, elevated CBF is also evident on the contralateral side, but this phenomenon is poorly understood. OBJECTIVE: To analyze retrospectively the relationship between a contralateral CBF increase and several clinical and radiologic features. MATERIALS AND METHODS: We retrospectively analyzed 40 patients with unilateral cervical carotid stenosis treated by carotid artery stenting (CAS)...
July 12, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28697940/characterization-of-perioperative-contralateral-stroke-after-carotid-endarterectomy
#19
W Darrin Clouse, Emel A Ergul, Virendra I Patel, R Todd Lancaster, Glenn M LaMuraglia, Richard P Cambria, Mark F Conrad
OBJECTIVE: Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioperative (30-day) contralateral stroke after CEA as well as predisposing preoperative and operative factors. Its specific effect on long-term survival was interrogated. METHODS: The Vascular Study Group of New England (VSGNE) was queried from April 1, 2003, to February 29, 2016, for all CEAs...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28697713/an-update-of-the-italian-stroke-organization-stroke-prevention-awareness-diffusion-group-guidelines-on-carotid-endarterectomy-and-stenting-a-personalized-medicine-approach
#20
Gaetano Lanza, Carlo Setacci, Stefano Ricci, Patrizio Castelli, Alberto Cremonesi, Jessica Lanza, Claudio Novali, Carlo Pratesi, Paola Santalucia, Francesco Speziale, Augusto Zaninelli, Gian Franco Gensini
Although proof-based medicine has generated much valid evidence for the drawing up of guidelines and recommendations for best clinical practice in symptomatic and asymptomatic carotid stenosis, whether and when it is better to employ endarterectomy or stenting as the intervention of choice still remain matters of debate. Moreover, guidelines have been targeted up to now to the 'representative' patient, as resulting from the statistical analyses of the studies conducted on the safety and efficacy of both interventions as well as on medical therapy alone...
July 2017: International Journal of Stroke: Official Journal of the International Stroke Society
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