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Carotid endarterectomy

Yan Zhang, Hong Li, Yingqin Jia, Pengfei Yang, Feng Zhao, Wei Wang, Wenqing Liu, Guisheng Chen, Xiaoqing Zhuang, Juan Li
BACKGROUD: Vascular calcification is currently recognized as an important pathobiological process in atherosclerosis, but the mechanism remains elusive. Given the similarities in vascular calcification and bone formation,18 F-sodium fluoride (18 F-NaF) is now considered a novel marker of vascular calcification. This study aimed to correlate18 F-NaF accumulation with the histological characterization of vascular calcification in carotid plaques. METHODS: A total of 8 patients who were undergoing carotid endarterectomy (CEA) for carotid artery stenosis were recruited...
March 16, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Todd R Vogel, Robin L Kruse, Ryan J Kim, Viktor Y Dombrovskiy
BACKGROUND: Race has been associated with inferior outcomes after multiple procedures, but the association of socioeconomic status with procedures for cerebrovascular disease is not well established. MATERIALS AND METHODS: Elective carotid artery stenting (CAS) and carotid endarterectomy (CEA) procedures were identified in the National Inpatient Sample, 2012 to 2014. Median household income was estimated from patient ZIP codes. Chi-square and multivariable logistic regression analysis evaluated outcomes, accounting for age, race, gender, comorbidities, procedure, income, insurance, and hospital characteristics...
January 1, 2018: Vascular and Endovascular Surgery
Lin Yang, Jianlin Liu, Guangyu Qi, Yanzi Li, Yamin Liu
This study aims to investigate the complication and middle-term outcome of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in Chinese patients, which was a retrospective case-control study and perioperative complications and 2-year end points were analyzed. Follow-up was done by a certified doctor, and restenosis was detected by ultrasound. Operation success rate were 100% in two groups. CAS showed the higher incidence rate of all stroke/TIA at 30days post-procedure (7.89% VS 1.85%, P = 0...
March 16, 2018: Scientific Reports
Marieke A Hillaert, Hester M den Ruijter, Imo E Hoefer, Eef G Lentjes, Gert J de Borst, Jean-Paul P M de Vries, Pieter A Doevendans, Gerard Pasterkamp, Leo Timmers
BACKGROUND: The renin-angiotensin-aldosterone system is increasingly being recognized to play an important role in the development and clinical course of cardiovascular diseases. Renin-angiotensin-aldosterone system activation is associated with clinical outcome in various populations of cardiovascular patients, such as patients with coronary artery, peripheral artery, and cerebrovascular disease. In this study, we investigated the associations between plasma renin and aldosterone concentrations and atherosclerotic plaque characteristics and secondary vascular events in patients undergoing carotid endarterectomy...
March 13, 2018: Journal of Vascular Surgery
Federico Moccetti, Craig C Weinkauf, Brian P Davidson, J Todd Belcik, Edmund R Marinelli, Evan Unger, Jonathan R Lindner
The aim of this study was to evaluate a panel of endothelium-targeted microbubble (MB) ultrasound contrast agents bearing small peptide ligands as a human-ready approach for molecular imaging of markers of high-risk atherosclerotic plaque. Small peptide ligands with established affinity for human P-selectin, VCAM-1, LOX-1 and von Willebrand factor (VWF) were conjugated to the surface of lipid-stabilized MBs. Contrast-enhanced ultrasound (CEUS) molecular imaging of the thoracic aorta was performed in wild-type and gene-targeted mice with advanced atherosclerosis (DKO)...
March 13, 2018: Ultrasound in Medicine & Biology
Yamaan S Saadeh, Luis E Savastano, Julian L Gendreau, Aditya S Pandey
Optimal management of patients with stroke due to symptomatic carotid artery disease coexistent with bacterial endocarditis is still not well established. We report the case of a patient who presented with multifocal left middle cerebral artery stroke in the setting of Enterococcus faecalis endocarditis and was found to have near-occlusive ipsilateral carotid artery stenosis in stroke workup. Carotid artery endarterectomy was performed, and atheroma material demonstrated complicated plaque with cultures positive for E...
March 15, 2018: BMJ Case Reports
E J Meester, B J Krenning, R H de Blois, J P Norenberg, M de Jong, M R Bernsen, K Van der Heiden
BACKGROUND: 111 In-DOTA-butylamino-NorBIRT (DANBIRT) is a novel radioligand which binds to Leukocyte Function-associated Antigen-1 (LFA-1), expressed on inflammatory cells. This study evaluated111 In-DANBIRT for the visualization of atherosclerotic plaque inflammation in mice. METHODS AND RESULTS: ApoE-/- mice, fed an atherogenic diet up to 20 weeks (n = 10), were imaged by SPECT/CT 3 hours post injection of111 In-DANBIRT (~ 200 pmol, ~ 40 MBq). Focal spots of111 In-DANBIRT were visible in the aortic arch of all animals, with an average Target-to-Background Ratio (TBR) of 1...
March 13, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Michael Young, Greg Imbarrato, Ajeet Gordhan
A 74-year-old male developed cervical carotid artery psuedoaneurysm 8 months after carotid endarterectomy. The patient was successfully managed with dual implantation of flow-diverter and conventional carotid stent. Flow-diverter was placed across the neck of pseudoaneurysm to provide flow diversion while carotid stent was implanted within the lumen of the expanded flow-diverter to approximate and hold the flow diverter proximal and distal to the pseudoaneurysm. Follow-up ultrasonography revealed complete resolution of the pseudoaneurysm...
March 2018: Neurointervention
Mohamed Barkat, Iain Roy, Stavros A Antoniou, Francesco Torella, George A Antoniou
We aim to perform a systematic review and meta-analysis to investigate outcomes of treatment strategies for asymptomatic carotid disease. We searched electronic bibliographic sources (MEDLINE, EMBASE, CINAHL and CENTRAL) to identify randomised controlled trials (RCT) reporting comparative outcomes of carotid endarterectomy (CEA), carotid stenting (CAS) and best medical therapy (BMT) in asymptomatic carotid disease. We performed pairwise meta-analysis applying random or fixed-effects models and reported the results as the odds ratio (OR) or risk difference (RD) and 95% confidence interval (CI)...
March 13, 2018: Scientific Reports
Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Gianfranco Varetto, Alessandra Trevisan, Giovanni Barile, Lorenzo Gibello, Flavia Spalla, Edoardo Frola, Daniele Pennica, Pietro Rispoli PhD
BACKGROUND: Pseudoaneurysm (PA) after carotid endarterectomy (CEA) is a rare and potentially life-threatening complication, with an incidence lower than 1%. Most of the cases described report PAs after carotid patch angioplasty and are associated with infection, often caused by Staphylococci. The management of PAs can be surgical, endovascular, or hybrid. METHODS: We herein present the case of an infected carotid PA 27 days after an eversion CEA. We performed a common to internal carotid bypass with the interposition of great saphenous vein (GSV) associated with specific polyantibiotic therapy for 4 weeks...
January 1, 2018: Vascular and Endovascular Surgery
K C Fok, Y C Chan, Y Law, S W Cheng
Infected carotid patch are rare. We present a gentleman who had an elective carotid endarterectomy with Dacron patch closure for symptomatic carotid stenosis under regional anaesthesia, and presented one month later with a discharging sinus at the lower aspect of the neck wound. CT scan showed a rim enhancing collection next to the carotid bifurcation. He subsequently underwent patch excision and repair with autologous saphenous vein graft, with good recovery. Of significance was that he had dental extraction for a loose tooth one day before the index operation as advised by the anesthestist...
March 5, 2018: Annals of Vascular Surgery
Aleksander Falkowski, Iwona Gorący, Mariusz Kaczmarczyk, Marcin Szemitko, Hubert Bogacki, Julia Kostka
BACKGROUND: To compare the results of computer estimation of atherosclerotic plaque with biochemical data and ascertain any relationship with the occurrence of stroke. METHODS: The study involved 20 atherosclerotic plaques causing 70-99% stenosis of internal carotid arteries (ICA). Ultrasonographic examination (USG) images of plaques were analyzed using a computer program. A histogram was obtained for each plaque and a gray scale median (GSM) was determined for each histogram in order to measure the echogenicity of an examined plaque...
March 6, 2018: International Angiology: a Journal of the International Union of Angiology
(no author information available yet)
No abstract text is available yet for this article.
January 2018: Medicine (Baltimore)
Yoshiro Ito, Wataro Tsuruta, Yasunobu Nakai, Tomoji Takigawa, Aiki Marushima, Tomohiko Masumoto, Yuji Matsumaru, Eiichi Ishikawa, Akira Matsumura
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are not appropriate treatment procedure for internal carotid artery stenosis (ICAS) in some patients. The importance of plaque vulnerability and the treatment risk evaluation has been reported. We analyzed whether treatment selection contributes to the outcome. We retrospectively examined 121 patients who underwent CEA or CAS. Treatment was selected based on plaque vulnerability and the treatment risk evaluation. We selected CAS for patients with stable plaques and CEA for patients with unstable plaques, and considered the other treatment for high-risk patients...
March 3, 2018: Neurologia Medico-chirurgica
Slobodan Tanaskovic, Djordje Radak, Nikola Aleksic, Branko Calija, Vera Maravic-Stojkovic, Dragoslav Nenezic, Nenad Ilijevski, Petar Popov, Goran Vucurevic, Srdjan Babic, Predrag Matic, Predrag Gajin, Dragan Vasic, Zoran Rancic
BACKGROUND: Inflammation is one of the mechanisms that leads to carotid restenosis (CR). The aim of this study was to examine the influence of increased values of inflammation markers (high-sensitivity C-reactive protein [hs-CRP], C3 complement, and fibrinogen) on CR development after eversion carotid endarterectomy (CEA). METHODS: A consecutive 300 patients were included in the study, in which eversion CEA was performed between March 1 and August 1, 2010. Demographic data, atherosclerosis risk factors, comorbidities, and ultrasound plaque characteristics were listed in relation to potential risk factors for CR...
March 1, 2018: Journal of Vascular Surgery
Ann H Kim, Gener Augustin, Andrew Shevitz, Hannah Kim, Michael R Trivonovich, Alexis R Powell, Norman Kumins, Robert Tarr, Vikram S Kashyap
The decision to intervene for internal carotid stenosis often depends on the degree of stenosis seen on duplex ultrasound (US). The aim of this study is to compare the diagnostic accuracy of two criteria: modified University of Washington (UW) and 2003 Carotid Consensus Panel (CCP). All patients undergoing US in an accredited (IAC) vascular laboratory from January 2010 to June 2015 were reviewed ( n=18,772 US exams). Patients receiving a neck computed tomography angiography (CTA) within 6 months of the US were included in the study ( n=254)...
March 1, 2018: Vascular Medicine
Fábio Hüsemann/Menezes, Natália Ponzio/Pagliuso, Giovani José Dal Poggetto/Molinari
INTRODUCTION: Carotid endarterectomy is one of the most performed vascular procedures. Since the first reports in the late 1950's the conventional open and the eversion techniques are the popularized ones. A short extraction or partial eversion technique has been previously described and recently has been subject to case-series reports. OBJECTIVE: to present the experience of a teaching hospital with modified or partial eversion endarterectomy compared to the conventional open procedure, performed exclusively by training vascular surgeons...
March 1, 2018: Annals of Vascular Surgery
Atsuhiro Kojima, Isako Saga, Mami Ishikawa
BACKGROUND: Hypoglossal nerve deficit is a possible complication caused by carotid endarterectomy (CEA). The accidental injury of the hypoglossal nerve during surgery is one of the major reasons for permanent hypoglossal nerve palsy. In this study, we investigated the usefulness of intraoperative mapping of the hypoglossal nerve to identify this nerve during CEA. METHODS: Five consecutive patients who underwent CEA for the treatment of symptomatic or asymptomatic carotid artery stenosis were studied...
February 28, 2018: World Neurosurgery
Charles Timothy West, Cecilia Brassett, Michael Gaunt
BACKGROUND: The carotid sinus (CS) is a dilatation in the carotid bifurcation usually at the origin of proximal internal carotid artery (ICA). It contains baroreceptors which influence blood pressure. Variations in the location of the CS are of importance as atheromatous plaque commonly forms in this area and procedures such as carotid endarterectomy are performed to reduce the risk of stroke. Inadvertent stimulation of the CS baroreceptors during interventions can have profound effects on the patient's hemodynamic status both intra- and postoperatively, causing serious complications...
March 3, 2018: Folia Morphologica (Warsz)
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