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carotid endarterectomy(CEA)

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https://www.readbyqxmd.com/read/29237404/computed-tomography-scan-based-prediction-of-the-vulnerable-carotid-plaque
#1
Hadi Mahmoud Haider Diab, Lars Melholt Rasmussen, Stevo Duvnjak, Axel Diederichsen, Pia Søndergaard Jensen, Jes Sanddal Lindholt
BACKGROUND: Primary to validate a commercial semi-automated computed tomography angiography (CTA) -software for vulnerable plaque detection compared to histology of carotid endarterectomy (CEA) specimens and secondary validating calcifications scores by in vivo CTA with ex vivo non-contrast enhanced computed tomography (NCCT). METHODS: From January 2014 to October 2016 53 patients were included retrospectively, using a cross-sectional design. All patients underwent both CTA and CEA...
December 13, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/29234612/near-infrared-spectroscopy-versus-transcranial-doppler-based-monitoring-in-carotid-endarterectomy
#2
Jun Woo Cho, Jae Seok Jang
Background: Proper monitoring of cerebral perfusion during carotid artery surgery is crucial for determining if a shunt is needed. We compared the safety and reliability of near-infrared spectroscopy (NIRS) with transcranial Doppler (TCD) for cerebral monitoring. Methods: This single-center, retrospective review was conducted on patients who underwent carotid endarterectomy (CEA) using selective shunt-based TCD or NIRS at Daegu Catholic University Medical Center from November 2009 to June 2016...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29224943/outcomes-after-early-and-delayed-carotid-endarterectomy-in-patients-with-symptomatic-carotid-artery-stenosis
#3
Ying Huang, Peter Gloviczki, Audra A Duncan, Manju Kalra, Gustavo S Oderich, Randall R DeMartino, William S Harmsen, Thomas C Bower
OBJECTIVE: The objective of this study was to define outcomes after carotid endarterectomy (CEA) in patients with symptomatic carotid artery stenosis (CAS) when patients are operated on within 14 days after onset of symptoms. METHODS: Clinical data of consecutive patients who underwent CEA between 2003 and 2012 for symptomatic CAS were reviewed. Patients were classified into group 1, CEA ≤14 days of minor stroke or transient ischemic attack, and group 2, CEA >14 days...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29217445/factors-that-predict-failure-to-meet-mips-quality-measures-for-asymptomatic-carotid-endarterectomy
#4
Anahita Dua, Steven Koprowski, Fadwa Ali, Sapan S Desai
INTRODUCTION: The Physician Quality Reporting System (PQRS) created by the Centers for Medicare and Medicaid Services (CMS) financially penalizes providers who fail to meet expected quality of care measures. The purpose of this study is to evaluate the factors that predict failure to meet PQRS measures for carotid endarterectomy (CEA). METHODS: PQRS measures 260 (discharge by postoperative day 2 following CEA in asymptomatic patients) and 346 (rate of postoperative stroke or death following CEA in asymptomatic patients) were evaluated using hospital records from the state of Florida from 2008-2012...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29217437/carotid-endarterectomy-performed-before-the-weekend-is-associated-with-increased-length-of-stay
#5
Thomas W Cheng, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Myriam Castagne, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVE: Length of stay (LOS) is commonly used to gauge hospital resource utilization and can affect hospital profit margin. Other fields of surgery have showed that operations performed close to the weekend have longer LOS and higher patient morbidity. Our goal was to investigate whether asymptomatic patients undergoing elective carotid endarterectomy (CEA) earlier in the week had a shorter LOS and improved clinical outcomes compared to those treated before the weekend. METHODS: The Vascular Quality Initiative (VQI) database was queried for elective weekday CEAs performed for asymptomatic carotid stenosis from 2005 to 2017...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29205297/meta-analysis-of-the-procedural-risks-of-carotid-endarterectomy-and-carotid-artery-stenting-over-time
#6
REVIEW
K Lokuge, D D de Waard, A Halliday, A Gray, R Bulbulia, B Mihaylova
BACKGROUND: Stroke/death rates within 30 days of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in RCTs inform current clinical guidelines. However, the risks may have changed in recent years with wider use of effective stroke prevention therapies, especially statins, improved patient selection and growing operator expertise. The aim of this study was to investigate whether the procedural stroke/death risks from CEA and CAS have changed over time. METHODS: MEDLINE and Embase were searched systematically from inception to May 2016 for observational cohort studies of CEA and CAS...
December 4, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29204653/national-patterns-of-carotid-revascularization-before-and-after-the-carotid-revascularization-endarterectomy-vs-stenting-trial-crest
#7
Fadar Oliver Otite, Priyank Khandelwal, Amer M Malik, Seemant Chaturvedi
Importance: The Carotid Revascularization Endarterectomy vs Stenting Trial (CREST) showed greater safety of carotid artery stenting (CAS) in patients younger than 70 years and carotid endarterectomy (CEA) in those older than 70 years. It is unknown how the result of CREST has influenced carotid revascularization choices in the United States. Objective: To evaluate national patterns in CAS performance in patients older than 70 years in the post-CREST (2011-2014) compared with the pre-CREST (2007-2010) era...
December 4, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29197612/pre-operative-cardiac-stress-testing-in-the-southern-california-vascular-outcomes-improvement-collaborative
#8
Kaelan Chan, Ahmed M Abou-Zamzam, Karen Woo
OBJECTIVE: The objective of this study is to examine the use of pre-operative cardiac stress testing (PCST) in the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe). METHODS: A retrospective review was performed of data in all modules of the So Cal VOICe from September 2012 through May 2016. PCST was defined as stress echocardiogram or nuclear stress test. A new post-operative myocardial infarction (MI) was defined as troponin elevation and/or electrocardiogram/imaging changes with or without ischemic symptoms...
November 29, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29196199/midt-term-results-after-fast-track-prophylactic-carotid-surgery-program-the-risk-of-overlooking-occult-cancer
#9
Liv Schoellhammer, Alan Owen-Falkenberg, Bo Gottschalksen, Saeid Shahidi
BACKGROUND: Most guidelines recommend fast-track carotid endarterectomy (CEA) within 14 days of the last ischemic event. Long-term survival after fast-track CEA is unknown. The purpose of this study was to determine whether the fast-track CEA program in our region was associated with a reduced or increased 2-year survival and overall complication rate in our population. METHODS: Prospective 2-year follow-up in patients after the implementation of a fast-track CEA program during a period of 3½ years...
November 28, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29186602/intraoperative-computed-tomography-angiography-a-novel-completion-imaging-modality-for-carotid-endarterectomy
#10
Anish N Sen, Jared Fridley, Sherly Sebastian, Edward A M Duckworth
BACKGROUND: Intraoperative computed tomography angiography (ICTA) is a novel completion imaging modality for carotid endarterectomy (CEA). No studies exist in the literature describing ICTA use in CEA. OBJECTIVE: To evaluate the feasibility and efficacy of ICTA as a method of immediately evaluating the technical results of CEA. METHODS: Twenty-three consecutive CEAs were performed by a single neurosurgeon over an 8-month period. Of this series, 12 utilized ICTA for completion imaging, 10 utilized duplex ultrasonography (US), and 1 utilized no intraoperative completion imaging...
December 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29180087/changes-in-blood-flow-velocity-of-the-middle-cerebral-artery-after-carotid-endarterectomy-daily-assessment-with-transcranial-color-coded-sonography
#11
Satoshi Koizumi, Yumiko Yamaoka, Takeshi Matsuo, Toshikazu Kimura, Tomohiro Inoue
BACKGROUND: Hyperperfusion syndrome (HPS) is a well-known complication of carotid endarterectomy (CEA) warranting repeatable inexpensive monitoring. Transcranial color-coded sonography (TCCS) may provide a potential modality for such monitoring, but little is known about TCCS trends after CEA. METHODS: Between January 2016 and February 2017, we prospectively included patients with CEA at our institute in this study. TCCS was performed preoperatively and repeated daily from the operation day until postoperative day (POD) 7...
November 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29180080/long-term-outcome-after-carotid-endarterectomy-in-patients-with-ischemic-heart-disease
#12
Hyo Jung Nam, Sung Hyuk Heo, Bum Joon Kim, Jin San Lee, Hyo Chul Youn, Ji Sung Lee, Sun U Kwon, Cheryl D Bushnell, Dae-Il Chang
BACKGROUND: The long-term outcome after carotid endarterectomy (CEA) is determined by many confounding factors. Ischemic heart disease (IHD) is linked to atherosclerotic stroke, and it is a very important cause of death during the perioperative and follow-up periods after CEA. We aimed to investigate mortality and long-term major adverse cardiovascular events (MACEs) in IHD patients compared with non-IHD patients. METHODS: We consecutively enrolled 229 patients who underwent CEA procedures from 2000 to 2011...
November 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29143732/surgical-and-endovascular-treatment-of-extracranial-carotid-stenosis
#13
Hans-Henning Eckstein, Pavlos Tsantilas, Andreas Kühnl, Bernhard Haller, Thorben Breitkreuz, Alexander Zimmermann, Michael Kallmayer
BACKGROUND: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) can be used to prevent stroke due to arteriosclerotic lesions of the carotid artery. In Germany, legally mandated quality assurance (QA) enables the evaluation of outcome quality after CEA and CAS performed under routine conditions. METHODS: We analyzed data on all elective CEA and CAS procedures performed over the periods 2009-2014 and 2012-2014, respectively. The endpoints of the study were the combined in-hospital stroke and death rate, stroke rate and mortality separately, local complications, and other complications...
October 27, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29136204/thrombolysis-is-an-independent-risk-factor-for-poor-outcome-after-carotid-revascularization
#14
Ananth K Vellimana, Chad W Washington, Chester K Yarbrough, Thomas K Pilgram, Brian L Hoh, Colin P Derdeyn, Gregory J Zipfel
BACKGROUND: Thrombolysis is the standard of care for acute ischemic stroke patients presenting in the appropriate time window. Studies suggest that the risk of recurrent ischemia is lower if carotid revascularization is performed early after the index event. The safety of early carotid revascularization in this patient population is unclear. OBJECTIVE: To evaluate the safety of carotid revascularization in patients who received thrombolysis for acute ischemic stroke...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#15
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29129364/diabetes-control-decreases-morbidity-and-mortality-after-carotid-endarterectomy
#16
Matthew S Parr, Viktor Y Dombrovskiy, Khanjan H Nagarsheth, Randy Shafritz, Saum A Rahimi
BACKGROUND: Single-institution studies have demonstrated a negative effect of diabetes mellitus on outcomes after carotid endarterectomy (CEA). The aim of this study was to compare patients with explicitly controlled and uncontrolled diabetes at the population level. METHODS: Using the National Inpatient Sample 2006-2013, we selected patients undergoing CEA. Rates of stroke, myocardial infarction (MI), and hospital mortality, as well as duration of stay and cost were compared among patients with uncontrolled diabetes (UCDM), well-controlled diabetes (WCDM), and those without diabetes (NDM)...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29117648/serum-neuron-specific-enolase-as-a-marker-of-brain-ischemia-reperfusion-injury-in-patients-undergoing-carotid-endarterectomy
#17
Marek Iłżecki, Joanna Iłżecka, Stanisław Przywara, Piotr Terlecki, Aneta Grabarska, Andrzej Stepulak, Tomasz Zubilewicz
In patients with atherosclerotic stenosis of the extracranial segment of internal carotid artery, surgical intervention is an effective method to prevent cerebral ischemic stroke. However, this surgical procedure may cause vascular brain damage. The aim of the study was to investigate consequential brain ischemia-reperfusion injury by measuring the cerebral specific marker, neuron-specific (NSE), in serum of patients having undergone internal carotid endarterectomy (CEA). The study involved 25 patients that underwent CEA due to internal carotid artery stenosis...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29117272/risks-associated-with-primary-and-redo-carotid-endarterectomy-in-the-endovascular-era
#18
Isibor J Arhuidese, Muhammad Faateh, Besma J Nejim, Satinderjit Locham, Christopher J Abularrage, Mahmoud B Malas
Importance: Clinical experience suggests worse outcomes for redo carotid endarterectomy (CEA) relative to primary CEA. Objective quantification of the excess risk attributable to redo CEA in this era of proliferating endovascular therapy remains to be determined. Objective: To evaluate the risks of redo CEA relative to primary CEA. Design, Setting, and Participants: This study was a retrospective analysis of a prospective cohort of patients maintained by the Society for Vascular Surgery in the Vascular Quality Initiative between January 1, 2003, and April 30, 2016...
November 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29113863/long-term-outcomes-after-carotid-artery-stenting-of-patients-with-prior-neck-irradiation-or-surgery
#19
Ho-Hin K Choy, Damianos G Kokkinidis, Ryan Cotter, Gagan D Singh, R Kevin Rogers, Stephen W Waldo, John R Laird, Ehrin J Armstrong
BACKGROUND: Carotid artery stenting (CAS) is often performed in patients with carotid artery stenosis who have relative contraindications to carotid endarterectomy (CEA), including hostile neck anatomy (e.g., history of neck irradiation or prior surgery). We examined the impact of hostile neck anatomy on long-term outcomes after CAS. METHODS: All carotid artery stent procedures performed at two institutions from 2006 to 2016 were reviewed. Routine duplex carotid ultrasound was used to assess target lesion restenosis at regular intervals...
September 21, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29100876/preoperative-antiplatelet-and-statin-use-does-not-affect-outcomes-after-carotid-endarterectomy
#20
Brianna M Krafcik, Alik Farber, Robert T Eberhardt, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Steven L Pike, Jeffrey J Siracuse
OBJECTIVE: The use of statin and antiplatelet medications has been advocated in patients with cerebrovascular disease as primary medical therapy and as an adjunct to carotid endarterectomy (CEA). Our goal was to assess the prevalence of preoperative statin and antiplatelet use and its effect on perioperative outcomes after CEA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program targeted CEA database was queried for patients undergoing CEA between 2011 and 2014...
October 31, 2017: Annals of Vascular Surgery
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