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carotid endarterectomy(CEA)

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https://www.readbyqxmd.com/read/29050148/-the-analysis-of-risk-factors-and-outcomes-of-carotid-endarterectomy-for-carotid-artery-stenosis
#1
Z G Chen, Y J Li, Y P Diao, R Sun, Y H Zheng, C W Liu, Y X Chen
Objective: To evaluate the early and long-term outcomes of carotid endarterectomy for carotid artery stenosis and analyse the risk factors for the outcomes. Methods: A retrospective review of 369 patients underwent carotid endarterectomy(CEA) in Peking Union Medical College Hospital from Oct 2006 to Nov 2012 was conducted. Clinical data including general conditions, perioperative and follow-up outcomes were collected. Results: Three hundred sixty-nine patients underwent 407 CEAs. The long-term follow-up rate (≥30 d) was 89...
September 26, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29049809/association-of-quality-improvement-registry-participation-with-appropriate-follow-up-after-vascular-procedures
#2
Benjamin S Brooke, Adam W Beck, Larry W Kraiss, Andrew W Hoel, Andrea M Austin, Amir A Ghaffarian, Jack L Cronenwett, Philip P Goodney
Importance: Ensuring that patients undergo surveillance imaging after surgery is a key quality metric after many vascular procedures. It is unclear whether hospital participation in a national quality improvement registry such as the Vascular Quality Initiative (VQI) achieves this goal. Objective: To determine if hospital participation in the VQI registry is associated with increased rates of surveillance imaging after vascular procedures. Design, Setting, and Participants: A quasi-experimental study used Medicare claims to study 2174 US hospitals in which 1 530 102 patients had undergone an endovascular abdominal aortic aneurysm repair (EVAR), 1 403 067 patients had undergone a lower extremity bypass (LEB) or peripheral vascular intervention (PVI), and 294 942 patients had undergone carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedures between January 1, 2007, and December 31, 2012...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29046977/carotid-angioplasty-and-stenting-and-embolic-protection
#3
REVIEW
Enrico Giordan, Giuseppe Lanzino
PURPOSE OF REVIEW: We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues. RECENT FINDINGS: Randomized trials have demonstrated a progressive decrease of periprocedural strokes after CAS. Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. This is especially true after the age of 70 and immediately after a presenting symptomatic event...
October 18, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29042076/perioperative-outcomes-after-reoperative-carotid-endarterectomy-are-worse-than-expected
#4
Brianna M Krafcik, Thomas W Cheng, Alik Farber, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Reoperative carotid endarterectomy (CEA) can be technically challenging because of significant scarring as a consequence of the initial CEA procedure. There are limited data that describe outcomes after reoperative CEA, and as such, our goal was to determine the effect of reoperative CEA on perioperative outcomes. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database was queried for patients undergoing index and reoperative CEA between 2005 and 2014...
October 14, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29029228/development-of-a-whole-task-simulator-for-carotid-endarterectomy
#5
Gabrielle Santangelo, Doran Mix, Ahmed Ghazi, Michael Stoner, G Edward Vates, Jonathan J Stone
BACKGROUND: Surgical education relies on operative exposure with live patients. Carotid endarterectomy (CEA) demands an experienced surgeon with a very low complication rate. The high-risk nature of this procedure and the decline in number of CEAs performed annually has created a gap in residency training. OBJECTIVE: To develop a high-fidelity whole-task simulation for CEA that demonstrates content, construct, and face validity. METHODS: Anatomically accurate models of the human neck were created using multilayered poly-vinyl alcohol hydrogels...
September 27, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29021357/radiographic-and-symptomatic-brain-ischemia-in-cea-and-cas-a-systematic-review-and-meta-analysis
#6
Sung-Min Cho, Abhishek Deshpande, Vinay Pasupuleti, Adrian V Hernandez, Ken Uchino
OBJECTIVE: In a systematic review, we compared ratio of new periprocedural radiographic brain ischemia (RBI) to the number of strokes and TIAs among patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We searched 5 databases for entries related to brain ischemia in CEA or CAS from inception through September 2015. We included articles with CEA or CAS and systematic performance of preprocedural and postprocedural brain MRI and reporting of RBI and stroke incidence...
October 11, 2017: Neurology
https://www.readbyqxmd.com/read/29019319/the-asymptomatic-carotid-surgery-trial-2-acst-2-an-ongoing-randomised-controlled-trial-comparing-carotid-endarterectomy-with-carotid-artery-stenting-to-prevent-stroke
#7
Richard Bulbulia, Alison Halliday
BACKGROUND: A successful open surgical operation to remove atheromatous carotid artery narrowing that has not yet caused a stroke (asymptomatic carotid stenosis) carries some procedural risk but, if completed successfully, halves patients' future annual stroke risk for at least 10 years. A newer, less invasive alternative is carotid stenting, which also carries some procedural risk, especially if the carotid lesion has recently given rise to a stroke (symptomatic carotid stenosis). For both surgery and stenting, improvements in technique (and in medication) have reduced risk...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28994832/carotid-endarterectomy-for-treatment-of-carotid-in-stent-restenosis-long-term-follow-up-results-and-surgery-experiences-from-one-single-centre
#8
Le-Bao Yu, Wei Yan, Qian Zhang, Ji-Zong Zhao, Yan Zhang, Rong Wang, Jun-Shi Shao, Dong Zhang
OBJECTIVE: Few studies have reported the surgical treatment of carotid in-stent restenosis (ISR), more data and longer follow-up are needed. We describe the surgical treatment of ISR by standard carotid endarterectomy (CEA) with stent removal, including long-term follow-up in 10 patients from our centre. METHODS: Ten patients from our centre who underwent CEA with stent removal for ISR were retrospectively analysed, including nine symptomatic and one asymptomatic ISR of at least 70% with mean age 67...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28991720/cerebral-hyperperfusion-syndrome-and-intracranial-hemorrhage-after-carotid-endarterectomy-or-carotid-stenting-a-meta-analysis
#9
REVIEW
George Galyfos, Argiri Sianou, Konstantinos Filis
INTRODUCTION: Cerebral hyperperfusion syndrome (CHS) and intracranial hemorrhage (ICH) after carotid revascularization have been associated with significant morbidity and mortality, although pooled data comparing these outcomes between open and endovascular treatment are lacking. Aim of this meta-analysis is to compare CHS and ICH risk between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS). METHODS: A systematic literature review was conducted conforming to established criteria, in order to identify eligible articles published prior to February 2017...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28982691/carotid-stent-fractures-are-not-associated-with-adverse-events-results-from-the-act-1-multicenter-randomized-trial
#10
Ido Weinberg, Joshua A Beckman, Jon S Matsumura, Kenneth Rosenfield, Gary Ansel, Seemant Chaturvedi, William A Gray, D Chris Metzger, Tom S Riles, Yu Shu, Lawrence R Wechsler, Michael R Jaff
Background -The impact of carotid artery stent fractures on the incidence of adverse clinical events remains unclear. The objective of this study is to report the stent fracture rate and its association with in-stent restenosis and adverse outcomes in the Asymptomatic Carotid Trial (ACT)-1. Methods -ACT-1 is a prospective multicenter trial of standard surgical risk patients with severe asymptomatic carotid artery stenosis randomized to carotid artery stenting (CAS) or carotid endarterectomy (CEA) (Abbott Vascular, Santa Clara, California, USA)...
October 5, 2017: Circulation
https://www.readbyqxmd.com/read/28959490/abcd-2-risk-score-does-not-predict-the-presence-of-cerebral-microemboli-in-patients-with-hyper-acute-symptomatic-critical-carotid-artery-stenosis
#11
Mahmud Saedon, Charles E Hutchinson, Christopher H E Imray, Donald R J Singer
INTRODUCTION: ABCD(2) risk score and cerebral microemboli detected by transcranial Doppler (TCD) have been separately shown to the predict risk of recurrent acute stroke. We studied whether ABCD(2) risk score predicts cerebral microemboli in patients with hyper-acute symptomatic carotid artery stenosis. PARTICIPANTS AND METHODS: We studied 206 patients presenting within 2 weeks of transient ischaemic attack or minor stroke and found to have critical carotid artery stenosis (≥50%)...
June 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28943008/development-and-validation-of-a-score-to-predict-life-expectancy-after-carotid-endarterectomy-in-asymptomatic-patients
#12
Michele Carmo, Iacopo Barbetta, Daniele Bissacco, Santi Trimarchi, Vincenzo Catanese, Matteo Bonzini, Stefano Bonardelli, Piergiorgio G Settembrini
OBJECTIVE: Recent improvement of best medical treatment for carotid stenosis has sparked a debate on the role of surgery identification of patients who may benefit from carotid endarterectomy (CEA) is crucial to avoid overtreatment. An expected 5-year postoperative survival is one of the main selection criteria. The aim of this study was the development of a score for predicting survival of asymptomatic patients after CEA. METHODS: Our score was derived from a retrospective analysis of 648 consecutive asymptomatic patients from a single hospital...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28943006/outcomes-of-mini-incision-eversion-carotid-endarterectomy-combined-with-nontouch-isolation-technique-of-the-internal-carotid-artery
#13
Kota Shukuzawa, Takao Ohki, Yuji Kanaoka, Makoto Sumi, Koji Maeda, Naoki Toya, Hirotsugu Ozawa
OBJECTIVE: We developed a mini-incision eversion carotid endarterectomy (CEA) procedure (the Jikei method CEA) to prevent perioperative embolic stroke. The aim of this study was to retrospectively analyze perioperative and midterm outcomes after the Jikei method CEA. METHODS: We evaluated patients with the Jikei method CEA at our institution between January 2006 and June 2014. The primary end point was a major adverse event, which included death, stroke, intracranial hemorrhage, and myocardial infarction, within 30 days of CEA...
September 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28940441/quantitative-analysis-of-the-effect-of-end-tidal-carbon-dioxide-on-regional-cerebral-oxygen-saturation-in-patients-undergoing-carotid-endarterectomy-under-general-anaesthesia
#14
Seung-Hee Ki, Jin-Ho Rhim, Jae-Hong Park, Young-Jin Han, Yong-Pil Cho, Tae-Won Kwon, Byung-Moon Choi, Gyu-Jeong Noh
AIM: Regional cerebral oxygen saturation (rSO2 ) is currently the most used measure in clinical practice to monitor cerebral ischemia in patients undergoing carotid endarterectomy (CEA). Although end-tidal carbon dioxide (PET CO2 ) is known as a factor that influences rSO2 , the relationship between PET CO2 and rSO2 has not been quantitatively evaluated in patients with severe arteriosclerosis. This study aimed to evaluate the effect of PET CO2 on rSO2 in patients undergoing CEA under general anaesthesia...
September 23, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28931261/carotid-endarterectomy-in-patients-with-thrombocytopenia-analysis-of-the-national-surgical-quality-improvement-program-registry
#15
Adnan I Qureshi, Aiman Zafar, Muhammad Shah Miran, Vishal B Jani
BACKGROUND: Carotid endarterectomy (CEA) is infrequently performed in patients with mild to moderate thrombocytopenia. OBJECTIVE: To determine whether preoperative thrombocytopenia is associated with a higher rate of complications after CEA. METHODS: We analyzed patient characteristics, comorbid conditions, operative details, and 30-day postoperative outcomes for patients who underwent CEA in the CEA-targeted American College of Surgeons National Surgical Quality Improvement Program Registry...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28919267/post-carotid-endarterectomy-hypertension-part-2-association-with-peri-operative-clinical-anaesthetic-and-transcranial-doppler-derived-parameters
#16
Jeremy E Newman, Mathew J Bown, Robert D Sayers, Jonathan P Thompson, Thompson G Robinson, Bryan Williams, Ronney Panerai, Peter Lacy, A Ross Naylor
OBJECTIVE/BACKGROUND: The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH. METHODS: In total, 106 patients underwent carotid endarterectomy (CEA) under general anaesthesia...
September 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28916863/intracerebral-hemorrhage-as-a-manifestation-of-cerebral-hyperperfusion-syndrome-after-carotid-revascularization-systematic-review-and-meta-analysis
#17
REVIEW
Pedro Abreu, Jerina Nogueira, Filipe Brogueira Rodrigues, Ana Nascimento, Mariana Carvalho, Ana Marreiros, Hipólito Nzwalo
BACKGROUND: Intracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. METHODS: We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization...
September 15, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28894898/effective-collateral-circulation-may-indicate-improved-perfusion-territory-restoration-after-carotid-endarterectomy
#18
Tianye Lin, Zhichao Lai, Yuelei Lv, Jianxun Qu, Zhentao Zuo, Hui You, Bing Wu, Bo Hou, Changwei Liu, Feng Feng
OBJECTIVES: To investigate the relationship between the level of collateral circulation and perfusion territory normalisation after carotid endarterectomy (CEA). METHODS: This study enrolled 22 patients with severe carotid stenosis that underwent CEA and 54 volunteers without significant carotid stenosis. All patients were scanned with ASL and t-ASL within 1 month before and 1 week after CEA. Collateral circulation was assessed on preoperative ASL images based on the presence of ATA...
September 11, 2017: European Radiology
https://www.readbyqxmd.com/read/28893482/comparison-of-early-outcomes-and-restenosis-rate-between-carotid-endarterectomy-and-carotid-artery-stenting-using-propensity-score-matching-analysis
#19
Seon-Hee Heo, Kyoung-Won Yoon, Shin-Young Woo, Yang-Jin Park, Young-Wook Kim, Keon-Ha Kim, Chin-Sang Chung, Oh-Young Bang, Dong-Ik Kim
OBJECTIVE/BACKGROUND: Despite randomised evidence, the debate continues about the preferred treatment strategy for carotid stenosis in routine clinical practice. The aim of this study was to compare early outcomes and restenosis rates after carotid endarterectomy (CEA) and carotid stenting (CAS) in unselected patients using propensity score matching (PSM). METHODS: The 30 day incidence of major adverse clinical events (MACE; defined as stroke, transient ischaemic attack, myocardial infarction, or death) and procedure related complications, as well as restenosis rates during follow-up were compared between unselected patients undergoing CEA or CAS between January 2002 and December 2015 at a single institution...
September 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28890063/the-value-of-carotid-endarterectomy-as-a-learning-tool-for-trainees
#20
L M Cacioppa, R Pini, M Longhi, A Vacirca, E Gallitto, G L Faggioli, M Gargiulo, A Stella
INTRODUCTION: Carotid endarterectomy (CEA) intervention needs a specific training and a sufficient learning curve to obtain optimal results in terms of outcome. A formative program was settled up in a single academic center in order to optimize training of standard CEA procedures. This study aims to evaluate the 11-year results of the teaching CEA program. METHODS: The trainees CEA teaching program is carried on during the 5-year vascular surgery residency period and it is stratified as follows: learning theory and intervention assistance (minimum 50 procedures per-year) in the first and second residency-year; performing CEA as second operator in the third and fourth residency-year (minimum 50 procedures per-year); CEA execution as first operator with attending supervision in the last residency-year...
September 7, 2017: Annals of Vascular Surgery
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