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carotid endarterectomy(CEA)

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https://www.readbyqxmd.com/read/29663514/combined-carotid-endarterectomy-and-transcatheter-aortic-valve-replacement-technique-and-outcomes
#1
Robert J Moraca, Anil A Shah, Stephen H Bailey, Daniel Benckart, David Lasorda, Ramzi Khalil, Bart Chess, Walter McGregor, Michael S Halbreiner
BACKGROUND: Stroke and transient ischemic attack after transcatheter aortic valve replacement results in significantly higher morbidity and mortality. Severe carotid artery disease may be a contributing factor to this increased risk. We report our technique and outcomes of combined carotid endarterectomy (CEA) with transcatheter aortic valve replacement (TAVR). METHODS: From March 2013 to November 2017 a total of 753 TAVRs were performed at our institution for symptomatic severe aortic stenosis...
April 16, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29643966/cosmetic-effects-of-skin-crease-camouflage-incision-versus-longitudinal-incision-following-carotid-endarterectomy
#2
Arkadiusz Kazimierczak, Anita Rybicka, Pawel Rynio, Piotr Gutowski, Ireneusz Wiernicki
Introduction: Despite the increasing use of carotid angioplasty and stenting (CAS), carotid endarterectomy (CEA) nonetheless remains a more medically beneficial method of treatment for carotid artery stenosis. Therefore, one possibility for progress within this procedure may be to use minimally invasive carotid surgery, especially when the scar is in plain sight: the use of the natural wrinkles (skin crease) as a camouflage of the skin incision provides significant cosmetic improvements...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29628544/anesthetic-considerations-for-carotid-endarterectomy-a-postgraduate-educational-review
#3
REVIEW
Ahmed Yousef A Al Sultan, Abdulrahman Mawadh A Alsubhi
Carotid endarterectomy (CEA) has shown a significant benefit in preventing ipsilateral stroke when it is compared to conservative management. Surgical morbidity and mortality must be kept to a minimum to achieve this benefit. Neurological status of the CEA patients can be monitored easily during regional anesthesia depending on the awake testing (neurocognitive assessment) method of the CEA patients. In addition, specific parameters can help us to monitor and to predict the neurological status of the CEA patients during the procedures such as regional cerebral oxygen saturation (rSO2 ) and middle cerebral artery velocity (MCAv) changes...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29622356/risk-and-outcome-profile-of-carotid-endarterectomy-with-proximal-intervention-is-concerning-in-multi-institutional-assessment
#4
W Darrin Clouse, Emel A Ergul, Zachary J Wanken, Julia Kleene, David H Stone, R Clement Darling, Richard P Cambria, Mark F Conrad
OBJECTIVE: Approaching tandem bifurcation and brachiocephalic disease using carotid endarterectomy (CEA) with ipsilateral proximal endovascular intervention (IPE) has been promulgated as safe and durable. There have been recent concerns about neurologic risk with this technique. The goal of this study was to define stroke and perioperative risk with this uncommon procedure across multiple centers. METHODS: Between August 2002 and July 2016, patients who underwent CEA + IPE were identified by operative records at three institutions...
April 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29619341/right-carotid-cutaneous-fistula-and-right-carotid-pseudoaneurysm-formation-secondary-to-a-chronically-infected-polyethylene-terephthalate-patch
#5
W T Hillman Terzian, Samuel Schadt, Sharvil U Sheth
Carotid endarterectomy (CEA) remains the treatment for significant carotid stenosis and stroke prevention. Approximately 100,000 CEAs are performed in the United States every year. Randomized trials have demonstrated an advantage of patch carotid angioplasty over primary closure. Complications from patches include thrombosis, transient ischemic attack, stroke, restenosis, pseudoaneurysm (PA), and infection. PA after CEA is rare, with a reported average of 0.37% of cases. We describe an unusual case of PA after polyethylene terephthalate (PTFE) patching for CEA...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29615352/long-term-comparative-effectiveness-of-carotid-stenting-versus-carotid-endarterectomy-in-a-large-tertiary-care-vascular-surgery-practice
#6
Robert P Garvin, Evan J Ryer, Andrea L Berger, James R Elmore
OBJECTIVE: Carotid interventional trials have strict inclusion and exclusion criteria that make translation of their results to the real-world population challenging. Furthermore, the specialty of the operating surgeon and the role of clinical decision-making are not well studied. This study compares the effectiveness of carotid endarterectomy (CEA) vs carotid artery stenting (CAS) in a real-world setting when the procedure is performed by fellowship-trained vascular surgeons. METHODS: A retrospective study was conducted of all consecutive patients undergoing CEA and CAS performed by vascular surgeons in a large rural tertiary health care system from 2004 to 2014...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29610601/carotid-endarterectomy-in-women-versus-man-patient-characteristics-and-perioperative-complication-30-day
#7
Muhamed Djedović, Bilal Imširović, Samed Djedović, Amel Hadžimehmedagić, Haris Vukas, Bekir Rovčanin, Ibrahim Kamenjašević
AIM: Compare the basic characteristics of patients and to examine the existence of higher rates of perioperative complications (0 - 30 days) in women versus men after carotid endarterectomy (CEA). METHODS: This is a retrospective-prospective study included 270 patients with significant stenosis of carotid in whom CEA was performed, during the period from 2012 to 2017. Patients they were divided: group 1 - 100 female patients, group 2 - 170 male patients. RESULTS: No statistically significant age difference was observed between the two groups, group 1 - 66...
March 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29601328/statin-loading-in-cardiovascular-surgery-never-too-early-to-treat
#8
Niki Katsiki, Filippos Triposkiadis, Athanasios D Giannoukas, Dimitri P Mikhailidis
PURPOSE OF REVIEW: The effects of statin loading before, during or after vascular interventions on cardiovascular and renal outcomes are discussed. Furthermore, the selection of optimal statin type and dose, according to current evidence or guidelines, is considered. The importance of treating statin intolerance and avoiding statin discontinuation is also discussed. RECENT FINDINGS: Statin loading has been shown to beneficially affect cardiovascular outcomes, total mortality and/or contrast-induced acute kidney injury, in patients undergoing vascular procedures such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CEA), carotid artery stenting, endovascular aneurysm repair, open abdominal aortic aneurysms (AAA) repair and lower extremities vascular interventions...
March 29, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29600890/preoperative-brain-temperature-imaging-on-proton-magnetic-resonance-spectroscopy-predicts-hemispheric-ischemia-during-carotid-endarterectomy-for-unilateral-carotid-stenosis-with-inadequate-collateral-blood-flow
#9
Shouta Tsutsui, Takamasa Nanba, Yoshichika Yoshioka, Makoto Sasaki, Shunrou Fujiwara, Masakazu Kobayashi, Kenji Yoshida, Kenya Miyoshi, Shinpei Sato, Kuniaki Ogasawara
Objective Preoperative magnetic resonance (MR) angiography sometimes shows the absence of collateral flow via the circle of Willis. This study examined whether brain temperature (BT) imaging on multi-voxel proton MR spectroscopy after this finding increases the accuracy of predicting hemispheric ischemia during internal carotid artery (ICA) clamping during endarterectomy for patients with symptomatic unilateral carotid stenosis. Methods In 52 patients with ICA stenosis (≥70%) and absence of collateral blood flow via the circle of Willis on preoperative MR angiography, BT imaging was displayed using proton multi-voxel MR spectroscopy...
March 30, 2018: Neurological Research
https://www.readbyqxmd.com/read/29571763/plaque-characteristics-of-patients-with-symptomatic-mild-carotid-artery-stenosis
#10
Hiroki Takai, Juniti Uemura, Yoshiki Yagita, Yukari Ogawa, Keita Kinoshita, Satoshi Hirai, Manabu Ishihara, Keijirou Hara, Hiroyuki Toi, Shunji Matsubara, Hirotake Nishimura, Masaaki Uno
BACKGROUND: Carotid revascularization may be considered for severe stenosis, but its use for symptomatic mild stenosis (<50%) with vulnerable plaque or ulcer remains uncertain. The characteristics of patients with symptomatic mild stenosis who underwent revascularization are reviewed. METHODS: The subjects of this study were 18 patients with symptomatic mild stenosis (<50%) on angiography from among 175 patients who underwent revascularization in our department...
March 20, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29571620/regional-variation-in-patient-outcomes-in-carotid-artery-disease-treatment-in-the-vascular-quality-initiative
#11
Katie E Shean, Thomas F X O'Donnell, Sarah E Deery, Alexander B Pothof, Joseph R Schneider, Caron B Rockman, Brian W Nolan, Marc L Schermerhorn
OBJECTIVE: Quality metrics were developed to improve outcomes after carotid artery revascularization; however, few studies have evaluated regional differences in perioperative outcomes. This study aimed to evaluate regional variation in mortality and perioperative outcomes after carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We identified all patients who underwent CEA or CAS from 2009 to 2016 in the Vascular Quality Initiative. Patients were analyzed on the basis of their symptom status...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29559195/safety-of-stenting-and-endarterectomy-for-asymptomatic-carotid-artery-stenosis-a-meta-analysis-of-randomised-controlled-trials
#12
REVIEW
Likun Cui, Yanshuo Han, Shuai Zhang, Xun Liu, Jian Zhang
OBJECTIVE/BACKGROUND: A meta-analysis of recently published randomised controlled trials (RCTs) was performed to evaluate the safety of carotid artery stenting (CAS) versus carotid endarterectomy (CEA) for asymptomatic carotid stenosis with average risk. METHODS: The MEDLINE, Embase, and Cochrane Library databases were systematically searched for RCTs that compared CAS with CEA for asymptomatic carotid stenosis. These publications reported clinical outcomes after revascularisation in patients with asymptomatic carotid stenosis during their primary intervention...
March 17, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29555399/noninvasive-assessment-of-carotid-plaques-calcification-by-18-f-sodium-fluoride-accumulation-correlation-with-pathology
#13
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
https://www.readbyqxmd.com/read/29554858/racial-and-socioeconomic-disparities-after-carotid-procedures
#14
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
https://www.readbyqxmd.com/read/29549284/the-middle-term-outcome-of-carotid-endarterectomy-and-stenting-for-treatment-of-ischemic-stroke-in-chinese-patients
#15
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
https://www.readbyqxmd.com/read/29535395/systematic-review-and-network-meta-analysis-of-treatment-strategies-for-asymptomatic-carotid-disease
#16
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
https://www.readbyqxmd.com/read/29535017/hybrid-treatment-of-tandem-common-carotid-innominate-artery-and-ipsilateral-carotid-bifurcation-stenoses-by-simultaneous-retrograde-proximal-stenting-and-eversion-carotid-endarterectomy-preliminary-results-of-a-case-series
#17
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
https://www.readbyqxmd.com/read/29519202/carotid-pseudoaneurysm-after-eversion-endarterectomy-a-case-report-and-review-of-the-literature
#18
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
https://www.readbyqxmd.com/read/29503393/treatment-strategy-based-on-plaque-vulnerability-and-the-treatment-risk-evaluation-for-internal-carotid-artery-stenosis
#19
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
https://www.readbyqxmd.com/read/29503001/scoring-system-to-predict-early-carotid-restenosis-after-eversion-endarterectomy-by-analysis-of-inflammatory-markers
#20
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
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