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carotid endarterectomy(CEA)

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https://www.readbyqxmd.com/read/28323231/carotid-endarterectomy-in-the-southern-california-vascular-outcomes-improvement-collaborative
#1
Kaelan Chan, Ahmed Abouzamzam, Karen Woo
OBJECTIVE: The objective of this study is to examine the variation in practice patterns and associated outcomes for carotid endarterectomy (CEA) within the Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe), a regional quality group of the Vascular Quality Initiative (VQI). METHODS: All cases entered in the CEA registry by the So Cal VOICe were included in the study. RESULTS: From September 2010 through September 2015, 1110 CEA cases were entered by nine centers in the So Cal VOICe...
March 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28318997/diastolic-blood-pressure-is-a-risk-factor-for-peri-procedural-stroke-following-carotid-endarterectomy-in-asymptomatic-patients
#2
D D de Waard, G J de Borst, R Bulbulia, A Huibers, A Halliday
OBJECTIVE/BACKGROUND: Carotid endarterectomy (CEA) prevents future stroke, but this benefit depends on detection and control of high peri-operative risk factors. In symptomatic patients, diastolic hypertension has been causally related to procedural stroke following CEA. The aim was to identify risk factors causing peri-procedural stroke in asymptomatic patients and to relate these to timing of surgery and mechanism of stroke. METHODS: In the first Asymptomatic Carotid Surgery Trial (ACST-1), 3,120 patients with severe asymptomatic carotid stenosis were randomly assigned to CEA plus medical therapy or to medical therapy alone...
March 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28318956/carotid-endarterectomy-to-remove-retained-solitaire-stent-retriever-inside-carotid-stent-after-mechanical-thrombectomy
#3
Mary In-Ping Huang Cobb, Tony P Smith, Patrick A Brown, L Fernando Gonzalez, Ali R Zomorodi
BACKGROUND: Tandem occlusions of the internal carotid artery (ICA) and middle cerebral artery (MCA) occur in up to a third of patients with acute ischemic strokes undergoing endovascular mechanical thrombectomy. Understanding open neurosurgical management of associated complications with this procedure is important. CASE REPORT: A 67-year-old man with acute onset of left hemiparesis and a tandem right ICA and MCA occlusion. He underwent carotid stent angioplasty of a stenotic ICA, followed by attempted Solitaire stent retrieval of an MCA clot...
March 16, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28318887/multi-focus-beamforming-for-thermal-strain-imaging-using-a-single-ultrasound-linear-array-transducer
#4
Man M Nguyen, Xuan Ding, Steven A Leers, Kang Kim
Ultrasound-induced thermal strain imaging (TSI) has been used successfully to identify lipid- and water-based tissues in atherosclerotic plaques in some research settings. However, TSI faces several challenges to be realized in clinics. These challenges include motion artifacts and displacement tracking accuracy, as well as limited heating capability, which contributes to low thermal strain signal-to-noise ratio, and a limited field of view. Our goal was to address the challenge in heating tissue in TSI. Current TSI systems use separate heating and imaging transducers, which require physical alignment of the heating and imaging beams and result in a bulky setup that limits in vivo operation...
March 15, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28289241/symptomatic-patients-remain-at-substantial-risk-of-arterial-disease-complications-before-and-after-endarterectomy-or-stenting
#5
Cristina Hobeanu, Philippa C Lavallée, Peter M Rothwell, Leila Sissani, Gregory W Albers, Natan M Bornstein, Louis R Caplan, Geoffrey A Donnan, José M Ferro, Michael G Hennerici, Julien Labreuche, Carlos Molina, Philippe Gabriel Steg, Pierre-Jean Touboul, Shinichiro Uchiyama, Éric Vicaut, Lawrence K S Wong, Pierre Amarenco
BACKGROUND AND PURPOSE: After carotid endarterectomy (CEA) or carotid artery stenting (CAS) in patients with transient ischemic attack or minor ischemic stroke, recurrent stroke risk falls to a low rate on modern medical treatment. METHODS: We used data from 4583 patients with recent transient ischemic attack or minor stroke enrolled in the TIAregistry.org to perform a nested case-control analysis to evaluate pre- and post-CEA/CAS risk. Cases were defined as patients with a CEA/CAS during the 1-year follow-up period...
March 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28268107/prosthetic-bypass-for-restenosis-after-endarterectomy-or-stenting-of-the-carotid-artery
#6
Giulio Illuminati, Romain Belmonte, Fabrice Schneider, Giulia Pizzardi, Francesco G Calió, Jean-Baptiste Ricco
OBJECTIVE: The objective of this study was to evaluate the results of prosthetic carotid bypass (PCB) with polytetrafluoroethylene (PTFE) grafts as an alternative to carotid endarterectomy (CEA) in treatment of restenosis after CEA or carotid artery stenting (CAS). METHODS: From January 2000 to December 2014, 66 patients (57 men and 9 women; mean age, 71 years) presenting with recurrent carotid artery stenosis ≥70% (North American Symptomatic Carotid Endarterectomy Trial [NASCET] criteria) were enrolled in a prospective study in three centers...
March 4, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28268070/post-carotid-endarterectomy-hypertension-part-1-association-with-pre-operative-clinical-imaging-and-physiological-parameters
#7
J E Newman, M J Bown, R D Sayers, J P Thompson, T G Robinson, B Williams, R Panerai, P Lacy, A R Naylor
OBJECTIVE/BACKGROUND: Post-endarterectomy hypertension (PEH) is a well recognised, but poorly understood, phenomenon after carotid endarterectomy (CEA) that is associated with post-operative intracranial haemorrhage, hyperperfusion syndrome, and cardiac complications. The aim of the current study was to identify pre-operative clinical, imaging, and physiological parameters associated with PEH. METHODS: In total, 106 CEA patients undergoing CEA under general anaesthesia underwent pre-operative evaluation of 24 hour ambulatory arterial blood pressure (BP), baroreceptor sensitivity, cerebral autoregulation, and transcranial Doppler measurement of cerebral blood flow velocity (CBFv) and pulsatility index...
March 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28267525/relationship-between-white-matter-hyperintensities-volume-and-the-circle-of-willis-configurations-in-patients-with-carotid-artery-pathology
#8
Luca Saba, Roberto Sanfilippo, Michele Porcu, Pierleone Lucatelli, Roberto Montisci, Fulvio Zaccagna, Jasjit Suri, Michele Anzidei, Max Wintermark
PURPOSE: We aimed to assess if there is a difference of distribution and volume of white matter hyperintensities (WMH) in the brain according to the Circle of Willis (CoW) configuration in patients with carotid artery pathology. MATERIAL AND METHODS: One-hundred consecutive patients (79 males, 21 females; mean age 70 years; age range 46-84 years) that underwent brain MRI before carotid endarterectomy (CEA) were included. FLAIR-WMH lesion volume was performed using a semi-automated segmentation technique and the status of the circle of Willis was assessed by two neuroradiologists in consensus...
April 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28259574/a-comparison-of-results-of-carotid-endarterectomy-in-octogenarians-and-nonagenarians-to-younger-patients-from-the-mid-america-vascular-study-group-and-the-society-for-vascular-surgery-vascular-quality-initiative
#9
Joseph R Schneider, Cheryl R Jackson, Irene B Helenowski, Michael J Verta, Julia B Wilkinson, Stanley Kim, Andrew W Hoel
OBJECTIVE: Carotid endarterectomy (CEA) reduces stroke risk in selected patients. However, CEA risk profile may be different in older patients. We compared characteristics and outcomes of octogenarians and nonagenarians with those of younger patients. METHODS: Deidentified data from CEA patients were obtained from the Society for Vascular Surgery Vascular Quality Initiative (VQI) database. Prior CEA, carotid artery stent, or combined CEA and coronary artery bypass were excluded, yielding 7390 CEAs in octogenarians and nonagenarians (≥80 years of age) and 35,303 CEAs in younger patients (<80 years of age)...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28238871/utility-of-the-lone-star%C3%A2-retractor-system-in-microsurgical-carotid-endarterectomy-technical-notes
#10
Shingo Toyota, Tetsuya Kumagai, Tetsu Goto, Kanji Mori, Takuyu Taki
BACKGROUND: The retractor system is an important device in carotid endarterectomy (CEA). We applied the Lone Star® (LS) retractor system, which is a self-retaining retractor originally designed for improved visualization in many other surgical fields, in microsurgical CEA. METHODS: The LS disposal retractor (14.1 cm x 14.1 cm) and LS elastic stays (5mm sharp hook) were utilized as a retractor system in 38 consecutive CEAs. RESULTS: Using the LS retractor system, a shallow operative field could be obtained by lifting up the connective tissue surrounding the deep structures hooked by the LS elastic stays...
February 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28236927/systematic-review-and-meta-analysis-of-postcarotid-endarterectomy-hypertension-after-eversion-versus-conventional-carotid-endarterectomy
#11
REVIEW
Serdar Demirel, Käthe Goossen, Hans Bruijnen, Pascal Probst, Dittmar Böckler
OBJECTIVE: Blood pressure (BP) instability after carotid endarterectomy (CEA) is a risk factor for cerebrovascular and cardiovascular complications. The role of the operative technique in the development of post-CEA hemodynamic instability is unclear. The primary goal of this study was to systematically review the literature to determine whether hypertension in the early postoperative period is dependent on the surgical technique used. METHODS: We searched MEDLINE, Cochrane CENTRAL, and Web of Science through June 2016 without restrictions to language or starting date...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28236921/targeting-the-most-important-complications-in-vascular-surgery
#12
Kyla M Bennett, K Craig Kent, Jessica Schumacher, Caprice C Greenberg, John E Scarborough
OBJECTIVE: This study was conducted to identify the most clinically relevant and costly perioperative complications occurring in vascular surgery patients. METHODS: The analysis included patients in the 2012 to 2014 National Surgical Quality Improvement Program database undergoing one of four high-risk vascular procedures. The procedures-aortic reconstruction, lower extremity bypass, lower extremity amputation, and carotid endarterectomy (CEA)-were selected because they have been established as high risk in the literature, rendering them natural targets for quality improvement initiatives...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28236597/cognitive-change-1-year-after-cea-or-cas-compared-with-medication
#13
Junko Watanabe, Toshiyasu Ogata, Toshio Higashi, Tooru Inoue
BACKGROUND: Whether improvement of cognitive function can be maintained remains controversial. AIMS: This study aimed to investigate cognitive changes between before carotid endarterectomy (CEA) or carotid artery stenting (CAS) and 1 year after intervention using cognitive evaluation tools. METHODS: Patients suspected as having carotid stenosis were prospectively registered for evaluation of cognitive function from October 2011 to December 2013 in the Department of Neurosurgery, Fukuoka University Hospital...
February 21, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28216356/fixed-and-variable-cost-of-carotid-endarterectomy-and-stenting-in-the-united-states-a-comparative-study
#14
Tammam Obeid, Husain Alshaikh, Besma Nejim, Isibor Arhuidese, Satinderjit Locham, Mahmoud Malas
OBJECTIVE: Despite multiple landmark clinical trials, little data exists on real-world cost of carotid artery stenting (CAS) and carotid endarterectomy (CEA) to the United States healthcare system. We aim to study differences in actual hospitalization cost between patients who underwent CAS vs CEA in a nationally representative database. METHODS: We studied hospital discharge and billing records of all patients, in the Premier Perspective Database, who underwent CEA or CAS between the third quarter of 2009 and the first quarter of 2015...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28214642/short-term-results-of-carotid-endarterectomy-and-stenting-after-the-introduction-of-carotid-magnetic-resonance-imaging-a-single-institutional-retrospective-study
#15
Ryu Fukumitsu, Kazumichi Yoshida, Yoshitaka Kurosaki, Koichi Torihashi, Nobutake Sadamasa, Masaomi Koyanagi, Osamu Narumi, Tsukasa Sato, Masaki Chin, Akira Handa, Sen Yamagata, Susumu Miyamoto
OBJECTIVE: While carotid artery stenting (CAS) has been gaining popularity as an alternative to carotid endarterectomy (CEA), the perioperative stroke rate following contemporary CAS remains significantly higher than that in CEA. The purpose of this study was to assess perioperative (within 30-day) therapeutic results in patients with carotid stenosis (CS) after the introduction of preoperative carotid magnetic resonance plaque evaluation in a single center offering both CEA and CAS. METHODS: Based on prospectively collected data for patients with CS who were scheduled for carotid revascularization, retrospective analysis was conducted of 295 consecutive CS patients...
February 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28203558/cerebral-monitoring-during-carotid-endarterectomy-by-transcranial-doppler-ultrasonography
#16
Woo-Sung Yun
PURPOSE: To evaluate the efficacy and safety of cerebral monitoring by transcranial Doppler ultrasonography (TCD) for the detection of cerebral ischemia during carotid endarterectomy (CEA). METHODS: From August 2004 to December 2013, 159 CEAs were performed in a tertiary hospital. All procedures were performed under general anesthesia. Intraoperative TCD was routinely used to detect cerebral ischemia. Of the 159 patients, 102 patients were included in this study, excluding 27 patients who had a poor transtemporal isonation window and 30 patients who used additional cerebral monitoring systems such as electroencephalography or somatosensory evoked potentials...
February 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28202829/-treatment-strategy-and-results-of-carotid-endarterectomy-in-chronic-renal-failure-patients
#17
Takeo Murahashi, Kenji Kamiyama, Toshiaki Osato, Toshiichi Watanabe, Tatsuya Ogino, Hironori Sugio, Hideki Endo, Kazuki Takahira, Koichiro Shindo, Shuhei Takahashi, Hirohiko Nakamura
INTRODUCTION: The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. METHODS: The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014...
February 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28190720/endarterectomy-versus-stenting-in-patients-with-prior-ipsilateral-carotid-artery-stenting
#18
Isibor J Arhuidese, Besma Nejim, Susruth Chavali, Satinderjit Locham, Tammam Obeid, Caitlin W Hicks, Mahmoud B Malas
OBJECTIVE: In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perform an evaluation of redo-CAS vs CEA in a large contemporary cohort of patients who underwent prior ipsilateral CAS. METHODS: We studied all patients in the Vascular Quality Initiative (VQI) database, who underwent CEA or CAS between January 1, 2003, and April 30, 2016, after prior ipsilateral CAS...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190714/carotid-endarterectomy-should-not-be-based-on-consensus-statement-duplex-velocity-criteria
#19
Jesse A Columbo, Bjoern D Suckow, Claire L Griffin, Jack L Cronenwett, Philip P Goodney, Timothy G Lukovits, Robert M Zwolak, Mark F Fillinger
OBJECTIVE: Randomized trials support carotid endarterectomy (CEA) in asymptomatic patients with ≥60% internal carotid artery (ICA) stenosis. The widely referenced Society for Radiologists in Ultrasound Consensus Statement on carotid duplex ultrasound (CDUS) imaging indicates that an ICA peak systolic velocity (PSV) ≥230 cm/s corresponds to a ≥70% ICA stenosis, leading to the potential conclusion that asymptomatic patients with an ICA PSV ≥230 cm/s would benefit from CEA. Our goal was to determine the natural history stroke risk of asymptomatic patients who might have undergone CEA based on consensus statement PSV of ≥230 cm/s but instead were treated medically based on more conservative CDUS imaging criteria...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28188324/-regional-anesthesia-for-carotid-surgery-an-overview-of-anatomy-techniques-and-their-clinical-relevance
#20
A Koköfer, J Nawratil, M Opperer
BACKGROUND: Perioperative care for patients undergoing carotid endarterectomy (CEA) often presents a challenge to the anesthesia provider, as this patient group commonly suffers from a wide range of comorbidities. Although clinical trials could not demonstrate a significant benefit associated with regional anesthesia for outcomes such as insult, cardiac infarction or mortality, many authors concur that regional anesthetic techniques might be preferential in specific patient populations for this type of surgery...
February 10, 2017: Der Anaesthesist
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