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carotid endarterectomy(CEA)

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https://www.readbyqxmd.com/read/28632941/systematic-review-of-carotid-artery-procedures-and-the-volume-outcome-relationship-in-europe
#1
REVIEW
P Phillips, E Poku, M Essat, H B Woods, E A Goka, E C Kaltenthaler, P Shackley, S Walters, J A Michaels
BACKGROUND: Hospitals that conduct more procedures on the carotid arteries may achieve better outcomes. In the context of ongoing reconfiguration of UK vascular services, this systematic review was conducted to evaluate the relationship between the volume of carotid procedures and outcomes, including mortality and stroke. METHODS: Searches of electronic databases identified studies that reported the effect of hospital or clinician volume on outcomes. Reference and citation searches were also performed...
June 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28623598/cost-effectiveness-of-two-decision-strategies-for-shunt-use-during-carotid-endarterectomy
#2
Joe L P Kolkert, Rolf H H Groenwold, Vanessa J Leijdekkers, Joep Ter Haar, Clark J Zeebregts, Anco Vahl
BACKGROUND: Arterial shunting during carotid endarterectomy (CEA) is essential in some patients because of insufficient cerebral perfusion during cross-clamping. However, the optimal diagnostic modality identifying these patients is still debated. None of the currently used modalities has been proved superior to another. The aim of this study was to assess the cost-effectiveness of two modalities, stump pressure measurement (SPM) versus electroencephalography (EEG) combined with transcranial Doppler (TCD) during CEA...
June 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28623378/carotid-stenting-in-neuroradiology-a%C3%A2-short-journey-from-the-past-to-current-debates
#3
REVIEW
Joachim Berkefeld, Marlies Wagner, Richard du Mesnil
After a period of stagnation due to negative results of randomized trials for patients with symptomatic stenosis, the relevance of carotid artery stenting (CAS) is increasing again. CAS has become an important and evidence-based part of interventional stroke treatment. Our ability to manage acute recanalization of carotid occlusions and other niche indications properly led some skeptical neurologists to trust in carotid intervention for elective cases as well. The evolution of CAS from initial euphoria to more realistic views under consideration of trial results and guidelines is reviewed...
June 16, 2017: Clinical Neuroradiology
https://www.readbyqxmd.com/read/28611148/failure-to-account-for-practice-effects-leads-to-clinical-misinterpretation-of-cognitive-outcome-following-carotid-endarterectomy
#4
Christopher J Marley, Andrew Sinnott, Judith E Hall, Gareth Morris-Stiff, Paul V Woodsford, Michael H Lewis, Damian M Bailey
Carotid endarterectomy (CEA) is a surgical procedure to remove stenotic atherosclerotic plaque from the origin of the carotid artery to reduce the risk of major stroke. Its impact on postoperative cognitive function (POCF) remains controversial; complicated, in part, by a traditional failure to account for practice effects incurred during consecutive psychometric testing. To address this for the first time, we performed psychometric testing (learning and memory, working memory, attention and information processing, and visuomotor coordination) in 15 male patients aged 68 ± 8 years with symptomatic carotid stenosis the day before and 24 h following elective CEA (two consecutive tests, 48 h apart)...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28604285/hybrid-treatment-of-extracranial-carotid-artery-disease
#5
Joseph Bozzay, Mike Broce, Albeir Y Mousa
OBJECTIVE: High-degree stenosis of both innominate (IA) or left common carotid artery (CCA) and carotid bifurcation is uncommon but still represents a significant challenge to interventionists in many aspects including techniques, timing, and priority. There are several strategies for intervention that have been reported in the literature. A well-described, less-invasive strategy for extracranial tandem carotid lesions is concomitant carotid endarterectomy (CEA) with retrograde carotid angioplasty and stenting (CAS)...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28594795/-assessing-efficacy-of-carotid-endarterectomy-by-means-of-intraoperative-flowmetry
#6
V A Luk'ianchikov, A S Tokarev, N A Polunina, O Iu Nakhabin, E V Udodov, V A Dalibaldian, A V Sytnik, V V Krylov
AIM: The study was aimed at determining volumetric blood flow velocity (VBFV) through the internal carotid artery (ICA) and assessing functional outcomes of treatment of patients, taking into consideration the dynamics of VBFV before and after the operation. PATIENTS AND METHODS: The study comprised a total of 53 patients subjected to examination of VBFV through the ICA before and after carotid endarterectomy (CEA) assessed by means of flowmetry. Neurological deficit was evaluated by means of the NIHS Scale (the M NIHSS prior to operation equalling 2...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28585145/correlation-of-enhancement-degree-on-contrast-enhanced-ultrasound-with-histopathology-of-carotid-plaques-and-serum-high-sensitive-c-reactive-protein-levels-in-patients-undergoing-carotid-endarterectomy
#7
Li Xiong, Wei-Jun Sun, Hua-Ying Cai, Yuan Yang, Jiang Zhu, Bo-Wen Zhao
This study was undertaken to investigate the correlation of the enhancement degree on contrast-enhanced ultrasound (CEUS) with the histopathology of carotid plaques and the serum high sensitive C-reactive protein (hs-CRP) levels in patients undergoing carotid endarterectomy (CEA). Carotid CEUS was performed preoperatively in 115 patients who would undergo CEA, and the enhancement degree of the carotid plaques was evaluated by both the visual semiquantitative analysis and the quantitative time-intensity curve analysis...
June 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/28584353/lactate-pyruvate-monitoring-during-carotid-endarterectomy-under-general-anaesthesia-versus-cervical-plexus-block-a-randomised-controlled-study
#8
Gomaa Z Hussien, Ahmed M Elbadawy, Hossam A Elshamaa
BACKGROUND AND AIMS: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with significant carotid stenosis and may be performed under general anaesthesia (GA) or regional anaesthesia (RA). This study aimed to compare RA and GA with regard the jugular venous bulb blood lactate and pyruvate levels. METHODS: This randomised-controlled trial was done between October-2013 and September-2015. Thirty-six patients were randomised into either GA or RA groups, with six excluded after randomisation...
May 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28584227/quantitative-analysis-of-lipid-rich-necrotic-core-in-carotid-atherosclerotic-plaques-by-in-vivo-magnetic-resonance-imaging-and-clinical-outcomes
#9
Jun Xia, Anyu Yin, Zhenzhou Li, Xin Liu, Xianghong Peng, Ni Xie
BACKGROUND The aim of this study was to explore the accuracy of in vivo magnetic resonance imaging (MRI) in the quantitative evaluation of lipid-rich necrotic core (LRNC) in carotid atherosclerotic plaques compared with histopathology, and to assess the association of LRNC size with cerebral ischemia symptoms. MATERIAL AND METHODS Thirty patients were enrolled and 19 patients (16 men and 3 women) were analyzed. All the patients were submitted to MRI on a Siemens Avanto (1.5-Tesla) device before carotid endarterectomy (CEA)...
June 6, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28583737/development-of-a-validated-model-to-predict-30-day-stroke-and-1-year-survival-after-carotid-endarterectomy-for-asymptomatic-stenosis-using-the-vascular-quality-initiative
#10
Randall R DeMartino, Benjamin S Brooke, Dan Neal, Adam W Beck, Mark F Conrad, Shipra Arya, Sapan Desai, Faisal Aziz, Patrick Ryan, Jack L Cronenwett, Larry W Kraiss
OBJECTIVE: Carotid endarterectomy (CEA) has been shown to be an effective treatment for patients with asymptomatic carotid artery stenosis when perioperative stroke rates are low and patients survive long enough to benefit from the intervention. Our objective was to develop and to validate a simple risk prediction model for 30-day stroke and 1-year mortality to guide optimal selection of patients for CEA. METHODS: Asymptomatic patients undergoing first-time elective CEA within the Vascular Quality Initiative (VQI) from 2010 to 2015 were selected...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28577790/impact-of-provider-characteristics-on-outcomes-of-carotid-endarterectomy-for-asymptomatic-carotid-stenosis-in-new-york-state
#11
Andrew J Meltzer, Christopher Agrusa, Peter H Connolly, Darren B Schneider, Art Sedrakyan
OBJECTIVE: (s)The purpose of this study was to explore the impact of surgeon characteristics (including annual volume, specialty, and years in practice) on outcomes of carotid endarterectomy (CEA) for asymptomatic carotid atherosclerosis in New York State. METHODS: The New York Statewide Planning and Cooperation System (SPARCS) database was utilized to identify patients undergoing CEA from 2004-2011. Provider characteristics were determined by linkage to the New York Office of Professions and National Provider Identification databases...
May 31, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28575478/the-preservation-of-cognition-1-yr-after-carotid-endarterectomy-in-patients-with-prior-cognitive-decline
#12
Robert J Dempsey, Daren C Jackson, Stephanie M Wilbrand, Carol C Mitchell, Sara E Berman, Sterling C Johnson, Nirvedh H Meshram, Tomy Varghese, Bruce P Hermann
BACKGROUND: Vascular cognitive decline is critically important in the course of atherosclerosis and stroke. OBJECTIVE: To explore the hypothesis that carotid endarterectomy (CEA) by removing an unstable plaque may slow the course of vascular cognitive decline in both symptomatic and asymptomatic patients. METHODS: Patients with clinically significant (>60%) carotid stenosis were studied preop and 1 yr post-CEA for clinical symptoms, vascular cognitive decline, instability of carotid plaque-presence of microemboli, brain white matter changes, and medical risk factors...
June 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28574038/-prediction-of-ischaemic-lesions-of-the-brain-in-reconstructive-operations-on-internal-carotid-arteries
#13
M M Tanashian, R B Medvedev, A N Evdokimenko, É G Gemdzhian, S I Ckrylev, O V Lagoda, M V Krotenkova, A S Suslin
The present study was undertaken to examine the relationship between the level of the intensity of the ultrasonic signal reflected from atherosclerotic plaques (ATP) of carotid arteries and the risk for formation of an ischaemic lesion in the brain matter, detected during diffusion-weighted magnetic resonance imaging (DW-MRI) performed 24 hours after carotid endarterectomy (CEA) or carotid angioplasty and stenting (CAS). Our prospective study included a total of 78 patients presenting with stenosis of the sinus of the interior carotid artery...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28573058/uncommon-etiology-for-seizure-cerebral-hyperperfusion-syndrome
#14
Mohankumar Kurukumbi, Ahn Truong, Naghemeh Pirsaharkhiz
Cerebral hyperperfusion syndrome (CHS) is a rare life-threatening complication of carotid endarterectomy (CEA) and carotid artery stenting (CAS) for carotid artery stenosis. The incidence varies between 0 and 3%, depending on the severity of the stenosis, perioperative hypertension, and contralateral carotid stenosis. This case report reports a 53-year-old female patient presenting with decreased alertness and multiple tonic-clonic seizures, in the background of bilateral CEA. She was found to have bilateral carotid stenosis...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28566933/outcomes-of-carotid-endarterectomy-with-primary-closure
#15
Ivy Cheng, Krishna S Vyas, Santhosh Velaga, Daniel L Davenport, Sibu P Saha
Carotid endarterectomy (CEA) reduces the risk of stroke in patients with internal carotid artery stenosis, although the optimal surgical technique is debated. The literature suggests that patch angioplasty reduces complication risk, although primary closure shortens cross-clamp time and eliminates complications associated with grafts. The objective of this study was to assess the complication rate after CEA with primary closure. Retrospective review of 240 consecutive patients between 2002 and 2010. Of these patients, 70% returned for follow-up visits for at least 2 or more years...
June 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28560568/outcome-of-carotid-artery-stenting-in-the-hands-of-vascular-surgeons
#16
Carola Marie Wieker, S Demirel, N Attigah, M Hakimi, U Hinz, D Böckler
OBJECTIVES: To analyze the procedural and clinical outcomes of carotid artery stenting (CAS) in the hands of endovascular trained vascular surgeons. METHODS: Between April 2008 to May 2013, 1197 patients were treated for extracranial internal carotid artery (ICA) stenosis. The proportion of endovascular treated patients was 5.0% (CAS n = 60 vs. carotid endarterectomy (CEA) n = 1137). All patients in the CAS group (44 males, median age 70 years) were treated by two senior vascular surgeons experienced in endovascular methods...
May 30, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28549958/a-novel-antegrade-approach-for-simultaneous-carotid-endarterectomy-and-angioplasty-of-proximal-lesions-in-patients-with-tandem-stenosis-of-supraaortic-arch-vessels
#17
Djordje Radak, Slobodan Tanaskovic, Dragan Sagic, Zelimir Antonic, Predrag Gajin, Srdjan Babic, Mihailo Neskovic, Predrag Matic, Vladimir Kovacevic, Dragoslav Nenezic, Nenad Ilijevski
INTRODUCTION: To date all published studies analyzing simultaneous treatment of carotid and proximal atherosclerotic lesions are describing retrograde approach and several technical variations. In the presented study, for the first time antegrade approach is described for simultaneous carotid endarterectomy (CEA) and associated brachiocephalic trunk (BCT) or common carotid artery (CCA) angioplasty in the hybrid operating room. METHODOLOGY: From January 2012 till January 2016 antegrade hybrid procedures were performed in 18 patients...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28546040/early-carotid-endarterectomy-provides-a-better-neurological-outcome-in-symptomatic-patients-a-single-center-experience
#18
Gianfranco Varetto, Lorenzo Gibello, Francesca Sperti, Alessandra Trevisan, Edoardo Frola, Paolo Garneri, Pietro Rispoli
INTRODUCTION: Many studies confirmed the role of early carotid endarterectomy to prevent recurrent stroke or transient ischemic attack however the mid-long term neurological benefit is still not completely investigated. The purpose of the study is to evaluate the role of early carotid endarterectomy on the peri and post-operative stroke/death complications of patients with a symptomatic carotid stenosis Material and methods: ninety consecutive patients were referred to our center for a symptomatic carotid stenosis...
May 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28527733/society-for-vascular-nursing-carotid-endarterectomy-cea-updated-nursing-clinical-practice-guideline
#19
Kathleen Rich, Diane Treat-Jacobson, Theresa DeVeaux, Karen Fitzgerald, Laura Kirk, Lily Thomson, Anne Foley, Debbie Hill
No abstract text is available yet for this article.
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28514469/association-of-very-low-volume-practice-with-vascular-surgery-outcomes-in-new-york
#20
Jialin Mao, Philip Goodney, Jack Cronenwett, Art Sedrakyan
Importance: Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. Objective: To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. Design, Settings, and Participants: This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals...
May 17, 2017: JAMA Surgery
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