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carotid endarterectomy(CEA)

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https://www.readbyqxmd.com/read/28724881/effect-of-carotid-endarterectomy-on-retinal-function-in-asymptomatic-patients-with-hemodynamically-significant-carotid-artery-stenosis
#1
Anna Machalińska, Aleksandra Kowalska-Budek, Miłosz Piotr Kawa, Arkadiusz Kazimierczak, Krzysztof Safranow, Marta Kirkiewicz, Paweł Rynio, Grażyna Wilk, Wojciech Lubiński, Piotr Gutowski, Bogusław Machaliński
INTRODUCTION    The corrective effect of carotid endarterectomy (CEA) on disturbed ophthalmic artery flow in patients with a significant internal carotid artery stenosis (ICAS) presenting with ocular ischemic syndrome (i.e., symptomatic patients) is well established. However, no clear evidence exists regarding the efficacy of CEA for improvement of neuro-retinal function in patients without symptoms of ocular ischemic syndrome. OBJECTIVES    We determined the effects of CEA on retinal function in asymptomatic patients with hemodynamically significant internal carotid artery stenosis...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28712813/factors-affecting-operative-time-and-outcome-of-carotid-endarterectomy-in-the-vascular-quality-initiative
#2
Jennifer L Perri, Brian W Nolan, Philip P Goodney, Randall R DeMartino, Benjamin S Brooke, Shipra Arya, Mark F Conrad, Jack L Cronenwett
OBJECTIVE: Prior studies have suggested a relationship between operative (Op) time and outcome after major vascular procedures. This study analyzed factors associated with Op time and outcome after carotid endarterectomy (CEA) in the Vascular Quality Initiative (VQI) registry. METHODS: Elective, primary CEAs without high anatomic risk or concomitant procedures from 2012 to 2015 in the VQI were analyzed (N = 26,327, performed by 1188 surgeons from 249 centers). Multivariable analysis was used to identify patient, procedure, and surgeon factors associated with Op time and major adverse events (MAEs), categorized as either technical (ipsilateral stroke, cranial nerve injury, reoperation) or cardiac (myocardial infarction, congestive heart failure, dysrhythmia requiring treatment, surgical site infection, and death)...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28697940/characterization-of-perioperative-contralateral-stroke-after-carotid-endarterectomy
#3
W Darrin Clouse, Emel A Ergul, Virendra I Patel, R Todd Lancaster, Glenn M LaMuraglia, Richard P Cambria, Mark F Conrad
OBJECTIVE: Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioperative (30-day) contralateral stroke after CEA as well as predisposing preoperative and operative factors. Its specific effect on long-term survival was interrogated. METHODS: The Vascular Study Group of New England (VSGNE) was queried from April 1, 2003, to February 29, 2016, for all CEAs...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28689950/an-accumulated-deficits-model-predicts-perioperative-and-long-term-adverse-events-after-carotid-endarterectomy
#4
Natalie D Sridharan, Rabih A Chaer, Bryan Boyuan Wu, Mohammad H Eslami, Michel S Makaroun, Efthymios D Avgerinos
OBJECTIVE: There is increasing recognition that decreased reserve in multiple organ systems, known as accumulated deficits, may better stratify perioperative risk than traditional risk indices. We hypothesized that an AD model would predict both perioperative adverse events and long-term survival after carotid endarterectomy (CEA), particularly important in asymptomatic patients. METHODS: Consecutive patients undergoing CEA between 1/1/2000 and 12/31/2010 were retrospectively identified...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28688529/predictors-of-cross-clamp-induced-intraoperative-monitoring-changes-during-carotid-endarterectomy-using-both-electroencephalography-and-somatosensory-evoked-potentials
#5
Natalie Domenick Sridharan, Partha Thirumala, Rabih Chaer, Jeffrey Balzer, Becky Long, Donald Crammond, Michel Makaroun, Efthymios Avgerinos
OBJECTIVE: The efficacy of selective shunting during carotid endarterectomy (CEA) using intraoperative monitoring (IOM) for detection of cerebral ischemia is well established. There is mounting evidence that monitoring of both electroencephalography (EEG) and somatosensory evoked potentials (SSEPs) increases the sensitivity of cerebral ischemia detection. Predictors of cerebral ischemia requiring selective shunt placement using IOM of both EEG and SSEPs have not been previously identified...
July 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28679848/carotid-stenting-versus-endarterectomy-for-asymptomatic-carotid-artery-stenosis-a-systematic-review-and-meta-analysis
#6
Paola Moresoli, Bettina Habib, Pauline Reynier, Matthew H Secrest, Mark J Eisenberg, Kristian B Filion
BACKGROUND AND PURPOSE: There is no consensus on the comparative efficacy and safety of carotid artery stenting (CAS) versus carotid endarterectomy (CEA) in patients with asymptomatic carotid artery stenosis. To evaluate CAS versus CEA in asymptomatic patients, we conducted a systematic review and meta-analysis of randomized controlled trials. METHODS: We systematically searched EMBASE, PubMed, MEDLINE, and the Cochrane Library for randomized controlled trials comparing CAS to CEA in asymptomatic patients using a pre-specified protocol...
July 5, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28666824/carotid-artery-revascularization-in-patients-with-contralateral-carotid-artery-occlusion-stent-or-endarterectomy
#7
Besma Nejim, Hanaa Dakour Aridi, Satinderjit Locham, Isibor Arhuidese, Caitlin Hicks, Mahmoud B Malas
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) considers that contralateral carotid artery occlusion puts the patients at high risk for carotid endarterectomy (CEA) and agrees to reimburse for carotid artery stenting (CAS) in these patients. However, there is a paucity of evidence that support the superiority of CAS compared with CEA in patients with contralateral carotid occlusion. METHODS: All patients who underwent CEA or CAS with contralateral carotid artery occlusion were identified in the Vascular Quality Initiative (VQI) registry between 2005 and 2016...
June 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28655552/the-impact-of-contralateral-carotid-artery-stenosis-on-outcomes-after-carotid-endarterectomy
#8
Alexander B Pothof, Peter A Soden, Margriet Fokkema, Sara L Zettervall, Sarah E Deery, Thomas C F Bodewes, Gert J de Borst, Marc L Schermerhorn
OBJECTIVE: Patients with contralateral carotid occlusion (CCO) have been excluded from randomized clinical trials because of a deemed high risk for adverse neurologic outcomes with carotid endarterectomy (CEA). Evidence for this rationale is limited and conflicting. Therefore, we aimed to compare outcomes after CEA between patients with and without CCO and varying degrees of contralateral carotid stenosis (CCS). METHODS: We identified patients undergoing CEA from 2003 to 2015 in the Vascular Study Group of New England (VSGNE) registry...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28652057/carotid-endarterectomy-induces-the-release-of-inflammatory-markers-and-the-activation-of-coagulation-as-measured-in-the-jugular-bulb
#9
Bjorn Kragsterman, David Bergqvist, Agneta Siegbahn, Hakan Parsson
BACKGROUND AND PURPOSE: Transient cerebral hypoxia may induce neuronal injury through an ischemia-reperfusion (I/R) response, with a subsequent activation of inflammation and coagulation-fibrinolysis. During carotid endarterectomy (CEA), the artery is clamped, which might impair the regional cerebral perfusion and initiate a local I/R response. Data suggest that the CD40-CD40 ligand dyad acts as a modulator in the induced activation. The aim of this study was to locally measure soluble CD40 ligand (sCD40L), in conjunction with inflammation and coagulation activation markers, during CEA...
June 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28651865/pre-operative-carotid-plaque-echolucency-assessment-has-no-predictive-value-for-long-term-risk-of-stroke-or-cardiovascular-death-in-patients-undergoing-carotid-endarterectomy
#10
D de Waard, G J de Borst, R Bulbulia, H Pan, A Halliday
INTRODUCTION: In patients with carotid stenosis receiving medical treatment, carotid plaque echolucency has been thought to predict risk of future stroke and of other cardiovascular events. This study evaluated the prognostic value of pre-operative plaque echolucency for future stroke and cardiovascular death in patients undergoing carotid endarterectomy in the first Asymptomatic Carotid Surgery Trial (ACST-1). METHODS: In ACST-1, 1832/3120 patients underwent carotid endarterectomy (CEA), of whom 894 had visual echolucency assessment according to the Gray-Weale classification...
June 23, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28650577/time-dependent-trends-in-cardiovascular-adverse-events-during-follow-up-after-carotid-or-iliofemoral-endarterectomy
#11
I D van Koeverden, S T W van Haelst, S Haitjema, J-P P M de Vries, F L Moll, H M den Ruijter, I E Hoefer, G W Dalmeijer, G J de Borst, G Pasterkamp
BACKGROUND: Recent observations have suggested a decline in vulnerable carotid artery and iliofemoral atherosclerotic plaque characteristics over the past decade. The aim of this study was to determine whether, in the presence of clinically manifest carotid or peripheral artery disease, secondary adverse cardiovascular events decreased over this period. METHODS: Patients included in the Athero-Express biobank between 2003 and 2012 were analysed. During 3-year follow-up, composite cardiovascular endpoints were documented yearly, including: myocardial infarction, coronary interventions, stroke, peripheral interventions and cardiovascular death...
June 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28647637/transcervical-carotid-artery-stenting-using-a-prosthetic-arterial-conduit-case-series-of-a-novel-surgical-technique
#12
Nandakumar Menon, Ali Khalifeh, Charles B Drucker, Sunny Sahajwani, Danon Garrido, Richa Kalsi, Brajesh K Lal, Shahab Toursavadkohi
We present a series of 4 patients with carotid restenosis following carotid endarterectomy (CEA) who underwent transcervical carotid artery stenting (CAS) using a novel prosthetic conduit technique. The patients were high risk for repeat CEA (short and obese necks) and had contraindications to transfemoral CAS (Bovine arch, prior dissection). Carotid artery stenting was thus performed via a transcervical approach with a polytetrafluoroethylene (PTFE) conduit anastomosed to the proximal common carotid artery (CCA)...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28639143/quality-of-life-after-carotid-endarterectomy-a-review-of-the-literature
#13
REVIEW
Mariusz Chabowski, Anna Grzebien, Agnieszka Ziomek, Karolina Dorobisz, Michał Leśniak, Dariusz Janczak
Strokes are one of the leading causes of death, morbidity, and disability worldwide, mainly among elderly people. It is also the third most common cause of years of life being lost, indicating a high risk of premature mortality. Revascularisation with endarterectomy (CEA) is effective in reducing the risk of death and strokes in patients with carotid artery stenosis, but the effect of invasive treatment on quality of life (QoL) still needs attention. To shed more light on the patients' perspective on this health condition, we carried out a review of the literature which aimed to analyze the level of health-related QoL among stroke survivors, with special attention to patients who had been treated with CEA...
June 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28632941/systematic-review-of-carotid-artery-procedures-and-the-volume-outcome-relationship-in-europe
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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