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Ayşegül İdil Soylu, Sümeyra Arıkan Cortcu, Fatih Uzunkaya, Yunus Oktay Atalay, Tumay Bekçi, Levent Güngör, Ümit Belet
OBJECTIVES: Platelet-to-lymphocyte ratio is a novel biomarker, recently shown to be correlated with atherosclerotic inflammation. This study investigated the role of platelet-to-lymphocyte ratio in patients with carotid artery stenosis and stroke. METHODS: Patients, who underwent carotid angiography with Multiple Detector Computed Tomography Angiography at our hospital, were retrospectively screened. Patients enrolled were divided into three groups based on the platelet-to-lymphocyte ratio...
October 20, 2016: Vascular
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
T G Brott, G Howard, G S Roubin
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Manish Mehta, Yi Zhou, Philip S K Paty, Medhi Teymouri, Kamran Jafree, Humayun Bakhtawar, Jeffrey Hnath, Paul Feustel
BACKGROUND: This study evaluated the feasibility, safety, and effectiveness of endovascular interventions for common femoral artery (CFA) occlusive disease. METHODS: Using a prospectively maintained multicenter database, we analyzed outcomes in 167 consecutive patients who underwent percutaneous CFA interventions for Rutherford class 3 to class 6 (R3-R6) disease. The standardized treatment approach included primary percutaneous transluminal angioplasty (PTA) only, atherectomy + PTA, and provisional stenting...
August 2016: Journal of Vascular Surgery
H Wilkens, S Konstantinides, I Lang, A C Bunck, M Gerges, F Gerhardt, A Grgic, C Grohé, S Guth, M Held, J Hinrichs, M M Hoeper, W Klepetko, T Kramm, U Krüger, M Lankeit, B C Meyer, K M Olsson, H-J Schäfers, M Schmidt, H J Seyfarth, S Ulrich, C B Wiedenroth, E Mayer
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH), but also other significant subgroups of pulmonary hypertension (PH). In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany to discuss open and controversial issues surrounding the practical implementation of the European Guidelines...
October 2016: Deutsche Medizinische Wochenschrift
Nikola Dobrilovic, Peter Soukas, Immad Sadiq, Lisa Goldstein, Jaishankar Raman
BACKGROUND: The CorMatrix (CorMatrix Cardiovascular, Roswell, Ga) biologic extracellular patch derived from porcine small intestinal mucosa provides a biologic scaffold for cellular ingrowth and eventual tissue regeneration. It has been used in a variety of applications, including cardiac and vascular repair procedures. METHODS: CorMatrix was used as a patch arterioplasty for femoral artery repair in conjunction with endarterectomy for seven separate procedures in six patients (one patient underwent staged, bilateral femoral procedures)...
October 14, 2016: Journal of Vascular Surgery
Rodolfo Pini, Gianluca Faggioli, Matteo Longhi, Liborio Ferrante, Andrea Vacirca, Enrico Gallitto, Mauro Gargiulo, Andrea Stella
BACKGROUND: The influence of acute cerebral ischemic lesions (CILs) on the revascularization outcome of symptomatic carotid stenosis has been scarcely investigated in the literature. This study evaluated the effect of CILs and their volume on the results of carotid revascularization in symptomatic patients. METHODS: All patients with symptomatic carotid artery stenosis who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS) between 2005 and 2014 were considered...
October 14, 2016: Journal of Vascular Surgery
Tuba Akinci, Eda Derle, Seda Kibaroğlu, Ali Harman, Feride Kural, Pınar Cınar, Munire Kilinc, Hakki T Akay, Ufuk Can, Ulku S Benli
OBJECTIVE: To review our results of carotid artery stenting (CAS) and carotid endarterectomy (CEA). METHODS: We evaluated the medical records of patients undergoing carotid artery revascularization procedure, between 2001 and 2013 in Baskent University Hospital, Ankara, Turkey. Carotid artery stenting or CEA procedures were performed in patients with asymptomatic carotid stenosis (>/=70%) or symptomatic stenosis (>/=50%). Demographic data, procedural details, and clinical outcomes were recorded...
October 2016: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Joshua T Chai, Luca Biasiolli, Linqing Li, Mohammad Alkhalil, Francesca Galassi, Chris Darby, Alison W Halliday, Linda Hands, Timothy Magee, Jeremy Perkins, Ed Sideso, Ashok Handa, Peter Jezzard, Matthew D Robson, Robin P Choudhury
OBJECTIVES: The aim of this study was to: 1) provide tissue validation of quantitative T2 mapping to measure plaque lipid content; and 2) investigate whether this technique could discern differences in plaque characteristics between symptom-related and non-symptom-related carotid plaques. BACKGROUND: Noninvasive plaque lipid quantification is appealing both for stratification in treatment selection and as a possible predictor of future plaque rupture. However, current cardiovascular magnetic resonance (CMR) methods are insensitive, require a coalesced mass of lipid core, and rely on multicontrast acquisition with contrast media and extensive post-processing...
October 6, 2016: JACC. Cardiovascular Imaging
R Seidel, K Zukowski, A Wree, M Schulze
BACKGROUND AND OBJECTIVE: Ultrasound-guided blocks of the cervical plexus are established anesthetic procedures for carotid endarterectomy. This randomized, double-blind, placebo-controlled study tested the hypothesis that an additional ultrasound-guided periarterial injection of local anesthetic leads to a lower frequency of periarterial supplementation by the surgeon. METHODS: A total of 40 patients were randomly assigned to 1 of 2 groups. In both groups an ultrasound-guided intermediate cervical plexus block (20 ml of 0...
October 14, 2016: Der Anaesthesist
Andrea Duca, Andy Jagoda
The definition of a transient ischemic attack (TIA) has evolved over the past decade from a clinical diagnosis to a tissue-based definition based on neuroimaging results. TIA shares the same pathophysiology as stroke, which occurs in up to 5% of patients within 48 hours of the TIA and 10% within 90 days. This rate is decreasing, likely due to improved diagnostic and management strategies. Decision support scores have been developed to risk stratify patients, which include clinical and radiological elements...
November 2016: Emergency Medicine Clinics of North America
Chang-Ki Hong, Yu Shik Shim, Yong Cheol Lim, Yong Sam Shin, Hyeonseon Park, Joonho Chung
BACKGROUND: Blood pressure (BP) was reported to decrease significantly after carotid endarterectomy (CEA) or carotid stenting (CAS) up to the 1-year follow-up. We evaluated changes in BP for 3 years after treating hypertensive patients with symptomatic carotid artery stenosis by either CEA or CAS and determined predisposing factors for normotensive BP at the 3-year follow-up. METHODS: A total of 123 hypertensive patients with at least 3 years of clinical and radiographic follow-up after treatment were included in this study and placed in the CEA (n = 65) or CAS group (n = 58)...
October 13, 2016: Acta Neurochirurgica
Aldo Bonaventura, François Mach, Aline Roth, Sébastien Lenglet, Fabienne Burger, Karim J Brandt, Aldo Pende, Maria Bertolotto, Giovanni Spinella, Bianca Pane, Domenico Palombo, Franco Dallegri, Michele Cea, Nicolas Vuilleumier, Fabrizio Montecucco, Federico Carbone
Serum c-reactive protein (CRP) was suggested for the assessment of intermediate cardiovascular (CV) risk. Here, systemic or intraplaque CRP levels were investigated as predictors of major adverse cardiovascular events (MACEs) in patients with severe carotid stenosis. CRP levels were assessed in the serum and within different portions (upstream and downstream) of carotid plaques of 217 patients undergoing endarterectomy. The association between CRP and intraplaque lipids, collagen, neutrophils, smooth muscle cells (SMC), and macrophage subsets was determined...
2016: Mediators of Inflammation
Pavlos Tsantilas, Andreas Kuehnl, Thomas König, Thorben Breitkreuz, Michael Kallmayer, Christoph Knappich, Sofie Schmid, Martin Storck, Alexander Zimmermann, Hans-Henning Eckstein
BACKGROUND AND PURPOSE: Guidelines recommend that carotid endarterectomy should be performed within 2 weeks in patients with a symptomatic carotid stenosis. Because a Swedish register study indicated that patients treated within the first days after a stroke or transient ischemic attack might have an increased perioperative stroke and mortality risk, this study aimed to find out whether these findings are also true under everyday conditions in Germany. METHODS: Secondary data analysis including 56 336 elective carotid endarterectomy procedures performed for symptomatic carotid stenosis under everyday conditions between 2009 and 2014...
October 13, 2016: Stroke; a Journal of Cerebral Circulation
Manar Khashram, Rachel Falconer, Afif Mahmud, Adib Khanafer, Peter Laws, Tim Beresford, Justin Roake
AIMS: Rapid access carotid endarterectomy (RACE) is the gold standard for stroke prevention in symptomatic patients with 50-99% internal carotid artery stenosis. Diagnosis and referral of eligible patients may be delayed by disruption to local health services. The aim of this study was to evaluate whether service provision was maintained at an appropriate standard (<2 weeks) following a natural disaster. METHODS: Consecutive symptomatic patients who underwent carotid endarterectomy (CEA) at a tertiary hospital between January 2006 and December 2014 were identified...
October 14, 2016: New Zealand Medical Journal
Soo Han Kim, Jae Won Lee, Jung-Min Ahn, Dae-Hee Kim, Jong-Min Song, Sang-Do Lee, Jae Seung Lee
Background/Aims: Pulmonary endarterectomy (PEA) is the gold standard for treating chronic thromboembolic pulmonary hypertension (CTEPH) in Western countries. The aim of this study was to investigate the long-term outcomes of performing PEA on CTEPH patients in comparison with medical therapy at a single Korean center. Methods: This retrospective study included 88 CTEPH patients. These patients were classified into the PEA group (n = 37) or non-PEA group (i.e., medical therapy; n = 51)...
October 13, 2016: Korean Journal of Internal Medicine
Johanna M U Silvola, Helena Virtanen, Riikka Siitonen, Sanna Hellberg, Heidi Liljenbäck, Olli Metsälä, Mia Ståhle, Tiina Saanijoki, Meeri Käkelä, Harri Hakovirta, Seppo Ylä-Herttuala, Pekka Saukko, Matti Jauhiainen, Tibor Z Veres, Sirpa Jalkanen, Juhani Knuuti, Antti Saraste, Anne Roivainen
Given the important role of inflammation and the potential association of the leukocyte trafficking-associated adhesion molecule vascular adhesion protein 1 (VAP-1) with atherosclerosis, this study examined whether functional VAP-1 is expressed in atherosclerotic lesions and, if so, whether it could be targeted by positron emission tomography (PET). First, immunohistochemistry revealed that VAP-1 localized to endothelial cells of intra-plaque neovessels in human carotid endarterectomy samples from patients with recent ischemic symptoms...
October 12, 2016: Scientific Reports
Jun Gyo Gwon, Tae Won Kwon, Yong Pil Cho, Dong Wha Kang, Youngjin Han, Minsu Noh
BACKGROUND AND PURPOSE: Carotid endarterectomy (CEA) is performed to prevent cerebral infarction, but a common side effect is cerebral microinfarcts. This study aimed to identify the variables related to the production of microinfarcts during CEA as well as determine their association with delayed postoperative infarction. METHODS: This was a retrospective review of data collected prospectively from 548 patients who underwent CEA. The clinical characteristics of the patients and the incidence rates and causes of microinfarcts were analyzed...
October 7, 2016: Journal of Clinical Neurology
Hisato Minamide, Yutaka Hayashi, Megumi Ueno
BACKGROUND: An intraluminal thrombus in the carotid artery is relatively rare. A high frequency of perioperative symptomatic stroke has been reported in patients undergoing carotid endarterectomy, and no standard therapy has yet been developed. CASE PRESENTATION: A 69-year-old woman, with no history of trauma, presented with ischemic stroke and mild right hemiparesis. Computed tomography and MRI showed an infarction in the left parietal region. A carotid Doppler study showed carotid stenosis on the left side...
October 2016: No Shinkei Geka. Neurological Surgery
Takashi Kawakami, Aiko Ogawa, Katsumasa Miyaji, Hiroki Mizoguchi, Hiroto Shimokawahara, Takanori Naito, Takashi Oka, Kei Yunoki, Mitsuru Munemasa, Hiromi Matsubara
BACKGROUND: Balloon pulmonary angioplasty (BPA) is an alternative therapy for patients with chronic thromboembolic pulmonary hypertension who are ineligible for standard therapy, pulmonary endarterectomy. Although there are several classifications of vascular lesions, these classifications are based on the features of the specimen removed during pulmonary endarterectomy. Because organized thrombi are not removed during balloon pulmonary angioplasty, we attempted to establish a new classification of vascular lesions based on pulmonary angiographic images...
October 2016: Circulation. Cardiovascular Interventions
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