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https://www.readbyqxmd.com/read/28639143/quality-of-life-after-carotid-endarterectomy-a-review-of-the-literature
#1
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
#2
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/28629953/3d-black-blood-mr-angiography-of-the-carotid-arteries-a-simple-sequence-for-plaque-hemorrhage-and-stenosis-evaluation
#3
Monica Sigovan, Clément Bidet, Sébastien Bros, Loic Boussel, Laura Mechtouff, Philip M Robson, Zahi A Fayad, Antoine Millon, Philippe Douek
OBJECTIVES: To evaluate the diagnostic performance of a new three-dimensional T1-weighted turbo-spin-echo sequence (3D T1-w TSE) compared to 3D contrast-enhanced angiography (CE-MRA) for stenosis measurement and compared to 2D T1-w TSE for intra-plaque hemorrhage (IPH) detection. METHODS: Eighty three patients underwent carotid MRI, using a new elliptic-centric phase encoding T1-weighted 3D TSE sequence in addition to the clinical protocol. Two observers evaluated image quality, presence of flow artifacts, and presence of intra-plaque hemorrhage, and computed the NASCET degree of stenosis for CE-MRA and for the new sequence...
June 16, 2017: Magnetic Resonance Imaging
https://www.readbyqxmd.com/read/28628189/-a-statement-the-polish-cardiac-society-working-group-on-pulmonary-circulation-on-screening-for-cteph-patients-after-acute-pulmonary-embolism
#4
Michał Ciurzyński, Marcin Kurzyna, Grzegorz Kopeć, Piotr Błaszczak, Łukasz Chrzanowski, Karol Kamiński, Katarzyna Mizia-Stec, Tatiana Mularek-Kubzdela, Ewa Mroczek, Andrzej Biederman, Piotr Pruszczyk, Adam Torbicki
Both pharmacological and invasive treatment of chronic thromboembolic pulmonary hypertension (CTEPH) is now available in Poland and the awareness of the disease among physicians is growing. Thus, the Polish Cardiac Society's Working Group on Pulmonary Circulation in cooperation with independent experts in this field, have launched the statement on algorithm to guide a CTEPH diagnosis in patients with previous acute pulmonary embolism (APE). In Poland, every year this disease affects about 250 patients. CTEPH should be suspected in individuals after APE with dyspnea, despite at least 3 months period of effective anticoagulation, particularly when specified risk factors are present...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28623598/cost-effectiveness-of-two-decision-strategies-for-shunt-use-during-carotid-endarterectomy
#5
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
#6
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/28623117/open-heart-surgery-does-not-increase-the-incidence-of-ipsilateral-ischemic-stroke-in-patients-with-asymptomatic-severe-carotid-stenosis
#7
John E Castaldo, Hussam A Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny
BACKGROUND AND PURPOSE: We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. METHODS: In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28612517/two-dimensional-knowledge-based-volumetric-reconstruction-of-the-right-ventricle-documents-short-term-improvement-in-pulmonary-hypertension
#8
Johannes P Schwaiger, Daniel S Knight, Thomas Kaier, Adele Gallimore, Christopher P Denton, Benjamin E Schreiber, Clive Handler, John G Coghlan
BACKGROUND: Data are scarce about short-term right ventricular changes in pulmonary hypertension. Two-dimensional knowledge-based reconstruction of the right ventricle with 2D echocardiography (2DKBR) has been shown to be a valid alternative to Cardiac MRI. PATIENTS AND METHODS: In this longitudinal study 25 pulmonary hypertension patients underwent 2DKBR of the right ventricle, assessment of NT-proBNP levels and functional class at baseline and after a mean follow-up of 6...
June 2017: Echocardiography
https://www.readbyqxmd.com/read/28611148/failure-to-account-for-practice-effects-leads-to-clinical-misinterpretation-of-cognitive-outcome-following-carotid-endarterectomy
#9
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/28605922/surgical-coronary-revascularization-on-pump-versus-off-pump-in-patients-with-stenosis-of-the-main-tree-of-the-left-coronary-artery-and-carotid-stenosis
#10
Edin Kabil, Bedrudin Banjanović, Emir Mujanović
OBJECTIVE: The aim of this study was to show perioperative complications of CABG procedure with and without cardiopulmonary bypass (CPB) in patients with combined coronary and carotid disease. PATIENTS AND METHODS: This retrospective survey included patients with left main stenosis greater than 50% and carotid stenosis over 50%, who had undergone CABG without carotid endarterectomy at the BH Heart Centre, from May 2009 to May 2014. The patients were divided into two groups according to the surgical method used...
May 2017: Acta Medica Academica
https://www.readbyqxmd.com/read/28604285/hybrid-treatment-of-extracranial-carotid-artery-disease
#11
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/28603515/factors-influencing-decision-making-for-carotid-endarterectomy-versus-stenting-in-the-very-elderly
#12
REVIEW
Sung Hyuk Heo, Cheryl D Bushnell
As the population ages worldwide, the number of elderly patients with carotid stenosis is also increasing. There have been many large clinical trials comparing carotid endarterectomy (CAE) versus stenting, but the inclusion criteria (i.e., symptomatic or asymptomatic), stenting methods (i.e., protection device), and primary end point (i.e., the definition of myocardial infarction and follow-up period) were different between trials. Therefore, the interpretation of those results is difficult and requires attention...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28596038/predictors-of-30-day-postoperative-major-adverse-clinical-events-after-carotid-artery-stenting-an-analysis-of-the-procedure-targeted-american-college-of-surgeons-national-surgical-quality-improvement-program
#13
Kyla M Bennett, John R Hoch, John E Scarborough
BACKGROUND: Information about carotid artery stenting (CAS) is largely derived from clinical trials, consensus statements, and outcomes comparisons between CAS and carotid endarterectomy. Given these limitations, the goal of this study was to identify risk factors for adverse outcomes after CAS among hospitals participating in the CAS-targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). METHODS: Our study sample consisted of patients from the 2012 to 2015 CAS-targeted ACS NSQIP data set...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28594802/-remote-results-of-carotid-endarterectomy-in-patients-with-type-2-diabetes-mellitus
#14
Iu I Kazakov, A P Kas'ianenko, N Iu Sokolova, A V Bakulina, A O Iakovlev
The authors comparatively analysed the remote results of carotid endarterectomy and risk factors for unfavourable outcomes in patients with and without type 2 diabetes mellitus (DM). The outcomes of carotid endarterectomy were studied in a total of 168 patients, with the follow-up terms up to 8 years. Depending on the presence or absence of DM, the patients were divided into two groups. Group One comprised 79 patients with an atherosclerotic lesion of the internal carotid artery and accompanying DM, with Group Two consisting of 89 non-diabetic patients...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28594795/-assessing-efficacy-of-carotid-endarterectomy-by-means-of-intraoperative-flowmetry
#15
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/28592064/-clinical-analysis-on-monitoring-and-comprehensive-treatment-after-carotid-endarterectomy
#16
X Y Wang, Z H Sun, L Liu, C Wu, Z Ji
Objective: To discuss the therapeutic effect of management of carotid endarterectomy in care unit. Methods: A total of 315 patients with carotid atherosclerotic stenosis were enrolled. All of the patients were taken into care unit under tracheal intubation anesthesia after carotid endarterectomy. Then the patients were managed with a breathing machine, continuous sedation, strict monitoring of hemodynamics and pupil change, strict control of heart rate and blood pressure, atomization inhalation therapy, treatment of anticoagulation and antiplatelet therapy and classification management of airway...
May 30, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28591785/results-from-more-than-20%C3%A2-years-of-surgical-pulmonary-endarterectomy-for-chronic-thromboembolic-pulmonary-hypertension-in-denmark
#17
Kasper Korsholm, Asger Andersen, Søren Mellemkjær, Dorthe Viemose Nielsen, Kaj Erik Klaaborg, Lars Bo Ilkjær, Jens Erik Nielsen-Kudsk
OBJECTIVES: Chronic thromboembolic pulmonary hypertension is a fatal disease if left untreated, and pulmonary endarterectomy (PEA) is the potentially curable treatment of choice. We aimed to estimate the current in-hospital mortality rate, complication rate and long-term survival for patients with chronic thromboembolic pulmonary hypertension undergoing PEA in Denmark. METHODS: All chronic thromboembolic pulmonary hypertension patients who underwent PEA in the period 1994 till 2016 were consecutively enrolled in our single-centre study...
June 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28590505/carotid-endarterectomy-for-symptomatic-carotid-stenosis
#18
REVIEW
Saritphat Orrapin, Kittipan Rerkasem
BACKGROUND: Stroke is the third leading cause of death and the most common cause of long-term disability. Severe narrowing (stenosis) of the carotid artery is an important cause of stroke. Surgical treatment (carotid endarterectomy) may reduce the risk of stroke, but carries a risk of operative complications. This is an update of the Cochrane Review, originally published in 1999, and most recently updated in 2011. OBJECTIVES: To determine the balance of benefit versus risk of endarterectomy plus best medical management compared with best medical management alone, in people with a recent symptomatic carotid stenosis (i...
June 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28586938/superficial-temporal-artery-middle-cerebral-artery-bypass-using-a-thick-sta-after-endarterectomy-a-rescue-technique
#19
Motohiro Nomura, Akira Tamase, Tomoya Kamide, Kentaro Mori, Syunsuke Seki, Yu Iida, Yuichi Kawabata, Tatsu Nakano, Hiroshi Shima, Kunio Yanagimoto
Background and Objective Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass is a procedure to reconstruct cerebral blood flow in the MCA territory. In some cases, the STA wall is thickened and the size discrepancy between STA and MCA is apparent. In such a situation, STA-MCA bypass is challenging. We present two patients who underwent STA-MCA bypass using STA in which a thickened intima was removed. We discuss the usefulness of this rescue technique. Patients and Results A patient with an atherosclerotic MCA occlusion and another with an occluded internal carotid artery are included...
June 6, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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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