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https://www.readbyqxmd.com/read/29036794/assessing-the-effect-of-different-operation-techniques-on-postoperative-duplex-ultrasound-quality-after-carotid-endarterectomy
#1
E Grambow, T Heller, P Wieneke, C Weiß, E Klar, M Weinrich
BACKGROUND: Duplex ultrasound is the first choice in diagnostics and surveillance of stenoses of the internal carotid arteries before and even after surgery. Therefore, the quality of duplex ultrasound is crucial to investigate these vascular pathologies. OBJECTIVE: Aim of this study was the evaluation whether different surgical techniques affect the postoperative quality of duplex ultrasound. METHODS: In a time period from January to May 2015 duplex ultrasound of the cervical vessels was performed in 75 patients after unilateral endarterectomy of the internal carotid artery at our department between 2006 and 2012...
October 7, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29033041/short-term-venoarterial-extracorporeal-membrane-oxygenation-for-massive-endobronchial-hemorrhage-after-pulmonary-endarterectomy
#2
Stefan Guth, Christoph B Wiedenroth, Marc Wollenschläger, Manuel Jonas Richter, Hossein A Ghofrani, Matthias Arlt, Eckhard Mayer
OBJECTIVES: Pulmonary endarterectomy (PEA) is the only curative treatment option for patients with chronic thromboembolic pulmonary hypertension. Massive endobronchial bleeding that precludes weaning from cardiopulmonary bypass is an often-fatal complication of PEA. The aim of this study was to determine whether short-term extracorporeal membrane oxygenation (ECMO) is a safe and feasible procedure in patients with severe endobronchial bleeding. METHODS: From January 2014 to December 2016, 396 patients (mean age 60 ± 18 years, 54...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29030224/transfer-molded-wrappable-microneedle-meshes-for-perivascular-drug-delivery
#3
JiYong Lee, Dae Hyun Kim, Kang Ju Lee, Il Ho Seo, Seung Hyun Park, Eui Hwa Jang, Youngjoo Park, Young-Nam Youn, WonHyoung Ryu
After surgical procedures such as coronary/peripheral bypass grafting or endarterectomy for the treatment of organ ischemia derived from atherosclerosis, intimal hyperplasia (IH) which leads to restenosis or occlusion at the site of graft anastomosis frequently occurs. In order to inhibit IH caused by abnormal growth of smooth muscle cells (SMCs) in tunica media, various perivascular drug delivery devices are reported for delivery of anti-proliferation drugs into vascular tissue. However, there still remain conflicting requirements such as local and unidirectional delivery vs device porosity, and conformal tight device installation vs pulsatile expansion and constriction of blood vessels...
October 10, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/29029716/balloon-pulmonary-angioplasty-in-chronic-thromboembolic-pulmonary-hypertension-new-horizons-in-the-interventional-management-of-pulmonary-embolism
#4
Michael D Rivers-Bowerman, Rebecca Zener, Arash Jaberi, Marc de Perrot, John Granton, John M Moriarty, Kong T Tan
Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed potential complication of acute or recurrent pulmonary thromboembolic disease. Multiple studies suggest that up to 5% of patients with acute pulmonary thromboembolic disease go on to develop CTEPH. The prognosis of untreated CTEPH is poor, but advances in medical and surgical treatments over the past few decades have improved patient outcomes. The gold standard and curative treatment for CTEPH is pulmonary endarterectomy; however, some patients are inoperable and others who have undergone pulmonary endarterectomy experience persistent or recurrent pulmonary hypertension despite medical therapy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029228/development-of-a-whole-task-simulator-for-carotid-endarterectomy
#5
Gabrielle Santangelo, Doran Mix, Ahmed Ghazi, Michael Stoner, G Edward Vates, Jonathan J Stone
BACKGROUND: Surgical education relies on operative exposure with live patients. Carotid endarterectomy (CEA) demands an experienced surgeon with a very low complication rate. The high-risk nature of this procedure and the decline in number of CEAs performed annually has created a gap in residency training. OBJECTIVE: To develop a high-fidelity whole-task simulation for CEA that demonstrates content, construct, and face validity. METHODS: Anatomically accurate models of the human neck were created using multilayered poly-vinyl alcohol hydrogels...
September 27, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29027516/-chronic-thromboembolic-pulmonary-hypertension-recognition-diagnosis-and-treatment
#6
D Ruigrok, P Symersky, P W G Elbers, S Kamminga, L J Meijboom, H J Bogaard
- Chronic thromboembolic pulmonary hypertension (CTEPH), characterised by pulmonary hypertension and persistent perfusion defects despite adequate anticoagulation, causes significant morbidity and mortality.- Persistent dyspnoea after acute pulmonary embolism is frequent and an indication for additional diagnostics. Only a minority of these patients develop CTEPH.- Echocardiography and perfusion scintigraphy are the cornerstone of diagnostics when suspecting CTEPH. Right-heart catheterisation and pulmonary angiography should confirm the diagnosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29024865/impaired-kidney-function-is-associated-with-intraplaque-hemorrhage-in-patients-undergoing-carotid-endarterectomy
#7
Marian Wesseling, Ian D van Koeverden, Guus W van Lammeren, Sander W van der Laan, Saskia Haitjema, Jean-Paul P M de Vries, Hester M den Ruijter, Saskia C A de Jager, Imo Hoefer, Peter Blankestijn, Marianne Verhaar, Dominique P V de Kleijn, Gert J de Borst, Gerard Pasterkamp
BACKGROUND AND AIMS: Previously, we showed that patients undergoing carotid endarterectomy have an increased risk for major atherosclerotic events in the presence of moderate or poor kidney function. Acceleration of vascular inflammatory responses is considered to be causally involved in progression of atherogenesis and poor outcome in chronic kidney disease patients. The association between kidney function and plaque composition has not been thoroughly investigated yet. The aim of this study was to investigate the association between kidney function and atherosclerotic plaque composition in patients undergoing carotid endarterectomy...
September 22, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29021357/radiographic-and-symptomatic-brain-ischemia-in-cea-and-cas-a-systematic-review-and-meta-analysis
#8
Sung-Min Cho, Abhishek Deshpande, Vinay Pasupuleti, Adrian V Hernandez, Ken Uchino
OBJECTIVE: In a systematic review, we compared ratio of new periprocedural radiographic brain ischemia (RBI) to the number of strokes and TIAs among patients undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We searched 5 databases for entries related to brain ischemia in CEA or CAS from inception through September 2015. We included articles with CEA or CAS and systematic performance of preprocedural and postprocedural brain MRI and reporting of RBI and stroke incidence...
October 11, 2017: Neurology
https://www.readbyqxmd.com/read/29019319/the-asymptomatic-carotid-surgery-trial-2-acst-2-an-ongoing-randomised-controlled-trial-comparing-carotid-endarterectomy-with-carotid-artery-stenting-to-prevent-stroke
#9
Richard Bulbulia, Alison Halliday
BACKGROUND: A successful open surgical operation to remove atheromatous carotid artery narrowing that has not yet caused a stroke (asymptomatic carotid stenosis) carries some procedural risk but, if completed successfully, halves patients' future annual stroke risk for at least 10 years. A newer, less invasive alternative is carotid stenting, which also carries some procedural risk, especially if the carotid lesion has recently given rise to a stroke (symptomatic carotid stenosis). For both surgery and stenting, improvements in technique (and in medication) have reduced risk...
October 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29017805/atherosclerotic-plaque-characteristics-are-not-associated-with-future-cardiovascular-events-in-patients-undergoing-iliofemoral-endarterectomy
#10
Steven T W van Haelst, Saskia Haitjema, Wouter Derksen, Ian van Koeverden, Jean-Paul P M de Vries, Frans L Moll, Hester M den Ruijter, Gerard Pasterkamp, Gert J de Borst
BACKGROUND: Plaque characteristics such as intraplaque hemorrhage (IPH) have been associated with secondary cardiovascular events (CVE) in patients undergoing carotid endarterectomy. In addition, carotid plaques containing macrophage infiltration or a large lipid core size were associated with less restenosis. It is currently unknown whether iliofemoral plaque histopathologic characteristics are predictive for secondary CVE in patients with peripheral arterial disease undergoing iliofemoral endarterectomy...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28994832/carotid-endarterectomy-for-treatment-of-carotid-in-stent-restenosis-long-term-follow-up-results-and-surgery-experiences-from-one-single-centre
#11
Le-Bao Yu, Wei Yan, Qian Zhang, Ji-Zong Zhao, Yan Zhang, Rong Wang, Jun-Shi Shao, Dong Zhang
OBJECTIVE: Few studies have reported the surgical treatment of carotid in-stent restenosis (ISR), more data and longer follow-up are needed. We describe the surgical treatment of ISR by standard carotid endarterectomy (CEA) with stent removal, including long-term follow-up in 10 patients from our centre. METHODS: Ten patients from our centre who underwent CEA with stent removal for ISR were retrospectively analysed, including nine symptomatic and one asymptomatic ISR of at least 70% with mean age 67...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28991720/cerebral-hyperperfusion-syndrome-and-intracranial-hemorrhage-after-carotid-endarterectomy-or-carotid-stenting-a-meta-analysis
#12
REVIEW
George Galyfos, Argiri Sianou, Konstantinos Filis
INTRODUCTION: Cerebral hyperperfusion syndrome (CHS) and intracranial hemorrhage (ICH) after carotid revascularization have been associated with significant morbidity and mortality, although pooled data comparing these outcomes between open and endovascular treatment are lacking. Aim of this meta-analysis is to compare CHS and ICH risk between carotid endarterectomy (CEA) and carotid angioplasty with stenting (CAS). METHODS: A systematic literature review was conducted conforming to established criteria, in order to identify eligible articles published prior to February 2017...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28990089/kinin-b1-receptor-as-a-novel-prognostic-progression-biomarker-for-carotid-atherosclerotic-plaques
#13
Tiantian Liu, Hengfang Liu, Li Feng, Bo Xiao
Stroke caused by atherosclerosis remains a leading cause of morbidity and mortality worldwide, associated with carotid plaque rupture and inflammation progression. However, the inflammatory biomarkers which aid in predicting the future course of plaques are less detailed. The present study investigated the association between plaque vulnerable and inflammatory biomarkers using blood and plaque specimens. Carotid plaque specimens were obtained from 80 patients following stroke, 14 patients suffering from transient ischaemic attack and 17 asymptomatic patients that underwent carotid endarterectomy...
October 3, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28987316/bypass-for-symptomatic-in-stent-carotid-restenosis
#14
Francesco Stilo, Pasqualino Sirignano, Nunzio Montelione, Wassim Mansour, Laura Capoccia, Vincenzo Catanese, Francesco Spinelli, Francesco Speziale
BACKGROUND: To evaluate early and long-term outcomes of symptomatic patients treated for in-stent carotid restenosis (ISR) with carotid bypass (CB). METHODS: Data were retrospectively collected from a prospectively compiled database on patients treated with CB in two high-volume Italian centers between 2008 and 2016, for symptomatic high-grade ISR after CAS. After carotid endarterectomy and stent removal, a greater saphenous vein (GSV) was preferentially employed as the graft; when the GSV was not accessible, a 6mm polytetrafluoroethylene (PTFE) graft was implanted...
September 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28982786/preoperative-cerebral-oxygen-extraction-fraction-imaging-generated-from-7t-mr-quantitative-susceptibility-mapping-predicts-development-of-cerebral-hyperperfusion-following-carotid-endarterectomy
#15
J-I Nomura, I Uwano, M Sasaki, K Kudo, F Yamashita, K Ito, S Fujiwara, M Kobayashi, K Ogasawara
BACKGROUND AND PURPOSE: Preoperative hemodynamic impairment in the affected cerebral hemisphere is associated with the development of cerebral hyperperfusion following carotid endarterectomy. Cerebral oxygen extraction fraction images generated from 7T MR quantitative susceptibility mapping correlate with oxygen extraction fraction images on positron-emission tomography. The present study aimed to determine whether preoperative oxygen extraction fraction imaging generated from 7T MR quantitative susceptibility mapping could identify patients at risk for cerebral hyperperfusion following carotid endarterectomy...
October 5, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28982691/carotid-stent-fractures-are-not-associated-with-adverse-events-results-from-the-act-1-multicenter-randomized-trial
#16
Ido Weinberg, Joshua A Beckman, Jon S Matsumura, Kenneth Rosenfield, Gary Ansel, Seemant Chaturvedi, William A Gray, D Chris Metzger, Tom S Riles, Yu Shu, Lawrence R Wechsler, Michael R Jaff
Background -The impact of carotid artery stent fractures on the incidence of adverse clinical events remains unclear. The objective of this study is to report the stent fracture rate and its association with in-stent restenosis and adverse outcomes in the Asymptomatic Carotid Trial (ACT)-1. Methods -ACT-1 is a prospective multicenter trial of standard surgical risk patients with severe asymptomatic carotid artery stenosis randomized to carotid artery stenting (CAS) or carotid endarterectomy (CEA) (Abbott Vascular, Santa Clara, California, USA)...
October 5, 2017: Circulation
https://www.readbyqxmd.com/read/28975306/carotid-endarterectomy-and-carotid-artery-stenting-in-the-us-medicare-population-1999-2014
#17
Judith H Lichtman, Michael R Jones, Erica C Leifheit, Alice J Sheffet, George Howard, Brajesh K Lal, Virginia J Howard, Yun Wang, Jeptha Curtis, Thomas G Brott
Importance: Carotid endarterectomy and carotid artery stenting are the leading approaches to revascularization for carotid stenosis, yet contemporary data on trends in rates and outcomes are limited. Objective: To describe US national trends in performance and outcomes of carotid endarterectomy and stenting among Medicare beneficiaries from 1999 to 2014. Design, Setting, and Participants: Serial cross-sectional analysis of Medicare fee-for-service beneficiaries aged 65 years or older from 1999 to 2014 using the Medicare Inpatient and Denominator files...
September 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28975025/outcome-of-coronary-endarterectomy-with-coronary-artery-bypass-grafting-in-patients-with-diffuse-coronary-artery-disease-in-bangladesh-a-retrospective-cohort-study
#18
Redoy Ranjan, Dipannita Adhikary, Sabita Mandal, Anjali Seedher, Asit Baran Adhikary
BACKGROUND: In this study, we aimed to review the consequences of coronary endarterectomy with coronary artery bypass grafting, and assess outcomes of this combined surgical technique for patients with diffuse coronary artery disease in a single surgeon's practice. METHODS: We retrospectively reviewed outcome of 1198 endarterectomized coronary artery in 1000 patients with diffuse coronary artery disease, who have had experienced coronary endarterectomy with off pump coronary artery bypass grafting in between 2009 and 2016...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28974632/outcomes-of-primary-and-secondary-carotid-artery-stenting
#19
Isibor J Arhuidese, Muhammad Rizwan, Besma Nejim, Mahmoud Malas
BACKGROUND AND PURPOSE: Little is known of the excess risk attributable to secondary carotid angioplasty and stenting (CAS). This study evaluates outcomes of redo-CAS and CAS after prior ipsilateral carotid endarterectomy (CASAPICEA) relative to primary-CAS. METHODS: We studied all patients in the Vascular Quality Initiative, who underwent primary-CAS, CASAPICEA, or redo-CAS (2003-2016). Kaplan-Meier, multivariable logistic and Cox regression analyses were used to evaluate outcomes within 30 days and up to 1 year and identify their predictors...
October 3, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28973212/should-we-screen-this-patient-for-carotid-artery-stenosis-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#20
Gerald W Smetana, Marc Schermerhorn, Kenneth J Mukamal
In July 2014, the U.S. Preventive Services Task Force (USPSTF) published a clinical guideline on screening for asymptomatic carotid artery stenosis. The guideline recommended against screening in asymptomatic adults, based primarily on the results of 3 large randomized trials (grade D recommendation). The principal screening test was carotid ultrasonography, and the intervention in the 3 trials was carotid endarterectomy for patients with stenosis exceeding 50% to 60%. In a meta-analysis, carotid endarterectomy reduced rates of 1) perioperative stroke, death, or subsequent ipsilateral stroke and 2) perioperative stroke, death, or any subsequent stroke...
October 3, 2017: Annals of Internal Medicine
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