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Carotid angioplasty

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https://www.readbyqxmd.com/read/29136204/thrombolysis-is-an-independent-risk-factor-for-poor-outcome-after-carotid-revascularization
#1
Ananth K Vellimana, Chad W Washington, Chester K Yarbrough, Thomas K Pilgram, Brian L Hoh, Colin P Derdeyn, Gregory J Zipfel
BACKGROUND: Thrombolysis is the standard of care for acute ischemic stroke patients presenting in the appropriate time window. Studies suggest that the risk of recurrent ischemia is lower if carotid revascularization is performed early after the index event. The safety of early carotid revascularization in this patient population is unclear. OBJECTIVE: To evaluate the safety of carotid revascularization in patients who received thrombolysis for acute ischemic stroke...
November 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29135355/changes-in-ocular-hemodynamics-after-carotid-artery-angioplasty-and-stenting-caas-in-patients-with-different-severity-of-ocular-ischemic-syndrome
#2
Feiyan Ma, Jing Su, Qingli Shang, Jingxue Ma, Tongdi Zhang, Xin Wang, Honglei Ma, Jianghua Yu
PURPOSE: To evaluate the effects of carotid artery angioplasty and stenting (CAAS) on patients who were diagnosed with ocular ischemic syndrome (OIS). METHODS: Sixty-four eyes of 64 OIS patients with ipsilateral internal carotid artery stenosis ≥70% were included in the study. The study eyes were divided into two groups according to the presence of iris neovascularization: NVI-absent group and NVI-present group, with 32 eyes, respectively. All patients received ocular treatment modality according to the presence of non-perfusion area (pan-retinal photocoagulation) and intraocular pressure (medical treatment included timolol maleate eye drops combined with brinzolamide eye drop; trabeculectomy and cyclophotocoagulation)...
November 14, 2017: Current Eye Research
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#3
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#4
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29107156/advantages-of-staged-angioplasty-in-a-patient-with-internal-carotid-artery-pseudo-occlusion-besides-prevention-of-cerebral-hyperperfusion-syndrome
#5
Satoshi Takahashi, Takenori Akiyama, Jin Nakahara, Takahito Yoshizaki, Norihiro Suzuki, Kazunari Yoshida
BACKGROUND: Staged angioplasty for carotid artery stenosis has been reported to be effective in preventing postoperative cerebral hyperperfusion syndrome (CHS) in patients with severe carotid stenosis; thus, it is also recommended for patients with internal carotid artery (ICA) pseudo-occlusion, the treatment strategy for which is controversial. CASE DESCRIPTION: This study reports the case of an Asian male in his 50s who suffered from motor aphasia and right-side weakness due to pseudo-occlusion of the left ICA...
October 26, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29097132/cavernous-carotid-stenosis-following-stereotactic-radiosurgery-for-cushing-s-disease-a-rare-complication-and-review-of-the-literature
#6
Mohana Rao Patibandla, Zhiyuan Xu, David Schlesinger, Jason P Sheehan
Intracranial carotid stenosis or occlusion after SRS is an extraordinarily rare event. Because of the rarity of this event, increased awareness within the neurosurgical community is required. For those with post-radiosurgical carotid stenosis who are asymptomatic, longitudinal follow up is recommended. Management depends on whether the patient is symptomatic or asymptomatic. Those who are symptomatic may require balloon angioplasty, stenting, or bypass surgery.
October 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#7
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29064890/carotid-artery-reactivity-predicts-events-in-peripheral-arterial-disease-patients
#8
Anke C C M van Mil, Sjaak Pouwels, Jelmer Wilbrink, Michiel C Warlé, Dick H J Thijssen
OBJECTIVE: Patients with peripheral arterial disease (PAD) have increased risk on future cerebro- and cardiovascular events. Our aim was to examine whether carotid artery reactivity (CAR; a novel, simple procedure to examine endothelial function) predicts cardiovascular events in PAD patients. BACKGROUND: Increased risk for future cardiovascular events in PAD patients is likely related to endothelial dysfunction, highlighting the necessity for simple assessment of endothelial function...
October 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29058047/recurrent-stenosis-following-carotid-artery-stenting-treated-with-a-drug-eluting-balloon-a-single-center-retrospective-analysis
#9
C Pohlmann, J Höltje, M Zeile, F Bonk, P P Urban, R Brüning
PURPOSE: Early in-stent restenosis after stent-protected angioplasty of the carotid artery (SPAC) is an infrequent, but potentially harmful condition for patients with carotid artery disease. METHODS: In our retrospective single-center analysis of 176 patients with carotid artery stenting between 2009 and 2015, using duplex ultrasound, we detected 9 patients with high-grade carotid artery in-stent restenosis. All restenosis patients were treated with a drug-eluting balloon (DEB) to prevent recurrent neointimal hyperplasia...
October 20, 2017: Neuroradiology
https://www.readbyqxmd.com/read/29049525/impact-of-the-haga-braincare-strategy-on-the-burden-of-haemodynamic-and-embolic-strokes-related-to-cardiac-surgery
#10
Friso Duynstee, Ruud W M Keunen, Agnes van Sonderen, Ali M Keyhan-Falsafi, Gerard J F Hoohenkerk, Gayleen Stephens, Erik Teeuws, Jan W K van Alphen, Dénes L J Tavy, Arne Mosch, Sebastiaan F T M de Bruijn, Hans van Overhagen, Frank E E Treurniet, Lucas C van Dijk, Paulien M van Kampen
OBJECTIVES: This study prospectively evaluates the impact of the Haga Braincare Strategy (HBS) on the occurrence of haemodynamic and embolic stroke in a cohort of patients who underwent coronay artery bypass grafting (CABG), valve replacement of a combination of both types of surgery between 2012 and 2015 at the Haga Teaching Hospitals. METHODS: The HBS is a dual strategy based on a preoperative vascular work-up of the cerebral circulation by transcranial Doppler and a perioperative monitoring of the cerebral circulation by cerebral oximetry...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29046977/carotid-angioplasty-and-stenting-and-embolic-protection
#11
REVIEW
Enrico Giordan, Giuseppe Lanzino
PURPOSE OF REVIEW: We review the evidence on the safety and efficacy of carotid angioplasty and stenting (CAS) compared to carotid endarterectomy (CEA) and also summarizes emerging technical issues. RECENT FINDINGS: Randomized trials have demonstrated a progressive decrease of periprocedural strokes after CAS. Overall, in symptomatic patients, CAS is associated with a slightly higher risk of periprocedural strokes when compared to CEA. This is especially true after the age of 70 and immediately after a presenting symptomatic event...
October 18, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29037856/platelet-cd40-mediates-leukocyte-recruitment-and-neointima-formation-after-arterial-denudation-injury-in-atherosclerosis-prone-mice
#12
Rong Jin, Adam Y Xiao, Zifang Song, Shiyong Yu, Jarvis Li, Mei-Zhen Cui, Guohong Li
The role of platelets in the development of thrombosis and abrupt closure after angioplasty is well recognized. However, the direct impact of platelets on neointima formation after arterial injury remains undetermined. Herein, we show that neointima formation after carotid artery wire injury reduces markedly in CD40(-/-) apolipoprotein E-deficient (apoE(-/-)) mice but only slightly in CD40 ligand(-/-)apoE(-/-) mice, compared with apoE(-/-) mice. Wild-type and CD40-deficient platelets were isolated from blood of apoE(-/-) and CD40(-/-)apoE(-/-) mice, respectively...
October 14, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#13
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
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
#14
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/28974632/outcomes-of-primary-and-secondary-carotid-artery-stenting
#15
MULTICENTER STUDY
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...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28959477/staged-carotid-artery-angioplasty-and-stenting-for-patients-with-high-grade-carotid-stenosis-with-high-risk-of-developing-hyperperfusion-injury-a-retrospective-analysis-of-44-cases
#16
Dapeng Mo, Gang Luo, Bo Wang, Ning Ma, Feng Gao, Xuan Sun, Xiaotong Xu, Zhongrong Miao
BACKGROUND: Hyperperfusion syndrome (HPS) is a rare but potentially a life-threatening complication after carotid artery angioplasty and stenting (CAS). Staged CAS has been an alternative to prevent HPS. MATERIALS AND METHODS: 44 of 908 patients with high-grade internal carotid artery stenosis or near occlusion were at risk of HPS because of poor collateral flow and impaired cerebral blood flow (CBF). They were treated with first (stage 1), followed by a full CAS (stage 2) 1 month later...
December 2016: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28955509/the-annual-trends-between-neurointerventional-and-neurosurgical-procedures-in-korea-analysis-using-hira-data-from-2010-to-2016
#17
Sang Hyun Suh
PURPOSE: The purpose of this study was to evaluate the annual trend for several neurosurgical and neurointerventional procedures (NIPs) in Korea between 2010 and 2016 by using medical claim data. MATERIALS AND METHODS: All data during the recent 7 years were collected from Bigdata Hub provided by the Health Insurance Review & Assessment Service (HIRA). Using several codes for medical practice, we estimated the number of in-patients for each practice and calculated the annual variation of each procedure...
September 2017: Neurointervention
https://www.readbyqxmd.com/read/28935292/clinical-significance-of-reversal-of-flow-in-the-vertebral-artery-identified-on-cerebrovascular-duplex-ultrasound
#18
Aleksandra Policha, Melissa Baldwin, Victoria Lee, Mark A Adelman, Caron Rockman, Todd Berland, Neal S Cayne, Thomas S Maldonado
BACKGROUND: Reversal of flow in the vertebral artery (RFVA) is an uncommon finding on cerebrovascular duplex ultrasound examination. The clinical significance of RFVA and the natural history of patients presenting with it are poorly understood. Our objective was to better characterize the symptoms and outcomes of patients presenting with RFVA. METHODS: A retrospective review was performed of all cerebrovascular duplex ultrasound studies performed at our institution between January 2010 and January 2016 (N = 2927 patients)...
September 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28918014/artificial-zinc-finger-transcription-factor-of-a20-suppresses-restenosis-in-sprague-dawley-rats-after-carotid-injury-via-the-ppar%C3%AE-pathway
#19
Zhaoyou Meng, Pan Gao, Lin Chen, Jing Peng, Jialu Huang, Min Wu, Kangning Chen, Zhenhua Zhou
The inhibition of inflammation and vascular smooth muscle cell (VSMC) proliferation is an ideal strategy to suppress intimal hyperplasia after percutaneous transluminal angioplasty (PTA). Evidence has indicated that overexpression of A20 suppresses neointima formation, but its low transfection efficiency limits its application. Hence, we upregulated A20 expression via transfection of rAd.ATF (recombinant adenovirus vector of artificial transcription factor) and rAd.A20 in rat carotid arteries after balloon dilatation (in vivo) and isolated VSMCs (in vitro)...
September 15, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28916863/intracerebral-hemorrhage-as-a-manifestation-of-cerebral-hyperperfusion-syndrome-after-carotid-revascularization-systematic-review-and-meta-analysis
#20
REVIEW
Pedro Abreu, Jerina Nogueira, Filipe Brogueira Rodrigues, Ana Nascimento, Mariana Carvalho, Ana Marreiros, Hipólito Nzwalo
BACKGROUND: Intracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. METHODS: We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization...
November 2017: Acta Neurochirurgica
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