Risk of Inhospital Stroke or Death Is Associated With Age But Not Sex in Patients Treated With Carotid Endarterectomy for Asymptomatic or Symptomatic Stenosis in Routine Practice: Secondary Data Analysis of the Nationwide German Statutory Quality Assurance Database From 2009 to 2014 Cardiovascular Surgery

ConclusionsThis study shows that increasing age, but not sex, is associated with a higher risk of in‐hospital stroke or death following carotid endarterectomy under everyday conditions in Germany. Whereas the risk of death (alone) is significantly associated with age, the association between age and the risk of stroke (alone) can be considered of minor importance.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Aging, Women, Cardiovascular Surgery, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Research Source Type: research

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CONCLUSIONS: Since the destabilization of the atherosclerotic plaque is a multifactorial process, a combination of various methods should be used to characterize the unstable plaques more accurately. In this context, studies characterizing plaque content from a cellular point ofview could elucidate some processes underlying the plaque progression. Together with morphological evaluation, these analyses could enable more precise assessment of plaque stability. PMID: 31782285 [PubMed - as supplied by publisher]
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
Introduction: Randomised trials have shown that successful carotid endarterectomy (CEA) approximately halves 5-year stroke risk among patients with tight asymptomatic carotid artery stenosis. The benefits of CEA with current medical therapies (including higher dose statins) are unclear. A reliable estimation of stroke risks requires follow up of a large cohort of patients with unoperated asymptomatic carotid stenosis and this report describes the design and characteristics of patients being recruited to this UK Carotid Cohort Study.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: Carotid endarterectomy is an established surgical intervention that is associatedwith a reduction in the future risk of stroke in symptomatic patients. However, the identification of culprit carotid plaque remains challenging for number of reasons including the suboptimal evaluation of carotid plaque morphology, disease activity and future stroke risk stratification.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction - Carotid artery stenting (CAS) is currently associated with an increased risk of 30-day stroke and death compared to carotid endarterectomy (CEA), while following this periprocedural period both interventions seem equally durable. In light of recent developments, both procedures could become equally effective in the periprocedural period. Consequently, a thorough comparison of costs and cost-effectiveness for CAS and CEA is warranted to provide arguments to support clinical decision making.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction - In patients with asymptomatic carotid artery disease receiving optimal medical treatment, carotid plaque echolucency has been shown to predict the risk of future ipsilateral stroke. Therefore, carotid endarterectomy may be more beneficial in patients with definite echolucent carotid plaque and as a result plaque echolucency has been suggested as a tool to aid in patient selection for surgery. However, carotid plaque echolucency is also thought to predict other systemic cardiovascular events (i.e.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction - A number of ultrasonic texture features which include severity of stenosis, grey scale median (GSM), plaque area (PA), juxtaluminal plaque area (JBA) and discrete white area (DWA) have been shown to be independent predictors of future strokes in carotid disease patients. The primary aim of the present study was to determine the association between histological features and ultrasonic plaque texture features after carotid endarterectomy. Secondary aim was to assess the association between statin therapy and symptomatic disease or other histological features.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: To assess the differences of completion angiography after carotid endarterectomy between local and general anesthetic approach. Our secondary outcomes were to evaluate the relationship between intraoperative reparations and postoperative strokes; and to assess the usefulness of external carotid reparation when it was occluded during the procedure.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
This study updated with independent neurologic assessment the 30-day and 90-day outcomes in selected patients suffering stroke-in-evolution (SIE) , with or without preoperative thrombolysis , who underwent operations in our department with in 2 weeks of the index event
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with carotid artery stenosis yet also induces it. Hence, the latter has to be as low as possible, which is even more important since the outcome of patients treated conservatively has improved in the past years. Formerly, the occurrence of multiple microemboli postoperatively has been shown to indicate a severely increased risk of postoperative stroke. These data however stem mostly from more than a decade ago, i.e.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: Around fifty percent of perioperative strokes following carotid endarterectomy (CEA) are related to hemodynamic disturbances (hypertensive and hypotensive episodes) and can occur up to 30 days after surgery. Therefore, tight perioperative blood pressure (BP) control is an essential component of stroke prevention after CEA.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
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