Diagnostic Value of Somatosensory Evoked Potential Changes During Carotid Endarterectomy for 30-Day Perioperative Stroke

Carotid Endarterectomy (CEA) is a standard surgical treatment in the secondary prevention of stroke performed in patients with both symptomatic and asymptomatic carotid stenosis (CS)(Malcharek et al. 2013), (Pennekamp et al. 2011), (Pulli et al. 2002), (Reinert et al. 2012). CEA is shown to benefit symptomatic and asymptomatic patients, when compared to medical management alone in the short term and long term due to decreased stroke. (Akhmedov et al. 2013), (Baton et al. 2007), (Floriani et al. 1989), (Hartmann et al.
Source: Clinical Neurophysiology - Category: Neuroscience Authors: Source Type: research

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CONCLUSIONS: The presence of one or more prognostic factors as well as the various risk prediction models can guide selection of ACS patient subgroups for which a prophylactic CEA should or should not be offered. Decisions to offer prophylactic CEA should weigh in factors like surgeon's experience and hospital expertise/volume. Asymptomatic patients not expected to live long enough to benefit from the procedure should not be considered for CEA, but should be offered best medical treatment. PMID: 31814375 [PubMed - as supplied by publisher]
Source: International Angiology - Category: Cardiology Tags: Int Angiol Source Type: research
AbstractPurpose of reviewThe goal of this paper is to provide the reader with a review of the evidence supporting the surgical and medical management of patients with asymptomatic internal carotid artery (ICA) stenosis.Recent findingsBased on the results of earlier clinical trials, surgical intervention with carotid endarterectomy (CEA) has long been the preferred method of management for patients with asymptomatic severe carotid stenosis. Carotid artery stenting (CAS) is another less invasive surgical option that has similar outcomes over the long-term. However, more recent improvements in medical management have reduced ...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
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
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
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