A comparison of outcomes of eversion versus conventional carotid endarterectomy: one centre experience
ConclusionThese two carotid endarterectomy techniques are equivalent in terms of outcome, but ECEA can be performed in a significantly shorter operative time and reduces need for shunting.
In their systematic review and meta-analysis (n=5 studies; 16,712 patients), Giannopoulos et al.1 compared synchronous carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) vs. staged carotid artery stenting (CAS) followed by CABG. They demonstrated that perioperative stroke (3% [447/15,727] vs. 3% [33/985], for CEA/CABG vs. CAS/CABG, respectively; odds ratio [OR]: 0.84; 95% confidence interval [CI]: 0.43-1.64; I2=39.1%) and transient ischemic attack (TIA) rates (1% [2/193] vs 4% [4/95] for CEA/CABG vs.
This study investigated 30-day morbidity and mortality as well as late survival in symptomatic and asymptomatic nonagenarians with severe carotid stenosis undergoing CEA.
CONCLUSIONS: Carotid endarterectomy continues to demonstrate effectiveness and safety for management of acute strokes, while carotid stenting has limitations. Carotid artery stenting has been shown to be non-inferior in some patient populations, but more recent and future technologic developments may expand the potential acceptable patient selection criteria. PMID: 31603298 [PubMed - as supplied by publisher]
ulo M Abstract INTRODUCTION: The best timing for carotid endarterectomy in patients with stroke is still matter of debate, particularly in case of significant cerebral ischemic lesion or neurological deterioration. The present review and meta-analysis aims to report the best evidence in the outcome of patients submitted to urgent (
Regarding "The association between platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and carotid artery stenosis and stroke following carotid endarterectomy". Vascular. 2019 Oct 04;:1708538119880389 Authors: Raffort J, Lareyre F PMID: 31584349 [PubMed - as supplied by publisher]
HISTORICALLY, carotid endarterectomy (CEA) surgery has generated several disputes regarding the choice of anesthesia provided and intraoperative neuromonitoring. The landmark General Anesthesia versus Local Anesthesia trial,1 which included 3,526 patients, showed no difference in the occurrence of stroke, myocardial infarction, or death at 30 days after surgery with respect to either local or general anesthesia. Harky et al.2 conducted a systematic review and meta-analysis of general versus local anesthesia in CEA surgery and concluded that each of the anesthetic techniques was noninferior to one another.
Medical intervention (risk factor identification, lifestyle coaching, and medication) for stroke prevention has improved significantly. It is likely that no more than 5.5% of persons with advanced asymptomatic carotid stenosis (ACS) will now benefit from a carotid procedure during their lifetime. However, some question the adequacy of medical intervention alone for such persons and propose using markers of high stroke risk to intervene with carotid endarterectomy (CEA) and/or carotid angioplasty/stenting (CAS).
AbstractAimsIdentifying factors associated with worse outcome following carotid endarterectomy (CEA) is important to improve prevention of major adverse cardiovascular and cerebrovascular events (MACCE), yet rarely used for registries. We intended to identify predictors of MACCE following CEA as recently analysed for stenting.Methods and resultsPatients undergoing CEA at 2 centers over 13 years were entered into a database. Baseline clinical characteristics, procedural factors and a panel of clinical and lesion-related high-risk features (SHR) and exclusion criteria (SE), empirically compiled for stratification in th...
Conclusions: Redo-CEA/CAS seem to have similar results as primary procedures (as reported in the literature) with favorable periprocedural and long-term outcomes. PMID: 31549937 [PubMed - as supplied by publisher]
Abstract BACKGROUND: The aim of this study was to evaluate the frequency of postoperative complications in patients who underwent coronary artery bypass grafting (CABG) and simultaneous carotid endarterectomy (CEA) and find predictors of postoperative complications. METHODS: We retrospectively evaluated 86 patients after simultaneous CABG and CEA. Inclusion criteria were: patients with asymptomatic carotid stenosis with a reduction of the carotid lumen diameter of more than 70% detected with Doppler ultrasound and diagnosed with one, two, or three vessel coronary artery disease with coronary stenosis more tha...