Carotid artery stenting - an update.
[Carotid artery stenting - an update.] Radiologe. 2013 Feb 24; Authors: Gölitz P, Dörfler A Abstract CLINICAL/METHODICAL ISSUE: Therapy of carotid stenosis should be based on an accurate assessment of the stenosis and a differentiation between symptomatic and asymptomatic patients. STANDARD RADIOLOGICAL METHODS: According to current guidelines carotid artery stenting (CAS) can be considered as an established therapeutic alternative to carotid endarterectomy (CEA). METHODICAL INNOVATIONS: For the therapy of carotid stenosis CAS has become established as a minimally invasive alternative to CEA because the complication rate has been reduced due to growing experience, technical innovations and external quality assessment. PERFORMANCE: The CAS procedure should be performed in centers with documented complication rates of
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]
This study evaluates the impact of surgical specialty, specifically vascular surgery (VS) versus non-VS (NVS; namely, cardiac surgery, thoracic surgery, general surgery, or neurosurgery) on perioperative carotid endarterectomy (CEA) outcomes stratified by symptom status on presentation.
Int J Angiol DOI: 10.1055/s-0039-3400478The technique of the eversion carotid endarterectomy (ECEA), as an alternative to the conventional endarterectomy with primary or patch angioplasty, is an established technique for managing internal carotid artery stenoses and recently its application has been upgraded through the European Society for Vascular Surgery guidelines (Recommendation 55: Class 1, Level A). However, the typical eversion method has been associated with postoperative hypertension due to loss of the baroreceptor reflex; the standard oblique transection at the bulb performed in the eversion endarterectomy inter...
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 ...
We present a case of cerebral hyperperfusion syndrome in an elderly gentleman after a staged bilateral internal carotid artery stenting. PMID: 31793276 [PubMed - in process]
CONCLUSIONS: Our findings reveal complex associations between CD4+CD28null T cells and cardiovascular disease. Although we confirm the reported positive associations with an adverse prognosis in patients with already established disease, the opposite associations with first-time coronary events in the population-based cohort may limit the clinical use of CD4+CD28null T cells. PMID: 31801374 [PubMed - as supplied by publisher]
The objective of this research study is to validate the hypothesis, if and how the WMH influences brain connectivity in a population with carotid artery stenosis (CAS), which are eligible for carotid endarterectomy (CEA). We used resting state functional connectivity (rs-fc) magnetic resonance (MR) to validate our hypothesis, focusing on the effects of the total number of WMH (TNWMH) and of the WMH Burden (WMHB).MethodsTwenty-three patients (sixteen males and seven females, mean age 74.34 years) with mono or bilateral carotid stenosis eligible for carotid endarterectomy (CEA), underwent an MR examination on a 1.5-T s...
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]
Introduction - The optimal treatment of patients with asymptomatic carotid disease remains controversial with no clear consensus as to which is the optimal therapy for them. Our objective was to undertake a systematic literature review and perform a meta-analysis to assess the outcomes of carotid endarterectomy (CEA), stenting (CAS) and best medical therapy (BMT) on asymptomatic carotid disease.
Introduction - Until 2008 all patients with significant stenosis of the internal carotid artery and scheduled heart surgery underwent simultaneous operation at the Medical University of Graz. Though by now simultaneous operations are restricted to neurologically symptomatic patients according to actual guidelines, the goal of this study was to determine factors that influence postoperative neurological outcome.