Early carotid endarterectomy for symptomatic stenosis of internal carotid artery in patients affected by transient ischemic attack or minor to moderate ischemic acute stroke: a single center experience

To report a single center experience with early surgical carotid revascularization in patients affected by transient ischemic attack and minor/moderate ischemic acute stroke.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research

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In 2007, the UK Department of Health (DOH) published its National Stroke Strategy, which detailed 20 quality markers for delivering a high quality stroke service, one of which was that patients suffering a transient ischaemic attack (TIA) or minor stroke should be investigated and treated more quickly after symptom onset.1 Interestingly, the National Stroke Strategy also advised that carotid endarterectomy (CEA) should be performed within 48  h of symptom onset, although no evidence was provided to support this threshold.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Tags: Editorial Source Type: research
Review of English-language articles published from PubMed (MEDLINE) and Google Scholar between January 1, 1985, and January 1, 2019.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Crescendo transient ischemic attacks should be treated by carotid endarterectomy within two days – but with increased perioperative stroke risk Source Type: research
CONCLUSIONS: Limb shaking TIA point to carotid artery disease in the majority of patients and vertebrobasilar artery disease in one third. Fast and timely treatment with either surgical or CAS eliminates the attacks and also reduce their risk of stroke. PMID: 31916976 [PubMed - as supplied by publisher]
Source: Revue Neurologique - Category: Neurology Tags: Rev Neurol (Paris) Source Type: research
Carotid endarterectomy (CEA) represents a standard procedure in case of symptomatic carotid stenosis of 50-99% within 2 weeks from onset of stroke or transient ischemic symptoms (TIA). The optimal time to perform CEA after Intravenous Thrombolysis (IVT) is still unclear. The aim of this study was to analyze the safety of CEA performed within 2 weeks from IVT.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research
Conclusions: Perioperative stroke drastically increases the risk of 30-day mortality. The occurrence of perioperative stroke exhibited high specificity but modest sensitivity in predicting 30-day mortality following CAS. This highlights the importance of neurophysiologic monitoring to detect intraoperative cerebral ischemia and perform timely interventions.
Source: Neurology India - Category: Neurology Authors: Source Type: research
Intraplaque haemorrhage (IPH) has been independently associated with a higher risk of future ipsilateral stroke in patients with carotid artery stenosis. Evaluation of plaque characteristics may contribute to risk assessment of recurrent (silent) cerebrovascular events in order to prioritise patients for timing of treatment. It is unknown if patients showing histologically apparent IPH also have increased risk of silent ischaemic brain lesions in the waiting period between index event and revascularisation.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
Review of English-language articles published from PubMed (MEDLINE) and Google Scholar between January 1, 1985, and January 1, 2019.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Crescendo transient ischemic attacks should be treated by carotid endarterectomy within 2 days —but with increased perioperative stroke risk Source Type: research
Introduction: Cerebral border zone infarctions (Watershed infarctions) on the early postoperative outcomes of patient undergoing carotid endarterectomy (CEA) were associated, in several studies, with a higher neurological complication rate. The current hypothesis is that hemodynamic phenomenon is involved. CEA performed under locoregional anesthesia enable to instantly reveal any hemodynamic phenomenon.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: Intraplaque hemorrhage (IPH) is an important feature of plaque vulnerability. Patients with a history of transient ischemic attack or stroke are treated with platelet aggregation inhibitors to prevent secondary myocardial infarction or ischemic stroke. Although antiplatelet medication is effective in reduction of clot formation, it also has adverse effects. It has therefore been hypothesized that platelet aggregation inhibitors could also initiate the onset or progression of IPH. A histopathological study on 154 carotid endarterectomy plaques found that preoperative antiplatelet therapy was associated with an...
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: Intravenous thrombolysis (IVT) can be combined with carotid endaterectomy either simultanously or in a staged procedure in the treatment of acute cartotis-associated stroke. It was the aim of this single-center retrospective studyto analyse the short-term results of sequential lysis with carotid endarterectomy, as well as long term results.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
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