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Clinical Prediction Model Suitable for Assessing Hospital Quality for Patients Undergoing Carotid Endarterectomy Stroke
Conclusions The NCDR CEA score, comprising 7 clinical variables, predicts in-hospital stroke or death after CEA. This model can be used to estimate hospital risk-adjusted outcomes for CEA and to assist with the assessment of hospital quality.
Source: JAHA:Journal of the American Heart Association - June 17, 2014 Category: Cardiology Authors: Wimmer, N. J., Spertus, J. A., Kennedy, K. F., Anderson, H. V., Curtis, J. P., Weintraub, W. S., Singh, M., Rumsfeld, J. S., Masoudi, F. A., Yeh, R. W. Tags: Stroke Source Type: research

Activities of Daily Living Is a Critical Factor in Predicting Outcome After Carotid Endarterectomy in Asymptomatic Patients Clinical Sciences
Conclusions— In this national data set, patient’s inability to perform basic activities of independent living is associated with adverse postoperative outcomes after CEA. Hence, FNS should be vigilantly assessed in clinic for risk stratification along with other objective factors for gauging risk of adverse outcomes after CEA.
Source: Stroke - May 27, 2014 Category: Neurology Authors: Dayama, A., Pimple, P., Badrinathan, B., Lee, R., Reeves, J. G. Tags: Carotid endarterectomy Clinical Sciences Source Type: research

Impact of Glomerular filtration rate on clinical outcomes after carotid artery revascularization in 11,832 patients from the CARE registry
ConclusionsPatients with CKD have a greater number of comorbidities and worse unadjusted in‐hospital and 30‐day outcomes; CKD was not, however, an independent predictor of in‐hospital and 30‐day outcomes after carotid artery revascularization. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - May 3, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Luis Gruberg, Allen Jeremias, John H. Rundback, H. Vernon Anderson, John A. Spertus, Kevin F. Kennedy, Kenneth A. Rosenfield Tags: Original Studies Source Type: research

A Risk Prediction Model for Determining Appropriateness of CEA in Patients With Asymptomatic Carotid Artery Stenosis
A scoring system based on the probability of long-term survival can be used to determine patients most likely to benefit from carotid endarterectomy (CEA). There is considerable controversy about which patients with asymptomatic carotid stenosis, even high-grade asymptomatic carotid stenosis, are most likely to benefit from a prophylactic CEA. Indeed, there are those who believe that asymptomatic carotid stenosis may be best treated with carotid artery stenting and those who also contend that with modern medical therapy, asymptomatic carotid stenosis may be best treated with medical therapy alone. Although it seems intuit...
Source: Journal of Vascular Surgery - March 24, 2014 Category: Surgery Authors: M.F. Conrad, J. Kang, S. Mukhopadhyay Tags: Abstracts Source Type: research

Clinical and anatomic outcomes after carotid endarterectomy
Objective: The purpose of this study was to examine 30-day and long-term outcomes after carotid endarterectomy (CEA) in a contemporary series and to identify variables associated with stroke and death after CEA.Methods: This was a retrospective review of patients undergoing an isolated CEA at a single institution between January 1989 and December 2005. Primary study end points were 30-day and long-term overall stroke, ipsilateral stroke, and death. Secondary end points were recurrent stenosis (>70% stenosis) and reintervention. Kaplan-Meier analysis was used to create survival curves for the long-term study end points. Mul...
Source: Journal of Vascular Surgery - March 24, 2014 Category: Surgery Authors: Jeanwan Kang, Mark F. Conrad, Virendra I. Patel, Shankha Mukhopadhyay, Ashu Garg, Matthew R. Cambria, Glenn M. LaMuraglia, Richard P. Cambria Tags: Clinical research studies Source Type: research

Reduction in Early Stroke Risk in Carotid Stenosis With Transient Ischemic Attack Associated With Statin Treatment
In patients with acute symptomatic carotid stenosis, statin pretreatment is associated with reduced stroke risk. Carotid endarterectomy (CEA) in patients with associated symptoms is highly effective for secondary stroke prevention. Maximum benefit appears to be in those who undergo surgery ≤2 weeks of symptom onset; however, the safety of very early CEA has been questioned. Data from the Swedish Vascular Registry indicated an 11.5% stroke and death rate in patients undergoing CEA ≤48 hours of symptom onset. This is a fourfold increase in the odds of a poor outcome compared with those undergoing CEA from 3 to 7 days (S...
Source: Journal of Vascular Surgery - January 24, 2014 Category: Surgery Authors: Á. Merwick, G.W. Albers, E.M. Arsava Tags: Abstracts Source Type: research

A Clinical Rule (Sex, Contralateral Occlusion, Age, and Restenosis) to Select Patients for Stenting Versus Carotid Endarterectomy: Systematic Review of Observational Studies With Validation in Randomized Trials Clinical Sciences
Conclusions— The SCAR rule is potentially useful to identify patients in whom CAS has a similar risk of perioperative stroke or death to CEA.
Source: Stroke - November 25, 2013 Category: Neurology Authors: Touze, E., Trinquart, L., Felgueiras, R., Rerkasem, K., Bonati, L. H., Meliksetyan, G., Ringleb, P. A., Mas, J.-L., Brown, M. M., Rothwell, P. M., in collaboration with the Carotid Stenting Trialists' Collaboration Tags: Clinical Sciences Source Type: research

Correlation of ABCD2 Score with Degree of Internal Carotid Artery Stenosis: An Observational Pilot Study
Conclusions: Because no correlation between ABCD2 scores and the degree of ICA stenosis was found, all patients with carotid territory TIA should undergo urgent imaging of the carotid arteries because a high proportion of these patients may benefit from RACE.
Source: Annals of Vascular Surgery - October 30, 2013 Category: Surgery Authors: Manar Khashram, Thodur M. Vasudevan, Andre Donnell, David R. Lewis Tags: Clinical Research Source Type: research

Comparison of Carotid Artery Stenting and Carotid Endarterectomy in Patients with Symptomatic Carotid Artery Stenosis: A Single Center Study.
CONCLUSION: In our trial of patients with symptomatic carotid artery stenosis, no significant difference could be shown in periprocedural outcomes, postprocedural outcomes except TIA, and in composite endpoints between the CEA and CAS groups. CAS is a safe and efficacious alternative for the treatment of symptomatic carotid artery stenosis. PMID: 24105435 [PubMed - as supplied by publisher]
Source: Advances in Therapy - October 9, 2013 Category: Drugs & Pharmacology Authors: Taş MH, Simşek Z, Colak A, Koza Y, Demir P, Demir R, Kaya U, Tanboga IH, Gundogdu F, Sevimli S Tags: Adv Ther Source Type: research

Impact of glomerular filtration rate on clinical outcomes following carotid artery revascularization in 11,832 patients from the care registry®
Conclusions: CKD patients have a greater number of comorbidities, and worse unadjusted in‐hospital and 30‐day outcomes, CKD was not, however, an independent predictor of in‐hospital and 30‐day outcomes after carotid artery revascularization. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - July 1, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Luis Gruberg, Allen Jeremias, John H. Rundback, H. Vernon Anderson, John A. Spertus, Kevin F. Kennedy, Kenneth A. Rosenfield Tags: Original Study Source Type: research

Outcome of 312 Japanese Patients with Carotid Endarterectomy and Factors Associated with Cardiovascular Events—A Single-center Study in Japan
Background: There have only been a few reports regarding the outcomes and risk factors after CEA. To clarify the factors associated with outcome in patients with carotid stenosis who underwent carotid endarterectomy (CEA), we investigated cardiovascular events and mortality in the Kyushu Medical Center in Japan.Methods: We consecutively registered patients with significant carotid stenosis who had CEA performed over 10 years and compared the incidences of stroke, myocardial infarction, and death. On admission, we evaluated medical records for stroke risk factors, including hypertension, diabetes mellitus, hypercholesterol...
Source: Journal of Stroke and Cerebrovascular Diseases - May 30, 2013 Category: Neurology Authors: Toshiyasu Ogata, Tooru Inoue, Yasushi Okada Tags: Original Articles Source Type: research

Optimal selection of asymptomatic patients for carotid endarterectomy based on predicted 5-year survival
We examined factors associated with 5-year survival following CEA in patients with asymptomatic internal carotid artery (ICA) stenosis.Methods: Prospectively collected data from 4114 isolated CEAs performed for asymptomatic stenosis across 24 centers in the Vascular Study Group of New England between 2003 and 2011 were used for this analysis. Late survival was determined with the Social Security Death Index. Cox proportional hazard models were used to identify risk factors for mortality within the first 5 years after CEA and to calculate a risk score for predicting 5-year survival.Results: Overall 3- and 5-year survival af...
Source: Journal of Vascular Surgery - March 13, 2013 Category: Surgery Authors: Jessica B. Wallaert, Jack L. Cronenwett, Daniel J. Bertges, Andres Schanzer, Brian W. Nolan, Randall De Martino, Jens Eldrup-Jorgensen, Philip P. Goodney, Vascular Study Group of New England Tags: Clinical research studies Source Type: research

Can Patient or Arterial Characteristics Guide the Choice between Carotid Angioplasty and Carotid Endarterectomy? The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) (P01.225)
CONCLUSIONS: Beyond the previously described differential treatment efficacy by age, there were no other patient or arterial characteristic detected to identify patient subgroups that would differentially benefit from the choice of CAS versus CEA. Our inability to identify factors to guide treatment choices could be due to the low number of stroke and death events, incomplete information regarding arterial characteristics in the CEA population, or the potential exclusion of "high risk" groups (such as those with severe arterial tortuosity) from the study.Disclosure: Dr. Moore has nothing to disclose. Dr. Roubin has receive...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Moore, W., Roubin, G., Rosenfield, K., Altafullah, I., Ansel, G., Voeks, J., Meschia, J., Lal, B., Howard, G., Brott, T. Tags: P01 Cerebrovascular Disease I Source Type: research

A Post-Hoc Assessment of Current Hormone Therapy on Revascularization Risk in Women: The Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) (P03.168)
CONCLUSIONS: We found that women on current HRT have lower periprocedural risk associated with CAS or CEA than non-users, but little difference in risk after the procedural period. The mechanism for this unexpected finding is elusive. We urge caution in the interpretation of this post-hoc observation and encourage replication or refutation by other revascularization studies with similar data.Disclosure: Dr. Mackey has nothing to disclose. Dr. Lutsep has received personal compensation for serving on Consultant/Advisory Boards for Concentric Medical/Stryker, Co-Axia, and AGA Medical. Dr. Lutsep has received personal compensa...
Source: Neurology - February 14, 2013 Category: Neurology Authors: Mackey, A., Lutsep, H., Milot, G., Voeks, J., Howard, V., Hughes, S., Tom, M., Longbottom, M., Sheffet, A., Brott, T. Tags: P03 Cerebrovascular Disease III Source Type: research

Carotid stenting in asymptomatic patients: how to identify patients without symptoms and at high risk for neurologic events.
Abstract During the last 20 years, asymptomatic patients with high-grade carotid stenosis have been treated with carotid endarterectomy and more recently with carotid artery stenting in order to prevent stroke. New, best medical treatment including statins, beta-blockers, antiplatelet therapies, and better diabetes and blood pressure control might reduce the incidence of stroke in this patient population making invasive treatment unnecessary. However, patients with asymptomatic carotid stenosis cannot be considered a homogenous population, and therefore, the therapeutic approach should take into consideration a su...
Source: The Journal of Cardiovascular Surgery - January 30, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Yamada R, Anderson MB, Guimaraes M, Schönholz C Tags: J Cardiovasc Surg (Torino) Source Type: research

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