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Patch angioplasty versus primary closure for carotid endarterectomy
CONCLUSIONS: Compared with primary closure, carotid patch angioplasty may reduce the risk of perioperative arterial occlusion and long-term restenosis of the operated artery. It would appear to reduce the risk of ipsilateral stroke during the perioperative and long-term period and reduce the risk of any stroke in the long-term when compared with primary closure. However, the evidence is uncertain due to the limited quality of included trials.PMID:35920689 | DOI:10.1002/14651858.CD000160.pub4
Source: Cochrane Database of Systematic Reviews - August 3, 2022 Category: General Medicine Authors: Saritphat Orrapin Thoetphum Benyakorn Boonying Siribumrungwong Kittipan Rerkasem Source Type: research

Carotid endarterectomy for symptomatic carotid stenosis.
CONCLUSIONS: Carotid endarterectomy reduced the risk of recurrent stroke for people with significant stenosis. Endarterectomy might be of some benefit for participants with 50% to 69% symptomatic stenosis (moderate-quality evidence) and highly beneficial for those with 70% to 99% stenosis (moderate-quality evidence). PMID: 32918282 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 11, 2020 Category: General Medicine Authors: Rerkasem A, Orrapin S, Howard DP, Rerkasem K Tags: Cochrane Database Syst Rev Source Type: research

Antithrombotic therapy to prevent cognitive decline in people with small vessel disease on neuroimaging but without dementia
CONCLUSIONS: We found no convincing evidence to suggest any clinically relevant cognitive benefit of using antithrombotic therapy in addition to standard treatment in people with cerebral small vessel disease but without dementia, but there may be an increased bleeding risk with this approach. There was marked heterogeneity across the trials and the certainty of the evidence was generally poor.PMID:35833913 | DOI:10.1002/14651858.CD012269.pub2
Source: Cochrane Database of Systematic Reviews - July 14, 2022 Category: General Medicine Authors: Joseph Kwan Melanie Hafdi Lorraine L W Chiang Phyo K Myint Li Siang Wong Terry J Quinn Source Type: research

Carotid endarterectomy for symptomatic carotid stenosis.
CONCLUSIONS: Endarterectomy was of some benefit for participants with 50% to 69% symptomatic stenosis (moderate-quality evidence), and highly beneficial for those with 70% to 99% stenosis without near-occlusion (moderate-quality evidence). We found no benefit in people with carotid near-occlusion (high-quality evidence). PMID: 28590505 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - June 7, 2017 Category: General Medicine Authors: Orrapin S, Rerkasem K Tags: Cochrane Database Syst Rev Source Type: research

Percutaneous transluminal angioplasty and stenting for vertebral artery stenosis
CONCLUSIONS: This Cochrane Review provides low- to moderate-certainty evidence indicating that there are no significant differences in either short- or long-term risks of stroke, death, or TIA between people with symptomatic vertebral artery stenosis treated with ET plus MT and those treated with MT alone.PMID:35579383 | DOI:10.1002/14651858.CD013692.pub2
Source: Cochrane Database of Systematic Reviews - May 17, 2022 Category: General Medicine Authors: Ran Xu Xiao Zhang Sihua Liu Xue Wang Wenjiao Wang Kun Yang Tao Wang Adam A Dmytriw Xuesong Bai Yan Ma Liqun Jiao Bin Yang Source Type: research

Anticoagulation versus placebo for heart failure in sinus rhythm
CONCLUSIONS: Based on the three RCTs, there is no evidence that oral anticoagulant therapy modifies mortality in people with HF in sinus rhythm. The evidence is uncertain if warfarin has any effect on all-cause death compared to placebo or no treatment, but it may increase the risk of major bleeding events. There is no evidence of a difference in the effect of rivaroxaban on all-cause death compared to placebo. It probably reduces the risk of stroke, but probably increases the risk of major bleedings. The available evidence does not support the routine use of anticoagulation in people with HF who remain in sinus rhythm.PMI...
Source: Cochrane Database of Systematic Reviews - May 18, 2021 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł Gregory Yh Lip Source Type: research

Direct thrombin inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in people with non-valvular atrial fibrillation.
CONCLUSIONS: DTIs were as efficacious as VKAs for the composite outcome of vascular death and ischaemic events and only the dose of dabigatran 150 mg twice daily was found to be superior to warfarin. DTIs were associated with fewer major haemorrhagic events, including haemorrhagic strokes. Adverse events that led to discontinuation of treatment occurred more frequently with the DTIs. We detected no difference in death from all causes. PMID: 24677203 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 27, 2014 Category: Journals (General) Authors: Salazar CA, Del Aguila D, Cordova EG Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Immediate versus delayed treatment for recently symptomatic carotid artery stenosis.
CONCLUSIONS: There is currently no high-quality evidence available to support either very early or delayed cerebral revascularization after a recent ischemic stroke. Hence, further randomized trials to identify which patients should undergo very urgent revascularization are needed. Future studies should stratify participants by age group, sex, grade of ischemia, and degree of stenosis. Currently, there is one ongoing RCT that is examining the timing of cerebral revascularization. PMID: 27611108 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 8, 2016 Category: Journals (General) Authors: Vasconcelos V, Cassola N, da Silva EM, Baptista-Silva JC Tags: Cochrane Database Syst Rev Source Type: research

Surgical and radiological interventions for treating symptomatic extracranial cervical artery dissection
CONCLUSIONS: No RCTs or CCTs compared either surgery or endovascular therapy with control. Thus, there is no available evidence to support their use for the treatment of extracranial cervical artery dissection in addition to antithrombotic therapy in people who continue to have neurological symptoms when treated with antithrombotic therapy alone.PMID:34559418 | DOI:10.1002/14651858.CD013118.pub2
Source: Cochrane Database of Systematic Reviews - September 24, 2021 Category: General Medicine Authors: Niamh Hynes Edel P Kavanagh Sherif Sultan Fionnuala Jordan Source Type: research

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