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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

Prevalence of Stenoses and Occlusions of Brain-Supplying Arteries in Young Stroke Patients
One-fifth of young patients with stroke have asymptomatic or symptomatic large-artery atherosclerosis. Significant extracranial atherosclerotic carotid stenosis and occlusions in adult stroke patients of all ages (21-94 years old) occur in 11% to 22% (Bogousslavsky J et al, Stroke 1988;19:1083-92 and Wasay M et al, Stroke 2009;40:708-12). However, in younger patients with stroke, atherosclerotic changes in the extracranial and large intracranial arteries have not been considered a major etiology of stroke. Only two previous studies have reported the prevalence of atherosclerotic stenosis in young stroke patients, with pre...
Source: Journal of Vascular Surgery - August 28, 2013 Category: Surgery Authors: B. von Sarnowski, U. Schminke, T. Tatlisumak Tags: Abstracts Source Type: research

The essential role of endothelial nitric oxide synthase activation in insulin-mediated neuroprotection against ischemic stroke in diabetes
Conclusions: These results suggest that eNOS activation is required for the neuroprotection of insulin against ischemic stroke in patients with diabetes.Clinical Relevance: Our findings indicate that the impact of insulin in patients with diabetes with acute ischemic stroke is concurrently dependent on both endothelial nitric oxide synthase (eNOS) signaling and antihyperglycemic effects. When eNOS dysfunction (eg, vascular endothelial dysfunction) is developed in patients with diabetes, the beneficial effect of insulin might be diminished in acute ischemic stroke in spite of its preserved antihyperglycemic effect. For diab...
Source: Journal of Vascular Surgery - May 9, 2013 Category: Surgery Authors: Shiang-Suo Huang, Yi-Jhu Lu, Jiung-Pang Huang, Yang-Tzu Wu, Yuan-Ji Day, Li-Man Hung Tags: Basic research studies Source Type: research

Carotid Plaque MRI and Stroke Risk: A Systematic Review and Meta-analysis
Dedicated magnetic resonance imaging (MRI) of plaque composition offers stroke risk information beyond measurement of luminal stenosis in carotid atherosclerotic disease. Stenosis severity is widely used as a marker for stroke risk in patients with atherosclerotic carotid disease. However, evidence also suggests plaque composition can also predict stroke risk independent of stenosis severity (den Hartog AG et al, Eur J Vasc Endovasc Surg 2013;45:7-21). MRI measurements of plaque composition may help characterize carotid plaques with respect to stroke risk. However, individual studies have been relatively small, and it is ...
Source: Journal of Vascular Surgery - March 24, 2014 Category: Surgery Authors: A. Gupta, H. Baradaran, A.D. Schweitzer Tags: Abstracts Source Type: research

Predictors and clinical significance of progression or regression of asymptomatic carotid stenosis
Conclusions: Progressive asymptomatic carotid stenosis identified a subgroup with about twice the risk of ipsilateral stroke compared with those without progression. However, the clinical value of screening for progression simply for selecting patients for carotid procedures is limited because of the low frequency of progression and its relatively low associated stroke rate. The cost effectiveness of screening for change in stenosis severity to better direct current optimal medical treatment needs testing.
Source: Journal of Vascular Surgery - December 30, 2013 Category: Surgery Authors: Stavros K. Kakkos, Andrew N. Nicolaides, Ioanna Charalambous, Dafydd Thomas, Argyrios Giannopoulos, A. Ross Naylor, George Geroulakos, Anne L. Abbott, Asymptomatic Carotid Stenosis and Risk of Stroke (ACSRS) Study Group Tags: Clinical research studies Source Type: research

Neurologic Outcomes of Carotid and Other Emergent Interventions for Ischemic Stroke Over 6  Years With Analysis Enhanced by Machine Learning
Despite continued evolution in treatment, stroke continues to represent one of the most common and debilitating diseases patients suffer. We created a novel machine-learning natural language processing algorithm to assist in performing outcomes research for patients undergoing treatment for stroke. This method enhanced our ability to accurately determine neurologic outcomes for all urgent stroke interventions. Results demonstrate stroke severity and functional neurologic outcomes for all ischemic stroke patients undergoing (1) urgent carotid endarterectomy (uCEA)/urgent carotid artery stenting (uCAS), (2) tissue plasminoge...
Source: Journal of Vascular Surgery - December 20, 2021 Category: Surgery Authors: P. Andrew Rivera, Bethany Jennings, Jeff Burton, Aaron Hayson, Faith Mason, Jaron Pettis, Adam Berenson, W.C. Sternbergh, Samuel Money, Daniel Fort, Hernan Bazan Source Type: research

Safety of carotid endarterectomy following thrombolysis for acute ischemic stroke
Conclusions: Despite slightly higher rates of postoperative hemorrhagic strokes than those in randomized trials, CEA appears safe following thrombolysis for acute ischemic stroke. However, more data on the timing of surgery is needed.
Source: Journal of Vascular Surgery - July 29, 2013 Category: Surgery Authors: Yao Pey Yong, John Saunders, Said Abisi, Nikola Sprigg, Krishna Varadhan, Shane MacSweeney, Nishath Altaf Tags: Review articles Source Type: research

Neurologic outcomes of carotid and other emergent interventions for ischemic stroke over six years with dataset enhanced by machine learning
Current mainstays of ischemic stroke treatment include the use of thrombolysis (tissue plasminogen activator, tPA), urgent carotid endarterectomy (uCEA) or carotid artery stenting (uCAS), and mechanical endovascular reperfusion/thrombectomy (MER). Scarce data describe the presenting stroke severity and neurologic outcomes for these acute ischemic stroke interventions, alone or in combination. The authors hypothesize that patients undergoing carotid interventions experience better functional neurologic outcomes than other stroke interventions.
Source: Journal of Vascular Surgery - June 24, 2022 Category: Surgery Authors: P. Andrew Rivera, Jeffrey Burton, Aaron Hayson, Bethany Jennings, Gabriel Vidal, W.C. Sternbergh, Daniel Fort, Hernan A. Bazan Source Type: research

Neurologic outcomes of carotid and other emergent interventions for ischemic stroke over 6  years with dataset enhanced by machine learning
The current mainstays of ischemic stroke treatment include the use of thrombolysis (tissue plasminogen activator [tPA]), urgent carotid endarterectomy (uCEA) or urgent carotid artery stenting (uCAS), and mechanical endovascular reperfusion/thrombectomy (MER). Scarce data describe the presenting stroke severity and neurologic outcomes for these acute ischemic stroke interventions, alone or in combination. The authors hypothesize that patients undergoing carotid interventions experience better functional neurologic outcomes than other stroke interventions.
Source: Journal of Vascular Surgery - June 24, 2022 Category: Surgery Authors: P. Andrew Rivera, Jeffrey Burton, Aaron Hayson, Bethany Jennings, Gabriel Vidal, Waldemar C. Sternbergh, Daniel Fort, Hernan A. Bazan Source Type: research

Risk of Early Recurrent Stroke in Symptomatic Carotid Stenosis
The risk of recurrent stroke in patients with symptomatic carotid artery stenosis is highest in the first weeks after a transient ischemic attack (TIA) or minor stroke and can be reduced with carotid endarterectomy (CEA). The optimal timing of CEA remains a controversial issue since very urgent CEA is associated with an increased procedural risk. The aim of this study was to determine the risk of very early recurrent stroke in a population with symptomatic high grade carotid stenosis.
Source: Journal of Vascular Surgery - January 23, 2015 Category: Surgery Authors: S. Strömberg, A. Nordanstig, T. Bentzel, K. Österberg, G.M.L. Bergström Source Type: research

Urgent carotid intervention is safe after thrombolysis for minor to moderate acute ischemic stroke
Carotid intervention shortly after an acute neurologic ischemic event is being performed more frequently in stroke centers to reduce the risk of recurrent stroke. Thrombolysis with recombinant tissue plasminogen activator (tPA) is offered to select patients with ischemic stroke symptoms who present within 4.5 hours. However, there is a paucity of data as to whether tPA followed by urgent carotid endarterectomy (CEA) or carotid artery stenting (CAS) has an increased risk of complications, particularly intracerebral hemorrhage (ICH).
Source: Journal of Vascular Surgery - September 24, 2015 Category: Surgery Authors: Hernan A. Bazan, Nicolas Zea, Bethany Jennings, Taylor A. Smith, Gabriel Vidal, W. Charles Sternbergh Tags: Clinical Paper Source Type: research

One-Year Risk of Stroke after Transient Ischemic Attack or Minor Stroke
There is a lower risk of cardiovascular events after transient ischemic attack (TIA) than previously reported. The ABCD2 score, findings and brain imaging, and presence of large-artery atherosclerosis help stratify the risk of recurrent stroke within 1  year after a TIA or minor stroke.
Source: Journal of Vascular Surgery - September 22, 2016 Category: Surgery Authors: P. Amarenco, P.C. Lavallee, J. Labreuche Tags: Abstract Source Type: research

Effects of Aspirin on Risk and Severity of Early Recurrent Stroke After Transient Ischemic Attack and Ischemic Stroke: Time-Course Analysis of Randomized Trials
Medical therapy substantially reduces risk of early recurrent stroke after TIA and minor stroke and aspirin is the key intervention.
Source: Journal of Vascular Surgery - November 18, 2016 Category: Surgery Authors: P.M. Rothwell, A. Algra, Z. Chen Tags: Abstract Source Type: research

Urgent Carotid Intervention in Patients With Minor to Moderate Strokes (National Institutes of Health Stroke Scale Score ≤10) Performed After 48 Hours Results in Greater Functional Independence at Discharge
Increasing evidence suggests that urgent carotid intervention after transient ischemic attack (TIA) or nondisabling stroke is safe.1 However, functional outcome after urgent carotid intervention for various degrees of stroke severity has not yet been quantified. We aimed to determine whether increased stroke severity on presentation is associated with poor functional outcomes in patients undergoing urgent carotid endarterectomy (CEA) or carotid artery stenting (CAS).
Source: Journal of Vascular Surgery - December 18, 2017 Category: Surgery Authors: Esther Mihindu, Alaa Mohammed, Bethany Jennings, Mustafa Alhasan, James Milburn, Taylor Smith, Clayton Brinster, W.C. Sternbergh Tags: Abstract from the 2018 Southern Association for Vascular Surgery Annual Meeting Source Type: research

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