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Protamine Reduces Serious Bleeding Complications Associated with Carotid Endarterectomy in Asymptomatic Patients without Increasing the Risk of Stroke, Myocardial Infarction, or Death in a Large National Analysis.
CONCLUSION: Protamine reduces serious bleeding complications at the time of CEA without increasing the risk of MI, stroke, or death, in this large North American analysis. Based on this and previous regional work regarding protamine use in CEA, it is believed that there is now sufficient evidence to support its routine use, and it should be considered as a benchmark for quality during CEA. PMID: 33127243 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - October 27, 2020 Category: Surgery Authors: Stone DH, Giles KA, Kubilis P, Suckow BD, Goodney PP, Huber TS, Powell RJ, Cronenwett JL, Scali ST Tags: Eur J Vasc Endovasc Surg Source Type: research

Interleukin-6 Predicts Carotid Plaque Severity, Vulnerability, and Progression
CONCLUSIONS: Circulating IL-6 predicts carotid plaque severity, vulnerability, and progression. The 2.0 pg/mL cutoff could facilitate the selection of individuals that would benefit from anti-IL-6 drugs for stroke prevention.PMID:35713008 | DOI:10.1161/CIRCRESAHA.122.320877
Source: Circulation Research - June 17, 2022 Category: Cardiology Authors: Joseph Kamtchum-Tatuene Luca Saba Mirjam R Heldner Michiel H F Poorthuis Gert J de Borst Tatjana Rundek Stavros K Kakkos Seemant Chaturvedi Raffi Topakian Joseph F Polak Glen C Jickling Carotid Atherosclerosis and Stroke Collaboration (CASCO) Source Type: research

The Impact of Full Collapse on the Risk of Ischaemic Stroke in Patients with Carotid Near Occlusion
Carotid near occlusion (CNO) is a severe carotid stenosis associated with a reduction in the calibre of the extracranial internal carotid artery distal to the stenosis.1 The risk of ipsilateral stroke in patients with CNO is a controversial issue. While a post hoc analysis of the North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the European Carotid Surgery Trial (ECST) reported a lower risk of ipsilateral stroke for medically treated patients with CNO compared with patients with severe (70 –99%) carotid stenosis2, more recent studies have shown that the CNO recurrence rate may be higher.
Source: European Journal of Vascular and Endovascular Surgery - April 20, 2023 Category: Surgery Authors: Andr és García-Pastor, Ana Iglesias-Mohedano, Antonio Gil-Núñez Tags: Editorial Source Type: research

PC052. The Effects of Stroke Unit Centralization for Patients With a Symptomatic Carotid Stenosis in the Carotid Endarterectomy Pathway
Carotid endarterectomy (CEA) should be performed on symptomatic, surgically suitable patients who present a stenosis greater than 50% North American Symptomatic Carotid Endarterectomy Trial stenosis of the internal carotid artery within 14 days of their symptoms. Aim of this study was to evaluate the effects of Stroke Uni centralization for patients with symptomatic carotid stenosis undergoing CEA.
Source: Journal of Vascular Surgery - May 22, 2018 Category: Surgery Authors: Emiliano Chisci, Lorenzo Nenci, Giulia Zaccagnini, Alberto Fortini, Gabriele Nenci, Luciana Tramacere, Massimo Cincotta, Stefano Michelagnoli Source Type: research

Using a CT Angiography Artificial Intelligence Carotid Plaque Morphology Model to Predict Stroke
The gold standard for determining carotid artery stenosis is to calculate stenosis using the North American Symptomatic Carotid Endarterectomy Trial criteria and ultimately plan for medical vs surgical management based on percent stenosis and symptomatic status. Few studies have assessed plaque morphology as an additive tool for stroke prediction. Our study uses an artificial intelligence software in conjunction with a patient's computed tomography (CT) scan of the neck to create a three-dimensional (3D) model of the carotid artery and assess plaque morphology including calcification, intraplaque hemorrhage, matrix, and pe...
Source: Journal of Vascular Surgery - May 23, 2023 Category: Surgery Authors: Rohini J. Patel, Daniel Willie-Permor, Sina Zarrintan, Austin Fan, Mahmoud Malas Tags: Poster Competition Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

One-Year Outcomes After Transcarotid Artery Revascularization (TCAR) in the ROADSTER 2 TRIAL
CONCLUSIONS: In patients with high risk factors, TCAR yields high technical success with a low stroke and death rate at one year. Further comparative studies to CEA are warranted.PMID:35381327 | DOI:10.1016/j.jvs.2022.03.872
Source: Atherosclerosis - April 5, 2022 Category: Cardiology Authors: Vikram S Kashyap Kristine L So Peter A Schneider Rama Rathore Thi Pham Raghu L Motaganahalli Douglas W Massop Mazin I Foteh Hans-Henning Eckstein Jeffrey Jim Jose Ignacio Leal Lorenzo James G Melton Source Type: research

Outcome Differences between Carotid artery stenting (CAS) and Carotid endarterectomy (CEA) in Postoperative Ventricular Arrhythmia, Neurological Complications and In-Hospital Mortality.
Conclusions: In short-term outcomes, CEA was associated with lower risk of postoperative ventricular arrhythmia, neurological complications, in-hospital mortality, and lower cost as compared with CAS. PMID: 32396028 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - May 14, 2020 Category: Internal Medicine Tags: Postgrad Med Source Type: research

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