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Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research.
CONCLUSIONS: Pre-clinical studies showed positive benefit of GSNO in animal stroke models. The meta-analysis of clinical studies demonstrated that GSNO is effective in reducing embolic signals in patients with symptomatic internal carotid artery stenosis undergoing carotid endarterectomy or stenting. Further investigation of this molecule is warranted. PMID: 32119935 [PubMed - as supplied by publisher]
Source: Experimental Neurology - February 27, 2020 Category: Neurology Authors: Liu S, Zheng H, Yu W, Ramakrishnan V, Shah S, Gonzalez LF, Singh I, Graffagnino C, Feng W Tags: Exp Neurol Source Type: research

64-detector CT angiography within 24 hours after carotid endarterectomy and correlation with postoperative stroke.
CONCLUSIONS CTA within 24 hours of CEA demonstrates characteristic anatomical findings. CCA step-offs and ECA flaps are relatively common and clinically insignificant, whereas ICA/CCA flaps and thrombi are less frequently seen and are associated with postoperative stroke/TIA. PMID: 25555168 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - January 2, 2015 Category: Neurosurgery Authors: Gallati CP, Jain M, Damania D, Kanthala AR, Jain AR, Koch GE, Kung NT, Wang HZ, Replogle RE, Jahromi BS Tags: J Neurosurg Source Type: research

Early Outcomes After Carotid Artery Stenting Compared With Endarterectomy for Asymptomatic Carotid Stenosis Clinical Sciences
Conclusions— For asymptomatic carotid stenosis, CAS is associated with a substantially higher risk of postoperative stroke or in-hospital death than CEA even after adjustment for baseline differences in hospital and patient characteristics.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Choi, J. C., Johnston, S. C., Kim, A. S. Tags: Acute Cerebral Infarction, Carotid Stenosis, Carotid endarterectomy, Angioplasty and Stenting Clinical Sciences Source Type: research

Clinical risk predictors for cerebral hyperperfusion syndrome after carotid endarterectomy
Conclusions Independent, prospective monitoring of a large cohort of CEA cases identified a brief time interval between ischaemic symptoms and endarterectomy as the clearest risk factor for CHS.
Source: Journal of Neurology, Neurosurgery and Psychiatry - April 8, 2013 Category: Neurosurgery Authors: Maas, M. B., Kwolek, C. J., Hirsch, J. A., Jaff, M. R., Rordorf, G. A. Tags: Epilepsy and seizures, Headache (including migraine), Pain (neurology), Stroke, Hypertension, Ophthalmology, Ischaemic heart disease, Disability Neurosurgery 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

Ischemic complications after tailored carotid artery stenting in different subpopulations with high-grade stenosis: Feared but rare
Publication date: Available online 28 November 2014 Source:Journal of Clinical Neuroscience Author(s): José E. Cohen , J. Moshe Gomori , Eyal Itshayek , Stylianos Pikis , Galina Keigler , Roni Eichel , Ronen R. Leker Although the procedural and postoperative safety profile of carotid artery stenting (CAS) has been steadily improving, many centers still recommend carotid endarectomy (CEA) over CAS. We assessed outcomes (procedural and postoperative stroke) following tailored CAS in a cohort of patients managed at a single academic medical center. Outcomes for patients with carotid artery stenosis treated from 2005–2013...
Source: Journal of Clinical Neuroscience - November 29, 2014 Category: Neuroscience Source Type: research

E-050 last chance carotid stenting: treatment and outcomes of carotid artery stenting in very high risk patients
ConclusionsOur study indicates that CAS can be safely performed in patients considered too high-risk for CEA and who were referred to our center as such by their physicians.DisclosuresJ. Lozano: None. F. Massari: None. C. Brooks: None. M. Perras: None. M. Howk: None. M. Gounis: 1; C; NIH, Philips Healthcare, Covidien/eV3 Neurovascular, Codman Neurovascular, Stryker Neurovascular, Wyss Institute, Tay Sachs Foundation. 2; C; Stryker Neurovascular. N. Henninger: None. A. Wakhloo: 1; C; Phillips Healthcare Medical. 2; C; Stryker. 3; C; Harvard Postgraduate Course, Miami Baptist Vascular Institute. A. Puri: 1; C; Stryker. 2; C; Codman, Covidien.
Source: Journal of NeuroInterventional Surgery - July 26, 2015 Category: Neurosurgery Authors: Lozano, J., Massari, F., Brooks, C., Perras, M., Howk, M., Gounis, M., Henninger, N., Wakhloo, A., Puri, A. Tags: SNIS 12th Annual Meeting Electronic Poster Abstracts Source Type: research

Predicting early mortality following single ‐stage coronary artery or valve surgery and carotid endarterectomy
ConclusionsConsidering that postoperative stroke rate and mortality was acceptably low, single-stage approach is an effective option in such selected high-risk patients.
Source: Journal of Cardiac Surgery - November 9, 2022 Category: Cardiovascular & Thoracic Surgery Authors: Marco Franchin, Walter Dorigo, Stefano Benussi, Sara Speziali, Raffaele Pulli, Stefano Bonardelli, Mohamad Bashir, Gabriele Piffaretti Tags: ORIGINAL ARTICLE Source Type: research

Results of carotid angioplasty and stenting are equivalent for critical versus high-grade lesions in patients deemed high risk for carotid endarterectomy
Conclusions: Despite concerns regarding the potential for increased neurologic complications, our data demonstrate that patients with high-grade and critical stenosis are able to safely undergo CAS and achieve similar periprocedural outcomes and mid-term prognosis.
Source: Journal of Surgical Research - August 8, 2013 Category: Surgery Authors: Brant W. Ullery, Ksenia Orlova, Eric K. Shang, Benjamin M. Jackson, Grace J. Wang, Ronald M. Fairman, Edward Y. Woo Tags: Association for Academic Surgery Source Type: research

Usefulness of the Clavien-Dindo Classification to rate complications after carotid endarterectomy and its implications in patient prognosis.
Abstract OBJECTIVE: Our primary objective was to test if the C-D-C is also applicable for the assessment of carotid surgery and how well it correlates with patient prognosis in the mid-term follow-up. METHODS: From January 2011 to March 2014, a total of 248 consecutive open surgical carotid revascularization procedures were performed at one academic institution. All patients, symptomatic and asymptomatic, had a high-grade (>70%) stenosis and were operated on under general anesthesia. Physicians graded all complications that were identified in the first 30 days after surgery according to C-D-C(9). Complicat...
Source: cmaj - September 11, 2018 Category: General Medicine Authors: Inaraja-Pérez GC, Júlvez-Blancas M Tags: Ann Vasc Surg Source Type: research

Comparison of postoperative results between carotid endarterectomy and carotid artery stenting for patients with contralateral carotid artery occlusion: A meta-analysis.
CONCLUSIONS: Carotid endarterectomy was associated with a lower incidence of mortality compared to carotid artery stenting for patients with contralateral carotid occlusion. Regarding stroke, myocardial infarction, and transient ischemic attack, there was no significant difference between the two groups. More randomized controlled trials and prospective cohorts are necessary to help further clarify the ideal approach for these patients. PMID: 31027468 [PubMed - as supplied by publisher]
Source: Vascular - April 25, 2019 Category: Surgery Authors: Xin WQ, Zhao Y, Ma TZ, Gao YK, Wang WH, Wang HY, Yang XY Tags: Vascular Source Type: research

Preoperative anxiety as predictor of perioperative clinical events following carotid surgery: a prospective observational study
ConclusionsThe present study indicates that preoperative anxiety is associated with the occurrence of intra- and postoperative neurological events in patients undergoing CEA. Patients who had a preoperative HADS-A score of 6 or less had a very low probability of experiencing these complications.
Source: Perioperative Medicine - December 8, 2021 Category: Surgery Source Type: research

Carotid Artery Stenting (CAS) Outcomes May Vary Between Operators/Institutions. The Results from Centers of CAS Excellence May Not Be Generalizeable
The debate between carotid artery stenting (CAS) and carotid endarterectomy (CEA) for the management of carotid stenosis continues. Supporters of CAS claim that CAS has achieved clinical equipoise with CEA.1,2 In contrast, based on the results of multicenter RCTs,3-5 others argue that it is currently premature to conclude that CAS is as effective as CEA.6 Even in the best academic centers, CAS is consistently associated with significantly higher rates of stroke or death compared with CEA.6 The CAS supporters counterattack by saying that the RCTs3-5 demonstrating that CEA is superior to CAS had seriously flawed designs, nam...
Source: Annals of Vascular Surgery - September 8, 2015 Category: Surgery Authors: Kosmas I. Paraskevas, Frank J. Veith Source Type: research

Carotid Artery Stenting (CAS) Outcomes May Vary between Operators and/or Institutions. The Results from Centers of CAS Excellence May Not Be Generalizable
The debate between carotid artery stenting (CAS) and carotid endarterectomy (CEA) for the management of carotid stenosis continues. Supporters of CAS claim that CAS has achieved clinical equipoise with CEA.1,2 In contrast, based on the results of multicenter randomized controlled trials (RCTs),3–5 others argue that it is currently premature to conclude that CAS is as effective as CEA.6 Even in the best academic centers, CAS is consistently associated with significantly higher rates of stroke or death compared with CEA.
Source: Annals of Vascular Surgery - September 8, 2015 Category: Surgery Authors: Kosmas I. Paraskevas, Frank J. Veith Tags: Invited Commentary Source Type: research

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