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Complication Rates and Center Enrollment Volume in the Carotid Revascularization Endarterectomy Versus Stenting Trial Clinical Sciences
Conclusions— Complication rates were low in CREST and were not associated with center enrollment volume. The data are consistent with the value of rigorous training and credentialing in trials evaluating endovascular devices and surgical procedures. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00004732.
Source: Stroke - October 27, 2014 Category: Neurology Authors: Gonzales, N. R., Demaerschalk, B. M., Voeks, J. H., Tom, M., Howard, G., Sheffet, A. J., Garcia, L., Clair, D. G., Barr, J., Orlow, S., Brott, T. G., on behalf of the CREST Investigators Tags: Carotid Stenosis, Carotid endarterectomy, Angioplasty and Stenting Clinical Sciences Source Type: research

A single-center experience of 30-day perioperative and one year clinical outcomes of transcarotid artery revascularization in 100 consecutive patients
CONCLUSION: Although the perioperative events were somewhat higher than what has been reported in previous registries, TCAR for patients who are high-risk for CEA has a low perioperative stroke and stroke/death rates with satisfactory outcome at 1 year. Further long-term data is probably needed to verify long-term outcome.PMID:35634873 | DOI:10.1177/17085381221106330
Source: Vascular - May 31, 2022 Category: Surgery Authors: Ali F AbuRahma Zachary T AbuRahma Adrian Santini Matthew Beasley Meghan Davis Andrew Lee Christina Veith Mazen Roshdy L Scott Dean Elaine Davis Source Type: research

Differential outcomes of carotid stenting and endarterectomy performed exclusively by vascular surgeons in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST)
Objective: Outcomes in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) did not differ between carotid artery stenting (CAS) and carotid endarterectomy (CEA) for the composite primary end point of stroke, myocardial infarction (MI), or death during the periprocedural period or ipsilateral stroke within 4 years. Rigorous credentialing and training of interventionists, including vascular surgeons, were required for the randomization phase of CREST. Because the lead-in phase of CREST had suggested higher perioperative risks after CAS performed by vascular surgeons, the purpose of this analysis was to...
Source: Journal of Vascular Surgery - December 26, 2012 Category: Surgery Authors: Carlos H. Timaran, Vito A. Mantese, Mahmoud Malas, O. William Brown, Brajesh K. Lal, Wesley S. Moore, Jenifer H. Voeks, Thomas G. Brott, CREST Investigators Tags: Clinical research studies Source Type: research

Selected Abstracts from the February Issue of the Journal of Vascular Surgery
Carlos H. Timaran, Vito A. Mantese, Mahmoud Malas, O. William Brown, Brajesh K. Lal, Wesley S. Moore, Jenifer H. Voeks, Thomas G. Brott Objective: Outcomes in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) did not differ between carotid artery stenting (CAS) and carotid endarterectomy (CEA) for the composite primary end point of stroke, myocardial infarction (MI), or death during the periprocedural period or ipsilateral stroke within 4 years. Rigorous credentialing and training of interventionists, including vascular surgeons, were required for the randomization phase of CREST. Because the lead...
Source: European Journal of Vascular and Endovascular Surgery - January 18, 2013 Category: Surgery Tags: JVS Abstracts Source Type: research

Carotid artery stenting and patient outcomes: The CABANA surveillance study
Conclusions: CAS with the Carotid WALLSTENT and FilterWire EZ yielded a low 30‐day MAE rate that did not differ significantly across operator experience and training levels. Clinicaltrials.gov identifier: NCT00741091. © 2014 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - June 19, 2014 Category: Cardiovascular & Thoracic Surgery Authors: L. Nelson Hopkins, Christopher J. White, Malcolm T. Foster, Richard J. Powell, Gerald Zemel, Juan Diaz‐Cartelle Tags: Original Studies Source Type: research

Carotid artery stenting and patient outcomes
ConclusionsCAS with the Carotid WALLSTENT and FilterWire EZ yielded a low 30‐day MAE rate that did not differ significantly across operator experience and training levels. Clinicaltrials.gov identifier: NCT00741091. © 2014 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - July 18, 2014 Category: Cardiovascular & Thoracic Surgery Authors: L. Nelson Hopkins, Christopher J. White, Malcolm T. Foster, Richard J. Powell, Gerald Zemel, Juan Diaz‐Cartelle Tags: Original Studies Source Type: research

The Impact of Operating Surgeon Experience, Supervised Trainee vs. Trained Surgeon, in Vascular Surgery Procedures: A Systematic Review and Meta-Analysis.
CONCLUSION: In select cases, with appropriate training and suitable experience, supervised trainees can perform surgical procedures without any detriment to patient care. To ensure high standards for patients of the future, supported training programmes are essential for today's surgical trainees. PMID: 31262675 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - June 27, 2019 Category: Surgery Authors: Bath MF, Awopetu AI, Stather PW, Sadat U, Varty K, Hayes PD Tags: Eur J Vasc Endovasc Surg Source Type: research

Potential of machine learning to predict early ischemic events after carotid endarterectomy or stenting: a comparison with surgeon predictions
AbstractCarotid endarterectomy (CEA) and carotid artery stenting (CAS) are recommended for high stroke-risk patients with carotid artery stenosis to reduce ischemic events. However, we often face difficulty in determining the best treatment strategy. We aimed to develop an accurate post-CEA/CAS outcome prediction model using machine learning that will serve as a basis for a new decision support tool for patient-specific treatment planning. Retrospectively collected data from 165 consecutive patients with carotid stenosis underwent CEA or CAS and were divided into training and test samples. The following five machine learni...
Source: Neurosurgical Review - June 2, 2021 Category: Neurosurgery Source Type: research

Case numbers in carotid surgery training can be accomplished and are not associated with an inferior outcome. Results of a university based tertiary care center study
Conclusions A VS trainee can expect to perform an average of 50 or more CEAs as primary operator and 80 or more CEAs as first assistant during a training period of 36 months. This exceeds the numbers required by the Austrian Medical Council and the European Vascular Board. There was neither an inferior overall outcome nor a higher complication rate between patients undergoing CEA performed by trainees as primary operator or as first assistant.
Source: European Surgery - October 23, 2014 Category: Surgery Source Type: research

Impact of Surgeon Experience During Carotid Endarterectomy Operation and Effects on Perioperative Outcomes
Conclusion: Younger surgeons perform carotid endarterectomy with similar techniques and have similar results compared to experienced surgeons. Younger surgeons rarely prefer using shunt during carotid endarterectomy. The experience and the skills gained by these surgeons during their training, under the supervision of experienced surgeons, will enable them to perform successful carotid endarterectomy operations independently after completion of their training period.
Source: Revista Brasileira de Cirurgia Cardiovascular - January 9, 2017 Category: Cardiovascular & Thoracic Surgery Source Type: research

Carotid Stenting in Neuroradiology
AbstractAfter a  period of stagnation due to negative results of randomized trials for patients with symptomatic stenosis, the relevance of carotid artery stenting (CAS) is increasing again. CAS has become an important and evidence-based part of interventional stroke treatment. Our ability to manage acute recanali zation of carotid occlusions and other niche indications properly led some skeptical neurologists to trust in carotid intervention for elective cases as well. The evolution of CAS from initial euphoria to more realistic views under consideration of trial results and guidelines is reviewed. Quality a ssurance in ...
Source: Clinical Neuroradiology - June 16, 2017 Category: Neurology Source Type: research

Shunt insertion in carotid endarterectomy - Can we simulate it and does it work?
Aim: Shunt insertion for carotid endarterectomy is a safe method of protecting cerebral perfusion and is associated with a low peri-operative stroke risk. As part of a regional training day for Vascular Surgical Registrars in South-West England we undertook simulation using a disposable multiport shunt with balloons. The aim was to assess effectiveness of simulation in shunt insertion.
Source: International Journal of Surgery - July 1, 2018 Category: Surgery Authors: T. Hardy, G. Dovell Source Type: research

Surgical Technique for Carotid Endarterectomy: Current Methods and Problems.
Authors: Uno M, Takai H, Yagi K, Matsubara S Abstract Over the last 60 years, many reports have investigated carotid endarterectomy (CEA) and techniques have thus changed and improved. In this paper, we review the recent literature regarding operational maneuvers for CEA and discuss future problems for CEA. Longitudinal skin incision is common, but the transverse incision has been reported to offer minimal invasiveness and better cosmetic effects for CEA. Most surgeons currently use microscopy for dissection of the artery and plaque. Although no monitoring technique during CEA has been proven superior, multiple mon...
Source: Neurologia Medico-Chirurgica - August 19, 2020 Category: Neurosurgery Tags: Neurol Med Chir (Tokyo) Source Type: research