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Clinical Response to Procedural Stroke Following Carotid Endarterectomy: A  Delphi Consensus Study
CONCLUSION: In patients having a stroke following carotid endarterectomy, expedited diagnostics should be performed initially in most phases. In patients who experience an ipsilateral intra-operative stroke following carotid clamp release, immediate re-exploration of the index carotid artery is recommended.PMID:34312072 | DOI:10.1016/j.ejvs.2021.05.033
Source: PubMed: Eur J Vasc Endovasc ... - July 27, 2021 Category: Surgery Authors: Armelle J A Meershoek Djurre D de Waard Jaap Trappenburg Clark J Zeebregts Richard Bulbulia Jaap L J Kappelle Gert-Jan de Borst Delphi consensus experts panel Source Type: research

Risk Factors For Stroke, Myocardial Infarction, or Death Following Carotid Endarterectomy: Results From the International Carotid Stenting Study.
CONCLUSIONS: Increasing diastolic blood pressure was the only independent risk factor for stroke, MI, or death following CEA. Cautious attention to blood pressure control following symptoms attributable to carotid stenosis could reduce the risks associated with subsequent CEA. PMID: 26460291 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - October 9, 2015 Category: Surgery Authors: Doig D, Turner EL, Dobson J, Featherstone RL, de Borst GJ, Stansby G, Beard JD, Engelter ST, Richards T, Brown MM, ICSS Investigators Tags: Eur J Vasc Endovasc Surg 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

Protamine Reduces Bleeding Complications without Increasing the Risk of Stroke after Carotid Endarterectomy: A Meta-analysis.
CONCLUSION: On the basis of the available data, heparin reversal with protamine seems to reduce the risk of wound haematoma, without increasing the risk of procedural stroke. However, taking into account the limitations of the analysis, further studies are needed to increase the level of evidence provided by the current meta-analysis. PMID: 27389942 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - July 3, 2016 Category: Surgery Authors: Kakisis JD, Antonopoulos CN, Moulakakis KG, Schneider F, Geroulakos G, Ricco JB Tags: Eur J Vasc Endovasc Surg Source Type: research

Unsedated Outpatient Percutaneous Endoscopic Gastrostomy in Stroke Patients: Is It Feasible and Safe?
This study sought to determine the feasibility and safety of outpatient, unsedated PEG implementation in stroke patients. This retrospective cohort study involved stroke victims who underwent unsedated outpatient PEG insertion from 2014 to 2017 at our Surgical Endoscopy Unit. Patients were given pharyngeal anesthesia with lidocaine 10% spray, while the PEG tube was placed under local anesthesia. The incidence of intraprocedural and postprocedural complications and 30-day mortality rate were recorded. Data from 127 cases were analyzed. The procedures were performed with minor, transient complications, which resolved after r...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - October 1, 2019 Category: Surgery Tags: Original Articles Source Type: research

The need for treatment of hemodynamic instability following carotid endarterectomy is associated with increased perioperative and 1-year morbidity and mortality
The objective of this study was to evaluate the outcomes of patients after carotid endarterectomy (CEA) who developed postoperative hypertension or hypotension requiring the administration of intravenous vasoactive medication (IVMED).Methods: We examined consecutive, primary elective CEA performed by 128 surgeons within the Vascular Study Group of New England (VSGNE) database (2003-2010) and compared outcomes of patients who required postoperative IVMED to treat hyper- or hypotension with those who did not. Outcomes included perioperative death, stroke, myocardial infarction (MI), congestive heart failure (CHF), hospital l...
Source: Journal of Vascular Surgery - September 3, 2013 Category: Surgery Authors: Tze-Woei Tan, Mohammad H. Eslami, Jeffrey A. Kalish, Robert T. Eberhardt, Gheorghe Doros, Philip P. Goodney, Jack L. Cronenwett, Alik Farber, Vascular Study Group of New England Tags: Clinical research studies Source Type: research

Locoregional anaesthesia and intraoperative angiography in carotid endarterectomy - 16-year results of a consecutive single-centre series
CONCLUSIONS: These data demonstrate a decline in the combined rates of any in-hospital major stroke or death after non-emergent CEA over time. Locoregional anaesthesia and intraoperative quality control were associated with these improvements and might be worthwhile in elective CEA.PMID:36229016 | DOI:10.1016/j.ejvs.2022.10.002
Source: PubMed: Eur J Vasc Endovasc ... - October 13, 2022 Category: Surgery Authors: Felix Kirchhoff Hans-Henning Eckstein Munich carotid investigation group Source Type: research

A Matched Case –Control Study on Early and Late Results of Carotid Endarterectomy Performed in Young Patients
ConclusionsCEA in patents aged 60 or less is safe and provides significantly better long-term results than those obtained in patients over 60 in terms of survival and stroke-free survival. Younger patients appear to have higher rates of recurrent carotid stenosis compared to the older cohort; however, these rarely require a secondary intervention.
Source: World Journal of Surgery - December 22, 2017 Category: Surgery Source Type: research

Results of carotid artery stenting with transcervical access
Conclusions: CAS with the transcervical approach is a safe procedure with low incidence of stroke and complications. It can be used as an alternative to femoral access in patients with unfavorable aortoiliac or aortic arch anatomy.
Source: Journal of Vascular Surgery - September 26, 2013 Category: Surgery Authors: George S. Sfyroeras, Konstantinos G. Moulakakis, Fotis Markatis, Constantinos N. Antonopoulos, George A. Antoniou, John D. Kakisis, Elias N. Brountzos, Christos D. Liapis Tags: Review article Source Type: research

Evaluation and comparison of postoperative outcomes of octogenarians and non-octogenarians undergoing carotid endarterectomy
ConclusionWe thought that CEA remains the most efficient treatment modality among symptomatic and asymptomatic octogenarians with severe carotid artery stenosis and no difference was found compared to non-octogenarians. Advanced age should not be considered as a  high-risk group and selected octogenarians are good candidates for CEA.
Source: European Surgery - April 15, 2019 Category: Surgery Source Type: research

Benefit of selective shunt use during carotid endarterectomy under regional anesthesia.
CONCLUSIONS: Selective-shunting did not demonstrate superiority for patients who developed focal deficits regarding stroke or other postoperative complications. However, due to the limitations of this study, the benefit of shunting cannot be excluded. Further randomized trials are recommended for precise results on this matter with current sparse clinical evidence. PMID: 32356684 [PubMed - as supplied by publisher]
Source: Vascular - April 30, 2020 Category: Surgery Authors: Rocha-Neves JM, Pereira-Macedo J, Dias-Neto MF, Andrade JP, Mansilha AA Tags: Vascular Source Type: research

Effects of pneumoperitoneum on hemodynamics evaluated by continuous noninvasive arterial pressure monitoring. A single-center observational study
CONCLUSIONS: In patients undergoing elective cholecystectomy, CNAP monitoring showed significant hemodynamic changes that would have been underappreciated with standard non-invasive monitoring with increase in arterial elastance under stable preload conditions. Whether this effect is due to unknown cardiovascular diseases facilitating ventriculo-arterial decoupling remains to be determined.KEY WORDS: Arterial Elastance, Cardiac Outp, Pneumoperitoneum, Stroke Volume, Stroke Volume Variation.PMID:37530058
Source: Annali Italiani di Chirurgia - August 2, 2023 Category: Surgery Authors: Luigi La Via Gaetano Palumbo Gloria Guccione Carlotta Continella Giulia Cirica Simona Tutino Tiziana Nicosia Marinella Astuto Filippo Sanfilippo Source Type: research

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