• Filter By:
• Specialty
• Source
• Condition
• Cancer
• Infectious Disease
• Drug
• Training
• Management
• Procedure
• Therapy
• Vaccine
• Nutrition
• Country

Comparison of Trends and In-Hospital Outcomes of Concurrent Carotid Artery Revascularization and Coronary Artery Bypass Graft Surgery: The United States Experience 2004 to 2012
Conclusions In patients with concomitant carotid and coronary disease undergoing combined revascularization, combined CEA+CABG is utilized most frequently, followed by staged CEA+CABG and staged CAS+CABG strategies. The staged CAS+CABG strategy was associated with lower risk of mortality, but higher risk of stroke. Future studies are needed to examine the risks/benefits of different carotid revascularization strategies for high-risk patients requiring concurrent CABG.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - February 5, 2017 Category: Cardiology Authors: Feldman, D. N., Swaminathan, R. V., Geleris, J. D., Okin, P., Minutello, R. M., Krishnan, U., McCormick, D. J., Bergman, G., Singh, H., Wong, S. C., Kim, L. K. Tags: CME Source Type: research

Carotid Artery Stenting
Carotid artery stenting (CAS) has achieved clinical equipoise with carotid endarterectomy (CEA), as evidenced by 2 large U.S. randomized clinical trials, multiple pivotal registry trials, and 2 multispecialty guideline documents endorsed by 14 professional societies. The largest randomized trial conducted in patients at average surgical risk of CEA, CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) found no difference between CAS and CEA for the combined endpoint of stroke, death, and myocardial infarction (MI) after 4 years of follow-up. The largest randomized trial comparing CAS and CEA in patients a...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - August 11, 2014 Category: Cardiology Source Type: research

Revascularization Strategies in Patients With Combined Carotid and Coronary Artery Disease
Shishehbor et al. (1) retrospectively compared 3 different approaches to carotid revascularization and open heart surgery (OHS) (coronary artery bypass graft in>80% of cases) analyzing the results obtained in 350 patients treated in a tertiary US center during a 12-year period. Their results revealed that staged carotid artery stenting (CAS)-OHS and combined carotid endarterectomy (CEA)-OHS are associated with better outcomes (a composite of death, stroke, or myocardial infarction) than staged CEA-OHS at 30 days. However, the outcomes were in favor of staged CAS-OHS after the first year. The authors concluded that staged ...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 16, 2014 Category: Cardiology Source Type: research

Reply Sometimes, Things Are Not Always What They Seem
Dr. Naylor, in his commentary on the report by Shishehbor et al. (1), has brought up an important point regarding the optimal treatment strategy for patients with asymptomatic unilateral carotid disease. Since the pivotal trials comparing carotid endarterectomy with medical therapy almost 2 decades ago (2,33), it has been accepted that carotid endarterectomy is superior to medical therapy in lowering the future risk for stroke in patients with asymptomatic high-grade carotid disease. Whether contemporary medical therapy with potent antiplatelet, lipid-lowering, and antihypertensive therapy has narrowed the gap between the...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - March 31, 2014 Category: Cardiology Source Type: research

A Direct Comparison of Early and Late Outcomes With Three Approaches to Carotid Revascularization and Open Heart Surgery
ConclusionsStaged CAS-OHS and combined CEA-OHS are associated with a similar risk of death, stroke, or MI in the short term, with both being better than staged CEA-OHS. However, the outcomes significantly favor staged CAS-OHS after the first year.
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - November 11, 2013 Category: Cardiology Source Type: research

Carotid Revascularization Before Open Heart Surgery The Data-Driven Treatment Strategy ∗
Optimal management of high-grade obstructive carotid artery disease at the time of open heart surgery (OHS) has never been addressed in a randomized clinical trial. Data suggest that the combined approach of carotid endarterectomy (CEA) and OHS leads to a higher risk of procedural stroke (1,2,3), and, therefore, staged carotid revascularization by CEA or carotid artery stenting (CAS) is often performed before OHS. Does the staged approach lead to an overall reduction in the rate of major adverse cardiovascular events (MACE = death, myocardial infarction, and stroke) for patients with concomitant coronary and cerebrovasc...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - November 11, 2013 Category: Cardiology Source Type: research