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Identification of the Distal End of Carotid Plaque Using 3-Dimensional Fast Spin Echo T1-Weighted Magnetic Resonance Plaque Imaging
Background: Complete removal of the distal end of the plaque is an important requirement in carotid endarterectomy (CEA) to avoid postoperative complication. Preoperative identification of the distal end of plaque contributes to complete plaque removal. Three-dimensional (3D) magnetic resonance (MR) plaque imaging has been widely used to evaluate carotid plaque characterization. The purpose of the present study was to determine whether preoperative 3D fast spin echo (FSE) T1-weighted MR plaque imaging could identify the distal end of carotid plaque.
Source: Journal of Stroke and Cerebrovascular Diseases - February 9, 2020 Category: Neurology Authors: Kohei Chida, Yasuyoshi Shimada, Kentaro Fujimoto, Jun Yoshida, Daigo Kojima, Shunrou Fujiwara, Masakazu Kobayashi, Kenji Yoshida, Makoto Sasaki, Kuniaki Ogasawara Source Type: research

Unstable Carotid Plaque as a Phenotype of Chronic Systemic Inflammation Enhances Renal Insufficiency
In this study, we explored the association between the unstable plaques and preoperative CKD in patients who underwent carotid endarterectomy (CEA)/carotid artery stenting (CAS). Furthermore, this study also aimed to explore whether there is a difference in the aggravation of renal function with the presence of stable or unstable plaques. Patients and Methods: The study included 90 patients who underwent CEA/CAS for carotid artery stenosis.
Source: Journal of Stroke and Cerebrovascular Diseases - February 20, 2020 Category: Neurology Authors: Daina Kashiwazaki, Kunitaka Maruyama, Shusuke Yamamoto, Hisayasu Saito, Naoki Akioka, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda Source Type: research

Investigation of Pupillary Changes After Carotid Endarterectomy and Carotid Stent Placement Using Automated Pupillometry
This study evaluates pupillary changes after these procedures using automated pupillometry.
Source: Journal of Stroke and Cerebrovascular Diseases - February 24, 2020 Category: Neurology Authors: Sitara M. Weerakoon, Sonja E. Stutzman, Folefac D. Atem, Kelly S. Kuchenbecker, DaiWai M. Olson, Venkatesh Aiyagari Source Type: research

Comparative Analysis of Carotid Artery Stenting and Carotid Endarterectomy in Clinical Practice
The objective of the study was to describe immediate and long-term results of carotid endarterectomy (CEA) versus carotid stenting (CAS) with embolic protection in patients with severe carotid artery stenosis in clinical practice. Materials and Methods: This is a retrospective cohort study, conducted between 2009 and 2017.During the analyzed period, 2132 operations (2006 patients) were performed: 1215 (57%) CEA and 917 (43%) CAS. 278 patients (13.8% of 2006) were not contactable during the follow-up period (>30 days) leaving 1791 cases (1728 patients) for inclusion in the analysis.
Source: Journal of Stroke and Cerebrovascular Diseases - March 8, 2020 Category: Neurology Authors: Andrey Karpenko, Vladimir Starodubtsev, Pavel Ignatenko, Frances Dixon, Savr Bugurov, Igor Bochkov, Artem Rabtsun, Alexander Gostev, Pavel Ruzankin, Anna Brusaynskaya Source Type: research

What should be the Optimal Carotid Stent Opening Rate Without Post-Dilation?
Atherosclerotic stenosis of the carotid bifurcations and adjacent segments causes 10-20% of all ischemic strokes.1,2 Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are two main treatment strategies for stenosis in this region. CEA remains the gold standard for treating symptomatic carotid stenosis. CAS is usually recommended for patients with high risk for CEA, radiation-induced stenosis, or restenosis after CEA.3 CAS has some other advantages over CEA, such as its less invasive nature and shorter length of hospital stay.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: L ütfi Öcal, Ayhan Küp, Mehmet Çelik, Sinan Cerşit, Muhammed Keskin, Nuri Havan, Mustafa Ozan Gürsoy, Müslüm Şahin, Hayati Eren, Atilla Koyuncu, Abdulkadir Uslu, Fatih Yılmaz, Mehmet Vefik Yazıcıoğlu, Mehmet Muhsin Türkmen Source Type: research

First Bite Syndrome Following Carotid Endarterectomy
A 67-year-old man underwent left carotid endarterectomy (CEA). The plaque was extended to the top end of the C2 vertebral body. We dissected the parotid gland deeply and revealed internal carotid artery (ICA) well above the hypoglossal nerve due to the high position plaque (Fig A, B). He presented with sharp pain around the ipsilateral parotid region several days after the surgery. The pain occurred at starting mastication and rapidly resolved as further eating. We diagnosed the pain as first bite syndrome (FBS).
Source: Journal of Stroke and Cerebrovascular Diseases - October 8, 2020 Category: Neurology Authors: Eri Shiozaki, Tsuyoshi Izumo, Yoichi Morofuji, Nobutaka Horie, Takeo Anda, Takayuki Matsuo Tags: Case Report Source Type: research

Cerebrovacular Reserve Predicts the Cerebral Hyperperfusion Syndrome After Carotid Endarterectomy
Cerebral hyperperfusion syndrome is a rare but potentially severe complication of carotid artery revascularisation that develops under conditions of resistant postoperative hypertension and impaired cerebrovascular autoregulation.
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2020 Category: Neurology Authors: Vladimir Manojlovic, Nebojsa Budakov, Slavko Budinski, Djordje Milosevic, Dragan Nikolic, Vladimir Manojlovic Source Type: research

Efficacy of Carotid Artery Stenting Performed under General Anesthesia with Somatosensory Evoked Potential Monitoring
Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) for carotid stenosis. Although it can be performed under local anesthesia, due to ischemic intolerance, patients sometimes become uncomfortable during the procedure and cannot maintain rest, rendering it difficult to perform CAS. Moreover, the carotid sinus reflex may cause hemodynamic instability, which has been reported to increase postoperative complications.1 –4
Source: Journal of Stroke and Cerebrovascular Diseases - August 15, 2021 Category: Neurology Authors: Masayuki Gekka, Toshiya Osanai, Takeshi Aoki, Naoki Nakayama, Ken Kazumata, Kiyohiro Houkin, Miki Fujimura Source Type: research

Elevated Neutrophil to Lymphocyte Ratio is Associated with Worse Outcomes after Carotid Endarterectomy in Asymptomatic Patients
Management of carotid artery stenosis (CAS) remains controversial and proper patient selection critical. Elevated neutrophil to lymphocyte ratio (NLR) has been associated with poor outcomes after vascular procedures. The effect of NLR on outcomes after carotid endarterectomy (CEA) in asymptomatic and symptomatic patients is assessed.
Source: Journal of Stroke and Cerebrovascular Diseases - September 29, 2021 Category: Neurology Authors: Alexander H. King, Ann H. Kim, Stephen Kwan, Jasmine Lee, Alvin H. Schmaier, Norman H. Kumins, Karem C. Harth, Virginia L. Wong, Benjamin D. Colvard, Vikram S. Kashyap, Jae S. Cho Source Type: research

Renal Dysfunction is the Strongest Prognostic Factor After Carotid Artery Stenting According to Real-World Data
This study focused on the prognostic factors of CAS using real-world data.
Source: Journal of Stroke and Cerebrovascular Diseases - December 25, 2021 Category: Neurology Authors: Shigeta Miyake, Ryosuke Suzuki, Taisuke Akimoto, Yu Iida, Wataru Shimohigoshi, Yasunobu Nakai, Hiroshi Manaka, Nobuyuki Shimizu, Tetsuya Yamamoto Source Type: research

Preoperative antithrombotic treatment in acutely symptomatic carotid artery stenosis
Early recurrence of cerebral ischemia in acutely symptomatic carotid artery stenosis can precede revascularization. The optimal antithrombotic regimen for this high-risk population is not well established. Although antiplatelet agents are commonly used, there is limited evidence for the use of anticoagulants. We sought to understand the safety and efficacy of short-term preoperative anticoagulants in secondary prevention of recurrent cerebral ischemic events from acutely symptomatic carotid stenosis in patients awaiting carotid endarterectomy (CEA).
Source: Journal of Stroke and Cerebrovascular Diseases - February 24, 2022 Category: Neurology Authors: Juan Carlos Martinez-Gutierrez, Alexis T. Roy, Salvatore D'Amato, Jillian M. Berkman, Daniel Montes, Cheryl A. Kimball, Guy A. Rordorf, Lori B. Chibnik, Javier M. Romero, Scott B. Silverman Source Type: research

Prediction of cerebral hyperperfusion following carotid endarterectomy using intravoxel incoherent motion magnetic resonance imaging
One of the risk factors for cerebral hyperperfusion following carotid endarterectomy (CEA) is a chronic reduction in cerebral perfusion pressure due to internal carotid artery (ICA) stenosis, which is clinically detected as increased cerebral blood volume (CBV). The perfusion fraction (f) is one of the intra-voxel incoherent motion (IVIM) parameters obtained using magnetic resonance (MR) imaging that theoretically reflects CBV. The present study aimed to determine whether preoperative IVIM-f on MR imaging predicts development of cerebral hyperperfusion following CEA.
Source: Journal of Stroke and Cerebrovascular Diseases - November 25, 2022 Category: Neurology Authors: Tatsuhiko Takahashi, Ikuko Uwano, Yosuke Akamatsu, Kohei Chida, Masakazu Kobayashi, Kenji Yoshida, Shunrou Fujiwara, Yoshitaka Kubo, Makoto Sasaki, Kuniaki Ogasawara Source Type: research

Predictors of hemodynamic instability during and persistent after carotid artery stenting
Carotid artery stenting (CAS) is an alternative to carotid endarterectomy (CEA) and is widely used to treat carotid artery stenosis. CAS and CEA have been demonstrated to be equally effective and safe in both symptomatic and asymptomatic cases of carotid artery stenosis.1-3 CAS-induced hemodynamic instability (HI), manifested as bradyarrhythmia and/or hypotension, has been reported to have an incidence ranging from 7% to 76%.4-7 HI induced by CAS may increase the risk of perioperative cardiac and neurological events.
Source: Journal of Stroke and Cerebrovascular Diseases - August 9, 2023 Category: Neurology Authors: Hongchen Zhao, Zigao Wang, Yifeng Ling, Yiting Mao, Qiang Dong, Wenjie Cao Source Type: research

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