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Impact of Circle of Willis Anatomy in Blunt Cerebrovascular Injury-Related Stroke
Cerebral vascular anatomy, specifically, the circle of Willis (COW), plays an unstudied role in the development of stroke after blunt cerebrovascular injury (BCVI) (carotid and vertebral arteries). Variant anatomy is very common, and certain variants such as persistent fetal circulation (enlarged posterior communicating artery) may improve collateralization between the anterior (carotid) and posterior (vertebral) circulations. Identifying patients at increased stroke risk may allow tailored anticoagulation, the mainstay of therapy.
Source: Journal of the American College of Surgeons - September 30, 2016 Category: Surgery Authors: Charles P. Shahan, Timothy C. Fabian, Richard I. Gray, Martin A. Croce Tags: Trauma Source Type: research

Risk Score Calculator for Stroke after Endovascular Repair of Thoracic Aortic Aneurysm in the Vascular Quality Initiative Database
This study aims to develop a score to predict the risk of in-hospital stroke after TEVAR.
Source: Journal of the American College of Surgeons - September 30, 2020 Category: Surgery Authors: Hanaa Dakour-Aridi, Aubrey Mwinyogle, Rebecca Ann Marmor, Jeffrey Joseph Siracuse, Ali Azizzadeh, Mahmoud Malas Tags: Vascular surgery Source Type: research

Does Bariatric Surgery Change the Risk of Acute Ischemic Stroke in Patients with History of Transient Ischemic Attack? A Nationwide Analysis
Stroke is the second most common cause of death worldwide and the fifth in the US, also representing the major cause of disability in older adults. We aim to determine the risk of acute ischemic stroke (AIS) in individuals with obesity, with past history of transient ischemic attack (TIA), compared with patients with a history of bariatric surgery (BaS).
Source: Journal of the American College of Surgeons - September 30, 2020 Category: Surgery Authors: Roberto J. Valera, Vicente J. Cogollo, Hong Liang, Mauricio Sarmiento-Cobos, Cristina Botero Fonnegra, Carlos E. Rivera, Emanuele Lo Menzo, Samuel Szomstein, Raul J. Rosenthal Tags: Bariatric and foregut Source Type: research

Goal-Directed Fluid Therapy using Stroke Volume Variation for Resuscitation after Low Central Venous Pressure Assisted Liver Resection. A Randomized Clinical Trial
Stroke volume variation-guided goal-directed fluid therapy was found to be safe and to result in equivalent morbidity compared to standard management. Patients in the goal-directed therapy arm received less intraoperative fluid, which was independently associated with postoperative morbidity on multivariate analysis.
Source: Journal of the American College of Surgeons - April 6, 2015 Category: Surgery Authors: Camilo Correa-Gallego, Kay See Tan, Vittoria Arslan-Carlon, Mithat Gonen, Stephanie C. Denis, Liana Langdon-Embry, Florence Grant, T Peter Kingham, Ronald P. DeMatteo, Peter J. Allen, Michael I. D’Angelica, William R. Jarnagin, Mary Fischer Tags: Original Scientific Article Source Type: research

Impact of Continuous Evaluation of Technology and Therapy: 30 Years of Research Reduces Stroke and Mortality from Blunt Cerebrovascular Injury
Blunt cerebrovascular injury (BCVI) was underdiagnosed until the 1990s when blunt carotid injuries were found to be more common than historically described. Technological advancements and regionalization of trauma care have resulted in increased screening and improved diagnosis of BCVI. The aim of this study was to demonstrate that systematic evaluation of the screening and diagnosis of BCVI, combined with early and aggressive treatment, have led to reductions in BCVI-related stroke and mortality.
Source: Journal of the American College of Surgeons - January 19, 2017 Category: Surgery Authors: Charles P. Shahan, Martin A. Croce, Timothy C. Fabian, Louis J. Magnotti Tags: Southern surgical association article Source Type: research

Minimally Invasive Placement of the Impella Assist Device is Associated with Low Stroke Risk
Cardiogenic shock is associated with high mortality rate and mechanical circulatory devices are critical in its treatment. The Impella device is a microaxial left ventricular assist device (LVAD) that is inserted through the aortic valve into left ventricular apex. The purpose of the study is to determine the incidence of stroke with the Impella device when it is placed through a minimally invasive approach.
Source: Journal of the American College of Surgeons - September 30, 2020 Category: Surgery Authors: Anthony Lemaire, Lindsay Volk, Leonard Y. Lee Tags: Cardiac Surgery Source Type: research

High Stroke Rate in Patients with Asymptomatic Severe Carotid Stenosis Who Are Medically Managed
Antiplatelet agents and statins have improved the medical management of internal carotid artery (ICA) stenosis since the publication of the ACAS trial. Yet, little is published about the natural history of medically managed patients with carotid stenosis. Stroke incidence and mortality associated with carotid stenosis remains high in the southeastern US. We sought to determine the outcomes of patients diagnosed with>70% ICA stenosis treated with medical management alone.
Source: Journal of the American College of Surgeons - October 22, 2021 Category: Surgery Authors: Sarah L. Weiner, William A. Marston, Mary H. Benton, Avital N. Yohann, Katharine L. McGinigle Tags: Vascular Surgery Source Type: research

Association Between Use of Electronic Cigarettes and Stroke
The objective of this research is to investigate whether there is an association between smoking e-cigarettes and the frequency of strokes in the adult population (18-64 years old) who completed the 2018 Behavioral Risk Factor Surveillance System (BRFSS). Additionally, this research is completed to determine if there is an associated frequency of stroke in people who switch from traditional combustible cigarettes to e-cigarettes.
Source: Journal of the American College of Surgeons - October 22, 2021 Category: Surgery Authors: Stephanie Lau, Jacob Risher Tags: Health Services Research Source Type: research

Discussion
DR SPENCE M TAYLOR (Greenville, SC): I have been a big fan of the vascular surgery group in West Virginia and have admired their work over the past 2 decades. They have published many wonderful studies on the surgical management of cerebrovascular disease and are truly authorities on the subject. In this paper, Dr AbuRahma and his associates analyzed a large cohort of more than 900 patients undergoing carotid endarterecomy, specifically looking at outcomes in patients with chronic renal insufficiency (CRI), which was measured both by elevated serum creatinine and by decreased glomerular filtration rate (GFR) using the Modi...
Source: Journal of the American College of Surgeons - April 1, 2013 Category: Surgery Tags: Southern Surgical Association Articles Source Type: research

Predictors of Operative Mortality in Cardiac Surgical Patients with Prolonged Intensive Care Unit Duration
Background: Several systems have been developed to predict mortality after intensive care unit (ICU) admission in medical and surgical patients. However, a similar tool specific to cardiac surgical patients with prolonged ICU duration does not exist. The purpose of the current study was to identify independent perioperative predictors of operative mortality among cardiac surgical patients with prolonged ICU duration.Study Design: From 2003 to 2008, a total of 13,105 cardiac surgical patients with ICU durations>48 hours were identified within a statewide database. Perioperative factors, including Society of Thoracic Surgeo...
Source: Journal of the American College of Surgeons - April 24, 2013 Category: Surgery Authors: Damien J. LaPar, Jacob R. Gillen, Ivan K. Crosby, Robert G. Sawyer, Christine L. Lau, Irving L. Kron, Gorav Ailawadi Tags: Original Scientific Articles Source Type: research

Outcomes of Thoracic Endovascular Aortic Repair and Subclavian Revascularization Techniques
Thoracic endovascular aortic repair with left subclavian coverage is associated with increased risk of stroke and upper extremity ischemia. Revascularization with carotid subclavian bypass or transposition offer comparable outcomes and reduced risk of stroke and upper extremity ischemia.
Source: Journal of the American College of Surgeons - March 11, 2015 Category: Surgery Authors: Kimberly C. Zamor, Mark K. Eskandari, Heron E. Rodriguez, Karen J. Ho, Mark D. Morasch, Andrew W. Hoel Source Type: research

Sex-Based Differences in Ten-Year Nationwide Outcomes of Carotid Revascularization
This retrospective study demonstrates asymptomatic women undergoing carotid revascularization have a similar risk of perioperative stroke, death, and/or myocardial infarction. Conversely, symptomatic women have an increased risk of stroke after carotid endarterectomy, and especially after carotid artery stenting.
Source: Journal of the American College of Surgeons - March 24, 2019 Category: Surgery Authors: Jessica M. Mayor, Jason L. Salemi, Deepa Dongarwar, Hamisu M. Salihu, Miguel Montero-Baker, Joseph L. Mills, Jayer Chung Tags: Western Surgical Association Article Source Type: research

Outcomes of Transcarotid Artery Revascularization and Carotid Endarterectomy at a Single Institution
Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are accepted revascularization modalities to treat carotid artery disease. Higher incidences of perioperative adverse neurological events and death have been reported in transfemoral CAS patients. Transcarotid artery revascularization (TCAR) is a newer operative technique that involves direct transcervical carotid access, minimizing the risk of embolic stroke via cerebral blood flow reversal. Perioperative stroke, myocardial infarction (MI), and death rates have been shown to be similar between TCAR and CEA, with TCAR having less complications.
Source: Journal of the American College of Surgeons - October 22, 2021 Category: Surgery Authors: Christopher A. Cappellini, Hong Zheng, Robert Luo Tags: Vascular Surgery Source Type: research

Bariatric Surgery Is Associated with a Reduction in Major Macrovascular and Microvascular Complications in Moderately to Severely Obese Patients with Type 2 Diabetes Mellitus
Background: Bariatric surgery (BAR) has been established as an effective treatment for type 2 diabetes mellitus (T2DM) in obese patients. However, few studies have examined the mid- to long-term outcomes of bariatric surgery in diabetic populations. Specifically, no comparative studies have broadly examined major macrovascular and microvascular complications in bariatric surgical patients vs similar, nonbariatric surgery controls.Study Design: We conducted a large, population-based, retrospective cohort study of adult obese patients with T2DM, from 1996 to 2009, using UB-04 administrative data and vital records. Eligible p...
Source: Journal of the American College of Surgeons - February 6, 2013 Category: Surgery Authors: Brent L. Johnson, Dawn W. Blackhurst, Bruce B. Latham, David L. Cull, Eric S. Bour, Thomas L. Oliver, Bradley Williams, Spence M. Taylor, John D. Scott Tags: Southern Surgical Association Articles Source Type: research

Effects of Carotid Artery Stenting on Arterial Geometry
Conclusions: Cartoid artery stenting can produce geometric changes to the artery that promote favorable conditions for complications and recurrent disease. Patients with circumferential, highly calcified plaques that are located relatively distal in the internal carotid artery are most likely to have post-stenting geometric changes.
Source: Journal of the American College of Surgeons - May 20, 2013 Category: Surgery Authors: Alexey V. Kamenskiy, Iraklis I. Pipinos, Yuris A. Dzenis, Jai Bikhchandani, Prateek K. Gupta, Nick Phillips, Syed A. Jaffar Kazmi, Jason N. MacTaggart Tags: Original Scientific Articles Source Type: research

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