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Outcomes and role of shunting during carotid endarterectomy for symptomatic patients
In this retrospective study of 4,652 patients with symptomatic carotid stenosis undergoing CEA and patch angioplasty, shunt placement was associated with two-fold increased risk of cranial nerve injury without reduction in postoperative stroke risk, irrespective of symptom severity.
Source: Journal of Vascular Surgery - July 7, 2022 Category: Surgery Authors: Antoine J. Ribieras, Marwan Tabbara, Jorge Rey, Omaida C. Velazquez, Arash Bornak Source Type: research

Rules of engagement: The delicate dance between vascular surgeons, industrial partners, and patient outcomes
In 1953, Michael E. DeBakey performed the first carotid endarterectomy successfully. It would be almost 60  years until a new technique disrupted the carotid world with as much furor. In 2012, transcarotid artery revascularization (TCAR) burst onto the scene. With its minimally invasive, hybrid appeal and equivalency to carotid endarterectomy stroke risk, TCAR quickly won the hearts of many vascular sur geons. The update of TCAR technology was rapid, increasing dramatically at 15% annually, with a real jolt coming in 2016 when the Centers for Medicare& Medicaid Services allowed coverage for TCAR under the existing nationa...
Source: Journal of Vascular Surgery - November 19, 2021 Category: Surgery Authors: Anahita Dua Tags: Invited commentary Source Type: research

Carotid double jeopardy
Tandem carotid artery stenoses, one at the carotid bifurcation and one more proximal in the common carotid artery or innominate artery, are rare. I suspect that their incidence may increase with the ubiquitous availability of computed tomography angiography. Treatment of these lesions with a hybrid approach with stent placement or angioplasty of the proximal lesion and open endarterectomy of the carotid bifurcation was first reported in 1996.1 A prior meta-analysis showed excellent results.2 More recent reports have urged caution because the stroke and death rate were almost reaching unacceptable levels.
Source: Journal of Vascular Surgery - May 20, 2021 Category: Surgery Authors: Luke S. Erdoes Tags: Invited commentary Source Type: research

Poststent ballooning during transcarotid artery revascularization
Poststent ballooning/angioplasty (post-SB) have been shown to increase the risk of stroke risk after transfemoral carotid artery stenting. With the advancement of transcarotid artery revascularization (TCAR) with dynamic cerebral blood flow reversal, we aimed to study the impact of post-SB during TCAR.
Source: Journal of Vascular Surgery - November 26, 2020 Category: Surgery Authors: Hanaa Dakour-Aridi, Christina L. Cui, Andrew Barleben, Marc L. Schermerhorn, Jens Eldrup-Jorgensen, Mahmoud B. Malas Source Type: research

Post-Stent Ballooning during TransCarotid Artery Revascularization
Post-stent ballooning/angioplasty (post-SB) have been shown to increase the risk of stroke risk after Transfemoral CAS. With the advancement of TransCarotid Artery Revascularization (TCAR) with dynamic cerebral blood flow reversal, we aimed to study the impact of post-SB during TCAR.
Source: Journal of Vascular Surgery - November 26, 2020 Category: Surgery Authors: Hanaa Dakour-Aridi, Christina L. Cui, Andrew Barleben, Marc L. Schermerhorn, Jens Eldrup-Jorgensen, Mahmoud B. Malas Source Type: research

Hemodynamic events during carotid stenting are associated with significant periprocedural stroke and adverse events
This study evaluates the risk attributable to the CAS-related hemodynamic events and the impact preprocedural medications have on mitigating this risk in a large, population-based cohort.
Source: Journal of Vascular Surgery - February 17, 2020 Category: Surgery Authors: Isibor J. Arhuidese, Mary E. Ottinger, Ankur J. Shukla, Neil Moudgil, Paul Armstrong, Karl Illig, Brad L. Johnson, Murray L. Shames Source Type: research

Misconceptions regarding the adequacy of best medical intervention alone for asymptomatic carotid stenosis
Medical intervention (risk factor identification, lifestyle coaching, and medication) for stroke prevention has improved significantly. It is likely that no more than 5.5% of persons with advanced asymptomatic carotid stenosis (ACS) will now benefit from a carotid procedure during their lifetime. However, some question the adequacy of medical intervention alone for such persons and propose using markers of high stroke risk to intervene with carotid endarterectomy (CEA) and/or carotid angioplasty/stenting (CAS).
Source: Journal of Vascular Surgery - September 25, 2019 Category: Surgery Authors: Anne L. Abbott, Alejandro M. Brunser, Athanasios Giannoukas, Robert E. Harbaugh, Timothy Kleinig, Simona Lattanzi, Holger Poppert, Tatjana Rundek, Saeid Shahidi, Mauro Silvestrini, Raffi Topakian Source Type: research

Immediate and Delayed Procedural Stroke or Death in Stenting Versus Endarterectomy for Symptomatic Carotid Stenosis
The Carotid Stenosis Trialists ’ Collaboration pooled data of four randomized trials that recruited patients between 2000 and 2008: Endarterectomy vs Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S), Stent-Protected Angioplasty vs Carotid Endarterectomy (SPACE), International Carotid Stenting Study (ICS S), and Carotid Revascularization Endarterectomy vs Stenting Trial (CREST).
Source: Journal of Vascular Surgery - February 21, 2019 Category: Surgery Authors: M.D. Muller, S. von Felten, A. Algra, J.P. Becquemin, M. Brown, R. Bulbulia Tags: Compared with carotid endarterectomy, the risks of carotid artery stenting are higher the day of the procedure and not during follow-up Source Type: research

A systematic review of patch angioplasty versus primary closure for carotid endarterectomy
Guidelines recommend routine patching after carotid endarterectomy (CEA) on the basis of a lower restenosis rate and presumed lower procedural stroke rate than with primary repair. Underlying evidence is based on studies performed decades ago with perioperative care that significantly differed from current standards. Recent studies raise doubt about routine patching and have suggested that a more selective approach to patch closure (PAC) might be noninferior for procedural safety and long-term stroke prevention.
Source: Journal of Vascular Surgery - February 18, 2019 Category: Surgery Authors: Eline Huizing, Cornelis G. Vos, Peter J. van den Akker, Michiel A. Schreve, Gert J. de Borst, Çağdaş Ünlü Source Type: research

Mean Platelet Volume as a Predictor for Restenosis After Carotid Angioplasty and Stenting
Carotid artery stenting (CAS) patients enrolled in the Nanjing Stroke Registry between December 2005 and November 2016.
Source: Journal of Vascular Surgery - July 20, 2018 Category: Surgery Authors: Z. Dai, J. Gao, S. Li, R. Li, Z. Chen, M. Liang Tags: Mean platelet volume may predict restenosis after carotid artery stenting and identify patients who may benefit from more intense antiplatelet therapy Source Type: research

IP107. Hemodynamic Events During Carotid Stenting Are Associated with Significant Periprocedural Stroke
This study evaluates the risk attributable to the hemodynamic events that occur during carotid angioplasty and stenting (CAS) and the impact that preprocedural and prophylactic medications have on mitigating this risk in a large, population-based cohort of patients.
Source: Journal of Vascular Surgery - May 22, 2018 Category: Surgery Authors: Isibor Arhuidese, Mary Ottinger, Ankur Shukla, Neil Moudgil, Paul A. Armstrong, Karl A. Illig, Brad Johnson, Murray Shames Source Type: research

Stenting for Symptomatic Vertebral Artery Stenosis: The Vertebral Artery Ischaemia Stenting Trial
This study provides class I evidence that for patients with symptomatic vertebral stenosis, angioplasty with stenting does not  reduce the risk of stroke. However, the study lacked the precision to exclude a benefit from stenting. Large phase 3 trials are required to determine whether stenting reduces stroke risk.
Source: Journal of Vascular Surgery - February 21, 2018 Category: Surgery Authors: H.S. Markus, S.C. Larsson, S.C. Kuker, W. Kuker, U.G. Schulz, I. Ford Tags: Vascular vantage point Source Type: research

IP131. Transfemoral Carotid Angioplasty and Stenting With Embolic Protection: A 7-year Retrospective Analysis of a Single-Center Experience
Carotid angioplasty and stenting (CAS) is an excellent, often superior, alternative to carotid endarterectomy (CEA). When performed by experienced operators, both are equivalent in periprocedural risk and stroke prevention. Widespread adoption of CAS in the United States has been impeded by reimbursement regulations mandated by the Centers for Medicare and Medicaid Services (CMS) that favor CEA over CAS for patients with asymptomatic carotid disease. This policy has led to decreased CAS volumes and an increase in percentages of patients receiving CAS for symptomatic vs asymptomatic disease.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Michael B. Silva, Garold Motes, Zulfiqar Faisal. Cheema, Grant Fankhauser, Nikita Tihonov, Jennifer Worsham, Kaled Diab, Charlie Cheng Tags: IP: Interactive Poster Session Source Type: research

PC206 Transdifferentiation and Remodeling of a Tissue-Engineered Collagen Scaffold in the Ovine Carotid Model: An Experimental Pilot Study
This study evaluated the performance and remodeling potential of a novel tissue-engineered collagen scaffold (VascuCel) in an ovine carotid model.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: William Morris Neethling Tags: C10: Poster Competition Source Type: research

PC164 Fast-Track Thrombolysis for Acute Lower Extremity In-Stent Occlusions: A Novel Approach to Minimize Complications of Standard Thrombolytic Therapy
The role of catheter-directed thrombolysis (CDT) in the treatment of acute lower extremity ischemia may require prolonged periods of time to achieve successful lysis. Prolonged thrombolysis infusion has demonstrated increased incidence of intracranial bleeding, stroke, and local complications. It is expensive and increases hospital length of stay. To minimize these potentially negative outcomes, we developed a fast track approach (FTA) that included the use of aggressive balloon angioplasty and stenting before the thrombus was completely lysed.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Syed Ali Rizvi, Anil Hingorani, Enrico Ascher, Natalie Marks Tags: C10: Poster Competition Source Type: research

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