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We would like to thank Lazarides et  al in their letter to the editor regarding our report “Literature Review of Primary versus Patching versus Eversion as Carotid Endarterectomy Closure.”1 We agree with most of their comments. However, we did include a meta-analysis by Texakalidis et al.2 They had performed a meta-analysis of r andomized trials comparing bovine pericardium and other patch materials for carotid endarterectomy (CEA), which showed that the incidence of 30-day stroke, myocardial infarction, wound infection, death, cranial nerve injury, carotid artery thrombosis, and death were comparable.
Source: Journal of Vascular Surgery - September 29, 2021 Category: Surgery Authors: Ali F. AbuRahma, R. Clement Darling Tags: Letter to the Editor Source Type: research

Invited commentary
Since current guidelines based on randomized clinical trials1-6 have established degree of carotid stenosis as the primary surrogate for stroke risk and indication for carotid endarterectomy or stenting, accurate assessment of the degree of carotid stenosis has been the traditional focus of carotid imaging.7 However, the degree of carotid stenosis is an inadequate assessment of stroke risk, and other key factors for determining carotid plaque vulnerability include intraplaque hemorrhage, plaque rupture, and luminal thrombus.
Source: Journal of Vascular Surgery - November 20, 2018 Category: Surgery Authors: Karen J. Ho Tags: From bench to bedside Source Type: research

Low carotid stump pressure as a predictor for ischemic symptoms and as a marker for compromised cerebral reserve in octogenarians undergoing carotid endarterectomy
Carotid artery occlusive disease can cause stroke by embolization, thrombosis, and hypoperfusion. The majority of strokes secondary to cervical carotid atherosclerosis are believed to be of embolic etiology. However, cerebral hypoperfusion could be an important factor in perioperative stroke. We retrospectively reviewed the stump pressure (SP) of carotid endarterectomy (CEA) of patients at Pennsylvania Hospital to identify whether physiologic perfusion differences account for differences in perioperative stroke rates, particularly in octogenarians.
Source: Journal of Vascular Surgery - February 23, 2018 Category: Surgery Authors: Sam C. Tyagi, Matthew J. Dougherty, Shinichi Fukuhara, Douglas A. Troutman, Danielle M. Pineda, Hong Zheng, Keith D. Calligaro Tags: Clinical paper Source Type: research

Posterior transverse plication of the internal carotid artery to correct for kinking
Conclusions: Although the indications for additional shortening procedures following CEA need to be defined, in this small series, PTP as an additional shortening procedure of the ICA following CEA seems feasible and safe with no additional periprocedural risk for narrowing at the plicature or thrombosis of the endarterectomy plane. However, restenosis at the plicature may hamper the long term benefit of carotid reconstruction.
Source: Journal of Vascular Surgery - January 21, 2014 Category: Surgery Authors: Michiel H.F. Poorthuis, Eelco C. Brand, Raechel J. Toorop, Frans L. Moll, Gert Jan de Borst Tags: Clinical research studies 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

Carotid endarterectomy for symptomatic low-grade carotid stenosis
Conclusions: This study shows that CEA is a safe, effective, and durable treatment for patients with symptomatic low-grade carotid stenosis associated with unstable plaque. Patients had excellent protection against further ischemic events and survived long enough to justify the initial surgical risk. Plaque instability seems to play a major part in the onset of ischemic events, regardless the entity of lumen narrowing.
Source: Journal of Vascular Surgery - August 19, 2013 Category: Surgery Authors: Enzo Ballotta, Annalisa Angelini, Franco Mazzalai, Giacomo Piatto, Antonio Toniato, Claudio Baracchini Tags: Clinical research studies Source Type: research

Patching plus extended exposure and tacking of the common carotid cuff may reduce the late incidence of recurrent stenosis after carotid endarterectomy
The objective of this study was to determine whether routine patch angioplasty and precautions related to the common carotid cuff could reduce the risks for perioperative stroke, internal carotid artery (ICA) thrombosis, or recurrent carotid stenosis.Methods: The senior author (N.H.) performed 1959 consecutive isolated CEAs at the Cleveland Clinic from 1976 to 2004. This series can be divided into three distinct eras with respect to patching and management of the proximal common carotid cuff: (1) primary arteriotomy closure with selective patching in only 38 of 653 CEAs (5.8%) from 1976 to 1983 (group 1); (2) routine patch...
Source: Journal of Vascular Surgery - June 3, 2013 Category: Surgery Authors: Norman R. Hertzer, James F. Bena Tags: Clinical research studies Source Type: research

The role of completion imaging following carotid artery endarterectomy
A variety of completion imaging methods can be used during carotid endarterectomy to recognize technical errors or intrinsic abnormalities such as mural thrombus or platelet aggregation, but none of these methods has achieved wide acceptance, and their ability to improve the outcome of the operation remains a matter of controversy.It is unclear if completion imaging is routinely necessary and which abnormalities require re-exploration. Proponents of routine completion imaging argue that identification of these abnormalities will allow their immediate correction and avoid a perioperative stroke. However, much of the evidenc...
Source: Journal of Vascular Surgery - April 23, 2013 Category: Surgery Authors: Jean-Baptiste Ricco, Fabrice Schneider, Giulio Illuminati, Russell H. Samson Tags: Trans-Atlantic debate Source Type: research