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Condition: Thrombosis
Procedure: Carotid Endarterectomy

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Total 111 results found since Jan 2013.

The Role of Neurosonology in the Diagnosis and Management of Patients with Carotid Artery Disease: A Review
ABSTRACT Carotid artery disease (CAD) is a common cause of ischemic stroke with high rates of recurrence. Carotid endarterectomy (CEA) or carotid artery stenting (CAS) are highly recommended for the secondary prevention of symptomatic CAD during the first 14 days following the index event of transient ischemic attack or minor stroke. CEA or CAS may also be offered in selected cases with severe asymptomatic stenosis. Herein, we review the utility of neurosonology in the diagnosis and pre‐/peri‐interventional assessment of CAD patients who undergo carotid revascularization procedures. Carotid ultrasound may provide inval...
Source: Journal of Neuroimaging - January 1, 2018 Category: Radiology Authors: Odysseas Kargiotis, Apostolos Safouris, Georgios Magoufis, Maria Georgala, Andromachi Roussopoulou, Eleftherios Stamboulis, Konstantinos G. Moulakakis, Andreas Lazaris, George Geroulakos, Spyros Vasdekis, Georgios Tsivgoulis Tags: Views and Reviews Source Type: research

Carotid artery disease: clinical features and management
The most common single cause of ischaemic carotid territory stroke is thromboembolism from stenoses in the extracranial internal carotid artery (ICA). In the majority, embolism is preceded by an acute change in plaque morphology predisposing the patient to overlying thrombus formation and embolization. The management of patients with carotid artery disease mandates risk factor modification, antiplatelet and statin therapy in everyone. There is grade A, level I evidence that recently symptomatic patients with 50 –99% NASCET stenoses gain significant benefit from carotid endarterectomy (CEA), despite a small risk of perioperative stroke.
Source: Surgery (Medicine Publishing) - April 25, 2018 Category: Surgery Authors: A. Ross Naylor Tags: Vascular surgery – I 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

Carotid web leads to new thrombus formation: computational fluid dynamic analysis coupled with histological evidence
We describe a 48-year-old woman with carotid web who developed embolic stroke. We obtained a fresh thrombus from the internal carotid artery when carotid endarterectomy was performed. A preoperative computational fluid dynamics (CFD) study showed stagnation of blood around the web structure as well as the low wall shear stress. The rheological analysis newly disclosed mechanisms of thrombus formation related to the carotid web. CFD study in the carotid web may determine indication and timing of surgical interventions with further accumulation of clinical evidence.
Source: Acta Neurochirurgica - March 9, 2020 Category: Neurosurgery Source Type: research

Protamine sulfate use during tibial bypass does not appear to increase thrombotic events or affect short-term graft patency.
CONCLUSIONS: Heparin reversal with protamine sulfate after tibial or peroneal bypass grafting is not associated with higher cardiovascular morbidity, bypass thrombosis, amputation, or mortality. Additionally, there was no statistically significant difference in post-operative bleeding or thrombosis complications for patients who did not receive protamine, although the findings are suggestive of a potential difference in a more adequately powered study. Our results suggest that protamine sulfate is safe for intraoperative use without increased risk of thrombotic complications or early tibial bypass graft failure. PMID:...
Source: Vascular - May 10, 2020 Category: Surgery Authors: Phair J, Futchko J, Trestman EB, Carnevale M, Friedmann P, Shukla H, Garg K, Koleilat I Tags: Vascular Source Type: research

Carotid artery disease: clinical features and management
The most common cause of ischaemic carotid territory stroke, around 50% of cases, is thromboembolism from stenoses at the origin of the extracranial internal carotid artery (ICA). Embolism is usually preceded by acute changes in plaque morphology, which predisposes towards overlying thrombus formation and embolization. The management of patients with carotid artery disease involves cardiovascular risk factor modification, antiplatelet and statin therapy in everyone. There is grade A, level I evidence that recently symptomatic patients with 50 –99% stenoses gain significant benefit from carotid endarterectomy (CEA), despi...
Source: Surgery (Medicine Publishing) - April 21, 2021 Category: Surgery Authors: Ross Naylor Tags: Vascular surgery – I Source Type: research

The Value of Contrast-Enhanced Ultrasound in the Evaluation of Carotid Web
ConclusionsCEUS may have a higher diagnostic accuracy for CaW with thrombosis, and it has a higher clinical application prospect.
Source: Frontiers in Neurology - April 27, 2022 Category: Neurology Source Type: research

Serum levels of anti-apolipoprotein A-1 auto-antibodies and myeloperoxidase as predictors of major adverse cardiovascular events after carotid endarterectomy.
In conclusion, combining the assessment of anti-apoA-1 IgG and MPO appears as a promising risk stratification tool in patients with severe carotid stenosis. PMID: 23364307 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - January 31, 2013 Category: Hematology Authors: Vuilleumier N, Montecucco F, Spinella G, Pagano S, Bertolotto M, Pane B, Pende A, Galan K, Roux-Lombard P, Combescure C, Dallegri F, Mach F, Palombo D Tags: Thromb Haemost 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

Spontaneous preoperative microembolic signals detected with transcranial Doppler are associated with vulnerable carotid plaque characteristics.
Conclusion: Spontaneous MES were detected in 26% of symptomatic patients scheduled for CEA and were associated with unstable carotid plaque characteristics. TCD might be a useful tool to help identify patients with vulnerable plaques. PMID: 23817452 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - July 1, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Van Lammeren GW, Van De Mortel RH, Visscher M, Pasterkamp G, De Borst GJ, Moll FL, Vink A, Tromp SC, De Vries JP Tags: J Cardiovasc Surg (Torino) Source Type: research

The collagen cross‐linking enzyme lysyl oxidase is associated with the healing of human atherosclerotic lesions
ConclusionsLOX may contribute to the healing of atherosclerotic lesions and to prevention of its lethal complications. Mediators of inflammation may control LOX expression in plaques and hence plaque stability.This article is protected by copyright. All rights reserved.
Source: Journal of Internal Medicine - February 1, 2014 Category: Internal Medicine Authors: Olga A. Ovchinnikova, Lasse Folkersen, Jonas Persson, Jan H. N. Lindeman, Thor Ueland, Pål Aukrust, Natalya Gavrisheva, Eugene Shlyakhto, Gabrielle Paulsson‐Berne, Ulf Hedin, Peder S. Olofsson, Göran K. Hansson Tags: Original Source Type: research

Time Dependent Changes in Atherosclerotic Plaque Composition in Patients Undergoing Carotid Surgery.
CONCLUSIONS: In conclusion, over the past decade, atherosclerotic plaques harvested during carotid endarterectomy show a time dependent change in plaque composition characterized by a decrease in features currently believed to be causal for plaque instability. This seems to go hand in hand with improvements in risk factor management. PMID: 24637558 [PubMed - as supplied by publisher]
Source: Circulation - March 17, 2014 Category: Cardiology Authors: van Lammeren GW, den Ruijter HM, Vrijenhoek JE, van der Laan S, Velema E, de Vries JP, de Kleijn DP, Vink A, de Borst GJ, Moll FL, Bots ML, Pasterkamp G Tags: Circulation 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

Identification of Patients with a Histologically Unstable Carotid Plaque Using Ultrasonic Plaque Image Analysis.
CONCLUSIONS: Computerized plaque analysis has the potential to identify patients with histologically unstable carotid plaques. This model requires validation, but offers the potential to influence patient selection for emergency interventions and the monitoring of medical therapy. PMID: 24947079 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - June 16, 2014 Category: Surgery Authors: Salem MK, Bown MJ, Sayers RD, West K, Moore D, Nicolaides A, Robinson TG, Naylor AR Tags: Eur J Vasc Endovasc Surg Source Type: research

Identification of Patients with a Histologically Unstable Carotid Plaque Using Ultrasonic Plaque Image Analysis
Objectives: In patients with carotid stenosis the risk of stroke is highest in the first few days after onset of symptoms and it is low in asymptomatic patients. The ability to identify patients with a high (or low) probability of having a histologically unstable plaque might become a complimentary method that can refine the indications for surgical intervention.Methods: Two histopathologists, using validated American Heart Association criteria, independently graded plaques harvested during carotid endarterectomy. Preoperative Duplex images were independently assessed for juxtaluminal black area, plaque type, plaque area, ...
Source: European Journal of Vascular and Endovascular Surgery - June 18, 2014 Category: Surgery Authors: M.K. Salem, M.J. Bown, R.D. Sayers, K. West, D. Moore, A. Nicolaides, T.G. Robinson, A.R. Naylor Tags: Carotid Disease Source Type: research