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Long-term Outcome After EndoVAC Hybrid Repair of Infected Vascular Reconstructions.
CONCLUSION: The EndoVAC technique is an alternative, less invasive, option for treatment of infected vascular reconstructions in selected cases, when neither traditional radical surgery, nor conservative simple negative pressure wound therapy are considered feasible or safe. The exact indications for this alternative hybrid treatment need to be established. PMID: 26944600 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 1, 2016 Category: Surgery Authors: Thorbjørnsen K, Djavani Gidlund K, Björck M, Kragsterman B, Wanhainen A Tags: Eur J Vasc Endovasc Surg Source Type: research

An ischemic stroke patient with free floating thrombus in carotid artery, successfully treated by open carotid thrombectomy: a first case report in Nepal.
We present a case in which we performed open surgery and achieved successful retrieval of the thrombus. A 40 year-old male patient presented with ischemic stroke and mild left hemiparesis. Computerized tomography and magnetic resonance imaging showed infarction in the right parieto-occipital area. Carotid Doppler study showed carotid stenosis on the right side. Further investigation with CT angiography of the neck vessels confirmed significant carotid artery occlusion with a free-floating thrombus in the internal carotid artery. Carotid endarterectomy was planned under EEG monitoring. The right carotid artery was exposed w...
Source: Hiroshima Journal of Medical Sciences - December 12, 2015 Category: Journals (General) Tags: Hiroshima J Med Sci Source Type: research

Decreased 13N‑labeled ammonia uptake in the ipsilateral and contralateral hemispheres following carotid endarterectomy.
Authors: Wang T, Wang X, He Y, Zhang T, Song J, Bai X, Han C Abstract Carotid artery plaques are a leading cause of ischemic stroke, and carotid endarterectomy (CEA) is one of the major treatment approaches for this disease. Changes in cerebral metabolism following CEA remain unclear. The present study aimed to evaluate the effect of cerebral ammonia metabolism following CEA using 13N‑labeled ammonia positron emission tomography (PET) in humans. A total of 20 patients were enrolled in the present study, with a mean age of 59.5 years, comprising 16 males and four females. Of these patients, eight underwent rig...
Source: Molecular Medicine Reports - September 10, 2015 Category: Molecular Biology Tags: Mol Med Rep Source Type: research

Mechanism of Procedural Stroke Following Carotid Endarterectomy or Carotid Artery Stenting Within the International Carotid Stenting Study (ICSS) Randomised Trial.
CONCLUSION: Although the mechanism of procedural stroke in both CAS and CEA is diverse, haemodynamic disturbance is an important mechanism. Careful attention to blood pressure control could lower the incidence of procedural stroke. PMID: 26160210 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - July 6, 2015 Category: Surgery Authors: Huibers A, Calvet D, Kennedy F, Czuriga-Kovács KR, Featherstone RL, Moll FL, Brown MM, Richards T, de Borst GJ Tags: Eur J Vasc Endovasc Surg Source Type: research

Carotid artery disease: clinical features and management
Publication date: Available online 5 June 2015 Source:Surgery (Oxford) Author(s): A Ross Naylor The most common 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 thereby 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 s...
Source: Surgery (Oxford) - June 6, 2015 Category: Surgery Source Type: research

64Cu-DOTATATE PET/MRI for Detection of Activated Macrophages in Carotid Atherosclerotic Plaques: Studies in Patients Undergoing Endarterectomy.
CONCLUSIONS: The novel PET tracer (64)Cu-DOTATATE accumulates in atherosclerotic plaques of the carotid artery. CD163 gene expression correlated independently with (64)Cu-DOTATATE uptake measured by real-time quantitative polymerase chain reaction in the final multivariate model, indicating that (64)Cu-DOTATATE PET is detecting alternatively activated macrophages. This association could potentially improve noninvasive identification and characterization of vulnerable plaques. PMID: 25977567 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - May 14, 2015 Category: Cardiology Authors: Folke Pedersen S, Vikjær Sandholt B, Høgild Keller S, Espe Hansen A, Ettrup Clemmensen A, Sillesen H, Højgaard L, Sejersten Ripa R, Kjær A Tags: Arterioscler Thromb Vasc Biol Source Type: research

Intraoperative Sonography During Carotid Endarterectomy: Normal Appearance and Spectrum of Complications
Carotid endarterectomy is a commonly performed procedure for prevention of stroke related to carotid stenosis. Intraoperative sonography is used to identify potentially correctable technical defects during carotid endarterectomy. The main risk of endarterectomy is perioperative stroke, and great effort has been put into trying to reduce this risk through various surgical techniques and evaluation of the surgical bed. Postoperative carotid thrombosis, or thombo-embolization from the arterectomy site, remains a common cause of perioperative stroke and is often related to technical defects in the arterial reconstruction proce...
Source: Journal of Ultrasound in Medicine - April 24, 2015 Category: Radiology Authors: Weinstein, S., Mabray, M. C., Aslam, R., Hope, T., Yee, J., Owens, C. Tags: Pictorial Essay Source Type: research

Expression of Vasohibin-1 in Human Carotid Atherosclerotic Plaque.
CONCLUSIONS: The VASH1 expression levels in atheroma reflect both enhanced neovascularization and the inflammatory burden. Therefore, the VASH1 level may be a novel biomarker for evaluating plaque instability in patients with carotid arteriosclerosis and predicting ischemic stroke. PMID: 25843115 [PubMed - as supplied by publisher]
Source: Journal of Atherosclerosis and Thrombosis - April 9, 2015 Category: Cardiology Tags: J Atheroscler Thromb Source Type: research

Stroke in a Young Woman Caused by Carotid Web (P1.024)
CONCLUSIONS: A carotid web increases stroke risk through thromboembolism. Unlike in other forms of carotid FMD, endarterectomy removes the focus of thrombosis without need for anticoagulation. Alternatively, anticoagulation or antiplatelet therapy might decrease stroke risk but would burden a young patient with increased lifetime risk of bleeding. Study Supported by: N/ADisclosure: Dr. Petrsoric has nothing to disclose. Dr. DeNiro has nothing to disclose. Dr. Labovitz has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Petrsoric, J., DeNiro, L., Labovitz, D. Tags: Cerebrovascular Disease and Interventional Neurology: Case Reports Source Type: research

Should TCDs be routinely used for evaluating intracranial circulation for screening high risk patients prior to cardiac surgery? (P2.280)
CONCLUSIONS: Our case elucidates the possibility of a hypoperfusion stroke related to left vertebral dominantly supplying intracranial circulation in presence of bilateral significant carotid stenosis. Due to lack of previous cardio/cerebrovascular events, his carotid stenosis was deemed asymptomatic prior to cardiac surgery. We propose that intracranial collateral flow should be investigated via TCD in patients with bilateral carotid stenosis undergoing procedures with high stroke risk to assess safety and efficacy of carotid revascularization in this small but significant subset. Additional studies like acetazolamide wit...
Source: Neurology - April 8, 2015 Category: Neurology Authors: Vu, Q., Bishop, L., Edwards, M., Tegeler, C., Sarwal, A. Tags: Cerebrovascular Disease and Interventional Neurology: PFO and Other Cardiac Disease Source Type: research

Acute Stroke After Carotid Endarterectomy: Time for a Paradigm Shift? Multicenter Experience With Emergent Carotid Artery Stenting With or Without Intracranial Tandem Occlusion Thrombectomy
CONCLUSION: Emergent endovascular evaluation in the setting of acute post--carotid endarterectomy thrombosis is a safe and timely treatment option, with the benefit of detecting and treating embolic intracranial lesions. Immediate angiography and intervention in this rare surgical complication show promising initial results. ABBREVIATIONS: CAS, carotid artery stenting CEA, carotid endarterectomy ICA, internal carotid artery NASCET, North American Symptomatic Carotid Endarterectomy Trial
Source: Neurosurgery - March 19, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

Emergent intracranial surgical embolectomy in conjunction with carotid endarterectomy for acute internal carotid artery terminus embolic occlusion and tandem occlusion of the cervical carotid artery due to plaque rupture.
Abstract Acute internal carotid artery (ICA) terminus occlusion is associated with extremely poor functional outcomes or mortality, especially when it is caused by plaque rupture of the cervical ICA with engrafted thrombus that elongates and extends into the ICA terminus. The goal of this study was to evaluate the efficacy and safety of surgical embolectomy in conjunction with carotid endarterectomy (CEA) for acute ICA terminus occlusion associated with cervical plaque rupture resulting in tandem occlusion. A retrospective review of medical records was performed. Clinical and radiographic characteristics were eval...
Source: Journal of Neurosurgery - January 9, 2015 Category: Neurosurgery Authors: Hasegawa H, Inoue T, Tamura A, Saito I Tags: J Neurosurg Source Type: research

64-detector CT angiography within 24 hours after carotid endarterectomy and correlation with postoperative stroke.
CONCLUSIONS CTA within 24 hours of CEA demonstrates characteristic anatomical findings. CCA step-offs and ECA flaps are relatively common and clinically insignificant, whereas ICA/CCA flaps and thrombi are less frequently seen and are associated with postoperative stroke/TIA. PMID: 25555168 [PubMed - as supplied by publisher]
Source: Journal of Neurosurgery - January 2, 2015 Category: Neurosurgery Authors: Gallati CP, Jain M, Damania D, Kanthala AR, Jain AR, Koch GE, Kung NT, Wang HZ, Replogle RE, Jahromi BS Tags: J Neurosurg Source Type: research

Symptomatic Carotid Atherosclerotic Disease: Correlations Between Plaque Composition and Ipsilateral Stroke Risk Clinical Sciences
Conclusions— Features of the vulnerable carotid plaque, including plaque thrombus, low fibrous content, macrophage infiltration, and microvessel density, correlate with predicted stroke risk. This study provides a basis for plaque imaging studies focused on stroke risk stratification.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Howard, D. P. J., van Lammeren, G. W., Rothwell, P. M., Redgrave, J. N., Moll, F. L., de Vries, J.-P. P. M., de Kleijn, D. P. V., den Ruijter, H. M., de Borst, G. J., Pasterkamp, G. Tags: Pathophysiology, Carotid Stenosis, Primary and Secondary Stroke Prevention, Carotid endarterectomy Clinical Sciences Source Type: research

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