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Specialty: Surgery
Condition: Thrombosis
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Total 198 results found since Jan 2013.
Completion imaging techniques and their clinical role after carotid endarterectomy: Systematic review of the literature.
CONCLUSION: Completion imaging techniques can detect defects in almost 10% of patients that may lead to immediate intra-operative surgical revision with low intra-operative stroke/transient ischemic attack rate and low early carotid restenosis. During the 30-day follow-up period, in those patients, the incidence of stroke/transient ischemic attack may be low but present. This review cannot provide any evidence on which completion imaging technique is better, and the clinical impact conferred by each technique in the absence of a randomized control studies.
PMID: 32493183 [PubMed - as supplied by publisher]
Source: Vascular - June 2, 2020 Category: Surgery Authors: Spanos K, Nana P, Kouvelos G, Batzalexis K, Matsagkas MM, Giannoukas AD Tags: Vascular 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
Predictors of Cervical Bleeding after Carotid Endarterectomy
Conclusions: Postoperative severe bleeding after carotid surgery in our institution is not an uncommon complication. Its incidence is within the range reported in the literature, but it is not associated with major complications or mortality. Antiplatelet treatment with clopidogrel is the main risk factor associated with reintervention. Other factors, such as coagulation control, postoperative hypertension management, and the use of an autologous patch, could help reduce its incidence.
Source: Annals of Vascular Surgery - September 30, 2013 Category: Surgery Authors: Sara Mercedes Morales Gisbert, Vicente Andrés Sala Almonacil, Jose Miguel Zaragozá García, Beatriz Genovés Gascó, Francisco Julián Gómez Palonés, Eduardo Ortiz Monzón Tags: Clinical Research Source Type: research
Finding a Needle in the Common Carotid Artery 3 Years after Ingestion
A woman presented with an ischemic stroke involving the right middle cerebral artery. Investigations revealed a foreign body in the cervical area. It was identified as a metal needle, perforating the posterior pharyngeal wall and migrating into the right common carotid artery (CCA). Three years previously, this patient had complained of odynophagia, brought on by needle ingestion. Three days before her stroke, she had hematemesis, caused by migration of the needle into the CCA. The stroke was caused by migration of the thrombus. This type of event is rarely encountered in Europe. Early recognition could avoid dangerous vascular complications.
Source: Annals of Vascular Surgery - January 21, 2014 Category: Surgery Authors: Marie Gaudin, Geoffroy Couchet, Caroline Carrieres, Jean-Pierre Ribal, Eugenio Rosset Tags: Case Report Abstracts 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
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
Carotid artery disease: clinical features and management
Publication date: June 2018Source: Surgery (Oxford), Volume 36, Issue 6Author(s): A. Ross NaylorAbstractThe 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% NAS...
Source: Surgery (Oxford) - July 5, 2018 Category: Surgery Source Type: research
Contemporary trends and outcomes of thrombolytic therapy for acute lower extremity ischemia.
Conclusion Thrombolysis remains an effective treatment for acute limb ischemia with increased utilization over time. There was a significant increase in thrombolysis and endovascular procedure leading to improved outcomes. Thrombolysis alone carried the highest mortality and stroke rate, with T+OPEN associated with the highest amputation and complications. Although thrombolysis is effective, 25% of patients required an open procedure suggesting that patient selection for thrombolysis first instead of open surgery continues to be a clinical challenge.
PMID: 30193552 [PubMed - as supplied by publisher]
Source: Vascular - September 7, 2018 Category: Surgery Authors: Bath J, Kim RJ, Dombrovskiy VY, Vogel TR Tags: Vascular Source Type: research
Aspirin Alone Is Superior Therapy for Grade III Blunt Carotid Injury: A Multicenter Study from the Eastern Association for the Surgery of Trauma
The optimal treatment of blunt cerebrovascular injury (BCVI) remains unclear. Antiplatelet therapy and therapeutic anticoagulation have each demonstrated substantial reductions in BCVI-associated stroke without evidence of the superiority of either. Uncertainty surrounds grade III injury, in particular, because stroke can involve both platelet activation from endothelial injury and thrombus formation within the pseudoaneurysm sac. We hypothesized that treatment of grade III blunt carotid injury (BCI) with aspirin alone would be associated with a decreased rate of subsequent stroke compared with other medical therapies.
Source: Journal of Vascular Surgery - August 24, 2021 Category: Surgery Authors: Rishi Kundi, Emily C. Esposito, Thomas M. Scalea, Deborah M. Stein, Margaret Lauerman, East Blunt Cerebrovascular Injury Study Group Tags: S3: Plenary Session 3 Source Type: research
Adverse events are not increased with trainee participation in transcarotid revascularization
CONCLUSION: Vascular surgery trainee's involvement during TCAR did not increase adverse outcomes, such as stroke and death, in the perioperative period. The results presented herein should encourage other teaching institutions to provide surgical trainees with supervised, hands-on experience during TCAR.PMID:36377465 | DOI:10.1177/17085381221140158
Source: Vascular - November 15, 2022 Category: Surgery Authors: Regina Husman Akiko Tanaka Naveed U Saqib Aleem Mirza Mitchell J George Arash Keyhani Kourosh Keyhani S Keisin Wang Source Type: research
Aortic Mural Thrombus in the Normal or Minimally Atherosclerotic Aorta
Background: Aortic mural thrombus in a nonaneurysmal minimally atherosclerotic or normal aorta is a rare clinical entity and an uncommon cause of peripheral arterial embolization. Both anticoagulation therapy and aortic surgery are commonly used as primary treatment, but there are no consensuses or clinical guidelines to outline the best management strategy for this unusual problem. This systematic review compares the outcomes of these different strategies for the treatment of aortic mural thrombus.Methods: An extensive search of the literature was conducted, and all relevant publications were reviewed, with individual pat...
Source: Annals of Vascular Surgery - August 27, 2012 Category: Surgery Authors: Ziad Y. Fayad, Elie Semaan, Bashar Fahoum, Matt Briggs, Anthony Tortolani, Marcus D’Ayala Tags: Clinical Research 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
