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Predicting Transcarotid Artery Revascularization adverse outcomes by Imaging Characteristics
Approximately 20-30% of ischemic strokes are caused by internal carotid artery stenosis. Stroke is the leading cause of disability and the second leading cause of death in the United States. Second generation Trans Carotid Arterial Revascularization (TCAR) stenting, using the ENROUTE flow reversal technology to prevent embolic stroke during the stenting process, has demonstrated stroke and death outcomes equivalent to CEA with reduced cranial nerve injury. However, at present, it is not known whether imaging characteristics obtained pre-operatively can predict outcomes of TCAR procedures.
Source: Annals of Vascular Surgery - June 14, 2022 Category: Surgery Authors: Elizabeth Blears, Sefali Patel, Mark Doyle, Nicholas Lombardi, Satish Muluk Tags: Clinical Research Source Type: research

Embolic protection devices for carotid artery stenting: A network meta-analysis
CONCLUSIONS: PB deployment during CAS is superior to DF and DB in preventing distal embolization phenomena. However, no statistically significant difference in TIA and stroke rate was found among any of the analyzed EPD groups. Further research is warranted to investigate the association of embolic phenomena on imaging after CAS with clinically significant neurologic deficits.PMID:36394946 | DOI:10.1177/17085381221140616
Source: Vascular - November 17, 2022 Category: Surgery Authors: Stefanos Giannopoulos Marios Sagris Spyridon Giannopoulos Andreas Tzoumas Damianos G Kokkinidis Pavlos Texakalidis George Koutsias Panagiotis Volteas Li Jing Rafael D Malgor Source Type: research

Invited commentary
Although carotid endarterectomy and stenting for symptomatic significant carotid artery stenosis are widely accepted for stroke prevention, their use for asymptomatic stenosis is more controversial. With the advances in medical therapy, particularly the use of statins, and with an annual stroke risk of 1% to 2% for asymptomatic disease, justifying these interventions in these patients is more difficult. What is more disturbing is that ∼90% of all carotid endarterectomy and stenting procedures in the United States are performed on asymptomatic patients and that many were felt to be unnecessary, resulting in a cost of>$2 billion annually.
Source: Journal of Vascular Surgery - April 20, 2018 Category: Surgery Authors: Ali F. AbuRahma Tags: From bench to bedside Source Type: research

Reply
I am pleased Ross Naylor is of the opinion that I have built a convincing case with respect to the implications of increasing stenosis severity in asymptomatic patients with carotid stenosis. Furthermore, it is difficult to refute the statement that carotid interventions are not undertaken to prevent transient ischemic attack (TIA). Virtually all natural history studies (Asymptomatic Carotid Stenosis and Risk of Stroke [ACSRS], North American Symptomatic Carotid Endarterectomy Trial [NASCET]) including ours (see Conrad, reference 3) have indicated that the index neurologic event in previously asymptomatic patients is as li...
Source: Journal of Vascular Surgery - July 20, 2018 Category: Surgery Authors: Richard P. Cambria Tags: Letter to the Editor Source Type: research

Carotid artery stenting without using any embolic protective device A single Centre experience.
CONCLUSION: Revascularisation interventions to be able to prevent the development of stroke are evaluated as important treatment options in patients with symptomatic or severe carotid stenosis. With careful patient selection in experienced centres and a multi-disciplinary approach both before and after the procedure, pleasing results can be obtained without the use of embolic protective devices. KEY WORDS: Carotid artery stenting, Embolic protective device, Stroke. PMID: 30665216 [PubMed - in process]
Source: Annali Italiani di Chirurgia - January 23, 2019 Category: Surgery Tags: Ann Ital Chir Source Type: research

Trends in early postoperative major adverse cardiovascular and cerebrovascular events associated with bariatric surgery: an analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry
CONCLUSION: The overall risk of MACCE after BaS is .14% and has been declining in the last 5 years. This trend is likely multifactorial and further analysis is necessary to provide a detailed explanation.PMID:34600841 | DOI:10.1016/j.soard.2021.08.023
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - October 3, 2021 Category: Surgery Authors: Roberto J Valera Cristina Botero-Fonnegra Mauricio Sarmiento-Cobos Carlos E Rivera Lisandro Montorfano Rene Aleman Mileydis Alonso Emanuele Lo Menzo Samuel Szomstein Raul J Rosenthal Source Type: research

"The President's Syndrome": The Diagnosis and Treatment of Gerald Ford's Lingual Actinomycosis
Am Surg. 2022 May 27:31348221084953. doi: 10.1177/00031348221084953. Online ahead of print.ABSTRACTGerald R. Ford was the 38th president of the United States. He was appointed as vice president by Richard Nixon in 1974 upon the resignation of Spiro T. Agnew. In the midst of the Watergate Crisis, Nixon resigned making Ford the only president to serve without being elected as either president or vice president. In the year 2000, 13 years after his abbreviated term in office, he was attending the Republican National Convention in Philadelphia where he developed pain in his tongue, slurring of his speech, and signs of a stroke...
Source: The American Surgeon - May 27, 2022 Category: Surgery Authors: Janet Lee Theodore N Pappas Source Type: research

Why sex matters
Before writing this commentary, I performed a PubMed search using the terms “carotid endarterectomy” and “women” and retrieved 844 results. The current excellent study is one of the first to report the outcomes of transcarotid artery revascularization stratified by sex.1 However, the outcomes of carotid interventions for stroke prevention in women are still a matter of debate. Although stroke is the fifth leading cause of death in the United States, it remains the third leading cause among African-American and Hispanic women.
Source: Journal of Vascular Surgery - June 20, 2022 Category: Surgery Authors: Caron Rockman Tags: Invited Commentary Source Type: research

The effects of centralisation of vascular surgical services in the Bath, Bristol and Weston area on the carotid endarterectomy pathway.
Conclusion Centralisation has not significantly impacted the overall efficiency of the carotid endarterectomy pathway. This study highlights areas where improvement across the vascular network is required. This includes addressing the 35% patients that are not currently meeting the 14-day target and standardising the provision of care to outlying communities. Further follow-up is required to assess the longer term effects of centralisation. PMID: 28682128 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - July 6, 2017 Category: Surgery Authors: Partridge E, Brooks M, Curd C, Davis V, Oates C, McGeeney D Tags: Ann R Coll Surg Engl Source Type: research

The Use of Branched Endografts for the Aortic Arch in the Endovascular Era.
Authors: Tadros RO, Safir SR, Faries PL, Han DK, Chander RK, Abraham CZ, Marin ML, Stewart AS Abstract The endovascular realm has steadily increased its footing in the treatment of the aorta and all of its territories since the foundational case in 1990 by Parodi. The aortic arch, however, continues to be one of the last bastions for treatment via open surgery, which remains the gold standard. Significant comorbidity and prior cardiac surgery prevent open surgery from being the only preferred option, allowing novel endovascular procedures to be considered. Since 1999, more advanced endovascular systems have been cr...
Source: Surgical Technology International - July 13, 2017 Category: Surgery Tags: Surg Technol Int Source Type: research

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