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Source: European Journal of Vascular and Endovascular Surgery

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Total 289 results found since Jan 2013.

Keeping Things Simple, May Not Be So Simple
When I performed my first carotid endarterectomy (CEA) with retrograde intervention, it seemed so elegant. A simple, hybrid solution for tandem carotid lesions. I was taught to “keep things simple”. This applied. In this month's European Journal of Vascular and Endovascular Surgery, Meershoek et al. report their experience over 14 years in 16 symptomatic patients undergoing hybrid CEA with proximal intervention.1 Their results, with no operative stroke, transient isch aemic attack (TIA), or death, are not unusual in the literature.
Source: European Journal of Vascular and Endovascular Surgery - February 18, 2019 Category: Surgery Authors: William Darrin Clouse Tags: Invited Commentary Source Type: research

Let's Talk Big Data
In this issue, Darrin Clouse and colleagues1 identified the drivers of 30 day non-ipsilateral stroke after carotid endarterectomy (CEA) by assessing the Vascular Quality Initiative (VQI) database developed in 2011 by the Society for Vascular Surgery (SVS).2 The authors reported a number of features increasing risk such as combined procedures, haemodynamic fluctuations, and contralateral internal carotid occlusion. To date, because of the rarity of non-ipsilateral stroke risk in patients with CEA, no discernible recommendations have been given.
Source: European Journal of Vascular and Endovascular Surgery - January 23, 2019 Category: Surgery Authors: Jean-Baptiste Ricco, Farid Guetarni Tags: Invited Commentary Source Type: research

Re: “Systematic Review and Meta-Analysis of Very Urgent Carotid Intervention for Symptomatic Carotid Disease”
Milgrom et  al.1 recently performed a systematic review that discussed the timing of symptomatic carotid interventions. It is encouraging to see many authors trying to answer this question. Although these interventions are commendable for stroke patients, there are necessary comments that need to be made in t erms of this review.
Source: European Journal of Vascular and Endovascular Surgery - November 30, 2018 Category: Surgery Authors: Vladimir T. de Vasconcelos Tags: Correspondence Source Type: research

Primary Closure Following Carotid Endarterectomy Does not Increase the Rate of Significant Restenosis or Stroke
Introduction: Carotid patching compared to primary closure appears to be associated with a decreased risk of peri-operative stroke and is endorsed by the current guidelines.
Source: European Journal of Vascular and Endovascular Surgery - October 31, 2018 Category: Surgery Authors: L. Iacob, C. Canning, M.P. Colgan, Z. Martin, S. O'Neill, A. O'Callaghan, P. Madhavan Source Type: research

An Audit of the Timing of Carotid Endarterectomy for Symptomatic Carotid Disease
Background: Carotid endarterectomy (CEA) has been shown to reduce the risk of stroke in patients with symptomatic carotid artery stenosis. Multiple systematic reviews have established that the benefit from CEA is greatest when the surgery is performed within 48 hours to 14 days from the symptomatic event.
Source: European Journal of Vascular and Endovascular Surgery - October 31, 2018 Category: Surgery Authors: Kin Cheung Ng, Hazem Hseino, Joseph Dowdall, Stephen Sheehan, Mary Barry Source Type: research

Commentary on “Do Integrated Systems of Stroke Care Improve Symptom to Surgery Times in Patients With Symptomatic Carotid Stenosis? A Decision Tree Analysis”
“We need a comprehensive integrated approach to service delivery. We need to fight fragmentation.”1
Source: European Journal of Vascular and Endovascular Surgery - September 26, 2018 Category: Surgery Authors: Marc A. Cairols Tags: Invited commentary Source Type: research

Timing is Right Only When You Choose What is Right
The European Society for Vascular Surgery (ESVS) recommends that carotid endarterectomy (CEA) for symptomatic carotid stenosis should be performed as early as possible,1 within 14 days of the ischaemic event. However, the role of early carotid artery stenting (CAS) in these patients is unclear and may even be harmful. A large individual patient meta-analysis combining data from CREST, ICSS, EVA-3S, and SPACE reported worse 30 day death/stroke outcomes for early CAS compared with early CEA, in those treated within 7 days2 (9.4% vs.
Source: European Journal of Vascular and Endovascular Surgery - September 26, 2018 Category: Surgery Authors: Edward Choke Tags: Invited Commentary Source Type: research

Patients with Peripheral Artery Disease in the COMPASS Trial
Over 200 million people worldwide have peripheral artery disease (PAD) and this number is increasing because of ageing of the population.1 Patients with PAD are at high risk of major adverse cardiovascular events (MACE), including cardiovascular (CV) death, stroke, and myocardial infarction (MI), as well as major adverse limb events (MALE), including severe limb ischaemia and amputation.2,3 Many patients with PAD are significantly undertreated.4
Source: European Journal of Vascular and Endovascular Surgery - September 10, 2018 Category: Surgery Authors: Paul C. Kruger, Sonia S. Anand, Tim A.C. de Vries, John W. Eikelboom Tags: Editorial Source Type: research

Identification of Vulnerable Carotid Plaques: Contrasting Results from Contrast Enhanced Ultrasound Scan Studies
The extent of internal carotid artery narrowing is traditionally used to stratify stroke risk and is still one of the key factors in clinical decision making regarding surgical intervention to prevent strokes. However, the degree of stenosis alone cannot accurately predict future stroke in asymptomatic patients. Consequently, there has been a shift in carotid imaging focus to incorporate plaque biology quantification in attempts to better stratify stroke risk.
Source: European Journal of Vascular and Endovascular Surgery - September 5, 2018 Category: Surgery Authors: Edward Choke, Gert J. de Borst Tags: Invited Commentary Source Type: research

Do Integrated Systems of Stroke Care Improve Symptom to Surgery Times in Patients with Symptomatic Carotid Stenosis? A Single Centre Decision Tree Analysis
The objective of this study was to examine the impact of an integrated system of stroke care on symptom to surgery times, cost-effectiveness, and quality of life measures in patients with symptomatic carotid stenosis.
Source: European Journal of Vascular and Endovascular Surgery - August 30, 2018 Category: Surgery Authors: Reza Mofidi, Matthew Thomas, Peng F. Wong, Adrian Bergin, Gavin Young Source Type: research

The Dutch Audit of Carotid Interventions: Transparency in Quality of Carotid Endarterectomy in Symptomatic Patients in the Netherlands
This study describes the design of the DACI and results of patients with a symptomatic stenosis undergoing carotid endarterectomy (CEA). It aimed to evaluate variation between hospitals in process of care and (adjusted) outcomes, as well as predictors of major stroke/death after CEA.
Source: European Journal of Vascular and Endovascular Surgery - August 1, 2018 Category: Surgery Authors: Eleonora G. Karthaus, Anco Vahl, Laurien S. Kuhrij, Bernard H.P. Elsman, Robert H. Geelkerken, Michel W.J.M. Wouters, Jaap F. Hamming, Gert J. de Borst, the Dutch Society of Vascular Surgery, the Steering Committee of the Dutch Audit for Carotid Intervent Source Type: research

Only Time Will Tell!
There is good evidence that the highest risk period for suffering a recurrent stroke is the first 7 –14 days after the onset of symptoms. That is why the 2017 European Society for Vascular Surgery guidelines recommend that carotid endarterectomy (CEA) be performed “as soon as possible” after the onset of symptoms, preferably within 14 days.1 However, there are concerns that interventions per formed 
Source: European Journal of Vascular and Endovascular Surgery - July 20, 2018 Category: Surgery Authors: A. Ross Naylor Tags: Invited Commentary Source Type: research

Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting: A Systematic Review and Meta-analysis
Cerebral hyperperfusion syndrome (CHS) is a preventable cause of stroke after carotid endarterectomy (CEA). There are currently no pooled data available on the incidence of CHS after carotid artery stenting (CAS). The aim of this review was to assess the relevance of CHS in the procedural stroke rate following CAS.
Source: European Journal of Vascular and Endovascular Surgery - July 2, 2018 Category: Surgery Authors: Anne E. Huibers, Jan Westerink, Evelien E. de Vries, Anne Hoskam, Hester M. den Ruijter, Frans L. Moll, Gert J. de Borst Tags: Review Source Type: research

Editor's Choice – Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting: A Systematic Review and Meta-analysis
Cerebral hyperperfusion syndrome (CHS) is a preventable cause of stroke after carotid endarterectomy (CEA). There are currently no pooled data available on the incidence of CHS after carotid artery stenting (CAS). The aim of this review was to assess the relevance of CHS in the procedural stroke rate following CAS.
Source: European Journal of Vascular and Endovascular Surgery - July 2, 2018 Category: Surgery Authors: Anne E. Huibers, Jan Westerink, Evelien E. de Vries, Anne Hoskam, Hester M. den Ruijter, Frans L. Moll, Gert J. de Borst Tags: Review Source Type: research

Autologous Reconstruction of the Carotid Bifurcation: Should We Just Because We Can?
In patients who are deemed at higher risk of stroke while on optimal medical treatment, and who have anatomical restrictions for standard carotid endarterectomy (CEA) or endovascular therapy, the treating physician may need alternative revascularisation techniques. Reconstruction of the carotid bifurcation using autologous material may offer such a solution as long as the natural course risk outbalances the procedural risk.
Source: European Journal of Vascular and Endovascular Surgery - May 24, 2018 Category: Surgery Authors: Gert J. de Borst Tags: Invited Commentary Source Type: research