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Source: European Journal of Vascular and Endovascular Surgery
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Total 289 results found since Jan 2013.
Editor's Choice – An Updated Systematic Review and Meta-analysis of Outcomes Following Eversion vs. Conventional Carotid Endarterectomy in Randomised Controlled Trials and Observational Studies
A 2011 meta-analysis comparing eversion (eCEA) with conventional (cCEA) carotid endarterectomy in 16,251 patients concluded that eCEA was associated with lower rates of peri-operative stroke and late occlusion compared with cCEA. However, randomised controlled trials (RCTs) showed no difference in outcomes. Since then, the literature contains outcome data on 49,500 patients undergoing eCEA or cCEA. An updated meta-analysis was performed to establish whether eCEA confers significant benefit over cCEA.
Source: European Journal of Vascular and Endovascular Surgery - February 6, 2018 Category: Surgery Authors: Kosmas I. Paraskevas, Vaux Robertson, Athanasios N. Saratzis, A. Ross Naylor Tags: Review Source Type: research
An Updated Systematic Review and Meta-analysis of Outcomes Following Eversion vs. Conventional Carotid Endarterectomy in Randomised Controlled Trials and Observational Studies
A 2011 meta-analysis comparing eversion (eCEA) with conventional (cCEA) carotid endarterectomy in 16,251 patients concluded that eCEA was associated with lower rates of peri-operative stroke and late occlusion compared with cCEA. However, randomised controlled trials (RCTs) showed no difference in outcomes. Since then, the literature contains outcome data on 49,500 patients undergoing eCEA or cCEA. An updated meta-analysis was performed to establish whether eCEA confers significant benefit over cCEA.
Source: European Journal of Vascular and Endovascular Surgery - February 6, 2018 Category: Surgery Authors: Kosmas I. Paraskevas, Vaux Robertson, Athanasios N. Saratzis, A. Ross Naylor Tags: Review Source Type: research
Editor's Choice – An Updated Systematic Review and Meta-analysis of Outcomes Following Eversion vs. Conventional Carotid Endarterectomy in Randomised Controlled Trials and Observational Studies
A 2011 meta-analysis comparing eversion (eCEA) with conventional (cCEA) carotid endarterectomy in 16,251 patients concluded that eCEA was associated with lower rates of peri-operative stroke and late occlusion compared with cCEA. However, randomised controlled trials (RCTs) showed no difference in outcomes. Since then, the literature contains outcome data on 49,500 patients undergoing eCEA or cCEA. An updated meta-analysis was performed to establish whether eCEA confers significant benefit over cCEA.
Source: European Journal of Vascular and Endovascular Surgery - February 6, 2018 Category: Surgery Authors: Kosmas I. Paraskevas, Vaux Robertson, Athanasios N. Saratzis, A. Ross Naylor Tags: Review Source Type: research
Commentary on “A Propensity Matched Comparison for Open and Endovascular Treatment of Post-carotid Endarterectomy Restenosis”
The main conclusions from the study by Dorigo et al.1 were that (a) carotid artery stenting (CAS) and redo carotid endarterectomy (CEA) were associated with similar 30 day rates of death/stroke in the treatment of predominantly asymptomatic restenoses after CEA, (b) the very low 30 day death/stroke rates (0%) justified re-intervening (i.e., they were not causing unnecessary harm), (c) cranial nerve injuries were common after redo CEA (22%), but were rarely clinically relevant after 30 days, and that (d) cumulative freedom from late secondary restenoses was significantly lower after redo CEA (72%) than after CAS (100%).
Source: European Journal of Vascular and Endovascular Surgery - January 5, 2018 Category: Surgery Authors: A. Ross Naylor Tags: Invited commentary Source Type: research
Commentary to ‘Safety and efficacy of the new micromesh-covered stent CGuard™ in patients undergoing carotid artery stenting: early experience from a single centre’
A meta-analysis of pooled European randomised controlled trials (RCT) comparing carotid endarterectomy (CEA) with stenting (CAS) in symptomatic patients has clearly shown that CAS is associated with a significantly higher risk of procedural death/stroke (CAS = 8.9% vs. 5.8% after CEA, HR 1.53, 95% CI 1.20–1.95; p = .0006). Late clinical data of each of these RCTs revealed two further important messages: 1) severe restenosis/occlusion was rare, with no differences between CAS and CEA; and 2) provided that any strokes occurring within the first 30 days were excluded, there appeared to be no difference in the long-term...
Source: European Journal of Vascular and Endovascular Surgery - October 25, 2017 Category: Surgery Authors: Gert J. de Borst Tags: Invited Commentary Source Type: research
Corrigendum to “Risk of Early Recurrent Stroke in Symptomatic Carotid Stenosis” Eur J Vasc Endovasc Surg 49/2 (2015) 137–144
The authors regret that they have identified an error in the above mentioned paper.
Source: European Journal of Vascular and Endovascular Surgery - October 9, 2017 Category: Surgery Authors: Sofia Str ömberg, Annika Nordanstig, Tobias Bentzel, Klas Österberg, Göran M.L. Bergström Tags: Corrigendum Source Type: research
Can We Predict Who Will Develop Hypertension After Carotid Endarterectomy?
Haemorrhagic stroke is a rare and vexing complication of carotid endarterectomy (CEA). It occurs some days after a successful operation to prevent further ischaemic strokes, usually in the setting of post-operative hypertension, headache, or the full clinical picture of hyperperfusion syndrome, which features seizures, and cognitive and vigilance disturbances. The major risk factor associated with the hyperperfusion syndrome and intracerebral haemorrhage after CEA is post-operative hypertension and blood pressure lability.
Source: European Journal of Vascular and Endovascular Surgery - September 29, 2017 Category: Surgery Authors: Jos é M. Ferro Tags: Editorial Source Type: research
Something Old, Something New, Something Borrowed, and Something Blue
The 2017 European Society of Vascular Surgery (ESVS) guidelines on the management of atherosclerotic carotid and vertebral artery disease advise that carotid endarterectomy (CEA) should be performed as soon as possible after the onset of symptoms, preferably within 14 days.1 This is based on data that first entered the public domain in 2004,2 supplemented by contemporaneous natural history studies which suggest that the risk of recurrent stroke may be up to 10% in the first 7 days after symptom onset in patients with 50 –99% carotid stenosis.
Source: European Journal of Vascular and Endovascular Surgery - September 6, 2017 Category: Surgery Authors: A.R. Naylor, M. Vega de Ceniga Tags: Editorial Source Type: research
Pre-operative Carotid Plaque Echolucency Assessment has no Predictive Value for Long-Term Risk of Stroke or Cardiovascular Death in Patients Undergoing Carotid Endarterectomy
This study evaluated the prognostic value of pre-operative plaque echolucency for future stroke and cardiovascular death in patients undergoing carotid endarterectomy in the first Asymptomatic Carotid Surgery Trial (ACST-1).
Source: European Journal of Vascular and Endovascular Surgery - June 24, 2017 Category: Surgery Authors: D. de Waard, G.J. de Borst, R. Bulbulia, H. Pan, A. Halliday, ACST-1 collaborative group Source Type: research
Antiplatelet Resistance in Ischaemic Stroke Patients
Stroke constitutes a phenotype of cardiovascular disease. International recommendations implement antiplatelet therapy with aspirin and/or clopidogrel for ischaemic stroke patients.1 Both drugs inhibit pathways of platelet activation. However, there are patients on aspirin or clopidogrel who do not respond appropriately to these drugs. This phenomenon is described as “aspirin/clopidogrel resistance,” with prevalence in the range of 5–65% and 4–30% for each agent respectively, depending on cutoff values chosen, and population tested.
Source: European Journal of Vascular and Endovascular Surgery - May 18, 2017 Category: Surgery Authors: K. Spanos, G. Kouvelos, M. Matsagkas, A.D. Giannoukas Tags: Editorial Source Type: research
Commentary on “Near Infrared Spectroscopy as a Predictor for Shunt Requirement During Carotid Endarterectomy”
In this issue Jonsson et al. report on the relative value of two non-invasive methods, stump pressure and near infrared spectroscopy (NIRS), in predicting cerebral ischaemia during awake carotid endarterectomy (CEA).1 These two methods, amongst others, are frequently used to dictate the use of a shunt.2 Selective shunting is a generally established practice thought to prevent peri-operative stroke related to CEA, although a Cochrane meta-analysis has concluded that the data available were too limited to either support or refute the use of routine or selective shunting in CEA.
Source: European Journal of Vascular and Endovascular Surgery - April 18, 2017 Category: Surgery Authors: S.K. Kakkos, I.A. Tsolakis Tags: Invited commentary Source Type: research
Restenosis after Carotid Interventions and Its Relationship with Recurrent Ipsilateral Stroke: A Systematic Review and Meta-analysis
Do asymptomatic restenoses> 70% after carotid endarterectomy (CEA) and carotid stenting (CAS) increase the risk of late ipsilateral stroke?
Source: European Journal of Vascular and Endovascular Surgery - March 28, 2017 Category: Surgery Authors: R. Kumar, A. Batchelder, A. Saratzis, A.F. AbuRahma, P. Ringleb, B.K. Lal, J.L. Mas, M. Steinbauer, A.R. Naylor Tags: Review Source Type: research
Diastolic Blood Pressure is a Risk Factor for Peri-procedural Stroke Following Carotid Endarterectomy in Asymptomatic Patients
Carotid endarterectomy (CEA) prevents future stroke, but this benefit depends on detection and control of high peri-operative risk factors. In symptomatic patients, diastolic hypertension has been causally related to procedural stroke following CEA. The aim was to identify risk factors causing peri-procedural stroke in asymptomatic patients and to relate these to timing of surgery and mechanism of stroke.
Source: European Journal of Vascular and Endovascular Surgery - March 17, 2017 Category: Surgery Authors: D.D. de Waard, G.J. de Borst, R. Bulbulia, A. Huibers, A. Halliday, the Asymptomatic Carotid Surgery Trial-1 Collaborative Group Source Type: research
Choices of Stent and Cerebral Protection in the Ongoing ACST-2 Trial: A Descriptive Study
Several plaque and lesion characteristics have been associated with an increased risk for procedural stroke during or shortly after carotid artery stenting (CAS). While technical advancements in stent design and cerebral protection devices (CPD) may help reduce the procedural stroke risk, and anatomy remains important, tailoring stenting procedures according to plaque and lesion characteristics might be a useful strategy in reducing stroke associated with CAS. In this descriptive report of the ongoing Asymptomatic Carotid Surgery Trial-2 (ACST-2), it was assessed whether choice for stent and use or type of CPD was influenc...
Source: European Journal of Vascular and Endovascular Surgery - March 11, 2017 Category: Surgery Authors: D.D. de Waard, A. Halliday, G.J. de Borst, R. Bulbulia, A. Huibers, R. Casana, L.H. Bonati, V. Tolva, ACST-2 Collaborative Group Source Type: research
Robotic Arch Catheter Placement Reduces Cerebral Embolization During Thoracic Endovascular Aortic Repair (TEVAR)
This study investigates the incidence of cerebral embolization during catheter placement in the aortic arch, and compares robotic and manual techniques.
Source: European Journal of Vascular and Endovascular Surgery - February 13, 2017 Category: Surgery Authors: A.H. Perera, C.V. Riga, L. Monzon, R.G. Gibbs, C.D. Bicknell, M. Hamady Source Type: research
