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Source: European Journal of Vascular and Endovascular Surgery
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Total 289 results found since Jan 2013.
Long-term Mortality in Patients with Asymptomatic Carotid Stenosis: Implications for Statin Therapy
Recent studies with asymptomatic carotid patients on best medical management have shown that the annual risk of stroke has decreased to approximately 1%. There is no evidence that a similar decrease in mortality has occurred. In addition, the intensity of statin therapy for these patients has not yet been determined. The aims of this review were to determine (a) the reported long-term all-cause and cardiac-related mortality in patients with asymptomatic carotid stenosis (ACS) > 50%, (b) whether there has been a decrease in mortality in recent years, (c) the available methods of mortality risk stratification, and (d) whet...
Source: European Journal of Vascular and Endovascular Surgery - August 20, 2015 Category: Surgery Authors: A. Giannopoulos, S. Kakkos, A. Abbott, A.R. Naylor, T. Richards, D.P. Mikhailidis, G. Geroulakos, A.N. Nicolaides Tags: Review Source Type: research
Non-invasive Carotid Artery Imaging to Identify the Vulnerable Plaque: Current Status and Future Goals
The current clinical practise to determine if a patient should undergo carotid intervention to prevent stroke is to determine the clinical features combined with degree of carotid stenosis. However, this does not accurately determine the individual patient's risk for future stroke. A thin fibrous cap, a large lipid core, high macrophage count, and intraplaque haemorrhage have all been identified as markers of the so-called “vulnerable” plaque being related to a higher stroke risk. There is a need to assess the accuracy of in vivo imaging to identify vulnerable plaque characteristics, thereby enabling in vivo risk str...
Source: European Journal of Vascular and Endovascular Surgery - August 19, 2015 Category: Surgery Authors: A. Huibers, G.J. de Borst, S. Wan, F. Kennedy, A. Giannopoulos, F.L. Moll, T. Richards Tags: Review Source Type: research
Mechanism of Procedural Stroke Following Carotid Endarterectomy or Carotid Artery Stenting Within the International Carotid Stenting Study (ICSS) Randomised Trial
This study analysed the features of procedural strokes associated with carotid artery stenting (CAS) and carotid endarterectomy (CEA) within the International Carotid Stenting Study (ICSS) to identify the underlying pathophysiological mechanism.
Source: European Journal of Vascular and Endovascular Surgery - July 6, 2015 Category: Surgery Authors: A. Huibers, D. Calvet, F. Kennedy, K.R. Czuriga-Kovács, R.L. Featherstone, F.L. Moll, M.M. Brown, T. Richards, G.J. de Borst Source Type: research
Antithrombotic Treatment for Acute Extracranial Carotid Artery Dissections: A Meta-Analysis
Carotid artery dissection is a leading cause of stroke in younger patients, with an associated prevalence of 2.6–3.0 per 100,000 population. This meta-analysis aims to determine whether in patients managed medically, treatment with anticoagulants or antiplatelet agents was associated with a better outcome with respect to mortality, ischaemic stroke, and major bleeding episodes.
Source: European Journal of Vascular and Endovascular Surgery - June 21, 2015 Category: Surgery Authors: M.M. Chowdhury, C.N. Sabbagh, D. Jackson, P.A. Coughlin, J. Ghosh Tags: Review Source Type: research
Part One: For the Motion. Carotid Endarterectomy is Safer than Stenting in the Hyperacute Period After Onset of Symptoms
The updated 2014 American Heart Association (AHA) guidelines advise that carotid endarterectomy (CEA) be considered in patients presenting with a transient ischaemic attack (TIA) or ischaemic stroke in the preceding 6 months, and who have an ipsilateral 50–99% carotid stenosis, provided perioperative morbidity/mortality is
Source: European Journal of Vascular and Endovascular Surgery - May 22, 2015 Category: Surgery Authors: A.R. Naylor Source Type: research
Part Two: Against the Motion. Carotid Endarterectomy is not Safer than Stenting in the Hyperacute Period After Onset of Symptoms
The most commonly quoted risk of 1–2% at 1 week and 4% at 1 month are considered to be underestimated because patients are generally seen several weeks after a transient ischemic attack (TIA) or minor stroke.1,2 In a study of patients presenting to the emergency department within 24 h of a TIA, Johnston et al. reported a risk of stroke of around 5% at 2 days.3 Coull et al. reported on early risk of stroke after TIA/minor stroke, and found that the risk of recurrent stroke was 8.0% at 1 week, 11.5% at 1 month, and 17.3% at 3 months, and after a minor stroke they were 11.5%, 15.0%, and 18.5%, respectively.
Source: European Journal of Vascular and Endovascular Surgery - May 22, 2015 Category: Surgery Authors: A.F. AbuRahma Source Type: research
Metabolic Failure Drives Ischemia Reperfusion Injury during Human Kidney Transplantation
Introduction: Ischemia/reperfusion (I/R) injury, the paradoxical increase of tissue damage that occurs upon restoration of blood supply to ischemic tissue, is the primary cause of organ dysfunction after stroke, myocardial infarction, and organ transplantation. Despite a plethora of successful preclinical interventions, no intervention proved effective in the clinical context; pointing to incomplete understanding of human I/R injury. Ischemia and reperfusion is an inherent consequence of kidney transplantation, and underlies delayed graft function (DGF) following transplantation.
Source: European Journal of Vascular and Endovascular Surgery - May 22, 2015 Category: Surgery Authors: J. Lindeman Source Type: research
In the End, It All Comes Down to the Beginning!
The 2014 American Heart Association (AHA) guidelines on the management of symptomatic carotid disease expanded the indications for carotid artery stenting (CAS), advising that CAS is now an alternative to carotid endarterectomy (CEA) in the treatment of “average risk” patients suffering a transient ischaemic attack (TIA) or minor stroke during the preceding 6 months.1 This recommendation was based on a review of outcomes from contemporary randomised controlled trials (RCTs), most notably the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST),2 along with evidence from industry sponsored CAS registries.
Source: European Journal of Vascular and Endovascular Surgery - May 6, 2015 Category: Surgery Authors: G.J. de Borst, A.R. Naylor Tags: Editorial Source Type: research
Response to Correspondence by de Borst re: ‘The True Risk of Early Recurrent Stroke: Importance of Cohort Composition and Index Event Definition’
We read with interest the invited commentary of de Borst1 in response to our recent article on the risk of early recurrent stroke in a population with symptomatic carotid stenosis, and would like to take the opportunity to clarify a few points.2
Source: European Journal of Vascular and Endovascular Surgery - April 30, 2015 Category: Surgery Authors: K. Österberg, G.M.L. Bergström, S. Strömberg Tags: Correspondence Source Type: research
Re: ‘The True Risk of Early Recurrent Stroke: Importance of Cohort Composition and Index Event Definition’
In the individual patient with symptomatic significant carotid artery stenosis there are two means of reducing the overall risk of recurrent stroke: (i) by early recognition of the presenting symptom and fast work up to perform expedited carotid revascularization thus preventing recurrent events in the waiting time to surgery; and (ii) by performing safe carotid revascularization.1,2
Source: European Journal of Vascular and Endovascular Surgery - April 24, 2015 Category: Surgery Authors: G.J. de Borst Tags: Correspondence Source Type: research
Quality of Life and Functional Status After Carotid Revascularisation: A Systematic Review and Meta-Analysis
This study reviews (a) QOL after CEA, (b) QOL after CAS, (c) QOL differences between CEA and CAS, and (d) QOL compared with reference populations.
Source: European Journal of Vascular and Endovascular Surgery - April 13, 2015 Category: Surgery Authors: L. Shan, J. Shan, A. Saxena, D. Robinson Tags: Review Source Type: research
Clinical and Imaging Features Associated with an Increased Risk of Early and Late Stroke in Patients with Symptomatic Carotid Disease
The aim of this review was to identify clinical and/or imaging parameters that are associated with an increased (decreased) risk of early/late stroke in patients with symptomatic carotid disease.
Source: European Journal of Vascular and Endovascular Surgery - March 4, 2015 Category: Surgery Authors: A.R. Naylor, H. Sillesen, T.V. Schroeder Tags: Review Source Type: research
Peri-procedural Risk with Urgent Carotid Artery Stenting: A Population based Swedvasc Study
Current European Society for Vascular Surgery guidelines recommend that patients with a symptomatic carotid stenosis should be operated on within 14 days of onset of symptoms. Recent reports indicate that carotid endarterectomy (CEA) within 2 days of a neurological event may be associated with a higher peri-procedural risk of stroke. Whether urgent carotid artery stenting (CAS) carries a similar high risk is unclear. The aim of this study was to analyze if urgent CAS increases the peri-procedural risks.
Source: European Journal of Vascular and Endovascular Surgery - February 28, 2015 Category: Surgery Authors: M. Jonsson, P. Gillgren, A. Wanhainen, S. Acosta, D. Lindström Source Type: research
The True Risk of Early Recurrent Stroke: Importance of Cohort Composition and Index Event Definition
Guidelines for the treatment of symptomatic carotid artery disease currently recommend that carotid revascularization should be performed as soon as possible and certainly within 2 weeks of the index symptom. The underlying reason for this is growing evidence that the highest risk period for recurrent stroke is the early time period after onset of symptoms, but this must be balanced against the potential for incurring higher procedural risks. Accordingly, in the current era of better medical therapy, the key question is when exactly should interventions be performed in order to prevent recurrent stroke while not unduly inc...
Source: European Journal of Vascular and Endovascular Surgery - January 9, 2015 Category: Surgery Authors: G.J. de Borst Tags: Invited Commentary Source Type: research
Risk of Early Recurrent Stroke in Symptomatic Carotid Stenosis
The risk of recurrent stroke in patients with symptomatic carotid artery stenosis is highest in the first weeks after a transient ischemic attack (TIA) or minor stroke and can be reduced with carotid endarterectomy (CEA). The optimal timing of CEA remains a controversial issue since very urgent CEA is associated with an increased procedural risk. The aim of this study was to determine the risk of very early recurrent stroke in a population with symptomatic high grade carotid stenosis.
Source: European Journal of Vascular and Endovascular Surgery - December 26, 2014 Category: Surgery Authors: S. Strömberg, A. Nordanstig, T. Bentzel, K. Österberg, G.M.L. Bergström Source Type: research
