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Source: Stroke
Procedure: Carotid Endarterectomy
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Total 77 results found since Jan 2013.
Trials and Frontiers in Carotid Endarterectomy and Stenting Topical Review
Source: Stroke - June 25, 2018 Category: Neurology Authors: Douglas W. Jones, Thomas G. Brott, Marc L. Schermerhorn Tags: Revascularization, Stent, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Stenosis Topical Reviews Source Type: research
Outcomes of Primary and Secondary Carotid Artery Stenting Clinical Sciences
This study evaluates outcomes of redo-CAS and CAS after prior ipsilateral carotid endarterectomy (CASAPICEA) relative to primary-CAS.Methods—We studied all patients in the Vascular Quality Initiative, who underwent primary-CAS, CASAPICEA, or redo-CAS (2003–2016). Kaplan–Meier, multivariable logistic and Cox regression analyses were used to evaluate outcomes within 30 days and up to 1 year and identify their predictors.Results—There were 11 742 CAS procedures performed: 8519 (72%) primary-, 2645 (23%) CASAPICEA, and 578 (5%) redo-CAS. Comparing primary-CAS versus CASAPICEA versus redo-CAS, 30-day stroke/death was ...
Source: Stroke - October 23, 2017 Category: Neurology Authors: Isibor J. Arhuidese, Muhammad Rizwan, Besma Nejim, Mahmoud Malas Tags: Cardiovascular Surgery, Stent, Mortality/Survival, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures Original Contributions Source Type: research
For-Profit Hospital Status and Carotid Artery Stent Utilization in US Hospitals Performing Carotid Revascularization Brief Report
Background and Purpose—Carotid artery stenting may be an economically attractive procedure for hospitals and physicians. We sought to identify the association of hospital ownership (nonprofit versus for-profit) on carotid artery stenting (CAS) versus carotid endarterectomy utilization in US hospitals.Methods—Using the Nationwide Inpatient Sample admissions for cerebrovascular disease from 2008 to 2011, we identified all private, nonfederal US hospitals performing at least 20 carotid revascularization procedures annually, including carotid artery stenting (International Classification of Diseases-Ninth Revision 00.63) o...
Source: Stroke - October 23, 2017 Category: Neurology Authors: Justin V. Chandler, Benjamin P. George, Adam G. Kelly, Robert G. Holloway Tags: Health Services, Stenosis, Vascular Disease Brief Reports Source Type: research
Safety of Simultaneous Coronary Artery Bypass Grafting and Carotid Endarterectomy Versus Isolated Coronary Artery Bypass Grafting Clinical Sciences
Conclusions—Although our results cannot rule out a treatment-group effect because of lack of power, a superiority of the synchronous combined carotid endarterectomy+CABG approach seems unlikely. Five-year follow-up of patients is still ongoing.Clinical Trial Registration—URL: https://www.controlled-trials.com. Unique identifier: ISRCTN13486906.
Source: Stroke - September 25, 2017 Category: Neurology Authors: Christian Weimar, Konstantinos Bilbilis, Jan Rekowski, Torulv Holst, Friedhelm Beyersdorf, Martin Breuer, Manfred Dahm, Anno Diegeler, Arne Kowalski, Sven Martens, Friedrich W. Mohr, Jiri Ondrašek, Beate Reiter, Peter Roth, Ralf Seipelt, Markus Sig Tags: Cardiovascular Surgery Original Contributions Source Type: research
Factors Associated With Time to Site Activation, Randomization, and Enrollment Performance in a Stroke Prevention Trial Clinical Sciences
Conclusions—Overall, selection of sites with high enrollment rates will likely require customization to align the sites selected to the factor under study in the trial.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02089217.
Source: Stroke - August 28, 2017 Category: Neurology Authors: Bart M. Demaerschalk, Robert D. Brown Jr, Gary S. Roubin, Virginia J. Howard, Eldina Cesko, Kevin M. Barrett, Mary E. Longbottom, Jenifer H. Voeks, Seemant Chaturvedi, Thomas G. Brott, Brajesh K. Lal, James F. Meschia, George Howard Tags: Stent, Cognitive Impairment, Ischemic Stroke Original Contributions Source Type: research
Carotid Stenting Versus Endarterectomy for Asymptomatic Carotid Artery Stenosis Clinical Sciences
Conclusions—Although uncertainty surrounds the long-term outcomes of CAS versus CEA, the potential for increased risks of periprocedural stroke and periprocedural stroke or death with CAS suggests that CEA is the preferred option for the management of asymptomatic carotid stenosis.
Source: Stroke - July 24, 2017 Category: Neurology Authors: Paola Moresoli, Bettina Habib, Pauline Reynier, Matthew H. Secrest, Mark J. Eisenberg, Kristian B. Filion Tags: Epidemiology Original Contributions Source Type: research
Early Endarterectomy Carries a Lower Procedural Risk Than Early Stenting in Patients With Symptomatic Stenosis of the Internal Carotid Artery Clinical Sciences
Conclusions—In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00190398; URL: http://www.controlled-trials.com. Unique identifier: ISRCTN57874028; Unique identifier: ISRCTN25337470; URL: http://www.clinicaltrials.gov. Unique identifier: NCT00004732.
Source: Stroke - May 22, 2017 Category: Neurology Authors: Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Mart Tags: Cerebrovascular Disease/Stroke, Cerebrovascular Procedures Original Contributions Source Type: research
Vascular Anatomy Predicts the Risk of Cerebral Ischemia in Patients Randomized to Carotid Stenting Versus Endarterectomy Clinical Sciences
Background and Purpose—Complex vascular anatomy might increase the risk of procedural stroke during carotid artery stenting (CAS). Randomized controlled trial evidence that vascular anatomy should inform the choice between CAS and carotid endarterectomy (CEA) has been lacking.Methods—One-hundred eighty-four patients with symptomatic internal carotid artery stenosis who were randomly assigned to CAS or CEA in the ICSS (International Carotid Stenting Study) underwent magnetic resonance (n=126) or computed tomographic angiography (n=58) at baseline and brain magnetic resonance imaging before and after treatment. We invest...
Source: Stroke - April 24, 2017 Category: Neurology Authors: Mandy D. Muller, Frank J. Ahlhelm, Alexander von Hessling, David Doig, Paul J. Nederkoorn, Sumaira Macdonald, Philippe A. Lyrer, Aad van der Lugt, Jeroen Hendrikse, Christoph Stippich, H. Bart van der Worp, Toby Richards, Martin M. Brown, Stefan T. Engelt Tags: Magnetic Resonance Imaging (MRI), Revascularization, Stent, Cerebrovascular Disease/Stroke, Stenosis Original Contributions Source Type: research
Decreased Adiponectin-Mediated Signaling Through the AdipoR2 Pathway Is Associated With Carotid Plaque Instability Clinical Sciences
Background and Purpose—Adiponectin, the most abundantly secreted anti-inflammatory adipokine, protects against all stages of atherosclerotic plaque formation by acting on its receptors, AdipoR1 (adiponectin receptor 1) and AdipoR2 (adiponectin receptor 2). Through binding of AdipoR1, adiponectin leads to the activation of the AMPK (adenosine monophosphate–activated protein kinase) pathway, whereas stimulation of PPAR-α (peroxisome proliferator–activated receptor-α) is attributed to the binding of AdipoR2. However, the role of adiponectin and its receptors in plaque instability remains to be characterized. Thus, we ...
Source: Stroke - March 27, 2017 Category: Neurology Authors: Karina Gasbarrino, Huaien Zheng, Anouar Hafiane, John P. Veinot, Chi Lai, Stella S. Daskalopoulou Tags: Cell Signaling/Signal Transduction, Cerebrovascular Disease/Stroke, Atherosclerosis Original Contributions Source Type: research
Intraoperative Completion Studies, Local Anesthesia, and Antiplatelet Medication Are Associated With Lower Risk in Carotid Endarterectomy Clinical Sciences
Conclusions—Local anesthesia, patch plasty compared with primary closure, intraoperative completion studies by duplex ultrasound or angiography, and perioperative antiplatelet medication were independently associated with lower in-hospital stroke or death rates after carotid endarterectomy.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein Tags: Clinical Studies, Revascularization, Quality and Outcomes, Cerebrovascular Disease/Stroke, Atherosclerosis Original Contributions Source Type: research
Symptomatic Patients Remain at Substantial Risk of Arterial Disease Complications Before and After Endarterectomy or Stenting Clinical Sciences
Background and Purpose—After carotid endarterectomy (CEA) or carotid artery stenting (CAS) in patients with transient ischemic attack or minor ischemic stroke, recurrent stroke risk falls to a low rate on modern medical treatment.Methods—We used data from 4583 patients with recent transient ischemic attack or minor stroke enrolled in the TIAregistry.org to perform a nested case–control analysis to evaluate pre- and post-CEA/CAS risk. Cases were defined as patients with a CEA/CAS during the 1-year follow-up period. For each case, 2 controls with a follow-up time greater than the time from qualifying event to CEA/CAS w...
Source: Stroke - March 27, 2017 Category: Neurology Authors: Cristina Hobeanu, Philippa C. Lavallee, Peter M. Rothwell, Leila Sissani, Gregory W. Albers, Natan M. Bornstein, Louis R. Caplan, Geoffrey A. Donnan, Jose M. Ferro, Michael G. Hennerici, Julien Labreuche, Carlos Molina, Philippe Gabriel Steg, Pierre&ndash Tags: Secondary Prevention, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research
Timing of Carotid Revascularization Procedures After Ischemic Stroke Brief Report
Background and Purpose—In 2006, the American Heart Association recommended that carotid revascularization generally occurs within 2 weeks of stroke based on data from 2 trials of carotid endarterectomy (CEA). We aimed to determine whether the time between stroke and CEA or carotid artery stenting (CAS) has decreased and whether the proportion of procedures occurring within 14 days has increased.Methods—Using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes and administrative claims data from nonfederal hospitals in CA, FL, and NY, we identified patients with ischemic strok...
Source: Stroke - December 22, 2016 Category: Neurology Authors: Michael Reznik, Hooman Kamel, Gino Gialdini, Ankur Pandya, Babak B. Navi, Ajay Gupta Tags: Secondary Prevention, Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research
Impact of Clinical Trial Results on the Temporal Trends of Carotid Endarterectomy and Stenting From 2002 to 2014 Clinical Sciences
Background and Purpose—Randomized trials provide conflicting data for the efficacy of carotid-artery stenting compared with endarterectomy. The purpose of this study was to examine the impact of conflicting clinical trial publications on the utilization rates of carotid revascularization procedures.Methods—We conducted a population-level time-series analysis of all individuals who underwent carotid endarterectomy and stenting in Ontario, Canada (2002–2014). The primary analysis examined temporal changes in the rates of carotid revascularization procedures after publications of major randomized trials. Secondary analy...
Source: Stroke - November 27, 2016 Category: Neurology Authors: Mohamad A. Hussain, Muhammad Mamdani, Jack V. Tu, Gustavo Saposnik, Zeyad Khoushhal, Badr Aljabri, Subdoh Verma, Mohammed Al-Omran Tags: Cardiovascular Surgery, Revascularization, Stent, Health Services, Cerebrovascular Procedures Original Contributions Source Type: research
Validation of Noninvasive In Vivo Compound Ultrasound Strain Imaging Using Histologic Plaque Vulnerability Features Clinical Sciences
This study aims at in vivo validation of compound ultrasound strain imaging in patients by relating the measured strains to typical features of vulnerable plaques derived from histology after carotid endarterectomy.Materials and Methods—Strains were measured in 34 severely stenotic (>70%) carotid arteries at the culprit lesion site within 48 hours before carotid endarterectomy. In all cases, the lumen-wall boundary was identifiable on B-mode ultrasound, and the imaged cross-section did not move out of the imaging plane from systole to diastole. After endarterectomy, the plaques were processed using a validated histology ...
Source: Stroke - October 23, 2016 Category: Neurology Authors: Hansen, H. H. G., de Borst, G. J., Bots, M. L., Moll, F. L., Pasterkamp, G., de Korte, C. L. Tags: Imaging, Ultrasound, Cerebrovascular Disease/Stroke, Atherosclerosis, Stenosis Original Contributions Source Type: research
Short Time Interval Between Neurologic Event and Carotid Surgery Is Not Associated With an Increased Procedural Risk Clinical Sciences
Conclusions—The time interval between the index event and carotid endarterectomy was not associated with the risk of any in-hospital stroke or death in patients with symptomatic carotid stenosis in Germany. In clinically stable patients, carotid endarterectomy might, therefore, be performed safely as soon as possible after the neurological index event.
Source: Stroke - October 23, 2016 Category: Neurology Authors: Tsantilas, P., Kuehnl, A., Konig, T., Breitkreuz, T., Kallmayer, M., Knappich, C., Schmid, S., Storck, M., Zimmermann, A., Eckstein, H.–H. Tags: Complications, Quality and Outcomes, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research
