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Source: Journal of Vascular Surgery
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Total 705 results found since Jan 2013.
Result of 48-Hour Approach to Symptomatic Carotid Lesions in Patients With Stable Neurologic Examinations
Timing of treatment for symptomatic carotid disease has a controversial history with current guidelines recommending carotid surgery within 48 hours up to 2 weeks. Advocating for earlier carotid endarterectomy (CEA) after stroke (cerebrovascular accident [CVA]) or while a patient is having transient ischemic attacks (TIA) can potentially provide additional benefit to acute stroke patients resulting in improved stroke and death outcomes.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Tigran Divanyan, Jeffrey Hnath, Amanda Kistler, Misak Harutyunyan, W John Byrne, Julia Kleene Tags: Carotid Artery Interventions Source Type: research
Impact of Race on Perioperative Outcomes Following Carotid Endarterectomy, Transfemoral Carotid Artery Stenting, and Transcarotid Artery Revascularization
Carotid artery revascularization is performed less frequently among Black and minority populations despite a higher incidence of stroke and greater cardiovascular and stroke risk profile. Limited data exists on what impact race has on outcomes following carotid interventions. We assessed racial differences in perioperative outcomes following carotid endarterectomy (CEA), transfemoral carotid artery stenting (tfCAS), and transcarotid artery revascularization (TCAR) using the Vascular Quality Initiative database.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Pavel Kibrik, Ajit Rao, Jerry Zhu, Halbert Bai, Jason Storch, Daniel Han, Windsor Ting, Michael Marin, Peter Faries Tags: Carotid Artery Interventions Source Type: research
Optimal management of carotid artery disease in patients undergoing coronary artery bypass
It is well-known that patients undergoing coronary artery bypass grafting (CABG) with coexisting carotid artery disease are at increased risk for perioperative stroke and death. The prevalence of carotid disease among patients undergoing CABG is 6% to 14%,1 and the risk of stroke following CABG increases from 3% for unilateral 50% to 99% stenosis to 5% for bilateral 50% to 99% stenoses and 10% for carotid occlusion.2 The risk of stroke and death are notably higher in patients with a history of transient ischemic attack (TIA)/stroke.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Christopher K. Zarins Tags: Invited commentary Source Type: research
Fibromuscular dysplasia incidentally identified with computed tomography angiography
A 78-year-old woman had presented to the emergency room with altered mental status after the inadvertent consumption of a cannabis product. A stroke workup was initiated, including computed tomography angiography, which demonstrated severe tortuosity and a beaded appearance of her bilateral internal carotid arteries (A/Cover and B). The radiographic imaging findings, including alternating areas of bulging and narrowing, were consistent with fibromuscular dysplasia (FMD; C). The patient denied any history of transient ischemic attack, cerebrovascular accident, amaurosis fugax, or chronic kidney issues.
Source: Journal of Vascular Surgery - September 20, 2023 Category: Surgery Authors: Henry Lee, Bethany Lueck, Kevin M. Casey Tags: Vascular Image Source Type: research
Female and Male Patients Have Similar Outcomes After TransCarotid Artery Revascularization in Prospective Trials
Sex disparities in outcomes after carotid revascularization have long been a concern, with several studies demonstrating increased post-operative death and stroke for female patients after either carotid endarterectomy (CEA) or transfemoral stenting (TF-CAS). Adverse events after TF-CAS are higher in female patients, particularly in symptomatic cases. Our objective was to investigate outcomes after transcarotid revascularization (TCAR) stratified by patient sex hypothesizing that the results would be similar between males and females.
Source: Journal of Vascular Surgery - September 14, 2023 Category: Surgery Authors: Justin A. Smith, Jane M. Chung, Peter A. Schneider, Christopher J. Kwolek, Frank R. Arko, Steve Henao, Jessica Titus, Paul DiMuzio, Sean Roddy, Mark A. Farber, Vikram S. Kashyap, ROADSTER trial investigators Source Type: research
Symptomatic carotid web requires aggressive intervention
Carotid web (CaWeb) is a rare form of fibromuscular dysplasia that can produce embolic stroke. Misdiagnosis of symptomatic CaWeb as “cryptogenic stroke” or “embolic stroke of unknown source” is common and can lead to recurrent, catastrophic neurologic events. Reports of CaWeb in the literature are scarce, and their natural history is poorly understood. Appropriate management remains controversial.
Source: Journal of Vascular Surgery - September 7, 2023 Category: Surgery Authors: Clayton J. Brinster, James O'Leary, Aaron Hayson, Andrew Steven, Charles Leithead, W.C. Sternbergh, Samuel R. Money, Gabriel Vidal Source Type: research
Long-term outcomes of carotid endarterectomy vs transfemoral carotid stenting in a Medicare-matched database
Carotid endarterectomy (CEA) is associated with lower risk of perioperative stroke compared with transfemoral carotid artery stenting (TFCAS) in the treatment of carotid artery stenosis. However, there is discrepancy in data regarding long-term outcomes. We aimed to compare long-term outcomes of CEA vs TFCAS using the Medicare-matched Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network database.
Source: Journal of Vascular Surgery - August 25, 2023 Category: Surgery Authors: Kevin S. Yei, Claire Janssen, Nadin Elsayed, Isaac Naazie, Art Sedrakyan, Mahmoud B. Malas Source Type: research
Long-Term Outcomes of Carotid Endarterectomy vs. Transfemoral Carotid Stenting in a Medicare-Matched Database
Carotid endarterectomy is associated with lower risk of perioperative stroke compared to transfemoral carotid artery stenting in the treatment of carotid artery stenosis. However, there is discrepancy in data regarding long-term outcomes. We aimed to compare long-term outcomes of carotid endarterectomy vs transfemoral carotid artery stenting using the Medicare-matched Vascular Quality Initiative Vascular Implant Surveillance and Interventional Outcomes Network database.
Source: Journal of Vascular Surgery - August 25, 2023 Category: Surgery Authors: Kevin S. Yei, Claire Janssen, Nadin Elsayed, Isaac Naazie, Art Sedrakyan, Mahmoud B. Malas Source Type: research
Angiotensin-converting Enzyme Inhibitors and Angiotensin Receptor Blockers are Associated With Improved Amputation Free Survival in Chronic Limb-threatening Ischemia
In the Heart Outcomes Prevention Evaluation (HOPE) study, investigators found that ramipril was associated with improved survival as well as decreased myocardial infarction (MI) and stroke rates in patients with peripheral arterial disease. Nonetheless, their effect on chronic limb-threatening ischemia (CLTI)-specific outcomes is unclear. We aim to assess the effect of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEIs/ARBs) on amputation-free survival in patients with CLTI undergoing peripheral vascular intervention (PVI) in a Medicare-linked database.
Source: Journal of Vascular Surgery - August 18, 2023 Category: Surgery Authors: Nadin Elsayed, Darrin Clouse, Raghu L. Motaganahalli, Mahmoud Malas Source Type: research
Ultrasound Assessment of Internal Carotid Stenosis Pre- and Post-endarterectomy of Contralateral Near-occluded Carotid
Internal carotid artery (ICA) stenosis often presents bilaterally and is a major cause of stroke. Carotid duplex ultrasound is used for stenosis estimation via peak systolic velocity (PSV), end diastolic velocity (EDV), and ICA/common carotid artery (CCA) ratio. Carotid endarterectomy (CEA) is a common surgery for ICA stenosis and carries a high risk of stroke and mortality. In ICA near occlusion with>90% stenosis, collateral flow through contralateral ICA can compensate with increased velocities, artificially elevating contralateral stenosis.
Source: Journal of Vascular Surgery - August 18, 2023 Category: Surgery Authors: Vaishnavi Aradhyula, Lauren Workman, Todd E. Russell, Gregory Kasper, Brett Aplin, Fedor Lurie Source Type: research
A comparative effectiveness study of carotid intervention for long-term stroke prevention in patients with severe asymptomatic stenosis from a large integrated health system
In this study, we compared the observed effectiveness of CEA and standard medical therapy versus standard medical therapy alone to prevent ipsilateral stroke in a contemporary cohort of patients with ACS.
Source: Journal of Vascular Surgery - July 3, 2023 Category: Surgery Authors: Robert W. Chang, Noel Pimentel, Lue-Yen Tucker, Kara A. Rothenberg, Andrew L. Avins, Alexander C. Flint, Rishad M. Faruqi, Mai N. Nguyen-Huynh, Romain Neugebauer Source Type: research
Epidemiology, repair technique, and predictors of stroke and mortality in penetrating carotid artery injuries
This retrospective review of the NTDB found that carotid repair was associated with improved mortality outcomes compared to ligation; however, there was no difference in stroke outcome. The factors predictive of stroke were low GCS, high ISS, and a history of neurological deficit prior to injury and those predictive of in-hospital mortality were carotid ligation, low GCS, high ISS, and cardiac arrest.
Source: Journal of Vascular Surgery - June 26, 2023 Category: Surgery Authors: Anastasia Plotkin, Fred A. Weaver, Natthida Owattanapanich, Saskya Byerly, Morgan Schellenberg, Kenji Inaba, Gregory A. Magee Source Type: research
Multicentre International Registry of Open Surgical Versus Percutaneous Upper Extremity Access During Endovascular Aortic Procedures
To investigate access failure (AF) and stroke rates of aortic procedures performed with upper extremity access (UEA), and compare results of open surgical vs. percutaneous UEA techniques with closure devices.
Source: Journal of Vascular Surgery - June 20, 2023 Category: Surgery Authors: L. Bertoglio, G. Oderich, A. Melloni, M. Gargiulo, T. K ölbel, D.J. Adam, L. Di Marzo, G. Piffaretti, C.J. Agrusa, W. Van den Eynde, the SUPER-AXA Registry Collaborators Source Type: research
Frail indications
Carotid endarterectomy (CEA) for asymptomatic internal carotid artery stenosis has always been predicated on an expected life expectancy and quality of life to justify the initial morbidity risk.1 Treatment for asymptomatic disease can be quite variable and is a source of controversy.2,3 This concern can range from traditional CEA to primary medical management without any intervention. The treatment algorithm begins with a stroke risk assessment to determine those at high risk if untreated and then assessing the expected benefit.
Source: Journal of Vascular Surgery - June 20, 2023 Category: Surgery Authors: Jeffrey J. Siracuse Tags: Invited commentary Source Type: research
Impact of presenting stroke severity and thrombolysis on outcomes following urgent carotid interventions
Carotid interventions are increasingly performed in select patients following acute stroke. We aimed to determine the effects of presenting stroke severity (National Institutes of Health Stroke Scale [NIHSS]) and use of systemic thrombolysis (tissue plasminogen activator [tPA]) on discharge neurologic outcomes (modified Rankin scale [mRS]) following urgent carotid endarterectomy (uCEA) and urgent carotid artery stenting (uCAS).
Source: Journal of Vascular Surgery - June 15, 2023 Category: Surgery Authors: Aaron Hayson, Jeffrey Burton, Joseph Allen, W.C. Sternbergh, Daniel Fort, Hernan A. Bazan Source Type: research
