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Early vascular imaging and key system strategies expedite carotid revascularization after transient ischemic attack and stroke
International guidelines recommend carotid revascularization within 14  days for patients with a symptomatic transient ischemic attack (TIA) or stroke event. However, significant delays in care persist, with only 9% of outpatients and 36% of inpatients in Ontario meeting this target. The study objective was to explore the influence of health system factors on carotid revascularization timelines.
Source: Journal of Vascular Surgery - April 5, 2020 Category: Surgery Authors: Sophia Gocan, Aline Bourgoin, Rany Shamloul, Brammiya Sivakumar, Dar Dowlatshahi, Grant Stotts Source Type: research

IP131. Transfemoral Carotid Angioplasty and Stenting With Embolic Protection: A 7-year Retrospective Analysis of a Single-Center Experience
Carotid angioplasty and stenting (CAS) is an excellent, often superior, alternative to carotid endarterectomy (CEA). When performed by experienced operators, both are equivalent in periprocedural risk and stroke prevention. Widespread adoption of CAS in the United States has been impeded by reimbursement regulations mandated by the Centers for Medicare and Medicaid Services (CMS) that favor CEA over CAS for patients with asymptomatic carotid disease. This policy has led to decreased CAS volumes and an increase in percentages of patients receiving CAS for symptomatic vs asymptomatic disease.
Source: Journal of Vascular Surgery - May 17, 2017 Category: Surgery Authors: Michael B. Silva, Garold Motes, Zulfiqar Faisal. Cheema, Grant Fankhauser, Nikita Tihonov, Jennifer Worsham, Kaled Diab, Charlie Cheng Tags: IP: Interactive Poster Session Source Type: research

Hospital Process Redesign Leading to Waiting Time Improvements in Delivery of Stroke-Prevention Surgery to Patients With Symptomatic Carotid Artery Stenosis
This study assessed whether carotid endarterectomy (CEA) waiting times have improved after a collaborative hospital process redesign at The Ottawa Hospital (TOH) aimed at expediting referral, evaluation, and treatment of patients with symptomatic internal carotid artery stenosis.
Source: Journal of Vascular Surgery - October 23, 2015 Category: Surgery Authors: Pranavi Ravichandran, Grant Stotts, George Hajjar, Dalibor Kubelik, Andrew Hill, Tim Brandys, Sudhir Nagpal, Prasad Jetty Tags: Abstract from the 2015 Canadian Society for Vascular Surgery Annual Meeting Source Type: research

Outcomes of urgent carotid endarterectomy for stable and unstable acute neurologic deficits
Conclusions: Our results with U-CEA confirm that this population has a higher risk profile compared with elective surgery. The type of acute presentation is correlated with perioperative risk. U-CEA was safe when performed on patients presenting with transient ischemic attack. An acceptable complication rate was achieved for patients with minor to moderate strokes. The poorest outcomes occurred in patients presenting with stroke in evolution: U-CEA in these patients should be offered with extreme caution, although we are aware that a conservative treatment may not grant a better prognosis.
Source: Journal of Vascular Surgery - November 18, 2013 Category: Surgery Authors: Iacopo Barbetta, Michele Carmo, Giulio Mercandalli, Patrizia Lattuada, Daniela Mazzaccaro, Alberto M. Settembrini, Raffaello Dallatana, Piergiorgio G. Settembrini Tags: Clinical research studies Source Type: research