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Source: Journal of Vascular Surgery
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Total 705 results found since Jan 2013.
Females are Less Likely to Receive Best Medical Therapy for Stroke Prevention Before and After Carotid Revascularization than Males
Current professional guidelines recommend best medical therapy (BMT) with statin agents and antiplatelet therapy for primary and secondary stroke prevention in patients with carotid artery stenosis. We aimed to assess the association of patient sex with preoperative BMT in patients undergoing carotid revascularization.
Source: Journal of Vascular Surgery - October 11, 2022 Category: Surgery Authors: Sanuja Bose, David P. Stonko, Georgina M. Pappas, Laura M. Drudi, Michael C. Stoner, Caitlin W. Hicks Source Type: research
Carotid Artery Coiling Associated with Ipsilateral Ischemic Stroke Treated by Mechanical Thrombectomy
We have presented a case of asymptomatic internal carotid artery coiling resulting in a devastating ipsilateral ischemic stroke that was treated by intracranial mechanical thrombectomy.
Source: Journal of Vascular Surgery - March 17, 2023 Category: Surgery Authors: Jean-Claude Lubanda, Jan Fiksa Source Type: research
Using a CT Angiography Artificial Intelligence Carotid Plaque Morphology Model to Predict Stroke
The gold standard for determining carotid artery stenosis is to calculate stenosis using the North American Symptomatic Carotid Endarterectomy Trial criteria and ultimately plan for medical vs surgical management based on percent stenosis and symptomatic status. Few studies have assessed plaque morphology as an additive tool for stroke prediction. Our study uses an artificial intelligence software in conjunction with a patient's computed tomography (CT) scan of the neck to create a three-dimensional (3D) model of the carotid artery and assess plaque morphology including calcification, intraplaque hemorrhage, matrix, and pe...
Source: Journal of Vascular Surgery - May 23, 2023 Category: Surgery Authors: Rohini J. Patel, Daniel Willie-Permor, Sina Zarrintan, Austin Fan, Mahmoud Malas Tags: Poster Competition Source Type: research
The current national criteria for carotid artery stenting overestimate its efficacy in patients who are symptomatic and at high risk
In this study, we stratified patients who underwent CAS or CEA by CMS high-risk criteria and symptom status and examined their 30-day outcomes.Methods: A nonrandomized, retrospective cohort study was performed by chart review of all patients undergoing CEA or CAS from January 1, 2005, to December 31, 2010, at our institution. Demographic data and data pertaining to the presence or absence of high-risk factors were collected. Patients were stratified using symptom status and high-risk status as variables, and 30-day adverse events (stroke, death, myocardial infarction [MI]) were compared.Results: A total of 271 patients und...
Source: Journal of Vascular Surgery - April 8, 2013 Category: Surgery Authors: Shunsuke Yoshida, Rodney P. Bensley, Julia D. Glaser, Christoph S. Nabzdyk, Allen D. Hamdan, Mark C. Wyers, Elliot L. Chaikof, Marc L. Schermerhorn Tags: Clinical research studies Source Type: research
Clinical and anatomic outcomes after carotid endarterectomy
Objective: The purpose of this study was to examine 30-day and long-term outcomes after carotid endarterectomy (CEA) in a contemporary series and to identify variables associated with stroke and death after CEA.Methods: This was a retrospective review of patients undergoing an isolated CEA at a single institution between January 1989 and December 2005. Primary study end points were 30-day and long-term overall stroke, ipsilateral stroke, and death. Secondary end points were recurrent stenosis (>70% stenosis) and reintervention. Kaplan-Meier analysis was used to create survival curves for the long-term study end points. Mul...
Source: Journal of Vascular Surgery - March 24, 2014 Category: Surgery Authors: Jeanwan Kang, Mark F. Conrad, Virendra I. Patel, Shankha Mukhopadhyay, Ashu Garg, Matthew R. Cambria, Glenn M. LaMuraglia, Richard P. Cambria Tags: Clinical research studies Source Type: research
The need for treatment of hemodynamic instability following carotid endarterectomy is associated with increased perioperative and 1-year morbidity and mortality
The objective of this study was to evaluate the outcomes of patients after carotid endarterectomy (CEA) who developed postoperative hypertension or hypotension requiring the administration of intravenous vasoactive medication (IVMED).Methods: We examined consecutive, primary elective CEA performed by 128 surgeons within the Vascular Study Group of New England (VSGNE) database (2003-2010) and compared outcomes of patients who required postoperative IVMED to treat hyper- or hypotension with those who did not. Outcomes included perioperative death, stroke, myocardial infarction (MI), congestive heart failure (CHF), hospital l...
Source: Journal of Vascular Surgery - September 3, 2013 Category: Surgery Authors: Tze-Woei Tan, Mohammad H. Eslami, Jeffrey A. Kalish, Robert T. Eberhardt, Gheorghe Doros, Philip P. Goodney, Jack L. Cronenwett, Alik Farber, Vascular Study Group of New England Tags: Clinical research studies Source Type: research
In-hospital versus postdischarge adverse events following carotid endarterectomy
Conclusions: With 38% of perioperative adverse events after CEA happening posthospitalization, regardless of symptoms status, we need to be alert to the ongoing risks after discharge particularly in women, patients with renal failure, or chronic obstructive pulmonary disease. This emphasizes the need for reporting and comparing 30-day adverse event rates when evaluating outcomes for CEA, or comparing carotid stenting to CEA.
Source: Journal of Vascular Surgery - February 5, 2013 Category: Surgery Authors: Margriet Fokkema, Rodney P. Bensley, Ruby C. Lo, Allan D. Hamden, Mark C. Wyers, Frans L. Moll, Gert Jan de Borst, Marc L. Schermerhorn Tags: Clinical research studies Source Type: research
Management of common carotid artery dissection due to extension from acute type A (DeBakey I) aortic dissection
Conclusions: CCAD, due to extension from aortic arch dissection, has a low risk of subsequent stroke after the initial event. Based on current data, there is little evidence to suggest that aortic origin CCAD requires repair in the absence of recurrent symptoms, regardless of the degree of stenosis or false-lumen patency. Recommended optimal medical therapy includes either aspirin or anticoagulation for 6 months after initial presentation. Additional longitudinal studies are needed.
Source: Journal of Vascular Surgery - May 13, 2013 Category: Surgery Authors: Kristofer M. Charlton-Ouw, Ali Azizzadeh, Harleen K. Sandhu, Ali Sawal, Samuel S. Leake, Charles C. Miller, Anthony L. Estrera, Hazim J. Safi Tags: Clinical research studies 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
Differential outcomes of carotid stenting and endarterectomy performed exclusively by vascular surgeons in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST)
Objective: Outcomes in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) did not differ between carotid artery stenting (CAS) and carotid endarterectomy (CEA) for the composite primary end point of stroke, myocardial infarction (MI), or death during the periprocedural period or ipsilateral stroke within 4 years. Rigorous credentialing and training of interventionists, including vascular surgeons, were required for the randomization phase of CREST. Because the lead-in phase of CREST had suggested higher perioperative risks after CAS performed by vascular surgeons, the purpose of this analysis was to...
Source: Journal of Vascular Surgery - December 26, 2012 Category: Surgery Authors: Carlos H. Timaran, Vito A. Mantese, Mahmoud Malas, O. William Brown, Brajesh K. Lal, Wesley S. Moore, Jenifer H. Voeks, Thomas G. Brott, CREST Investigators Tags: Clinical research studies Source Type: research
Differences and Similarities Between Spontaneous Dissections of the Internal Carotid Artery and the Vertebral Artery
There are clinical, pathologic, and outcome differences in spontaneous dissections of the internal carotid artery vs those of the vertebral artery. Spontaneous cervical artery dissection is a major cause of stroke in younger patients. Spontaneous cervical artery dissection causes up to 25% of all ischemic strokes in patients 15 to 49 years of age (Putaala J et al, Stroke 2009;40:1195-203). Although constitutional and environmental factors are both thought to play a role in spontaneous cervical artery dissection, precise causes are poorly understood. Significant differences between spontaneous internal carotid artery disse...
Source: Journal of Vascular Surgery - December 27, 2013 Category: Surgery Authors: M. von Babo, G.M. De Marchis, H. Sarikaya Tags: Abstracts Source Type: research
Statins Reduce Neurologic Injury in Asymptomatic Carotid Endarterectomy Patients
This study defined neurologic injury after CEA as both clinical stroke and significant cognitive dysfunction. Agreeing to participate in the study were 328 asymptomatic patients with carotid stenosis scheduled for elective CEA. Patients were evaluated for perioperative stroke and cognitive dysfunction. Cognitive dysfunction was determined by a battery of neuropsychometric tests performed preoperatively and 1 day postoperatively (Heyer EJ et al, Arch Neurol 2002;59:217-22). Patients taking a statin medication at the time of their CEA had a lower incidence of clinical stroke (0.0% vs 3.1%; P = .02) and a lower incidence of c...
Source: Journal of Vascular Surgery - June 30, 2013 Category: Surgery Authors: E.J. Heyer, J.L. Mergeche, S.S. Bruce Tags: Abstracts Source Type: research
The impact of the present on admission indicator on the accuracy of administrative data for carotid endarterectomy and stenting
Conclusions: Administrative data has known limitations for assignment of symptom status and nonfatal perioperative outcomes. Given the uncertain timing of POA events as preoperative vs intraoperative and its apparent underestimation of the perioperative stroke rate, the use of administrative data even with the POA indicator for symptom status and non-fatal outcomes after CEA and CAS is hazardous.
Source: Journal of Vascular Surgery - August 29, 2013 Category: Surgery Authors: Margriet Fokkema, Rob Hurks, Thomas Curran, Rodney P. Bensley, Allen D. Hamdan, Mark C. Wyers, Frans L. Moll, Marc L. Schermerhorn Tags: Clinical research studies Source Type: research
Progression Rate and Ipsilateral Neurological Events in Asymptomatic Carotid Stenosis
In this study the authors sought to evaluate the yearly rate of change of carotid luminal narrowing as a risk factor for ipsilateral ischemic neurologic events in patients with ≥50% asymptomatic carotid stenosis. Patients were those who took part in the deferred endarterectomy arm of the Asymptomatic Carotid Surgery Trial (ACST). Secondary aims were to establish the annual incidence of progression and regression of luminal narrowing and identify other risk factors associated with ipsilateral neurological events in these patients. This was a retrospective analysis of data derived from the deferred endarterectomy arm of th...
Source: Journal of Vascular Surgery - April 24, 2014 Category: Surgery Authors: L.S. Hirt Tags: Abstracts Source Type: research
CAR 11. Concentration of Specific Markers in Patients With the Subclinical Form of Atherosclerosis
Stroke is the third most common cause of death and the most common reason for premature permanent invalidism. About 10% to 15% of strokes occur as the result of severe atherosclerotic malfunction of the internal carotid artery (ICA). Atherosclerosis is the main cause of carotid artery stenosis formation. However, the risk of stroke is higher in patients with soft atherosclerotic plaque. One of the options of stroke prevention, then, is a surgical treatment —carotid endarterectomy. However, the surgical benefit is not so significant in asymptomatic patients, in whom the risk of recurrent stroke in the first year after sur...
Source: Journal of Vascular Surgery - October 22, 2018 Category: Surgery Authors: Peter Štefanič, Vladimír Sihotský, František Sabol, Marián Tomečko, Martina Závacká, Ivan Kopolovets, Mária Frankovičová, Ján Luczy, Zdenka Hertelyová Source Type: research
