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Source: Journal of Vascular Surgery
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Total 705 results found since Jan 2013.
Revascularization versus Best Medical Therapy for the Management of Asymptomatic Carotid Artery Stenosis in Females: A Systematic Review and Meta-analysis
The objective of this study is to systematically review the evidence for revascularization (in the form of carotid endarterectomy [CEA] or carotid artery stenting [CAS]) and best medical therapy (BMT) for asymptomatic carotid stenosis>60% in female patients with respect to perioperative and long-term (>30 days) rates of stroke and death.
Source: Journal of Vascular Surgery - August 24, 2021 Category: Surgery Authors: Shira A. Strauss, Prasad Jetty, Chau Huynh, Na Zeng, Baies Haqani Tags: PC: Poster Competition Source Type: research
Transcarotid Artery Revascularization Is Associated With Favorable Outcomes in the Treatment of Restenosis After Prior Carotid Endarterectomy
Restenosis after carotid endarterectomy (CEA) has been associated with an increased risk of ipsilateral stroke. Redo-CEA has a significantly higher rate of stroke and cranial nerve injury compared with primary CEA. Carotid artery stenting might provide a safer treatment option for restenosis. However, the optimal treatment modality for this pathology has yet to be determined. Here, we evaluate the in-hospital outcomes of transcarotid artery revascularization (TCAR), redo-carotid CEA, and transfemoral carotid artery stenting (TFCAS) in a large contemporary cohort of patients who underwent treatment for restenosis after CEA.
Source: Journal of Vascular Surgery - August 24, 2021 Category: Surgery Authors: Nadin Elsayed, Ganesh Ramakrishnan, Isaac Naazie, Raghu L. Motaganahalli, Sharvil Sheth, Mahmoud B. Malas Tags: IPC: International Poster Competition Source Type: research
Emerging evidence suggests that patients with high-grade asymptomatic carotid stenosis should be revascularized
The management of asymptomatic carotid stenosis (ACS) remains a topic of extensive debate. According to the 2009 European Society for Vascular Surgery (ESVS) guidelines for the management of patients with carotid stenosis, carotid endarterectomy (CEA) can be recommended for asymptomatic men below 75 years of age with a 70% to 99% stenosis if the risk associated with surgery is less than 3% (grade A).1 The 2011 Society for Vascular Surgery (SVS) guidelines similarly recommended that patients with ≥60% ACS should be considered for CEA for reduction of long-term risk of stroke, provided they h ave a 3- to 5-year life expe...
Source: Journal of Vascular Surgery - December 21, 2021 Category: Surgery Authors: Christos D. Liapis, Hans-Henning Eckstein, Kosmas I. Paraskevas, Jack L. Cronenwett Tags: Editorial Source Type: research
Severity of stenosis in symptomatic patients undergoing carotid interventions might influence perioperative neurologic events
We examined the association of carotid artery stenosis severity with the outcomes for symptomatic patients who had undergone carotid intervention, including carotid endarterectomy (CEA), transfemoral carotid artery stenting (TFCAS), and transcervical carotid artery revascularization (TCAR).
Source: Journal of Vascular Surgery - April 4, 2022 Category: Surgery Authors: Karan Garg, Heepeel Chang, Jeffrey J. Siracuse, Glenn R. Jacobowitz, Jose Torres, Frank J. Veith, Virendra I. Patel, Thomas S. Maldonado, Mikel Sadek, Neal S. Cayne, Caron B. Rockman Source Type: research
One-year Outcomes of Transcarotid Artery Revascularization vs Carotid Endarterectomy in Medicare Database
Carotid endarterectomy (CEA) has played a major part in reducing stroke in patients with significant carotid artery stenosis. Transcarotid artery revascularization (TCAR) was introduced as a minimally invasive hybrid procedure to treat patients who are considered anatomically and/or medically high risk for CEA. Prior studies reported no differences in perioperative stroke/death between TCAR and CEA. However, data regarding 1-year outcomes of TCAR vs CEA are scarce, and all prior studies had only about 50% follow up at 1 year.
Source: Journal of Vascular Surgery - May 19, 2022 Category: Surgery Authors: Nadin Elsayed, Kevin Yei, Raghu L. Motaganahalli, Marc L. Schermerhorn, Mahmoud B. Malas Tags: IYSC: International Young Surgeons Competition Source Type: research
One-Year Outcomes of Transcarotid Artery Revascularization Versus Transfemoral Carotid Artery Stenting in a Medicare Database
Transfemoral carotid artery stenting (TFCAS) was introduced as a minimally invasive option for high-risk patients not eligible for carotid endarterectomy. However, TFCAS was found to be associated with higher rates of perioperative stroke. This was attributed to the unprotected manipulation of the aortic arch and carotid atherosclerotic lesion. Therefore, transcarotid artery revascularization (TCAR) was introduced as a hybrid alternative to TFCAS. Prior studies have shown a significantly lower risk of perioperative stroke and death compared with TFCAS.
Source: Journal of Vascular Surgery - May 19, 2022 Category: Surgery Authors: Nadin Elsayed, Kevin Yei, Marc L. Schermerhorn, Philip P. Goodney, Mahmoud B. Malas Tags: IP: Interactive Poster Session Source Type: research
Why sex matters
Before writing this commentary, I performed a PubMed search using the terms “carotid endarterectomy” and “women” and retrieved 844 results. The current excellent study is one of the first to report the outcomes of transcarotid artery revascularization stratified by sex.1 However, the outcomes of carotid interventions for stroke prevention in women are still a matter of debate. Although stroke is the fifth leading cause of death in the United States, it remains the third leading cause among African-American and Hispanic women.
Source: Journal of Vascular Surgery - June 20, 2022 Category: Surgery Authors: Caron Rockman Tags: Invited Commentary 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 - December 21, 2022 Category: Surgery Authors: Clayton J. Brinster, James O'Leary, Aaron Hayson, Andrew Steven, Gabriel Vidal, G. Ross Parkerson, Hernan Bazan, Charles Leithead, Samuel R. Money, W.C. Sternbergh Source Type: research
Transcarotid Artery Revascularization Sustains Its Advantage Over Transfemoral Carotid Artery Stenting in the Longer Term: Propensity Score-Matched Three-Year Outcomes
The superiority of transcarotid artery revascularization (TCAR) over transfemoral carotid artery stenting (TFCAS) has been established in the perioperative period with a lower risk of stroke and death. However, it remains unclear whether TCAR will sustain its advantage in the longer term. We evaluated the 3-year outcomes for death, transient ischemic attack (TIA), stroke, and myocardial infarction (MI) after TCAR and TFCAS.
Source: Journal of Vascular Surgery - March 17, 2023 Category: Surgery Authors: Jerry Zhu, Ajit Rao, Daniel Han, Ageliki Vouyouka, Windsor Ting, David Finlay, Sung Yup Kim, Rami Tadros, Michael Marin, Peter Faries Source Type: research
Risk Stratified Outcomes of Carotid Endarterectomy vs Transcarotid Artery Revascularization
Transcarotid artery revascularization (TCAR) offers a minimally invasive alternative to carotid endarterectomy (CEA) in patients at high risk for CEA. Prior studies suggest nearly comparable stroke and mortality outcomes in asymptomatic patients, whereas CEA is associated with lower periprocedural stroke risk in symptomatic patients. Here, we compare TCAR and CEA in risk-stratified patients to assist with clinical decision-making.
Source: Journal of Vascular Surgery - May 23, 2023 Category: Surgery Authors: Katharina Horn, Jose Antonio Munoz, Priya B. Patel, Panpan Chen, Danielle Bajakian, Nicholas Morrissey, Jeffrey J. Siracuse, Marc L. Schermerhorn, Thomas F.X. O'Donnell, Virendra I. Patel, Karan Garg Tags: Poster Competition Source Type: research
Change in Peak Systolic Velocity Estimation in Internal Carotid Artery Following Contralateral Near Occlusive Carotid Endarterectomy
Carotid artery stenosis (CAS) is one of the main causes of stroke, as the internal carotid artery (ICA) is a major source of cerebral blood supply. A common surgical intervention for CAS is carotid endarterectomy (CEA), which carries a high risk of stroke and mortality. CEA is indicated for 50% to 99% stenosis in symptomatic patients and 60% to 99% stenosis in asymptomatic patients. Carotid duplex ultrasound is frequently used to estimate peak systolic velocity (PSV), end diastolic velocity (EDV), and ICA/common carotid artery (CCA) ratio to determine the extent of stenosis.
Source: Journal of Vascular Surgery - May 23, 2023 Category: Surgery Authors: Vaishnavi Aradhyula, Lauren R. Workman, Fedor Lurie Tags: Interactive Poster Session 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
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
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
Sex-related differences in carotid plaque features and inflammation
Objective: Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary atherosclerosis, there are few data appraising gender-specific features of carotid plaques. We aimed to systematically compare the pathology and inflammatory features of carotid plaques in men vs women.Methods: Carotid plaque specimens were collected from patients undergoing surgical endarterectomy for asymptomatic or symptomatic carotid stenosis. Histologic analysis was performed, as well as measurements of plaque composition and inflammation.Results: A total of 457 pati...
Source: Journal of Vascular Surgery - October 10, 2012 Category: Surgery Authors: Giuseppe Sangiorgi, Sara Roversi, Giuseppe Biondi Zoccai, Maria Grazia Modena, Francesca Servadei, Arnaldo Ippoliti, Alessandro Mauriello Tags: Clinical research studies Source Type: research
