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Evaluation of Neurocognitive Abilities in Patients Undergoing Carotid Endarterectomy Surgery
CONCLUSION: The purpose of CEA in the past was the prevention of ischemic stroke and cerebrovascular disease (CVD) rather than neurocognitive recovery. Factors affecting neurocognition in CEA are multifactorial. Preservation and improvement of neurocognition are more important than any other period of history. By prioritizing cognitive abilities in the treatment of carotid stenosis, individualization of the treatment will help maximize the increase in cognitive abilities by providing optimum benefit to the patient of each factor.PMID:33635257 | DOI:10.1532/hsf.3371
Source: The Heart Surgery Forum - February 26, 2021 Category: Cardiovascular & Thoracic Surgery Authors: Zafer Cengiz Er Kivanc Atilgan Source Type: research

Carotid endarterectomy should be performed first rather than combined with coronary bypass
I read with interest the article addressing timing of carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG)1 since I had just been referred a patient from a cardiac surgeon with the need for both CEA and CABG. I was gratified to learn that in patients with stable angina, performing CEA first compared equally to combined CEA and CABG (CCAB) with regard to both stroke rate and myocardial infarction (MI). From a strictly scheduling standpoint, performing a staged procedure is easier on surgeons and staff.
Source: Journal of Vascular Surgery - November 19, 2020 Category: Surgery Authors: Joseph J. Piotrowski Tags: Letter to the Editor Source Type: research

Surgical Approaches to Stroke Risk Reduction
This article examines the evidence for using the available options. RECENT FINDINGS Carotid endarterectomy is an effective treatment option for reducing the risk of stroke in appropriately selected patients. Patients should be stratified for future stroke risk based on both the degree of stenosis and the presence of symptoms referable to the culprit lesion. Carotid stenting is also useful in reducing stroke risk, again in carefully selected patients. Because of the publication of significant data regarding both carotid endarterectomy and carotid artery stenting in the last several years, selection can be far more person...
Source: CONTINUUM: Lifelong Learning in Neurology - April 1, 2020 Category: Neurology Tags: REVIEW ARTICLES Source Type: research

Immune cells in carotid artery plaques: what can we learn from endarterectomy specimens?
CONCLUSIONS: Since the destabilization of the atherosclerotic plaque is a multifactorial process, a combination of various methods should be used to characterize the unstable plaques more accurately. In this context, studies characterizing plaque content from a cellular point ofview could elucidate some processes underlying the plaque progression. Together with morphological evaluation, these analyses could enable more precise assessment of plaque stability. PMID: 31782285 [PubMed - as supplied by publisher]
Source: International Angiology - December 1, 2019 Category: Cardiology Tags: Int Angiol Source Type: research

Haematomas after carotid endarterectomy can be reduced by direct pressure to the neck postoperatively.
Conclusion During recovery from CEA, focused and prolonged pressure by the operating surgeon is a highly effective method of reducing haematoma. PMID: 29909667 [PubMed - as supplied by publisher]
Source: Annals of the Royal College of Surgeons of England - June 18, 2018 Category: Surgery Authors: Saghir R, Humm G, Rix T Tags: Ann R Coll Surg Engl Source Type: research

Failure to account for practice effects leads to clinical misinterpretation of cognitive outcome following carotid endarterectomy
Abstract Carotid endarterectomy (CEA) is a surgical procedure to remove stenotic atherosclerotic plaque from the origin of the carotid artery to reduce the risk of major stroke. Its impact on postoperative cognitive function (POCF) remains controversial; complicated, in part, by a traditional failure to account for practice effects incurred during consecutive psychometric testing. To address this for the first time, we performed psychometric testing (learning and memory, working memory, attention and information processing, and visuomotor coordination) in 15 male patients aged 68 ± 8 years with symptomatic carotid sten...
Source: Physiological Reports - June 14, 2017 Category: Physiology Authors: Christopher J. Marley, Andrew Sinnott, Judith E. Hall, Gareth Morris ‐Stiff, Paul V. Woodsford, Michael H. Lewis, Damian M. Bailey Tags: Original Research Source Type: research

Large Artery Atherosclerotic Occlusive Disease
ABSTRACT: Purpose of Review: Extracranial or intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack. Given the high prevalence of large artery atherosclerosis in the general population, determining whether an identified atherosclerotic lesion is truly the cause of a patient’s symptomatology can be difficult. In all cases, optimally treating each patient to minimize future stroke risk is paramount. Extracranial or intracranial large artery atherosclerosis can be broadly compartmentalized into four distinct clinical scenarios based upon...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2017 Category: Neurology Tags: Review Articles Source Type: research

Carotid artery stenting
Learning objectives After reading this article the reader should:Know the appropriate diagnostic workup for patients with carotid artery disease. Be able to put in perspective, based on strengths and limitations, the results of randomised trials comparing carotid artery stenting and carotid endarterectomy. Be able to identify patients that may benefit from carotid artery stenting. Introduction In western countries, stroke is the fourth leading cause of death, after heart disease, cancer and chronic respiratory diseases.1 Carotid artery disease may be responsible for 10–15% of all ischaemic strokes.2 Randomised contro...
Source: Heart - June 9, 2016 Category: Cardiology Authors: Roffi, M., Kulcsar, Z., Carrera, E., Cremonesi, A. Tags: Education in Heart, Drugs: cardiovascular system, Interventional cardiology, Epidemiology, Tobacco use Source Type: research

Carotid endarterectomy versus stenting for stroke prevention: what we have and will learn from Carotid Revascularization Endarterectomy versus Stenting Trial
Abstract: The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) has major implications for the future of carotid revascularization and stroke prevention. The purpose of The William Hinter Harridge Lecture was to discuss the history of carotid revascularization before CREST, to delineate the emergence of carotid artery stenting as an alternative to carotid endarterectomy, analyze the key findings in CREST, and describe the next phase of investigation, CREST-2.
Source: American Journal of Surgery - March 28, 2014 Category: Surgery Authors: Fred A. Weaver Tags: Historian's Lecture Source Type: research

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