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Procedure: Carotid Endarterectomy

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Total 1010 results found since Jan 2013.

Unstable Carotid Plaque as a Phenotype of Chronic Systemic Inflammation Enhances Renal Insufficiency
In this study, we explored the association between the unstable plaques and preoperative CKD in patients who underwent carotid endarterectomy (CEA)/carotid artery stenting (CAS). Furthermore, this study also aimed to explore whether there is a difference in the aggravation of renal function with the presence of stable or unstable plaques. Patients and Methods: The study included 90 patients who underwent CEA/CAS for carotid artery stenosis.
Source: Journal of Stroke and Cerebrovascular Diseases - February 21, 2020 Category: Neurology Authors: Daina Kashiwazaki, Kunitaka Maruyama, Shusuke Yamamoto, Hisayasu Saito, Naoki Akioka, Naoya Kuwayama, Kyo Noguchi, Satoshi Kuroda Source Type: research

Carotid Endarterectomy Remains Safe in High-Risk Patients
Carotid endarterectomy (CEA) is a proven intervention for stroke risk reduction in symptomatic and asymptomatic patients. High-risk patients are often offered carotid stenting to minimize risk and to optimize outcomes. As a referral center for high-risk patients, we sought to evaluate and to analyze our experience with high-risk CEA patients.
Source: Journal of Vascular Surgery - February 20, 2020 Category: Surgery Authors: Nathan M. Droz, Sean P. Lyden, James Bena, Christopher J. Smolock, David Hardy, Behzad S. Farivar, Lee Kirksey, Francis J. Caputo Source Type: research

Defining the threshold surgeon volume associated with improved patient outcomes for carotid endarterectomy
The objective of the current study was to define the annual surgeon volume of CEAs that is associated with a lower risk of stroke or death rate.
Source: Journal of Vascular Surgery - February 18, 2020 Category: Surgery Authors: J. Gregory Modrall, Shirling Tsai, Bala Ramanan, Melissa L. Kirkwood, Mujtaba Ali, John E. Rectenwald, Carlos H. Timaran, Eric B. Rosero Source Type: research

Concomitant carotid endarterectomy and cardiac surgery does not decrease postoperative stroke rates
We examined the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database to evaluate the association of combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) with postoperative outcomes.
Source: Journal of Vascular Surgery - February 14, 2020 Category: Surgery Authors: Derek Klarin, Virendra I. Patel, Shuaiqi Zhang, Ying Xian, Andrzej Kosinski, Babatunde Yerokun, Vinay Badhwar, Vinod H. Thourani, Thoralf M. Sundt, David Shahian, Serguei Melnitchouk Source Type: research

Drain placement confers no benefit after carotid endarterectomy in the Vascular Quality Initiative
Whereas bleeding complications requiring a return to the operating room (OR) after carotid endarterectomy (CEA) are infrequent (1%), they are associated with an increased 30-day combined postoperative stroke or death rate. Drain placement after CEA varies among vascular surgeons, and there are limited data to support the practice. The goal of this study was to evaluate factors leading to drain placement and the effect of drains on postoperative outcomes including return to OR for bleeding, stroke, and death.
Source: Journal of Vascular Surgery - February 12, 2020 Category: Surgery Authors: Christopher J. Smolock, Katherine L. Morrow, Jeanwan Kang, Rebecca L. Kelso, James F. Bena, Daniel G. Clair Source Type: research

Identification of the Distal End of Carotid Plaque Using 3-Dimensional Fast Spin Echo T1-Weighted Magnetic Resonance Plaque Imaging
Background: Complete removal of the distal end of the plaque is an important requirement in carotid endarterectomy (CEA) to avoid postoperative complication. Preoperative identification of the distal end of plaque contributes to complete plaque removal. Three-dimensional (3D) magnetic resonance (MR) plaque imaging has been widely used to evaluate carotid plaque characterization. The purpose of the present study was to determine whether preoperative 3D fast spin echo (FSE) T1-weighted MR plaque imaging could identify the distal end of carotid plaque.
Source: Journal of Stroke and Cerebrovascular Diseases - February 10, 2020 Category: Neurology Authors: Kohei Chida, Yasuyoshi Shimada, Kentaro Fujimoto, Jun Yoshida, Daigo Kojima, Shunrou Fujiwara, Masakazu Kobayashi, Kenji Yoshida, Makoto Sasaki, Kuniaki Ogasawara Source Type: research

Intra-Operative Hypotension is a Risk Factor for Post-operative Silent Brain Ischaemia in Patients With Pre-operative Hypertension Undergoing Carotid Endarterectomy
This study aimed to investigate the relationship between peri-operative blood pressure (BP) and presence of post-operative DWI lesions in patients undergoing CEA.
Source: European Journal of Vascular and Endovascular Surgery - February 5, 2020 Category: Surgery Authors: Marjolijn L. Rots, Leonie M.M. Fassaert, L. Jaap Kappelle, Mark C.H. de Groot, Saskia Haitjema, Leo H. Bonati, Wilton A. van Klei, Gert J. de Borst Tags: Observational Study Source Type: research

Intra-Operative Hypotension is a Risk Factor for Post-operative Silent Brain Ischaemia in Patients With Pre-operative Hypertension Undergoing Carotid Endarterectomy.
CONCLUSION: In this exploratory study, high pre-operative BP and a larger drop of intra-operative BP were associated with peri-procedural cerebral ischaemia as documented with DWI. These results call for confirmation in an adequately sized prospective study, as they suggest important consequences for peri-operative haemodynamic management in carotid revascularisation. PMID: 32033871 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - February 5, 2020 Category: Surgery Authors: Rots ML, Fassaert LMM, Kappelle LJ, de Groot MCH, Haitjema S, Bonati LH, van Klei WA, de Borst GJ Tags: Eur J Vasc Endovasc Surg Source Type: research

Shunt intention during carotid endarterectomy in the early symptomatic period and perioperative stroke risk
Whether recent stroke mandates planned shunting during carotid endarterectomy (CEA) is controversial. Our goal was to determine associations of various shunting practices with postoperative outcomes of CEAs performed after acute stroke.
Source: Journal of Vascular Surgery - February 5, 2020 Category: Surgery Authors: Scott R. Levin, Alik Farber, Philip P. Goodney, Marc L. Schermerhorn, Virendra I. Patel, Nkiruka Arinze, Thomas W. Cheng, Douglas W. Jones, Denis Rybin, Jeffrey J. Siracuse Source Type: research

The impact of age on in-hospital outcomes after transcarotid artery revascularization, transfemoral carotid artery stenting, and carotid endarterectomy
This study aimed to compare the association between age and outcomes after TCAR, TFCAS, and CEA.
Source: Journal of Vascular Surgery - February 5, 2020 Category: Surgery Authors: Hanaa Dakour-Aridi, Vikram S. Kashyap, Grace J. Wang, Jens Eldrup-Jorgensen, Marc L. Schermerhorn, Mahmoud B. Malas Source Type: research

The impact of pre-operative symptoms on carotid endarterectomy Outcomes: Analysis of the ACS-NSQIP carotid endarterectomy database
Publication date: Available online 1 February 2020Source: Journal of Clinical NeuroscienceAuthor(s): Varun S. Shah, Daniel Kreatsoulas, David Dornbos, Santino Cua, Ciarán J. PowersAbstractCarotid artery stenosis accounts for up to 20% of ischemic strokes. Since the 1950 s, one of the primary surgical treatment for this condition is carotid endarterectomy (CEA). Because of improvement of medical therapy for carotid artery atherosclerosis and the increased use of carotid artery stents, CEA is indicated if the risk of stroke and death are low. The goal of this study is to characterize the impact of pre-operative stroke and ...
Source: Journal of Clinical Neuroscience - February 2, 2020 Category: Neuroscience Source Type: research

Comparison of Radiation And Contrast Exposure In Transfemoral Versus Transcarotid Stenting
In this study we compared the radiation exposure between TCAR and traditional transfemoral CAS procedures.
Source: Annals of Vascular Surgery - February 1, 2020 Category: Surgery Authors: David O'Connor, Lifen Cao, Jacqueline Steinman, Stanton Nielsen, Kristin Cook, Anjali Ratnathicam, Michael Wilderman, Gregory Simonian, Massimo Napolitano Source Type: research

Lessons Learned Establishing a 24/7 Rapid Access TIA Service
In 2007, the UK Department of Health (DOH) published its National Stroke Strategy, which detailed 20 quality markers for delivering a high quality stroke service, one of which was that patients suffering a transient ischaemic attack (TIA) or minor stroke should be investigated and treated more quickly after symptom onset.1 Interestingly, the National Stroke Strategy also advised that carotid endarterectomy (CEA) should be performed within 48  h of symptom onset, although no evidence was provided to support this threshold.
Source: European Journal of Vascular and Endovascular Surgery - January 24, 2020 Category: Surgery Authors: Ross Naylor, David Eveson Tags: Editorial Source Type: research

Carotid Endarterectomy and Carotid Artery Stenting for Patients With Crescendo Transient Ischemic Attacks: A Systemic Review
Review of English-language articles published from PubMed (MEDLINE) and Google Scholar between January 1, 1985, and January 1, 2019.
Source: Journal of Vascular Surgery - January 22, 2020 Category: Surgery Authors: A. Fereydooni, J. Gorecka, J. Xu Tags: Crescendo transient ischemic attacks should be treated by carotid endarterectomy within two days – but with increased perioperative stroke risk Source Type: research

The asymptomatic octogenarian and carotid endarterectomy —While we await the results of CREST-2
Currently there is no definitive level I evidence regarding the appropriate management of asymptomatic moderate to severe carotid artery stenosis in the octogenarian patient. In this 5-year review of National Surgical Quality Improvement Program registry data, exceptional “real-world” results are reported with use of carotid endarterectomy (CEA) in this growing cohort.1 The combined stroke and death rate was 2% at 30-day follow-up (stroke rate 1%!), with the authors stating that “age alone should not interdict this modality.”
Source: Journal of Vascular Surgery - January 22, 2020 Category: Surgery Authors: Lakshmikumar Pillai Tags: Invited commentary Source Type: research

Somatosensory Evoked Potential and Transcranial Doppler Monitoring to Guide Shunting in Carotid Endarterectomy
Conclusion In this retrospective series of simultaneous TCD and SEP monitoring during CEA surgery of predominantly symptomatic ICA stenosis patients, the stroke and death rate was 1.4%. SEP seemed to be superior to TCD in predicting the need for an intraoperative shunt and for predicting temporary postoperative deficits. Further prospective studies are needed. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: Journal of Neurological Surgery Part A: Central European Neurosurgery - January 14, 2020 Category: Neurosurgery Authors: Seidel, Kathleen Jeschko, Johannes Schucht, Philippe Bervini, David Fung, Christian Krejci, Vladimir Z'Graggen, Werner Fischer, Urs Arnold, Marcel Goldberg, Johannes Raabe, Andreas Beck, Juergen Tags: Original Article Source Type: research

Socioeconomic Disparities in Carotid Revascularization Procedures
The objective of the present study was to examine the intersectionality between race/ethnicity, insurance status, and postoperative outcomes in carotid procedures.
Source: Journal of Cardiothoracic and Vascular Anesthesia - January 13, 2020 Category: Anesthesiology Authors: Latha Panchap, Seyed A. Safavynia, Virginia Tangel, Robert S. White Tags: Original Article Source Type: research

Should We Be (Even More) Restrictive in Selecting Patients for Carotid Endarterectomy? Re: Prognostic Role of Pre-operative Symptom Status in Carotid Endarterectomy, A Systematic Review and Meta-analysis
The selection of patients for carotid endarterectomy (CEA) is one of the vascular surgeon's most delicate tasks. Although one knows that some patients will suffer a disabling stroke or die in the attempt to prevent these events, it is equally devastating when it happens. Thus, the solid evidence of the 1990s on the benefit of the procedure in patients with a significant symptomatic stenosis was welcomed.1,2 Even more welcomed were (and are) those studies further increasing the subgroups of patients who benefit the most, leading to well established evidence based guidelines.
Source: European Journal of Vascular and Endovascular Surgery - January 13, 2020 Category: Surgery Authors: Lisbet Knudsen Rathenborg Tags: Invited Commentary Source Type: research

Limb shaking transient ischemic attacks: A follow-up of 28 patients.
CONCLUSIONS: Limb shaking TIA point to carotid artery disease in the majority of patients and vertebrobasilar artery disease in one third. Fast and timely treatment with either surgical or CAS eliminates the attacks and also reduce their risk of stroke. PMID: 31916976 [PubMed - as supplied by publisher]
Source: Revue Neurologique - January 11, 2020 Category: Neurology Tags: Rev Neurol (Paris) Source Type: research

Can carotid endarterectomy be performed safely within 14 days after intravenous thrombolysis for acute stroke?
Carotid endarterectomy (CEA) represents a standard procedure in case of symptomatic carotid stenosis of 50-99% within 2 weeks from onset of stroke or transient ischemic symptoms (TIA). The optimal time to perform CEA after Intravenous Thrombolysis (IVT) is still unclear. The aim of this study was to analyze the safety of CEA performed within 2 weeks from IVT.
Source: Annals of Vascular Surgery - January 6, 2020 Category: Surgery Authors: Giuseppe Deiana, Antonio Baule, Patrizia Dalla Caneva, Genadi Genadiev Georgiev, Jorge Samuel Cabrera Morales, Antonio Manca, Stefano Camparini Tags: Clinical Research, Basic Science Source Type: research

Can Carotid Endarterectomy be Performed Safely within 14  days after Intravenous Thrombolysis for Acute Stroke?
Carotid endarterectomy (CEA) represents a standard procedure in case of symptomatic carotid stenosis of 50 –99% within 2 weeks from onset of stroke or transient ischemic attack (TIA) symptoms. The optimal time to perform CEA after intravenous thrombolysis (IVT) is still unclear. The aim of this study was to analyze the safety of CEA performed within 2 weeks from IVT.
Source: Annals of Vascular Surgery - January 6, 2020 Category: Surgery Authors: Giuseppe Deiana, Antonio Baule, Patrizia Dalla Caneva, Genadi Genadiev Georgiev, Jorge Samuel Cabrera Morales, Antonio Manca, Stefano Camparini Tags: Clinical Research Source Type: research

Perioperative Stroke in Carotid Artery Stenting as a Surrogate Marker and Predictor for 30-day Postprocedural Mortality & #8211; A Pooled Analysis of 156,000 Patients with Carotid Artery Disease
Conclusions: Perioperative stroke drastically increases the risk of 30-day mortality. The occurrence of perioperative stroke exhibited high specificity but modest sensitivity in predicting 30-day mortality following CAS. This highlights the importance of neurophysiologic monitoring to detect intraoperative cerebral ischemia and perform timely interventions.
Source: Neurology India - December 20, 2019 Category: Neurology Authors: Ahmed M Altibi Eyad E Saca Harbir Dhillon Parthasarathy D Thirumala Source Type: research

Clinical Impact of Routine Cardiology Consultation Prior to Elective Carotid Endarterectomy in Neurologically Asymptomatic Patients.
CONCLUSION: Routine cardiology consultation before elective CEA in patients with asymptomatic carotid stenosis reduced peri-operative cardiac complications and long term fatal cardiovascular events. This approach may be considered to maximise the risk/benefit ratio of CEA in asymptomatic patients. PMID: 31866235 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - December 19, 2019 Category: Surgery Authors: Squizzato F, Antonello M, Taglialavoro J, Prosdocimi L, Grego F, Lupia M, Piazza M Tags: Eur J Vasc Endovasc Surg Source Type: research

Magnetic Resonance Imaging Identified Brain Ischaemia in Symptomatic Patients Undergoing Carotid Endarterectomy Is Related to Histologically Apparent Intraplaque Haemorrhage
Intraplaque haemorrhage (IPH) has been independently associated with a higher risk of future ipsilateral stroke in patients with carotid artery stenosis. Evaluation of plaque characteristics may contribute to risk assessment of recurrent (silent) cerebrovascular events in order to prioritise patients for timing of treatment. It is unknown if patients showing histologically apparent IPH also have increased risk of silent ischaemic brain lesions in the waiting period between index event and revascularisation.
Source: Journal of Vascular Surgery - December 18, 2019 Category: Surgery Authors: M.L. Rots, N. Timmerman, D.P.V. de Kleijn, G. Pasterkamp, M.M. Brown, L.H. Bonati, G.J. de Borst Source Type: research

Carotid Endarterectomy and Carotid Artery Stenting for Patients With Crescendo Transient Ischemic Attacks: A Systemic Review
Review of English-language articles published from PubMed (MEDLINE) and Google Scholar between January 1, 1985, and January 1, 2019.
Source: Journal of Vascular Surgery - December 18, 2019 Category: Surgery Authors: A. Fereydooni, J. Gorecka, J. Xu, J. Schindler, A. Dardik Tags: Crescendo transient ischemic attacks should be treated by carotid endarterectomy within 2 days —but with increased perioperative stroke risk Source Type: research

Asymptomatic carotid stenosis: Revisionist history is usually wrong
In his landmark 1951 publication entitled “Occlusion of the Internal Carotid Artery,” C. Miller Fisher both described the pathogenesis of hemispheric stroke related to carotid bifurcation atherosclerosis and went on to speculate that “one day surgeons may even devise a way to remove the offending plaque and thereby prevent stroke.” His prophecy was soon realized when prophylactic carotid endarterectomy (CEA) was launched more or less simultaneously on three different continents in 1953. The fundamentals of this stroke preventive strategy remain clinically valid today, being supported by virtually every internation...
Source: Journal of Vascular Surgery - December 18, 2019 Category: Surgery Authors: Richard P. Cambria, Mark F. Conrad Tags: Editorial Source Type: research

Commentary on "Overview of Primary and Secondary Analyses From 20 Randomised Controlled Trials Comparing Carotid Artery Stenting With Carotid Endarterectomy"
As classical endpoints such as peri-procedural stroke and death during carotid interventions now occur infrequently, secondary outcome measures are being used increasingly. Batchelder et  al. recently performed an analysis of 20 randomised controlled trials investigating carotid endarterectomy (CEA) vs. carotid artery stenting (CAS).1 As a secondary outcome measure, they report more new white matter lesions (WMLs) after CAS than after CEA. However, the term WML is generally reserve d for lesions of the peri-ventricular areas or deep white matter, which develop over time as a result of cerebral small vessel disease.
Source: European Journal of Vascular and Endovascular Surgery - December 16, 2019 Category: Surgery Authors: Marjolijn L. Rots, Gert J. de Borst Tags: Correspondence Source Type: research

Outcomes of Carotid Endarterectomy according to the Anesthetic Method: General versus Regional Anesthesia.
Conclusion: RA with a reliable awake test reduces shunt use and decreases the clamp and operative times of CEA, eventually resulting in a reduced length of hospital stay. PMID: 31832375 [PubMed]
Source: Korean Journal of Thoracic and Cardiovascular Surgery - December 15, 2019 Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research

Prognostic factors of long-term survival to guide selection of asymptomatic patients for carotid endarterectomy.
CONCLUSIONS: The presence of one or more prognostic factors as well as the various risk prediction models can guide selection of ACS patient subgroups for which a prophylactic CEA should or should not be offered. Decisions to offer prophylactic CEA should weigh in factors like surgeon's experience and hospital expertise/volume. Asymptomatic patients not expected to live long enough to benefit from the procedure should not be considered for CEA, but should be offered best medical treatment. PMID: 31814375 [PubMed - as supplied by publisher]
Source: International Angiology - December 11, 2019 Category: Cardiology Tags: Int Angiol Source Type: research

Management of Asymptomatic Carotid Artery Stenosis
AbstractPurpose of reviewThe goal of this paper is to provide the reader with a review of the evidence supporting the surgical and medical management of patients with asymptomatic internal carotid artery (ICA) stenosis.Recent findingsBased on the results of earlier clinical trials, surgical intervention with carotid endarterectomy (CEA) has long been the preferred method of management for patients with asymptomatic severe carotid stenosis. Carotid artery stenting (CAS) is another less invasive surgical option that has similar outcomes over the long-term. However, more recent improvements in medical management have reduced ...
Source: Current Treatment Options in Cardiovascular Medicine - December 9, 2019 Category: Cardiology 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

Contemporary Stroke Risks of Patients with Asymptomatic Carotid Stenosis: Design and Characteristics of a Large Prospective Cohort Study
Introduction: Randomised trials have shown that successful carotid endarterectomy (CEA) approximately halves 5-year stroke risk among patients with tight asymptomatic carotid artery stenosis. The benefits of CEA with current medical therapies (including higher dose statins) are unclear. A reliable estimation of stroke risks requires follow up of a large cohort of patients with unoperated asymptomatic carotid stenosis and this report describes the design and characteristics of patients being recruited to this UK Carotid Cohort Study.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Michiel Poorthuis, Dylan Morris, Kamran Gaba, Dominic Howard, Gert de Borst, Richard Bulbulia, Alison Halliday, UKCCS Collaborative Group: John Radcliffe Hospital Oxford and Gloucestershire Hospitals NHS Foundation Trust Source Type: research

Early Experience with 18F-Fluoride Positron Emission Tomography- Magnetic Resonance Imaging in Patients with Symptomatic Carotid Artery Stenosis Undergoing Carotid Endarterectomy
Introduction: Carotid endarterectomy is an established surgical intervention that is associatedwith a reduction in the future risk of stroke in symptomatic patients. However, the identification of culprit carotid plaque remains challenging for number of reasons including the suboptimal evaluation of carotid plaque morphology, disease activity and future stroke risk stratification.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Jakub Kaczynski, Michelle Williams, Rachael Forsythe, Andrew Tambyraja, Christophe Lucatelli, Edwin van Beek, William Whiteley, David Newby Source Type: research

Carotid Artery Stenting Versus Carotid Endarterectomy: A Cost-Effectiveness Meta-Analysis
Introduction - Carotid artery stenting (CAS) is currently associated with an increased risk of 30-day stroke and death compared to carotid endarterectomy (CEA), while following this periprocedural period both interventions seem equally durable. In light of recent developments, both procedures could become equally effective in the periprocedural period. Consequently, a thorough comparison of costs and cost-effectiveness for CAS and CEA is warranted to provide arguments to support clinical decision making.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Evelien De Vries, Vyaas Baldew, Hester den Ruijter, Gert de Borst Source Type: research

Plaque Echolucency Assessment Prior to Carotid Endarterectomy has No Long-Term Predictive Value for Stroke or Cardiovascular Death
Introduction - In patients with asymptomatic carotid artery disease receiving optimal medical treatment, carotid plaque echolucency has been shown to predict the risk of future ipsilateral stroke. Therefore, carotid endarterectomy may be more beneficial in patients with definite echolucent carotid plaque and as a result plaque echolucency has been suggested as a tool to aid in patient selection for surgery. However, carotid plaque echolucency is also thought to predict other systemic cardiovascular events (i.e.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Djurre D. De Waard, Gert J. de Borst, Richard Bulbulia, Hongchao Pan, Alison Halliday, ACST-1 Collaborative Group Source Type: research

Carotid Endarterectomy in the Acute Phase of Stroke-in-evolution: An Update
This study updated with independent neurologic assessment the 30-day and 90-day outcomes in selected patients suffering stroke-in-evolution (SIE) , with or without preoperative thrombolysis , who underwent operations in our department with in 2 weeks of the index event
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Guy Leseche, Pierre Amarenco, Hugues Chabriat Source Type: research

Microemboli After Carotid Endarterectomy: Data from 1062 Patients from Two Centers
Introduction: Carotid endarterectomy (CEA) reduces the risk of stroke in patients with carotid artery stenosis yet also induces it. Hence, the latter has to be as low as possible, which is even more important since the outcome of patients treated conservatively has improved in the past years. Formerly, the occurrence of multiple microemboli postoperatively has been shown to indicate a severely increased risk of postoperative stroke. These data however stem mostly from more than a decade ago, i.e.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Werner Mess, Paul Bergs, Jan Willem Daemen, Michael Jacobs, Jochen Grommes Source Type: research

Home Blood Pressure Monitoring in Patients After Carotid Endarterectomy: A Feasibility Study
Introduction: Around fifty percent of perioperative strokes following carotid endarterectomy (CEA) are related to hemodynamic disturbances (hypertensive and hypotensive episodes) and can occur up to 30 days after surgery. Therefore, tight perioperative blood pressure (BP) control is an essential component of stroke prevention after CEA.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Leonie Fassaert, Martine Breteler, Raechel Toorop, Wouter van Solinge, Cor Kalkman, Gert J. de Borst Source Type: research

Timing of Procedural Complications Among Asymptomatic Patients Undergoing Carotid Endarterectomy: Analysis of VA, ACAS, ACST-1 And GALA Trials
Introduction: Effectiveness of carotid endarterectomy (CEA) for stroke prevention depends on low procedural risks. Detailed analysis of the timing of procedural events offers the possibility for the surgical team to adjust their treatment protocol by implementing preventive measures to lower the risk of periprocedural complications. We aimed to assess frequency and timing of procedural complications after CEA, which may clarify underlying mechanisms and help inform safe discharge policies.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Michiel Poorthuis, Dylan Morris, Hongchao Pan, Steff Lewis, Peter Rothwell, Richard Bulbulia, Gert de Borst, Alison Halliday, Carotid Stenting Trialists' Collaboration Source Type: research

Results of Carotid Endarteriectomy under Locoregional Anesthesia in acute Ischemic Stroke with Watershed zone Infarction Population
Introduction: Cerebral border zone infarctions (Watershed infarctions) on the early postoperative outcomes of patient undergoing carotid endarterectomy (CEA) were associated, in several studies, with a higher neurological complication rate. The current hypothesis is that hemodynamic phenomenon is involved. CEA performed under locoregional anesthesia enable to instantly reveal any hemodynamic phenomenon.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Nicolas Bouchareine, Maud Esteban-Madder, Hanan Alhazmi, Philippe Tresson, Nellie Dellaschiava, Antoine Millon Source Type: research

Triple Neuroprotection With Targeted Hypothermia, Controlled Induced Hypertension and Barbiturate Infusion During Emergency Carotid Endarterectomy for Acute Stroke
This study aims to establish the initial safety of Triple Neuroprotection (TN) in surgical management of acute stroke.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Sherif Sultan, Makinderjit Dulai, John Laffey, Kevin Clarkson, Abdelaly Ma Abedi, Nora Barrett, Wael Tawfick, Niamh Hynes Source Type: research

Risk Stratification of Carotid Endarterectomy According to Type of Symptoms and Timing of Intervention
Introduction: The optimal timing for carotid endarterectomy (CEA ) in symptomatic patients is still matter of debate. The purpose of present study to analyse the outcome of symptomatic CEA according to the specific type of symptoms, in order to evaluate the ideal timing of intervention for minimizing post-operative stroke/death rate.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Rodolfo Pini, Gianluca Faggioli, Enrico Gallitto, Andrea Vacirca, Mortalla Dieng, Martina Goretti, Mascoli Chiara, Mohammad Abualihn, Mauro Gargiulo Source Type: research

Contralateral Carotid Occlusion With Sufficient Circle of Willis is not Associated With A Higher Incidence of Neurologic Events During Carotid Endarterectomy Without Shunting
Introduction: Whereas large studies identified that contralateral carotid occlusion (CCO) has higher perioperative stroke risk in patients who underwent carotid endarterectomy (CEA), single-center studies have not confirmed this. Circle of Willis (CoW) is considered an important collateral network to maintain blood flow during cross-clamping in carotid endarterectomy (CEA). The aim of this study was to evaluate the impact of the CCO in association with CoW on immediate neurological event (INE) after CEA without shunt protection.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Peter Banga, Andrea Varga, Patrik Bayerle, Zsuzsanna Mih áy, Tamas Kovats, Zoltan Szeberin, Peter Sótonyi Source Type: research

Neurological Complication Rates of Intravenous Thrombolysis Combined With Early Carotid Endarterectomy for Treatment of Hyperacute Ischaemic Stroke
Introduction: Intravenous thrombolysis (IVT) can be combined with carotid endaterectomy either simultanously or in a staged procedure in the treatment of acute cartotis-associated stroke. It was the aim of this single-center retrospective studyto analyse the short-term results of sequential lysis with carotid endarterectomy, as well as long term results.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Ewa Swiecka, Martin Storck, Roland Zippel, Olaf Hinze Source Type: research

The Efficacy of Carotid Surgery by Subgroups – The Concept of Stroke Preventing Power (SPP)
Introduction - Carotid endarterectomy (CEA) is performed to prevent strokes. Post hoc analyses of the major randomized controlled trials (RCTs) have emphasized the importance of avoiding delay prior to CEA, but of all subgroups the effect is least present in the largest of groups, male patients with a high grade stenosis (1, 2). However, in the numerous reports on national and international CEA series, patient selection data and complication rates are often reported separately. Our aim was to investigate the effect of the main individual factors on the expected effect on stroke prevention and to develop a reporting standar...
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Ellinoora Aro, Leena Vikatmaa, Petra Ij äs, Krista Nuotio, Lauri Soinne, Maarit Venermo, Pirkka Vikatmaa Source Type: research

A Simple Clinical Score Identifies Higher Risk of Stroke in Patients with Asymptomatic Carotid Artery Stenosis
Introduction - Three large randomised trials have assessed the efficacy and safety of carotid endarterectomy (CEA) in patients with tight carotid stenosis and no recent unilateral symptoms. Although absolute risk reductions changed over time, the trials (VA, ACAS, ACST-1; 5226 participants recruited from 1983-2003) found that stroke risk was halved by successful surgery.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Dylan Morris, Richard Bulbulia, Hongchao Pan, Richard Peto, Peter Rothwell, Alison Halliday Source Type: research

Five-year Follow-up After Carotid Endarterectomy Shows Primary Closure to be an Equivalent Closure Technique Compared to Patch Angioplasty when Used in Selected Patients with Broad Carotid Artery, High Carotid Bifurcation or Occlusion of the Contralateral Carotid Artery
Introduction: In patients with symptomatic or asymptomatic severe internal carotid artery stenosis, carotid endarterectomy (CEA) reduces risk for stroke. The optimal surgical technique remains subject of debate. Our previous study based on perioperative results within 30 days after surgery showed no difference in complication rate comparing primary closure or patch angioplasty when used in selected patients.1This follow-up study aimed to assess long-term complication rate and restenosis after CEA with selective patching.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Vicky Maertens, Heidi Maertens, Anneleen Stockman, Stefanie De Buyser, Cedric Coucke, Yves Blomme Source Type: research

Stroke Prevention and Dementia: 15-year Follow-up of the Asymptomatic Carotid Surgery Trial-1 (ACST-1)
Introduction: Carotid endarterectomy (CEA) might protect against dementia by reducing future stroke risk and improving cerebral blood flow. Using linkage of randomised trial participants to electronic health records, we aimed to measure the long-term effect of CEA on stroke and on recorded dementia in ACST-1 (ISRCTN26156392).
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Alison Halliday, Anders Gotts äter, Mary Sneade, William Whiteley, Rebecca Llewellyn-Bennett, Sarah Parish, Sarah Pendlebury, Richard Peto, Martin Björck, Richard Bulbulia, Hongchao Pan Source Type: research

Protamine Reduces the Risk of Serious Bleeding at the Time of CEA without Increased Risk of Stroke, MI or Death
Introduction: Controversy persists regarding the use of Protamine during carotid endarterectomy (CEA) despite real world evidence to support its use. The purpose of this study was to best determine the impact of protamine reversal of heparin anticoagulation on the outcome of CEA throughout the United States.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: David Stone, Kristina Giles, Bjoern Suckow, Philip Goodney, Thomas Huber, Richard Powell, Jack Cronenwett, Salvatore Scali Source Type: research

Early and Long-term Impact of Postoperative Cerebrovascular Complications After Carotid Endarterectomy
Introduction: The rate of postoperative cerebrovascular complications (PCC), such as stroke and transient ischemic attack (TIA), associated with carotid endarterectomy (CEA) is generally lower than 3% for asymptomatic and 5% for symptomatic patients in the literature; however, few studies analyzed the impact of PCC on long-term outcome of patients submitted to CEA. The aim of the study was to identify predictors of PCC occurrence and to evaluate these patients in terms of survival, recurrences and clinical status at follow-up.
Source: European Journal of Vascular and Endovascular Surgery - December 1, 2019 Category: Surgery Authors: Andrea Vacirca, Gianluca Faggioli, Rodolfo Pini, Mortalla Dieng, Antonino Maria Logiacco, Enrico Gallitto, Chiara Mascoli, Michele Mirelli, Mauro Gargiulo Source Type: research