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Procedure: Carotid Endarterectomy

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Total 1088 results found since Jan 2013.

Emergency Carotid Endarterectomy Instead of Carotid Artery Stenting Reduces Delayed Hemorrhage in Thrombectomy Stroke Patients
ConclusionThe use of CEA is a  feasible alternative to CAS in acute stroke and has the advantage that DAPT/GpIIb/IIIa inhibitors are not needed. All PH2 in CEA patients occurred during the intervention, implying that hemorrhage in this group is likely to be caused by reperfusion injury, whereas delayed hemorrhage is likely to b e caused by DAPT/GpIIb/IIIa inhibitors.
Source: Clinical Neuroradiology - September 16, 2020 Category: Neurology Source Type: research

Simultaneous Treatment of Common Carotid Lesions Increases the Risk of Stroke and Death After Carotid Artery Stenting
Tandem carotid artery lesions that involve simultaneous internal carotid artery (ICA) and common carotid artery (CCA) stenoses present a complex clinical problem. The addition of a retrograde proximal intervention to treat a CCA lesion during a carotid endarterectomy increases the risk of stroke and death. However, the stroke and death risk associated with totally endovascular treatment of tandem lesions is unknown and is the subject of this study.
Source: Journal of Vascular Surgery - August 20, 2020 Category: Surgery Authors: Charles DeCarlo, Adam Tanious, Laura T. Boitano, Jahan Mohebali, David H. Stone, W. Darrin Clouse, Mark F. Conrad Source Type: research

Predictors and Consequences of Silent Brain Infarction in Patients with Asymptomatic Carotid Stenosis
Silent brain infarction (SBI) is associated with an increased risk of stroke in patients with asymptomatic carotid stenosis (ACS), and is therefore one of the criteria for performing carotid endarterectomy (CEA). Despite an extensive literature, this issue is still a matter of debate. Aim of the present work was to evaluate incidence and predictors of SBI in patients undergoing CEA for ACS, and to investigate its possible impact on CEA outcome.
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2020 Category: Neurology Authors: Rodolfo Pini, Gianluca Faggioli, Giuseppe Indelicato, Sergio Palermo, Andrea Vacirca, Enrico Gallitto, Chiara Mascoli, Mauro Gargiulo Source Type: research

Long-term Stroke Risk with Carotid Endarterectomy in Patients with Severe Carotid Stenosis
In this study, we report long-term stroke and death risk after CEA in a large integrated healthcare system.
Source: Journal of Vascular Surgery - July 20, 2020 Category: Surgery Authors: Kara A. Rothenberg, Lue-Yen Tucker, Rebecca C. Gologorsky, Andrew L. Avins, Hui C. Kuang, Rishad M. Faruqi, Alexander C. Flint, Mai N. Nguyen-Huynh, Robert W. Chang Source Type: research

Evaluation of Carotid Plaque Rupture and Neovascularization by Contrast-Enhanced Ultrasound Imaging: an Exploratory Study Based on Histopathology
This study aims to comprehensively assess the value of CEUS for the detection of plaque rupture and neovascularization in histologically verified plaques that had been removed from the patients who had undergone carotid endarterectomy (CEA). Fifty-one consecutive subjects (mean age, 67.0  ± 6.5 years; 43 [84.3%] men) scheduled for CEA were recruited. Standard ultrasound and CEUS were performed prior to surgery. Based on the direction of the contrast agents that diffuse within the plaques, plaques were divided as “inside-out” direction (contrast agents diffuse from the arte ry lumen towards the inside of the plaqu...
Source: Translational Stroke Research - June 28, 2020 Category: Neurology Source Type: research

Safety of Triple Neuroprotection with Targeted Hypothermia, Controlled Induced Hypertension, and Barbiturate Infusion during Emergency Carotid Endarterectomy for Acute Stroke after Missing the 24  Hours Window Opportunity
The aim of this study is to establish the initial safety of triple neuroprotection (TNP) in an acute stroke setting in patients presenting outside the window for systemic tissue plasminogen activator (tPA).
Source: Annals of Vascular Surgery - May 26, 2020 Category: Surgery Authors: Sherif Sultan, Makinderjit Dulai, John Laffey, Kevin Clarkson, Abdelaly M.A. Abedi, Nora Barrett, Mohamed Elsherif, Wael Tawfick, Niamh Hynes Tags: Clinical Research Source Type: research

Safety of Triple Neuroprotection with targeted hypothermia, controlled induced hypertension and barbiturate infusion during emergency carotid endarterectomy for acute stroke after missing the 24 hours window opportunity.
and Purpose: Our study aims to establish the initial safety of triple neuroprotection (TNP) in an acute stroke setting in patients presenting outside the window for systemic tissue plasminogen activator (tPA).
Source: Annals of Vascular Surgery - May 26, 2020 Category: Surgery Authors: Sherif Sultan, Makinderjit Dulai, John Laffey, Kevin Clarkson, Abdelaly MA. Abedi, Nora Barrett, Mohamed Elsherif, Wael Tawfick, Niamh Hynes Tags: Clinical Research, Basic Science Source Type: research

New Data and the Covid-19 Pandemic Mandate a Rethink of Antiplatelet Strategies in Patients With TIA or Minor Stroke Associated With Atherosclerotic Carotid Stenosis
The 2017 European Society for Vascular Surgery (ESVS) carotid  guidelines, as well as a subsequent literature review, recommend clopidogrel monotherapy or combination aspirin + dipyridamole in recently symptomatic patients not undergoing carotid endarterectomy (CEA).1,2 In patients scheduled for CEA, antiplatelet therapy was recommended throughout the peri- operative period and in the long-term.1 It was advised that early treatment with aspirin + clopidogrel or aspirin + dipyridamole ‘may be considered’ in order to prevent early recurrent events in patients with transient ischaemic attack (TIA) or minor ischaemi...
Source: European Journal of Vascular and Endovascular Surgery - May 2, 2020 Category: Surgery Authors: A.R. Naylor, D.J.H. McCabe Tags: For Debate: Hot Topic Source Type: research

Perioperative Stroke
AbstractPurpose of ReviewThis review overviews perioperative stroke as it pertains to specific surgical procedures.Recent FindingsAs awareness of perioperative stroke increases, so does the opportunity to potentially improve outcomes for these patients by early stroke recognition and intervention.SummaryPerioperative stroke is defined to be any stroke that occurs within 30  days of the initial surgical procedure. The incidence of perioperative stroke varies and is dependent on the specific type of surgery performed. This chapter overviews the risks, mechanisms, and acute evaluation and management of perioperative stroke i...
Source: Current Neurology and Neuroscience Reports - April 26, 2020 Category: Neuroscience 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

Timing of procedural stroke and death in asymptomatic patients undergoing carotid endarterectomy: individual patient analysis from four RCTs.
CONCLUSION: At least half of the procedural strokes in this study were ischaemic and ipsilateral to the treated artery. Half of all procedural complications occurred on the day of surgery, but one-third after day 3 when many patients had been discharged. PMID: 32162310 [PubMed - as supplied by publisher]
Source: The British Journal of Surgery - March 11, 2020 Category: Surgery Authors: Poorthuis MHF, Bulbulia R, Morris DR, Pan H, Rothwell PM, Algra A, Becquemin JP, Bonati LH, Brott TG, Brown MM, Calvet D, Eckstein HH, Fraedrich G, Gregson J, Greving JP, Hendrikse J, Howard G, Jansen O, Mas JL, Lewis SC, de Borst GJ, Halliday A, Carotid Tags: Br J Surg Source Type: research

Investigation of S-Nitrosoglutathione in stroke: A systematic review and meta-analysis of literature in pre-clinical and clinical research.
CONCLUSIONS: Pre-clinical studies showed positive benefit of GSNO in animal stroke models. The meta-analysis of clinical studies demonstrated that GSNO is effective in reducing embolic signals in patients with symptomatic internal carotid artery stenosis undergoing carotid endarterectomy or stenting. Further investigation of this molecule is warranted. PMID: 32119935 [PubMed - as supplied by publisher]
Source: Experimental Neurology - February 27, 2020 Category: Neurology Authors: Liu S, Zheng H, Yu W, Ramakrishnan V, Shah S, Gonzalez LF, Singh I, Graffagnino C, Feng W Tags: Exp Neurol Source Type: research

Role of Carotid Artery Stenting in Prevention of Stroke for Asymptomatic Carotid Stenosis: Bayesian Cross-Design and Network Meta-Analyses.
CONCLUSIONS: A similar risk for periprocedural MI between CEA and CAS in NRCSs suggested that concerns about periprocedural MI accompanied by CEA might not matter in real-world practice when preoperative evaluation and management are working. Maybe the benefits of CAS over MT have been overestimated considering advances in medical therapy within10-year gap between CEA-versus-MT and CEA-versus-CAS studies. PMID: 32096354 [PubMed - as supplied by publisher]
Source: Korean Circulation Journal - February 27, 2020 Category: Cardiology Tags: Korean Circ J 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 4, 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

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 5, 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 5, 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 19, 2019 Category: Neurology Authors: Ahmed M Altibi Eyad E Saca Harbir Dhillon Parthasarathy D Thirumala 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 - November 30, 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 - November 30, 2019 Category: Surgery Authors: Dylan Morris, Richard Bulbulia, Hongchao Pan, Richard Peto, Peter Rothwell, Alison Halliday Source Type: research

Outcomes of Primary and Secondary Carotid Artery Stenting Clinical Sciences
This study evaluates outcomes of redo-CAS and CAS after prior ipsilateral carotid endarterectomy (CASAPICEA) relative to primary-CAS.Methods—We studied all patients in the Vascular Quality Initiative, who underwent primary-CAS, CASAPICEA, or redo-CAS (2003–2016). Kaplan–Meier, multivariable logistic and Cox regression analyses were used to evaluate outcomes within 30 days and up to 1 year and identify their predictors.Results—There were 11 742 CAS procedures performed: 8519 (72%) primary-, 2645 (23%) CASAPICEA, and 578 (5%) redo-CAS. Comparing primary-CAS versus CASAPICEA versus redo-CAS, 30-day stroke/death was ...
Source: Stroke - October 23, 2017 Category: Neurology Authors: Isibor J. Arhuidese, Muhammad Rizwan, Besma Nejim, Mahmoud Malas Tags: Cardiovascular Surgery, Stent, Mortality/Survival, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures Original Contributions Source Type: research

Factors Associated With Time to Site Activation, Randomization, and Enrollment Performance in a Stroke Prevention Trial Clinical Sciences
Conclusions—Overall, selection of sites with high enrollment rates will likely require customization to align the sites selected to the factor under study in the trial.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02089217.
Source: Stroke - August 28, 2017 Category: Neurology Authors: Bart M. Demaerschalk, Robert D. Brown Jr, Gary S. Roubin, Virginia J. Howard, Eldina Cesko, Kevin M. Barrett, Mary E. Longbottom, Jenifer H. Voeks, Seemant Chaturvedi, Thomas G. Brott, Brajesh K. Lal, James F. Meschia, George Howard Tags: Stent, Cognitive Impairment, Ischemic Stroke Original Contributions Source Type: research

Age and the fuzzy edges of embolic stroke of undetermined source: Implications for trials
After an acute ischemic stroke, clinicians pursue further diagnostic assessment to identify the most plausible causes and tailor secondary prevention strategies. Available treatments with a high level of evidence for reducing recurrence stroke risk might include long-term oral anticoagulation in patients with a major-risk cardioembolic source (atrial fibrillation, prosthetic valves, etc), carotid endarterectomy in minor ischemic stroke related to moderate to severe internal carotid artery atherosclerotic stenosis, and best-practice medical management in those with lacunar stroke due to cerebral small vessel disease.1 Howev...
Source: Neurology - August 7, 2017 Category: Neurology Authors: Charidimou, A. Tags: Stroke in young adults, All Clinical trials, All Cerebrovascular disease/Stroke, Embolism, Infarction EDITORIALS Source Type: research

Open Heart Surgery Does Not Increase the Incidence of Ipsilateral Ischemic Stroke in Patients with Asymptomatic Severe Carotid Stenosis
We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis.
Source: Journal of Stroke and Cerebrovascular Diseases - June 13, 2017 Category: Neurology Authors: John E. Castaldo, Hussam A. Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny Source Type: research

Early Endarterectomy Carries a Lower Procedural Risk Than Early Stenting in Patients With Symptomatic Stenosis of the Internal Carotid Artery Clinical Sciences
Conclusions—In randomized trials comparing stenting with CEA for symptomatic carotid artery stenosis, CAS was associated with a substantially higher periprocedural risk during the first 7 days after the onset of symptoms. Early surgery is safer than stenting for preventing future stroke.Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00190398; URL: http://www.controlled-trials.com. Unique identifier: ISRCTN57874028; Unique identifier: ISRCTN25337470; URL: http://www.clinicaltrials.gov. Unique identifier: NCT00004732.
Source: Stroke - May 22, 2017 Category: Neurology Authors: Barbara Rantner, Barbara Kollerits, Gary S. Roubin, Peter A. Ringleb, Olaf Jansen, George Howard, Jeroen Hendrikse, Alison Halliday, John Gregson, Hans-Henning Eckstein, David Calvet, Richard Bulbulia, Leo H. Bonati, Jean-Pierre Becquemin, Ale Algra, Mart Tags: Cerebrovascular Disease/Stroke, Cerebrovascular Procedures Original Contributions Source Type: research

Vascular Anatomy Predicts the Risk of Cerebral Ischemia in Patients Randomized to Carotid Stenting Versus Endarterectomy Clinical Sciences
Background and Purpose—Complex vascular anatomy might increase the risk of procedural stroke during carotid artery stenting (CAS). Randomized controlled trial evidence that vascular anatomy should inform the choice between CAS and carotid endarterectomy (CEA) has been lacking.Methods—One-hundred eighty-four patients with symptomatic internal carotid artery stenosis who were randomly assigned to CAS or CEA in the ICSS (International Carotid Stenting Study) underwent magnetic resonance (n=126) or computed tomographic angiography (n=58) at baseline and brain magnetic resonance imaging before and after treatment. We invest...
Source: Stroke - April 24, 2017 Category: Neurology Authors: Mandy D. Muller, Frank J. Ahlhelm, Alexander von Hessling, David Doig, Paul J. Nederkoorn, Sumaira Macdonald, Philippe A. Lyrer, Aad van der Lugt, Jeroen Hendrikse, Christoph Stippich, H. Bart van der Worp, Toby Richards, Martin M. Brown, Stefan T. Engelt Tags: Magnetic Resonance Imaging (MRI), Revascularization, Stent, Cerebrovascular Disease/Stroke, Stenosis Original Contributions Source Type: research

Early Carotid Revascularization Reduces Readmission for Recurrent Ischemic Stroke in Acute Ischemic Stroke Patients: Analysis of United States Nationwide Readmissions Database (P4.294)
Conclusions:Patients with ischemic stroke undergoing carotid revascularization during the initial hospitalization have significantly lower risk of readmission related to another ischemic strokeDisclosure: Dr. Chaudhry has nothing to disclose. Dr. Gheith has nothing to disclose. Dr. Gu has nothing to disclose. Dr. Afzal has nothing to disclose. Dr. Rahman has nothing to disclose. Dr. Riaz has nothing to disclose. Dr. Sachdeva has nothing to disclose. Dr. Sattar has nothing to disclose. Dr. Razak has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Chaudhry, S., Gheith, T., Gu, S., Afzal, M.-R., Rahman, H., Riaz, A., Sachdeva, G., Sattar, A., Razak, A., Qureshi, A. Tags: In-Hospital Stroke Care Source Type: research

Intraoperative Completion Studies, Local Anesthesia, and Antiplatelet Medication Are Associated With Lower Risk in Carotid Endarterectomy Clinical Sciences
Conclusions—Local anesthesia, patch plasty compared with primary closure, intraoperative completion studies by duplex ultrasound or angiography, and perioperative antiplatelet medication were independently associated with lower in-hospital stroke or death rates after carotid endarterectomy.
Source: Stroke - March 27, 2017 Category: Neurology Authors: Christoph Knappich, Andreas Kuehnl, Pavlos Tsantilas, Sofie Schmid, Thorben Breitkreuz, Michael Kallmayer, Alexander Zimmermann, Hans-Henning Eckstein Tags: Clinical Studies, Revascularization, Quality and Outcomes, Cerebrovascular Disease/Stroke, Atherosclerosis Original Contributions Source Type: research

Symptomatic Patients Remain at Substantial Risk of Arterial Disease Complications Before and After Endarterectomy or Stenting Clinical Sciences
Background and Purpose—After carotid endarterectomy (CEA) or carotid artery stenting (CAS) in patients with transient ischemic attack or minor ischemic stroke, recurrent stroke risk falls to a low rate on modern medical treatment.Methods—We used data from 4583 patients with recent transient ischemic attack or minor stroke enrolled in the TIAregistry.org to perform a nested case–control analysis to evaluate pre- and post-CEA/CAS risk. Cases were defined as patients with a CEA/CAS during the 1-year follow-up period. For each case, 2 controls with a follow-up time greater than the time from qualifying event to CEA/CAS w...
Source: Stroke - March 27, 2017 Category: Neurology Authors: Cristina Hobeanu, Philippa C. Lavallee, Peter M. Rothwell, Leila Sissani, Gregory W. Albers, Natan M. Bornstein, Louis R. Caplan, Geoffrey A. Donnan, Jose M. Ferro, Michael G. Hennerici, Julien Labreuche, Carlos Molina, Philippe Gabriel Steg, Pierre&ndash Tags: Secondary Prevention, Ischemic Stroke, Transient Ischemic Attack (TIA) Original Contributions Source Type: research

18F-Fluoride and 18F-Fluorodeoxyglucose Positron Emission Tomography After Transient Ischemic Attack or Minor Ischemic Stroke: Case-Control Study Molecular Imaging
Conclusions— 18F-Fluoride PET/CT highlights culprit and phenotypically high-risk carotid plaque. This has the potential to improve risk stratification and selection of patients who may benefit from intervention.
Source: Circulation: Cardiovascular Imaging - March 14, 2017 Category: Radiology Authors: Vesey, A. T., Jenkins, W. S. A., Irkle,, A., Moss, A., Sng,, G., Forsythe, R. O., Clark, T., Roberts, G., Fletcher, A., Lucatelli, C., Rudd, J. H. F., Davenport,, A. P., Mills, N. L., Al-Shahi Salman, R., Dennis, M., Whiteley, W. N., van Beek, E. J. R., D Tags: Translational Studies, Imaging, Nuclear Cardiology and PET, Cerebrovascular Disease/Stroke, Atherosclerosis Molecular Imaging Source Type: research

Risk of Inhospital Stroke or Death Is Associated With Age But Not Sex in Patients Treated With Carotid Endarterectomy for Asymptomatic or Symptomatic Stenosis in Routine Practice: Secondary Data Analysis of the Nationwide German Statutory Quality Assurance Database From 2009 to 2014 Cardiovascular Surgery
ConclusionsThis study shows that increasing age, but not sex, is associated with a higher risk of in‐hospital stroke or death following carotid endarterectomy under everyday conditions in Germany. Whereas the risk of death (alone) is significantly associated with age, the association between age and the risk of stroke (alone) can be considered of minor importance.
Source: JAHA:Journal of the American Heart Association - March 13, 2017 Category: Cardiology Authors: Schmid, S., Tsantilas, P., Knappich, C., Kallmayer, M., Konig, T., Breitkreuz, T., Zimmermann, A., Kuehnl, A., Eckstein, H.–H. Tags: Aging, Women, Cardiovascular Surgery, Quality and Outcomes, Cerebrovascular Disease/Stroke Original Research Source Type: research

Timing of Carotid Revascularization Procedures After Ischemic Stroke Brief Report
Background and Purpose—In 2006, the American Heart Association recommended that carotid revascularization generally occurs within 2 weeks of stroke based on data from 2 trials of carotid endarterectomy (CEA). We aimed to determine whether the time between stroke and CEA or carotid artery stenting (CAS) has decreased and whether the proportion of procedures occurring within 14 days has increased.Methods—Using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes and administrative claims data from nonfederal hospitals in CA, FL, and NY, we identified patients with ischemic strok...
Source: Stroke - December 22, 2016 Category: Neurology Authors: Michael Reznik, Hooman Kamel, Gino Gialdini, Ankur Pandya, Babak B. Navi, Ajay Gupta Tags: Secondary Prevention, Quality and Outcomes, Cerebrovascular Disease/Stroke, Ischemic Stroke Brief Reports Source Type: research

Significant Association of Annual Hospital Volume With the Risk of Inhospital Stroke or Death Following Carotid Endarterectomy but Likely Not After Carotid Stenting: Secondary Data Analysis of the Statutory German Carotid Quality Assurance Database Peripheral Vascular Disease
Conclusions— An inverse volume–outcome relationship in CEA-treated patients was demonstrated. No significant association between hospital volume and the risk of stroke or death was found for CAS.
Source: Circulation: Cardiovascular Interventions - November 3, 2016 Category: Cardiology Authors: Kuehnl, A., Tsantilas, P., Knappich, C., Schmid, S., Konig, T., Breitkreuz, T., Zimmermann, A., Mansmann, U., Eckstein, H.-H. Tags: Ethics and Policy, Quality and Outcomes, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures Peripheral Vascular Disease Source Type: research

Validation of Noninvasive In Vivo Compound Ultrasound Strain Imaging Using Histologic Plaque Vulnerability Features Clinical Sciences
This study aims at in vivo validation of compound ultrasound strain imaging in patients by relating the measured strains to typical features of vulnerable plaques derived from histology after carotid endarterectomy.Materials and Methods—Strains were measured in 34 severely stenotic (>70%) carotid arteries at the culprit lesion site within 48 hours before carotid endarterectomy. In all cases, the lumen-wall boundary was identifiable on B-mode ultrasound, and the imaged cross-section did not move out of the imaging plane from systole to diastole. After endarterectomy, the plaques were processed using a validated histology ...
Source: Stroke - October 23, 2016 Category: Neurology Authors: Hansen, H. H. G., de Borst, G. J., Bots, M. L., Moll, F. L., Pasterkamp, G., de Korte, C. L. Tags: Imaging, Ultrasound, Cerebrovascular Disease/Stroke, Atherosclerosis, Stenosis Original Contributions Source Type: research

Short Time Interval Between Neurologic Event and Carotid Surgery Is Not Associated With an Increased Procedural Risk Clinical Sciences
Conclusions—The time interval between the index event and carotid endarterectomy was not associated with the risk of any in-hospital stroke or death in patients with symptomatic carotid stenosis in Germany. In clinically stable patients, carotid endarterectomy might, therefore, be performed safely as soon as possible after the neurological index event.
Source: Stroke - October 23, 2016 Category: Neurology Authors: Tsantilas, P., Kuehnl, A., Konig, T., Breitkreuz, T., Kallmayer, M., Knappich, C., Schmid, S., Storck, M., Zimmermann, A., Eckstein, H.–H. Tags: Complications, Quality and Outcomes, Cerebrovascular Disease/Stroke, Cerebrovascular Procedures, Ischemic Stroke Original Contributions Source Type: research

Prescription of Guideline-Based Medical Therapies at Discharge After Carotid Artery Stenting and Endarterectomy: An NCDR Analysis Clinical Sciences
Conclusions— US antiplatelet agent and statin discharge prescription rates were suboptimal after both CAS and CEA and varied by revascularization modality, operating physician specialty, and hospital characteristics. Improved and more uniform utilization after these procedures will be critical to the success of comprehensive stroke risk reduction efforts.
Source: Stroke - August 21, 2016 Category: Neurology Authors: Aronow, H. D., Kennedy, K. F., Wayangankar, S. A., Katzen, B. T., Schneider, P. A., Abou-Chebl, A., Rosenfield, K. A. Tags: Secondary Prevention, Cardiovascular Surgery, Stent, Cerebrovascular Disease/Stroke, Peripheral Vascular Disease Clinical Sciences Source Type: research

Nonstenotic carotid plaque on CT angiography in patients with cryptogenic stroke
Conclusions: Large but nonstenotic carotid artery plaque is considerably more common ipsilateral than contralateral to cryptogenic stroke, suggesting that nonstenotic plaque is an underrecognized cause of stroke. We measured plaque size using CT angiography, a method that could be easily implemented in clinical practice.
Source: Neurology - August 14, 2016 Category: Neurology Authors: Coutinho, J. M., Derkatch, S., Potvin, A. R. J., Tomlinson, G., Kiehl, T.-R., Silver, F. L., Mandell, D. M. Tags: CT, Stroke prevention, All Cerebrovascular disease/Stroke, Embolism ARTICLE Source Type: research

Long-Term Outcome After Carotid Artery Stenting: A Population-Based Matched Cohort Study Clinical Sciences
Conclusions— In this nationwide cohort study, CAS was associated with an increased long-term risk of ipsilateral stroke and death during after the perioperative phase when compared with CEA.
Source: Stroke - July 24, 2016 Category: Neurology Authors: Jonsson, M., Lindstrom, D., Gillgren, P., Wanhainen, A., Malmstedt, J. Tags: Cardiovascular Surgery, Cerebrovascular Disease/Stroke, Ischemic Stroke, Stenosis, Vascular Disease Clinical Sciences Source Type: research

Recurrent stroke in symptomatic carotid stenosis awaiting revascularization: A pooled analysis
Conclusions: We found high risk of recurrent ipsilateral ischemic events within the 14-day time period currently recommended for CEA. Randomized trials are needed to determine the benefits and safety of urgent vs subacute carotid revascularization within 14 days after symptom onset.
Source: Neurology - February 8, 2016 Category: Neurology Authors: Johansson, E., Cuadrado-Godia, E., Hayden, D., Bjellerup, J., Ois, A., Roquer, J., Wester, P., Kelly, P. J. Tags: All Cerebrovascular disease/Stroke ARTICLE Source Type: research

Sex Differences in the Presentation, Care, and Outcomes of Transient Ischemic Attack: Results From the Ontario Stroke Registry Brief Reports
Conclusions— We found only minor sex differences in the presentation and management of transient ischemic attack, suggesting that current public awareness campaigns focusing on classic warning signs are appropriate for both women and men. Future work should focus on evaluating whether lower rates of carotid imaging, endarterectomy, and lipid-lowering therapy in women reflect undertreatment of women or are appropriate based on patient eligibility.
Source: Stroke - December 28, 2015 Category: Neurology Authors: Li, O. L., Silver, F. L., Lichtman, J., Fang, J., Stamplecoski, M., Wengle, R. S., Kapral, M. K. Tags: Epidemiology, Secondary Prevention, Compliance/Adherence, Quality and Outcomes Brief Reports Source Type: research

Stroke: Highlights of Selected Articles Stroke: Highlights of Selected Articles
Source: Stroke - September 28, 2015 Category: Neurology Tags: Thrombolysis, Carotid endarterectomy, Angioplasty and Stenting Stroke: Highlights of Selected Articles Source Type: research

Periprocedural Myocardial Infarction After Carotid Endarterectomy and Stenting: Systematic Review and Meta-Analysis Clinical Sciences
Conclusions— The risk of MI after CEA and CAS did not significantly differ. Risk factors for MI are overall similar in both techniques except that men are at lower risk of MI after CAS but not after CEA.
Source: Stroke - September 28, 2015 Category: Neurology Authors: Boulanger, M., Cameliere, L., Felgueiras, R., Berger, L., Rerkasem, K., Rothwell, P. M., Touze, E. Tags: Acute myocardial infarction, Carotid Stenosis, Primary and Secondary Stroke Prevention, Carotid endarterectomy, Angioplasty and Stenting Clinical Sciences Source Type: research

Perivascular Adipose Adiponectin Correlates With Symptom Status of Patients Undergoing Carotid Endarterectomy Brief Reports
Conclusions— Symptomatic and asymptomatic carotid endarterectomy patients display a tissue-specific difference in perivascular adipose adiponectin. This difference, which was not seen in plasma or subcutaneous compartments, supports a potential local paracrine relationship with vascular disease processes that may be related to stroke mechanisms.
Source: Stroke - May 22, 2015 Category: Neurology Authors: Sharma, G., Tao, M., Ding, K., Yu, D., King, W., Deyneko, G., Wang, X., Longchamp, A., Schoen, F. J., Ozaki, C. K., Semel, M. E. Tags: Pathophysiology, Carotid Stenosis, Pathology of Stroke, Carotid endarterectomy Brief Reports Source Type: research

Outcomes After Acute Ischemic Stroke in the United States: Does Residential ZIP Code Matter? Stroke
Conclusions Patients from lower-income quartiles had decreased reperfusion on the first admission day, compared with patients from higher-income quartiles. The cost of hospitalization of patients from higher-income quartiles was significantly higher than that of patients from lowest-income quartiles, despite longer hospital stays in the latter group. This might be partially attributable to a lower use of key procedures among patients from lowest-income quartile.
Source: JAHA:Journal of the American Heart Association - March 15, 2015 Category: Cardiology Authors: Agarwal, S., Menon, V., Jaber, W. A. Tags: Stroke Source Type: research

Effect of Patching on Reducing Restenosis in the Carotid Revascularization Endarterectomy Versus Stenting Trial Clinical Sciences
Conclusions— Patch closure in CEA is associated with reduction in restenosis although it is not associated with improved clinical outcomes. Thus, more widespread use of patching should be considered to improve long-term durability. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00004732.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Malas, M., Glebova, N. O., Hughes, S. E., Voeks, J. H., Qazi, U., Moore, W. S., Lal, B. K., Howard, G., Llinas, R., Brott, T. G. Tags: Restenosis, Carotid Stenosis, Risk Factors for Stroke, Carotid endarterectomy Clinical Sciences Source Type: research

Residual High-Grade Stenosis After Recanalization of Extracranial Carotid Occlusion in Acute Ischemic Stroke Clinical Sciences
Conclusions— A residual high-grade stenosis of the extracranial ICA occurs in 1 of 6 patients with a symptomatic occlusion in the acute stage of cerebral ischemia. Because this may have implications for secondary prevention, we recommend follow-up imaging in these patients within a week after the event. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00880113.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Luitse, M. J. A., Velthuis, B. K., Dauwan, M., Dankbaar, J. W., Biessels, G. J., Kappelle, L. J., on behalf of the Dutch Acute Stroke Study Group, Majoie, Roos, Duijm, Keizer, van der Lugt, Dippel, Droogh-de Greve, Bienfait, van Walderveen, Wermer, Lyckla Tags: CT and MRI, Acute Cerebral Infarction, Carotid Stenosis Clinical Sciences Source Type: research

Symptomatic Carotid Atherosclerotic Disease: Correlations Between Plaque Composition and Ipsilateral Stroke Risk Clinical Sciences
Conclusions— Features of the vulnerable carotid plaque, including plaque thrombus, low fibrous content, macrophage infiltration, and microvessel density, correlate with predicted stroke risk. This study provides a basis for plaque imaging studies focused on stroke risk stratification.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Howard, D. P. J., van Lammeren, G. W., Rothwell, P. M., Redgrave, J. N., Moll, F. L., de Vries, J.-P. P. M., de Kleijn, D. P. V., den Ruijter, H. M., de Borst, G. J., Pasterkamp, G. Tags: Pathophysiology, Carotid Stenosis, Primary and Secondary Stroke Prevention, Carotid endarterectomy Clinical Sciences Source Type: research

Deficiency of the Stroke Relevant HDAC9 Gene Attenuates Atherosclerosis in Accord With Allele-Specific Effects at 7p21.1 Basic Sciences
Conclusions— Our results suggest that HDAC9 represents the disease-relevant gene at the stroke and coronary artery disease risk locus on 7p21.1, and that risk alleles in this region mediate their effects through increased HDAC9 expression. Targeted inhibition of HDAC9 might be a viable strategy to prevent atherosclerosis.
Source: Stroke - December 22, 2014 Category: Neurology Authors: Azghandi, S., Prell, C., van der Laan, S. W., Schneider, M., Malik, R., Berer, K., Gerdes, N., Pasterkamp, G., Weber, C., Haffner, C., Dichgans, M. Tags: Clinical genetics, Risk Factors, Genomics, Genetics of Stroke Basic Sciences Source Type: research

Prediction of recanalization in acute stroke patients receiving intravenous and endovascular revascularization therapy
ConclusionThe overall likelihood of recanalization was the highest in the endovascular group, and higher for intravenous thrombolysis compared with no revascularization therapy. However, our statistical models of recanalization for each individual patient indicate significant variability between treatment options, suggesting the need to include this prediction in the personalized treatment selection.
Source: International Journal of Stroke - June 30, 2014 Category: Neurology Authors: Guangming Zhu, Patrik Michel, Tudor Jovin, James T. Patrie, Wenjun Xin, Ashraf Eskandari, Weiwei Zhang, Max Wintermark Tags: Research Source Type: research

Clinical Prediction Model Suitable for Assessing Hospital Quality for Patients Undergoing Carotid Endarterectomy Stroke
Conclusions The NCDR CEA score, comprising 7 clinical variables, predicts in-hospital stroke or death after CEA. This model can be used to estimate hospital risk-adjusted outcomes for CEA and to assist with the assessment of hospital quality.
Source: JAHA:Journal of the American Heart Association - June 17, 2014 Category: Cardiology Authors: Wimmer, N. J., Spertus, J. A., Kennedy, K. F., Anderson, H. V., Curtis, J. P., Weintraub, W. S., Singh, M., Rumsfeld, J. S., Masoudi, F. A., Yeh, R. W. Tags: Stroke Source Type: research

History of Carotid Endarterectomy Then and Now: Personal Perspective Stroke History
Source: Stroke - May 27, 2014 Category: Neurology Authors: Easton, J. D. Tags: Carotid endarterectomy Stroke History Source Type: research