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A rare case of positional vertebrobasilar ischemia with the retrograde flow of the vertebral artery
J Surg Case Rep. 2023 May 12;2023(5):rjad222. doi: 10.1093/jscr/rjad222. eCollection 2023 May.ABSTRACTPositional vertebrobasilar ischemia, also known as Bow hunter stroke, is typically caused by mechanical compression of the vertebral artery (VA). On the other hand, subclavian steal syndrome is incidentally detected by vertigo, syncope or loss of consciousness due to the steal phenomenon. A 61-year-old man suffered from near syncope when he turned his head to the left side. Although asymmetric arm blood pressure of the right dominant was observed, arm claudication was not detected. Computed tomographic angiography and magn...
Source: Hand Surgery - May 16, 2023 Category: Surgery Authors: Toshihiro Kawahira Hiroki Morimoto Source Type: research

Flow Cytometry Based Platelet Reactivity Testing to Predict the Occurrence of Per-operative Solid Microemboli During Carotid Endarterectomy
CONCLUSION: Pre-operative platelet reactivity determined by flow cytometry after ADP stimulation correlated with the occurrence of intra-operative MES and post-operative MACE. Clopidogrel treatment showed the most substantial effect on reducing MES frequency and platelet reactivity measured by flow cytometry.PMID:35597705 | DOI:10.1016/j.ejvs.2022.03.005
Source: PubMed: Eur J Vasc Endovasc ... - May 21, 2022 Category: Surgery Authors: Aarent R T Brand Tesse C Leunissen Daniel van Vriesland Gerard Pasterkamp Mark Roest Suzanne J A Korporaal Rolf T Urbanus Gert J de Borst Source Type: research

Multimodality imaging of carotid web: A case report and literature review
CONCLUSIONS: carotid web is an under-recognized cause of ischemic stroke. It is easy to be missed or misdiagnosed. Carotid revascularization can effectively prevent recurrent stroke for patients with symptomatic carotid web. Clinicians should strength their learning and understanding of carotid web.PMID:35306924 | DOI:10.1177/17085381221084809
Source: Vascular - March 21, 2022 Category: Surgery Authors: Jie Zhang Yuzhu Yan Weikai Yao Jishuang Liu Li Cui Source Type: research

Relevance of Infarct Size, Timing of Surgery, and Peri-operative Management for Non-ischaemic Cerebral Complications After Carotid Endarterectomy
CONCLUSION: Infarct size and unintended high peri-operative blood pressure may increase the risk of non-ischaemic complications at CEA independently of whether performed early or delayed.PMID:34872814 | DOI:10.1016/j.ejvs.2021.09.044
Source: PubMed: Eur J Vasc Endovasc ... - December 7, 2021 Category: Surgery Authors: Stephan Hause Robert Sch önefuß Anne Assmann Jens Neumann Frank Meyer Joerg Tautenhahn Stefanie Schreiber Hans-Jochen Heinze Zuhir Halloul Michael Goertler Source Type: research

Intraoperative microembolic signals during carotid endarterectomy
Transcranial Doppler ultrasonography (TCD) can detect microembolic signals (MESs) that are one of the pathogenic indications of ischemic stroke. However, MESs are not uncommon findings during carotid endarterectomy (CEA). The aim of this study was to evaluate the association between MESs and postoperative neurologic events (transient ischemic attack [TIA] or stroke) or new brain lesions (NBLs) on magnetic resonance imaging (MRI).
Source: Annals of Vascular Surgery - November 11, 2021 Category: Surgery Authors: Choshin Kim, Jun Lee, Se-Jin Lee, Woo-Sung Yun Tags: Clinical Research Source Type: research

Cerebral Small Vessel Disease in Standard Pre-operative Imaging Reports Is Independently Associated with Increased Risk of Cardiovascular Death Following Carotid Endarterectomy.
CONCLUSION: Presence of SVD in pre-operative brain imaging reports can serve as a predictor for the three year risk of cardiovascular death in symptomatic patients undergoing CEA but does not predict peri-operative or long term risk of stroke. PMID: 32331995 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - April 20, 2020 Category: Surgery Authors: Timmerman N, Rots ML, van Koeverden ID, Haitjema S, van Laarhoven CJHCM, Vuurens AM, den Ruijter HM, Pasterkamp G, Kappelle LJ, de Kleijn DPV, de Borst GJ 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

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 - November 30, 2019 Category: Surgery Authors: Jakub Kaczynski, Michelle Williams, Rachael Forsythe, Andrew Tambyraja, Christophe Lucatelli, Edwin van Beek, William Whiteley, David Newby Source Type: research

A Diffusion-weighted Magnetic Resonance Imaging-based Study of Carotid Endarterectomy Versus Transcervical Carotid Artery Revascularization with Double Mesh Stent
Introduction: Endarterectomy remains the gold standard in carotid artery revascularization because carotid artery stenting entails more embolization. But the Roadster trial with the transcervical approach showed excellent results, similar to CEA stroke rates. The new generation stent is supposed to reduce plaque prolapse and postoperative embolization. The use of this stent in combination with the transcervical approach could improve the Roadster results.
Source: European Journal of Vascular and Endovascular Surgery - November 30, 2019 Category: Surgery Authors: Mar ía Pilar Lamarca Mendoza, F.J. Flores A. Peinado, D.Méndez B. Soto, B.Arriola A. Llergo, A.Estébanez S. Martín, B. Moreno R, R. Morcillo, K. Vivancos, Luchsinger J. Gutiérrez, M. Lobato P, Segundo J. Morín, Antonio Orgaz Pérez-Grueso 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: European Journal of Vascular and Endovascular Surgery - October 17, 2019 Category: Surgery Authors: Marjolijn L. Rots, Nathalie Timmerman, Dominique P.V. de Kleijn, Gerard Pasterkamp, Martin M. Brown, Leo H. Bonati, Gert J. de Borst Source Type: research

Magnetic Resonance Imaging Identified Brain Ischaemia in Symptomatic Patients Undergoing Carotid Endarterectomy Is Related to Histologically Apparent Intraplaque Haemorrhage.
CONCLUSION: Symptomatic patients with ipsilateral carotid stenosis and silent brain ischaemia on pre-operative MR-DWI, more often showed pathological evidence of IPH compared with those without ischaemic lesions. This identifies carotid IPH as a marker for patients at risk of silent brain ischaemia and possibly for future stroke and other arterial disease complications. Such patients may be more likely to benefit from CEA than those without evidence of ipsilateral carotid IPH. PMID: 31631008 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - October 16, 2019 Category: Surgery Authors: Rots ML, Timmerman N, de Kleijn DPV, Pasterkamp G, Brown MM, Bonati LH, de Borst GJ Tags: Eur J Vasc Endovasc Surg Source Type: research

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