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Predictive Factors for Pre-operative Recurrence of Cerebrovascular Symptoms in Symptomatic Carotid Stenosis.
CONCLUSION: More than every tenth patient with sCS experienced an early recurrent cerebrovascular event prior to scheduled CEA, despite optimal medication. However, stroke recurrence was lower than in earlier observational studies, which could be explained by improved care pathways, more aggressive medication, and expedited CEA. All recurrent strokes occurred in patients initially presenting with minor stroke. PMID: 33039297 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - October 7, 2020 Category: Surgery Authors: Eriksson H, Koskinen S, Nuotio K, Heikkilä HM, Vikatmaa P, Silvennoinen H, Valanne L, Mäyränpää MI, Kovanen PT, Soinne L, Lindsberg PJ, Ijäs P Tags: Eur J Vasc Endovasc Surg Source Type: research

Cerebrovacular Reserve Predicts the Cerebral Hyperperfusion Syndrome After Carotid Endarterectomy
Cerebral hyperperfusion syndrome is a rare but potentially severe complication of carotid artery revascularisation that develops under conditions of resistant postoperative hypertension and impaired cerebrovascular autoregulation.
Source: Journal of Stroke and Cerebrovascular Diseases - September 22, 2020 Category: Neurology Authors: Vladimir Manojlovic, Nebojsa Budakov, Slavko Budinski, Djordje Milosevic, Dragan Nikolic, Vladimir Manojlovic Source Type: research

Perioperative baseline β-blockers: An independent protective factor for post-carotid endarterectomy hypertension.
CONCLUSION: The perioperative use of β-blockers is a protective factor for post-carotid endarterectomy hypertension and contributes to stabilizing the postoperative peak systolic blood pressure three days after conventional endarterectomy. However, β-blockers might also lead to intraoperative hemodynamic depression, especially for patients with a low baseline heart rate. PMID: 32772840 [PubMed - as supplied by publisher]
Source: Vascular - August 8, 2020 Category: Surgery Authors: Teng L, Fang J, Zhang Y, Liu X, Qu C, Shen C Tags: Vascular Source Type: research

Completion imaging techniques and their clinical role after carotid endarterectomy: Systematic review of the literature.
CONCLUSION: Completion imaging techniques can detect defects in almost 10% of patients that may lead to immediate intra-operative surgical revision with low intra-operative stroke/transient ischemic attack rate and low early carotid restenosis. During the 30-day follow-up period, in those patients, the incidence of stroke/transient ischemic attack may be low but present. This review cannot provide any evidence on which completion imaging technique is better, and the clinical impact conferred by each technique in the absence of a randomized control studies. PMID: 32493183 [PubMed - as supplied by publisher]
Source: Vascular - June 2, 2020 Category: Surgery Authors: Spanos K, Nana P, Kouvelos G, Batzalexis K, Matsagkas MM, Giannoukas AD Tags: Vascular Source Type: research

Risk Factors for Postoperative Hypotension and Hypertension following Carotid Endarterectomy
Patients undergoing carotid endarterectomy (CEA) often experience postoperative hemodynamic changes that require intravenous medications for hypo- and hypertension. Prior studies have found these changes to be associated with increased risks of 30-day mortality, stroke, myocardial infarction (MI), and length of stay (LOS). Our aim is to investigate preoperative risk factors associated with the need for postoperative intravenous medications for blood pressure control.
Source: Annals of Vascular Surgery - June 1, 2020 Category: Surgery Authors: Samuel Lee, Allan M. Conway, Nhan Nguyen Tranh, Gautam Anand, Tung Ming Leung, Olga Fatakhova, Gary Giangola, Alfio Carroccio Tags: Clinical Research Source Type: research

Risk Factors for Post-operative Hypo- and Hypertension Following Carotid Endarterectomy
Patients undergoing carotid endarterectomy (CEA) often experience post-operative hemodynamic changes that require intravenous medications for hypo- and hypertension. Prior studies have found these changes to be associated with increased risks of 30-day mortality, stroke, myocardial infarction (MI), and length of stay (LOS). Our aim was to investigate pre-operative risk factors associated with the need for post-operative intravenous medications for blood pressure control.
Source: Annals of Vascular Surgery - June 1, 2020 Category: Surgery Authors: Samuel Lee, Allan M. Conway, Nhan Nguyen Tran, Gautam Anand, Tung Ming Leung, Olga Fatakhova, Gary Giangola, Alfio Carroccio Tags: Clinical Research, Basic Science 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

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 4, 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 4, 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

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 - November 30, 2019 Category: Surgery Authors: Sherif Sultan, Makinderjit Dulai, John Laffey, Kevin Clarkson, Abdelaly Ma Abedi, Nora Barrett, Wael Tawfick, Niamh Hynes Source Type: research

Asymptomatic Carotid Stenosis Is Associated With Circadian and Other Variability in Embolus Detection
Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this t...
Source: Frontiers in Neurology - April 15, 2019 Category: Neurology Source Type: research

Contralateral Occlusion and Concomitant Procedures Drive Risk of Non-ipsilateral Stroke After Carotid Endarterectomy.
CONCLUSION: Non-ipsilateral stroke after CEA is rare. Features driving risk surround global disease burden, combined procedures, and haemodynamic fluctuations. Contralateral occlusion independently increases non-ipsilateral stroke risk. Regardless of laterality or location, effects of stroke after CEA on long-term survival are similar. PMID: 30940430 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 29, 2019 Category: Surgery Authors: Clouse WD, Boitano LT, Ergul EA, Kashyap VS, Malas MB, Goodney PP, Patel VI, Conrad MF Tags: Eur J Vasc Endovasc Surg Source Type: research

Hemoglobin A1c-related histologic characteristics of symptomatic carotid plaques
Conclusions: Increased HbA1c values seem to contribute to plaque instability through the formation of a thin fibrous cup. Thus, of the carotid artery plaque parameters including fibrous cup thickness, plaque rupture, lipid core, inflammation, intraplaque hemorrhage, thrombus, calcification, necrotic core, and neovascularization, fibrous cup thickness is the only histomorphological feature that affected by HbA1c.
Source: Nigerian Journal of Clinical Practice - March 5, 2019 Category: Rural Health Authors: M Tecellioglu S Alan S Kamisli FS Tecellioglu O Kamisli C Ozcan Source Type: research

Intra-operative Video Characterization of Carotid Artery Pulsation Patterns in Case Series with Post-endarterectomy Hypertension and Hyperperfusion Syndrome
AbstractCerebral hyperperfusion syndrome (CHS) is a complication that can occur after carotid endarterectomy (CEA), the treatment of choice to decrease the subsequent risk of fatal or disabling stroke for patients with symptomatic severe stenosis of the carotid artery. Because of its rarity and complexity, the mechanism of the condition is still unclear, making its prevention via prediction and monitoring challenging. This is especially true during surgery, when multiple factors can induce physiological changes, including blood pressure and baroreceptor functions, which are crucial factors for post-CEA hypertension and CHS...
Source: Translational Stroke Research - October 1, 2018 Category: Neurology Source Type: research

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