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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

The Long-Term Effects of the Type of Carotid Endarterectomy on Blood Pressure
Carotid endarterectomy (CEA) has been one of the most studied and scrutinized operative procedures in vascular surgery. Retrospective series and randomized trials have shown no difference in perioperative stroke and long-term restenosis between conventional patch angioplasty (cCEA) and eversion (eCEA). A number of authors have shown acute hemodynamic disturbances in the immediate postoperative period leading to a temporary hypertensive state. eCEA may increase the risk of postoperative hypertension due to the more extensive dissection of the carotid bulb.
Source: Journal of Vascular Surgery - August 22, 2015 Category: Surgery Authors: Brian C. Adams, Mark R. Pedersen, Maen S. Hosn, Timothy F. Kresowik, Luigi Pascarella Tags: Abstract from the 2015 Midwestern Vascular Surgical Society Annual Meeting Source Type: research

Does the Technique of Carotid Endarterectomy Determine Postoperative Hypertension?
Hypertension (HT) after carotid endarterectomy (CEA) is a risk factor for postoperative myocardial infarction, stroke, and neck hematoma. We compared the incidence of postoperative HT within the week after eversion CEA (e-CEA) and patch closure CEA (p-CEA). Postoperative HT was defined as a systolic blood pressure (sBP) ≥ 160 mm Hg and/or the need for postoperative vasodilatators. The aim of our study was to determine if the technique of CEA had an effect on postoperative HT.
Source: Annals of Vascular Surgery - May 21, 2015 Category: Surgery Authors: Sabrina Ben Ahmed, Guillaume Daniel, Marie Benezit, Patrick Bailly, Bruno Aublet-Cuvelier, Aurélien Mulliez, Jean-Pierre Ribal, Eugenio Rosset Tags: Clinical Research Source Type: research

Does the Technique of Carotid Endarterectomy Determines Postoperative Hypertension?
Hypertension after carotid endarterectomy (CEA) is a risk factor for postoperative myocardial infarction, stroke and neck hematoma. We compared the incidence of postoperative hypertension within the week after eversion CEA (e-CEA) and patch closure CEA (p-CEA) . Postoperative hypertension was defined as a systolic blood pressure (sBP) ≥ 160 mmHg and/or the need for postoperative vasodilatators. The aim of our study was to determine if the technique of CEA had an effect on postoperative hypertension.
Source: Annals of Vascular Surgery - May 21, 2015 Category: Surgery Authors: Sabrina Ben Ahmed, Guillaume Daniel, Marie Benezit, Patrick Bailly, Bruno Aublet-Cuvelier, Aurélien Mulliez, Jean-Pierre Ribal, Eugenio Rosset Source Type: research

Thrombolysis and Expedited Carotid Revascularization.
Abstract With the move towards expedited carotid endarterectomy (CEA) in patients presenting with a TIA/minor stroke and for offering intravenous thrombolysis <3 hours to patients with acute ischemic stroke, it is inevitable that surgeons will be asked to consider CEA in patients who have made a good recovery from their stroke after thrombolysis and who have a 50-99% ICA stenosis. The key question is; 'how long after thrombolysis should I delay CEA to minimise the peri--operative risk (especially intracranial hemorrhage (ICH)), whilst also minimizing the risks of further embolization and stroke?' Thirteen serie...
Source: The Journal of Cardiovascular Surgery - January 9, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Naylor AR Tags: J Cardiovasc Surg (Torino) Source Type: research

Stroke Prevention - Medical and Lifestyle Measures
Background: According to the World Health Organization, stroke is the ‘incoming epidemic of the 21st century'. In light of recent data suggesting that 85% of all strokes may be preventable, strategies for prevention are moving to the forefront in stroke management. Summary: This review discusses the risk factors and provides evidence on the effective medical interventions and lifestyle modifications for optimal stroke prevention. Key Messages: Stroke risk can be substantially reduced using the medical measures that have been proven in many randomized trials, in combination with effective lifestyle modifications. The glob...
Source: European Neurology - January 6, 2015 Category: Neurology Source Type: research

Antithrombotic Therapy in Carotid Artery Stenosis: An Update
Carotid stenosis is generally associated with high risks of stroke and vascular events. In asymptomatic and symptomatic patients, with or without revascularization, optimal managements of carotid artery stenosis require the use of medications or lifestyle modifications (stopping smoking and monitoring hypertension, hyperlipidemia, and diabetes) to control the processes associated with atheroma to reduce the risk of embolic events. Moreover, antiplatelet therapy should be considered. There is little evidence that antiplatelet therapy is beneficial in preventing stroke or the progression of stenosis in asymptomatic patients,...
Source: European Neurology - November 7, 2014 Category: Neurology Source Type: research

Treatment with betablockers is associated with higher grey-scale median in carotid plaques
Conclusions: These results suggest the use of standardized ultrasound techniques as an important tool in evaluating the effect of anti-atherosclerotic medications and underline the need of.further prospective randomized studies on larger patient cohorts in order to confirm these results.
Source: BMC Cardiovascular Disorders - August 30, 2014 Category: Cardiology Authors: Giuseppe AsciuttoNuno DiasAna PerssonJan NilssonIsabel Gonçalves Source Type: research

Impact of Glomerular filtration rate on clinical outcomes after carotid artery revascularization in 11,832 patients from the CARE registry
ConclusionsPatients with CKD have a greater number of comorbidities and worse unadjusted in‐hospital and 30‐day outcomes; CKD was not, however, an independent predictor of in‐hospital and 30‐day outcomes after carotid artery revascularization. © 2013 Wiley Periodicals, Inc.
Source: Catheterization and Cardiovascular Interventions - May 3, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Luis Gruberg, Allen Jeremias, John H. Rundback, H. Vernon Anderson, John A. Spertus, Kevin F. Kennedy, Kenneth A. Rosenfield Tags: Original Studies Source Type: research

Reperfusion Injury on Magnetic Resonance Imaging After Carotid Revascularization Brief Reports
Conclusions— HARM after carotid revascularization is not uncommon. Symptomatic HARM was associated with old age, underlying leukoaraiosis, and postprocedural high blood pressure.
Source: Stroke - January 27, 2014 Category: Neurology Authors: Cho, A.-H., Cho, Y.-P., Lee, D. H., Kwon, T.-W., Kwon, S. U., Suh, D.-C., Kim, J. S., Kang, D.-W. Tags: Cerebrovascular disease/stroke, CT and MRI Brief Reports Source Type: research

Discharge on the First Postoperative Day after Elective Carotid Endarterectomy
Conclusion: In this study, the majority of patients undergoing elective CEA were discharged safely on the first postoperative day. Social reasons, rather than medical reasons, underlied most cases of later discharge. There were no unplanned readmissions for complications of CEA.
Source: Annals of Vascular Surgery - December 23, 2013 Category: Surgery Authors: Pierre Van den Brande, Isolde Van Heymbeeck, Erik Debing, Dimitri Aerden, Karl von Kemp, Leslie Moerman, Chris Verborgh, Patrick Haentjens Tags: Clinical Research Source Type: research

A Clinical Rule (Sex, Contralateral Occlusion, Age, and Restenosis) to Select Patients for Stenting Versus Carotid Endarterectomy: Systematic Review of Observational Studies With Validation in Randomized Trials Clinical Sciences
Conclusions— The SCAR rule is potentially useful to identify patients in whom CAS has a similar risk of perioperative stroke or death to CEA.
Source: Stroke - November 25, 2013 Category: Neurology Authors: Touze, E., Trinquart, L., Felgueiras, R., Rerkasem, K., Bonati, L. H., Meliksetyan, G., Ringleb, P. A., Mas, J.-L., Brown, M. M., Rothwell, P. M., in collaboration with the Carotid Stenting Trialists' Collaboration Tags: Clinical Sciences Source Type: research

Gender-specific 30-day outcomes after carotid endarterectomy and carotid artery stenting in the Society for Vascular Surgery Vascular Registry
Objective: Although the optimal treatment of carotid stenosis remains unclear, available data suggest that women have higher risk of adverse events after carotid revascularization. We used data from the Society for Vascular Surgery Vascular Registry to determine the effect of gender on outcomes after carotid endarterectomy (CEA) and carotid artery stenting (CAS).Methods: There were 9865 patients (40.6% women) who underwent CEA (n = 6492) and CAS (n = 3373). The primary end point was a composite of death, stroke, and myocardial infarction at 30 days.Results: There was no difference in age and ethnicity between genders, b...
Source: Journal of Vascular Surgery - November 18, 2013 Category: Surgery Authors: Jeffrey Jim, Ellen D. Dillavou, Gilbert R. Upchurch, Nicholas H. Osborne, Christopher T. Kenwood, Flora S. Siami, Rodney A. White, Joseph J. Ricotta, SVS Outcomes Committee Tags: Clinical research studies Source Type: research

Predictors of Cervical Bleeding after Carotid Endarterectomy
Conclusions: Postoperative severe bleeding after carotid surgery in our institution is not an uncommon complication. Its incidence is within the range reported in the literature, but it is not associated with major complications or mortality. Antiplatelet treatment with clopidogrel is the main risk factor associated with reintervention. Other factors, such as coagulation control, postoperative hypertension management, and the use of an autologous patch, could help reduce its incidence.
Source: Annals of Vascular Surgery - September 30, 2013 Category: Surgery Authors: Sara Mercedes Morales Gisbert, Vicente Andrés Sala Almonacil, Jose Miguel Zaragozá García, Beatriz Genovés Gascó, Francisco Julián Gómez Palonés, Eduardo Ortiz Monzón Tags: Clinical Research Source Type: research

The need for treatment of hemodynamic instability following carotid endarterectomy is associated with increased perioperative and 1-year morbidity and mortality
The objective of this study was to evaluate the outcomes of patients after carotid endarterectomy (CEA) who developed postoperative hypertension or hypotension requiring the administration of intravenous vasoactive medication (IVMED).Methods: We examined consecutive, primary elective CEA performed by 128 surgeons within the Vascular Study Group of New England (VSGNE) database (2003-2010) and compared outcomes of patients who required postoperative IVMED to treat hyper- or hypotension with those who did not. Outcomes included perioperative death, stroke, myocardial infarction (MI), congestive heart failure (CHF), hospital l...
Source: Journal of Vascular Surgery - September 3, 2013 Category: Surgery Authors: Tze-Woei Tan, Mohammad H. Eslami, Jeffrey A. Kalish, Robert T. Eberhardt, Gheorghe Doros, Philip P. Goodney, Jack L. Cronenwett, Alik Farber, Vascular Study Group of New England Tags: Clinical research studies Source Type: research

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