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Effect of Carotid Revascularization Endarterectomy Versus Stenting Trial Results on the Performance of Carotid Artery Stent Placement and Carotid Endarterectomy in the United States
BACKGROUND: CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) results, published in 2010, showed no difference in the rates of composite outcome (stroke, myocardial infarction, or death) between carotid artery stent placement (CAS) and carotid endarterectomy (CEA). OBJECTIVE: To identify any changes in use and outcomes of CAS and CEA subsequent to the CREST results. METHODS: We estimated the frequency of CAS and CEA procedures in the years 2009 (pre-CREST period) and 2011 (post-CREST period), using data from the National Inpatient Sample (NIS). Demographic and clinical characteristics and in-hospital o...
Source: Neurosurgery - October 22, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

High-Risk Factors in Symptomatic Patients Undergoing Carotid Artery Stenting With Distal Protection: Buffalo Risk Assessment Scale (BRASS)
CONCLUSION: Our results suggest that CAS should be avoided in patients with multiple anatomic risk factors. High presenting National Institutes of Health Stroke Scale score and renal disease also increase the complication risk. The CAS scoring system devised here is simple, reproducible, and clinically valuable in predicting complications risk in symptomatic patients undergoing CAS. ABBREVIATIONS: BRASS, Buffalo Risk Assessment Scale CAS, carotid artery stenting CCA, common carotid artery CEA, carotid endarterectomy CTA, computed tomographic angiogram ICA, internal carotid artery MI, myocardial infarction NASCET, North Ame...
Source: Neurosurgery - September 24, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research

Acute Stroke After Carotid Endarterectomy: Time for a Paradigm Shift? Multicenter Experience With Emergent Carotid Artery Stenting With or Without Intracranial Tandem Occlusion Thrombectomy
CONCLUSION: Emergent endovascular evaluation in the setting of acute post--carotid endarterectomy thrombosis is a safe and timely treatment option, with the benefit of detecting and treating embolic intracranial lesions. Immediate angiography and intervention in this rare surgical complication show promising initial results. ABBREVIATIONS: CAS, carotid artery stenting CEA, carotid endarterectomy ICA, internal carotid artery NASCET, North American Symptomatic Carotid Endarterectomy Trial
Source: Neurosurgery - March 19, 2015 Category: Neurosurgery Tags: Research-Human-Clinical Studies Source Type: research