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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

CYP2C19 Loss-of-Function Associated with First-Time Ischemic Stroke in Non-surgical Asymptomatic Carotid Artery Stenosis During Clopidogrel Therapy
This study measures effect ofCYP2C19 genotype on ischemic stroke risk during clopidogrel therapy for asymptomatic, extracranial carotid stenosis patients. Using deidentified electronic health records, patients were selected for retrospective cohort using administrative code for carotid stenosis, availability ofCYP2C19 genotype result, clopidogrel exposure, and established patient care. Patients with intracranial atherosclerosis, aneurysm, arteriovenous malformation, prior ischemic stroke, or observation time<1 month were excluded. Dual antiplatelet therapy patients were included. Patients with carotid endarterectomy or ...
Source: Translational Stroke Research - February 21, 2021 Category: Neurology 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

Stroke prevention.
Abstract Patients who have had a stroke are at high risk for recurrent stroke, myocardial infarction, and vascular death. Prevention of these events should be initiated promptly after stroke, because many recurrent events occur early, and should be tailored to the precise cause of stroke, which may require specific treatment. Lifestyle advice including abstinence from smoking, regular exercise, Mediterranean-style diet, and reduction of salt intake and alcohol consumption are recommended for all patients with stroke. For most patients with ischemic stroke or TIA, control of risk factors, including lowering blood p...
Source: Presse Medicale - November 1, 2016 Category: Journals (General) Authors: Isabel C, Calvet D, Mas JL Tags: Presse Med 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

Outcome of 312 Japanese Patients with Carotid Endarterectomy and Factors Associated with Cardiovascular Events—A Single-center Study in Japan
Background: There have only been a few reports regarding the outcomes and risk factors after CEA. To clarify the factors associated with outcome in patients with carotid stenosis who underwent carotid endarterectomy (CEA), we investigated cardiovascular events and mortality in the Kyushu Medical Center in Japan.Methods: We consecutively registered patients with significant carotid stenosis who had CEA performed over 10 years and compared the incidences of stroke, myocardial infarction, and death. On admission, we evaluated medical records for stroke risk factors, including hypertension, diabetes mellitus, hypercholesterol...
Source: Journal of Stroke and Cerebrovascular Diseases - May 30, 2013 Category: Neurology Authors: Toshiyasu Ogata, Tooru Inoue, Yasushi Okada Tags: Original Articles Source Type: research

Diastolic Blood Pressure is a Risk Factor for Peri-procedural Stroke Following Carotid Endarterectomy in Asymptomatic Patients.
CONCLUSION: In ACST-1, diastolic blood pressure was the only independent risk factor associated with peri-procedural stroke or death. While the underlying mechanisms of the association between lower diastolic blood pressure and peri-procedural risk remain unclear, good pre-operative control of blood pressure may improve procedural outcome of carotid surgery in asymptomatic patients. PMID: 28318997 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - March 15, 2017 Category: Surgery Authors: de Waard DD, de Borst GJ, Bulbulia R, Huibers A, Halliday A, Asymptomatic Carotid Surgery Trial-1 Collaborative Group Tags: Eur J Vasc Endovasc Surg Source Type: research

Closing the Loop: A 21-year Audit of Strategies for Preventing Stroke and Death Following Carotid Endarterectomy.
The objective of this review was to identify causes of stroke/death after carotid endarterectomy (CEA) and to develop transferable strategies for preventing stroke/death after CEA, via an overview of a 21-year series of themed research and audit projects. Three preventive strategies were identified: (i) intra-operative transcranial Doppler (TCD) ultrasound and completion angioscopy which virtually abolished intra-operative stroke, primarily through the removal of residual luminal thrombus prior to restoration of flow; (ii) dual antiplatelet therapy with a single 75-mg dose of clopidogrel the night before surgery in additio...
Source: PubMed: Eur J Vasc Endovasc ... - June 13, 2013 Category: Surgery Authors: Naylor AR, Sayers RD, McCarthy MJ, Bown MJ, Nasim A, Dennis MJ, London NJ, Bell PR Tags: Eur J Vasc Endovasc Surg 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

Closing the Loop: A 21-year Audit of Strategies for Preventing Stroke and Death Following Carotid Endarterectomy
The objective of this review was to identify causes of stroke/death after carotid endarterectomy (CEA) and to develop transferable strategies for preventing stroke/death after CEA, via an overview of a 21-year series of themed research and audit projects. Three preventive strategies were identified: (i) intra-operative transcranial Doppler (TCD) ultrasound and completion angioscopy which virtually abolished intra-operative stroke, primarily through the removal of residual luminal thrombus prior to restoration of flow; (ii) dual antiplatelet therapy with a single 75-mg dose of clopidogrel the night before surgery in additio...
Source: European Journal of Vascular and Endovascular Surgery - June 17, 2013 Category: Surgery Authors: A.R. Naylor, R.D. Sayers, M.J. McCarthy, M.J. Bown, A. Nasim, M.J. Dennis, N.J.M. London, P.R.F. Bell Tags: Carotid Disease Source Type: research

Prevalence, Risk Factors, and Clinical Significance of Asymptomatic Extracranial Vertebral Artery Disease in Patients with Symptomatic Internal Carotid Artery Stenosis: Analysis of Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) Trial (S42.002)
Conclusions: There appears to be an increased risk of stroke and death in patients with symptomatic internal carotid artery stenosis with concurrent asymptomatic extracranial vertebral artery stenosis. Key words: Extracranial vertebral artery; carotid stenosis; vertebral artery stenosis; vertebral artery occlusion; stroke; death.Disclosure: Dr. Qureshi has nothing to disclose. Dr. Chaudhry has nothing to disclose. Dr. Jansen has nothing to disclose. Dr. Eckstein has nothing to disclose. Dr. Ringleb has nothing to disclose.
Source: Neurology - February 7, 2016 Category: Neurology Authors: Qureshi, A., Chaudhry, S., Jansen, O., Eckstein, H.-H., Ringleb, P. Tags: Stroke Mechanism and Modifiers Source Type: research

Utilization of Carotid Revascularization for Ischemic Stroke/TIA: A Canadian Perspective (P5.276)
Conclusions:Use of CEA/CAS in patients with acute ischemic stroke/TIA admitted to hospitals in Canada has doubled over the last decade. Differences in utilization by age, sex and across provinces are seen.Disclosure: Dr. Najm has nothing to disclose. Dr. Lindsay has nothing to disclose. Dr. Hill has nothing to disclose. Dr. Demchuk has nothing to disclose. Dr. Menon has nothing to disclose.
Source: Neurology - April 17, 2017 Category: Neurology Authors: Najm, M., Lindsay, P., Hill, M. D., Demchuk, A., Menon, B. Tags: SubAcute Interventional Therapies in Cerebrovascular Disease Source Type: research

Primary Prevention of Stroke in Chronic Kidney Disease Patients: A Scientific Update
Background: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking.Summary: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population. The use of oral anticoagulation in AF appears safe...
Source: Cerebrovascular Diseases - January 9, 2018 Category: Neurology Source Type: research

Stroke Prevention: Little-Known and Neglected Aspects
Combining available therapies has the potential to reduce the risk of stroke by 80% or more. A comprehensive review of all aspects of stroke prevention would be very lengthy; in this narrative review, we focus on some aspects of stroke prevention that are little-known and/or neglected. These include the following: (1) implementation of a Mediterranean diet; (2) B vitamins to lower homocysteine; (3) coordinated approaches to smoking cessation; (4) intensive lipid-lowering therapy; (5) lipid lowering in the elderly; (6) physiologically individualized therapy for hypertension based on renin/aldosterone phenotyping; (7) avoidi...
Source: Cerebrovascular Diseases - May 27, 2021 Category: Neurology 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

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