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Drug: Aspirin
Procedure: Carotid Endarterectomy

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Total 32 results found since Jan 2013.

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

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

Technical improvements in carotid revascularization based on the mechanism of procedural stroke.
In conclusion, this review provides an overview of the pathophysiological mechanism of stroke following carotid revascularization (both CAS and CEA) and of the technical improvements that have contributed to reducing this stroke risk. PMID: 30827087 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - February 28, 2019 Category: Cardiovascular & Thoracic Surgery Authors: Fassaert LM, de Borst GJ Tags: J Cardiovasc Surg (Torino) 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

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

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

Optimal medical treatment versus carotid endarterectomy: the rationale and design of the Aggressive Medical Treatment Evaluation for Asymptomatic Carotid Artery Stenosis (AMTEC) study
The objective is to compare the efficacy of carotid endarterectomy + optimal medical therapy versus optimal medical therapy alone in patients with asymptomatic (70–79%) extracranial carotid stenosis. DesignThe Aggressive Medical Treatment Evaluation for Asymptomatic Carotid Artery Stenosis study is a prospective, randomized, parallel, two‐arm, multicenter trial. Primary end‐points will be analyzed using standard time‐to‐event statistical modeling with adjustment for major baseline covariates. The primary analysis is on an intent‐to‐treat basis. Study OutcomesThe primary outcome is nonfatal stroke, nonfata...
Source: International Journal of Stroke - March 15, 2013 Category: Neurology Authors: Igor Kolos, Mikhail Loukianov, Nikolay Dupik, Sergey Boytsov, Alexandr Deev Tags: Protocols Source Type: research

Urgent Best Medical Therapy May Obviate the Need for Urgent Surgery in Patients With Symptomatic Carotid Stenosis Clinical Sciences
Conclusions— CEA can be performed in the subacute period without significantly increasing the operative risk. The urgent best medical treatment was associated with significant reduction in the risk of early NR in CEA patients. It seems that urgent aggressive best medical treatment may obviate the need for urgent CEA.
Source: Stroke - July 22, 2013 Category: Neurology Authors: Shahidi, S., Owen-Falkenberg, A., Hjerpsted, U., Rai, A., Ellemann, K. Tags: Secondary prevention, Antiplatelets, Carotid endarterectomy, Transient Ischemic Attacks Clinical Sciences Source Type: research

Dual Antiplatelet Therapy Is Associated with Increased Risk of Bleeding and Decreased Risk of Stroke Following Carotid Endarterectomy
Despite many patients undergoing carotid endarterectomy (CEA) being on dual antiplatelet therapy (DAPT) for cardiac or neurologic indications, the impact of such therapy on perioperative outcomes remains unclear. We aim to compare rates of postoperative bleeding, stroke and major adverse events (stroke, death or MI) among patients on Aspirin alone (ASAA) versus DAPT (Clopidogrel and Aspirin).
Source: Annals of Vascular Surgery - July 31, 2022 Category: Surgery Authors: Rohini J. Patel, Rebecca Marmor, Hanaa Dakour, Nadin Elsayed, Mokhshan Ramachandran, Mahmoud B. Malas Tags: Clinical Research Source Type: research

Stenosis Length and Degree Interact With the Risk of Cerebrovascular Events Related to Internal Carotid Artery Stenosis
Conclusion: We found a statistically insignificant tendency for the ultrasound-measured length of sICAS<70% to be longer than that of sICAS≥70%. Moreover, the ultrasound-measured length of sICAS<90% was significantly longer than that of sICAS 90%. Among patients with sICAS≥70%, the degree and length of stenosis were inversely correlated. Larger studies are needed before a clinical implication can be drawn from these results. Introduction Internal carotid artery stenosis (ICAS) causes around one-fifth of ischemic cerebrovascular stroke and has the highest risk of early stroke recurrence...
Source: Frontiers in Neurology - April 8, 2019 Category: Neurology 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

Natural History of Non-operative Management in Asymptomatic Patients with 70%-80% Internal Carotid Artery Stenosis by Duplex Criteria.
CONCLUSION: Patients with asymptomatic moderate to severe carotid stenosis had a low rate of stroke/TIA without documented progression. However, there was a high rate of stenosis progression reinforcing the need to follow these patients closely. PMID: 32660806 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - July 9, 2020 Category: Surgery Authors: Cheng TW, Pointer KE, Gopal M, Farber A, Jones DW, Eberhardt RT, Kalish JA, Eslami MH, Rybin D, Siracuse JJ Tags: Eur J Vasc Endovasc Surg Source Type: research

Peri-Operative Outcomes of Carotid Endarterectomy are Not Improved on Dual Antiplatelet Therapy vs. Aspirin Monotherapy: A Systematic Review and Meta-Analysis
CONCLUSION: This meta-analysis found that CEA while on DAPT increased the risk of haemorrhagic complications, with similar rates of ischaemic complications, vs. aspirin monotherapy. This suggests that the risks of performing CEA on DAPT outweigh the benefits, even in patients with symptomatic carotid stenosis. The overall quality of studies was low, and improved reporting of CEA outcomes in the literature is necessary.PMID:35241374 | DOI:10.1016/j.ejvs.2021.12.037
Source: PubMed: Eur J Vasc Endovasc ... - March 4, 2022 Category: Surgery Authors: Jerry C Ku Shervin Taslimi Jeffrey Zuccato Christopher R Pasarikovski Nathalie Nasr Ofir Chechik Emiliano Chisci Daniele Bissacco Vincent Larrue Yefim Rabinovich Stefano Michelagnoli Piergiorgio G Settembrini Stefano M Priola Michael D Cusimano Victor X D Source Type: research